DefinePK

Abstract

The practice of medicine has always rested on service, patient care, education, and research. Corporatization, however, threatens this foundation. It redefines patients as consumers, physicians as providers, and care as a commodity, with decisions increasingly driven by revenue cycles. ¹ For Pakistan, the dangers are profound. Corporatization diverts resources toward lucrative services while neglecting primary care, trauma, and emergency medicine. ² It also accelerates the migration of skilled clinicians into private hospitals, draining the public sector. ³ Families already bearing over 60% of health costs out-of-pocket⁴ face further impoverishment through unnecessary investigations and procedures. ⁵ The ethical contradiction is stark. In Islam, healthcare is an amanah (trust), not a commodity. ⁶ International evidence is sobering as in United States alone, corporatization has produced the world’s highest health spending without better outcomes, ⁷ while in India it has fostered overuse of costly interventions. ⁸ But a LMIC like Pakistan cannot afford such distortions. A rejection of corporatization is unrealistic. Instead, Pakistan needs a hybrid model that combines efficiency with compassion. Hospitals must institutionalize clinical governance, ⁹ transparent procurement, and standardized service packages. Senior clinicians in administrative roles require managerial and leadership training to ensure fiscal responsibility without abandoning ethics. ¹⁰ However, there are good examples in Pakistan. The Indus Hospital Network offers free, high-quality care funded through philanthropy and efficiency, ¹¹ while Liaquat National Hospital demonstrates cross-subsidization where private revenue sustains charitable care. ¹² These models show that sustainability is possible without commodifying medicine. we must choose whether hospitals will be judged by profits or by lives healed. As Berwick notes, the true test of a health system is not whether it enriches shareholders but whether it relieves suffering. ¹³