RECENTLY the media has been awash with comments and write ups by some doctors who in a bid to justify the current strike of the Nigeria Medical Association are putting forward arguments that are capable of misinforming the public about the Nigerian health sector. Part of such arguments is that doctors are all in all and that they can effectively do the work of other health professionals while others cannot do the doctor's work.

 

They claim that the physician of old merely delegated some of his duties to people who are now called pharmacists, physiotherapists, nurses, laboratory technologists etc. just for convenience and he can take it back any time he so wishes. Some doctors also claim that other health workers having been trained by them to merely assist them do their work, should not now start to demand to hold any leadership position in the health sector because it should naturally be the birth right of the doctor. So, doctors see absolutely no reason for other health workers to seek to attain the post of consultants in their own field or directors in the hospitals as, according to them, it will just create crisis in the hospitals and other health facilities. Another claim by doctors is that most of the other health professionals found themselves in their respective fields because they were either unable to meet up with the requirements for medicine or were withdrawn from medical schools because they could not cope with the rigours. Thus many of these 'failures' now begrudge doctors and strive to become one through the back door.

 

I believe that if things are not put in proper perspective, these comments may successfully create an impression in the general public that other health workers are begrudging doctors or seeking to become doctors through the backdoor when it is indeed the doctors that are illegally encroaching into the constitutionally recognised roles of non- doctors.

 

While it is true in ages past, that physicians were a Jack of all trades as far as treatment of the patient was concerned, the practice in the wisdom of practitioners was later broken down into different disciplines for better efficiency and specialisation. It was not to make any health worker a servant or slave to the other. Every discipline is important and all are expected to work together and collaborate to achieve a better patient outcome. Therefore, a claim that the doctor can do the work of every member of the health team is, therefore, a very big fallacy because he was never trained to do so.

 

The multidisciplinary approach to treating patients which many Nigerian doctors are trying so hard to downplay today is firmly established, promoted and appreciated in developed countries like the United Kingdom, United States and Canada. There, no one feels superior to another. No one brandishes irrelevant ego. All that matter is the patient's well-being and everyone will go to any extent to put their heads together in order to achieve the best outcome for the patient.

 

Nigerian doctors when they travel abroad to practise follow these laid down principles and do their utmost to collaborate with other health professionals in the interest of the patient. However, in the shores of Nigeria, doctors have thrown global best practices to the wind and see other health professionals as servants who should receive orders rather than collaborate with them. They would rather have a less than desirable patient outcome than having to 'descend so low' as to seek the opinion of other health workers in the management of the patient. Even though some of them do, the majority others who do not, view them with derision and would want them blacklisted if they had their way.

 

The practice in developed countries which many doctors condemn as not being right for Nigeria, produces excellent results in these countries. Many Nigerians would rather go abroad to treat ailments like common cold or sprain because they have lost faith in the medical practice in Nigeria. Some notable Nigerians have been lost to wrong diagnosis of their medical conditions because by the time the correct diagnosis was made abroad, it had become too late to save them. A neighbour's uncle has sworn never to have any dealing with Nigerian doctors again, describing them as 'road side mechanics'. He lost his sight to a wrong diagnosis of his condition and had resigned to fate having been told that all hope to regain his sight was lost. Even though his doctor knew he could afford treatment abroad, he was told that nobody anywhere could help him. However, after the persistence of his children, he decided to try out a UK hospital and that was how one of the two eyes was salvaged. A lot of such ugly experiences that Nigerians have encountered in the hands of Nigerian doctors is one of the reasons why Nigeria is losing billions of dollars in foreign exchange to medical tourism today.

 

Rather than putting their heads together to discuss ways of tackling this problem and many others bedeviling the Nigerian health sector, the Nigerian doctors have preoccupied themselves with means of continuing the culture of suppression and intimidation of other health care professionals in the health sector.

 

For instance, why will the doctors go on strike because another health professional will be appointed a consultant in his own field having acquired the required knowledge and qualification? Why will the doctor negotiate for and accept to be paid 160% of his basic salary as call duty allowance but would insist that the radiologist must settle for less than 80% rather than the 100% he is clamouring for? Why will the Nigerian doctor threaten to go on strike if anyone but him is made the health minister knowing full well that the post is purely administrative and is not an exclusive preserve of health experts in most nations of the world? Why does the doctor have a phobia for a non-doctor becoming a permanent secretary in the ministry of health? Why are doctors being imposed on laboratory technologists and scientists to become HOD in many hospital laboratories? Several other acts of repression are perpetrated by doctors in the health sector.

 

I expect some of the commentators in the media to mention specific instances where other health care providers have encroached into the practice of doctors in the hospitals, which could have warranted such a high level of mistrust. Rather, all they did was base their arguments solely on vague assumptions.

 

PART 2

 

By Odedeyi Adekunle

Guardian

 

About the Author:

Adekunle is a practising pharmacist from Ogun State.