Nigerian doctors and their practices have come under intense scrutiny over the  last few years. These scrutinies by the public, the media and other health workers have most often been scathing. Industrial disharmony in the health sector remains a great challenge and has contributed much to the scathing criticism of the Nigerian doctor. Here are some quotes from recent newspaper editorials:

 

- Vanguard of July 3, 2014, titled Unending Doctors’ Strike: “Sadly, the current doctors’ strike… is not based on sustainable principles… The frequency of these strikes has become uncontrollable and untenable… It gives the impression that doctors are putting unhealthy union politics above their Hippocratic Oath…”

 

- Punch of July 6, 2014 titled Let Sanity Prevail: “Nigerian doctors have overused and abused the strike weapon… While the mandatory Hippocratic Oath enjoins doctors to save lives, patients die and suffer disabilities and pain when doctors stop work.”

 

- Daily Trust of July 10, 2014: “… pride and self glorification seem to be the problem… The NMA has instigated its members to embark upon a terrible repudiation of the Hippocratic Oath…”

 

- The Guardian of July 20, 2014: “This is a low depth for the country; and it is particularly repugnant to the medical profession whose members swore to the sacred Hippocratic Oath to uphold the dignity of human life at all times. …a 

blatant betrayal of the medical profession’s obligation to humanity.”

 

- The Sun Newspaper of 20th July 2014; “Doctors’ strike in Nigeria ranks among the most inconsiderate in the world… Even more disheartening is the fact that doctors in the past 14years have virtually made it an annual ritual to withdraw services for all kinds of reasons…It is embarrassing that doctors who took an oath to uphold the sanctity of life now embark on strikes like daily paid workers.”It is instructive that all the editorials accused the doctors, represented by the Nigerian Medical Association (NMA) of being ‘hypocrites to the Hippocratic Oath.’

 

Lamenting the serious and persistent disharmony in the health sector, a renowned former Health Minister, Prof. Ransome –Kuti, was reported to have said; “My only regret as I leave the health ministry is that I have not been able to mobilize all health workers behind the health system. Most health workers are only interested in how to maintain their position in the hospital system.”

 

Being the leader and seemingly the most visible practitioner in the health sector, all industrial actions (be it by doctors or other health workers) will most often be presumed to be caused or supported by doctors. The public often believes that doctors are directly or indirectly responsible for :

 

- The unaffordable (or high) cost of health care in Nigeria,

 

- Deaths and disabilities caused by the health care system, and

 

- Industrial disharmony in the health care sector. Before proceeding further, we must recognize that stakeholders in the health care sector will view this article in different ways;

 

- To the Government, it should be apt at these times of reforms and transformation.

 

- To other health workers, it will be viewed with utmost surprise that a doctor can consider himself and his colleagues as hypocrites.

 

- To the public and the media, it is another addition to a confusing array of literature.

 

- To my colleagues, this article is a ‘no brainer’- the hypocrite is surely not doctors who work harder and longer and get paid non-commensurate remuneration. It has to be the politicians who are messing things up and the public that is being too demanding on the doctor.

 

Hippocratic Oath:

The Hippocratic Oath is the ethical code attributed to the ancient Greek physician Hippocrates (400BC) and adopted as a guide to conduct by the medical profession throughout the ages. The modern version is still used in the graduation ceremonies of many medical schools. The oath dictates the obligations of the doctor to students of medicine and the duties of pupil to teacher. In the oath, the doctor pledges to prescribe only beneficial treatments, according to his abilities and judgment; to refrain from causing harm or hurt; and to live an exemplary  personal and professional life.

 

Do Nigerian doctors still abide by the tenets of these ethical standards? Has the Nigerian doctor turned bad? Are the activities of the Nigerian doctor now dangerous? Has the Nigerian doctor become hypocrites pretending to be true to the Hippocratic Oath? Are we asking the right questions and are there any appropriate solutions?

 

This article shall attempt to look at the charges against the Nigerian doctor, see if they are based on concrete evidence, attempt to pronounce a verdict and suggest ways forward. 

 

The Charges:

The charges against doctors in Nigeria are wide ranging but mostly anecdotal. Going through several media opinions, articles and editorials during the 2014 NMA strike action, several opinions were espoused, some of which are that;

 

- Doctors care only about money not about health.

 

- Doctors sometimes cause harm- medical negligence and errors are common but often covered up

 

- Doctors are poor manager/ administrators- chief medical directors (CMDs) have mismanaged many public hospitals

 

- Doctors are not good leaders or team players- they do not always acknowledge the contribution of other health workers.

 

- Doctors discriminate against other health workers and even against fellow doctors.

 

- Doctors obstruct reforms in the health sector- they oppose reforms that will enable other health workers attaint the ‘full potentials of their career’.

 

- Doctors are not self critical- they blame everyone else but themselves for the mess in the health care system.

 

- Doctors are a cult- they collude when in trouble and protect each other.

 

Interestingly, many of these accusations were espoused by other health workers,  especially during the period of ‘strike and counter-strike actions’ by Nigerian Medical Association (NMA) and Joint Health Sector Union (JOHESU), some by government officials trying to wriggle out of political pressure created by the health workers strike action and a few by the public.

 

* Continued In Part 2: The Evidence And The Verdict