For years, a healthy relationship existed between the doctor and all other healthcare workers. The nurse remained a nurse, the pharmacist remained a pharmacist, the laboratory scientist remained a laboratory scientist. It was same for all other healthcare workers. There was no conflict in roles. No one crossed the others path. No one envied the others pay package. Everyone was satisfied with what they were. 

 

In those days, there was no acrimony. There was instead harmony that allowed the hospital to work for the greater benefit of who it was really meant for:

 

The patient. Everyone understood that healthcare service was a teamwork and everyone knew who the team leader was. Those days are gone.

 

All through the military regime this breakdown in relationship did not exist. But with the levity that comes with democracy, it has come to be. 

 

In the beginning, the doctor worked alone in his practice. You see this often when you watch foreign movies concerning doctors, who practise in a rural setting. He tends wounds, he dispenses drugs. He has a microscope, a few laboratory equipment and reagents. This is in fact how it was with medical practice from the beginning. The doctor was an all rounder in the real sense of it. But with time he began to have assistants. That was the birth of allied health workers.  But as it is, those who the doctor helped exist have become Frankenstein monsters unto him. 

 

But even in a hospital setting, while the doctor can still do the job of a pharmacist, the job of a nurse, and the job of a laboratory scientist, they cannot do his job. Perhaps, all those who used to agree that healthcare work is teamwork, but the doctor is the head of the medical team have now eaten from the “tree of life.” As we say it here, “their eyes don open.”

 

Now, paramedics and even ward attendants want to become Chief Medical Director! The catechist can now become the parish priest, or even the bishop. Indeed, the dog has eaten the bone hung on its neck! 

 

Can the court clerk or bailiff because of his years of experience become a judge? Can the Clerk of the National Assembly, who is the highest administrative officer in the National Assembly, now aspire to be the President of the Senate?

 

When we were in medical school we had those who could not cope with the rigours of medicine, who were withdrawn. Some of those who were withdrawn went for other disciplines not even near science. But some opted for allied courses, so that they could work in a hospital. There were also others, who wanted to read medicine, but who could not meet up with the requirements, or the cut-off marks, then they opted for related courses. There are many of them. Brilliant chaps, but just that perhaps, as medicine is a calling, they were not called. But they have now come with a vengeance. They want to become doctors through the back-door! 

 

Care of patients is multidisciplinary, does not mean a nurse will perform a doctor’s role, or that a pharmacist should assume the role of a doctor. It does not also mean leadership role can be rotated. It only means that all the disciplines play their own unique roles to achieve a desired end.

 

There are many hospitals that have been set up by businessmen who are not even educated. But those hospitals are still headed by a medical director who is a medical doctor. Who heads the hospital is not in dispute. Even if a pharmacist, or a nurse, or a laboratory scientist decides to open a hospital, they will still put a doctor as the medical director. They know anything short of that will cast doubt on the integrity of the hospital. If these people will accord the doctor this respect in a private setting, why do they begrudge him a public setting? The grudge against doctors strikes at the concept called public hospital. Only in a public hospital will there be argument about who is in charge, only in a public hospital do you have conflicts of roles or who should be paid more. 

 

Every profession is unique, but certain things make some professions premium. The Good Book called the doctor a wise man. “Honour the physician for the need thou hast of him: for the most High hath created him...he shall receive gifts of the king. The skill of the physician shall lift up his head, and in the sight of great men he shall be praised. Give a sweet savour, and a memorial of fine flour, and make a fat offering, and then give place to the physician.”

 

It cannot be controverted that the doctor plays a special role in the healthcare system. In complex and risky situations where there is uncertainty as the health of humans can often be, the doctor is expected to manage the complexity. This is because of his training, which is rigorous and broad. We are told the syllabus for medicine is the human being.

 

Doctors are expected to have good judgement in every situation, even beyond the scope of guidelines and protocols. They know when to use protocols and apply them to problems and are quick to recognise changes.

 

In a multidisciplinary, team-based system as medical care has increasingly become, the doctor has the ultimate responsibility for a patient’s care. The team looks to the doctor for direction concerning the patient’s overall healthcare plan.

 

When something goes wrong with a patient it is the doctor that is expected to provide answers. Leadership falls automatically on the doctor. The special training of doctors places them in a position of authority on clinical standards and practice, especially with the intricate nature of diagnosis and treatment.

 

The medical degree cannot be substituted by on-the-job exposure by other health practitioners. There can never be a substitute for the extensive knowledge of clinical science and the full range of clinical skills that are the foundation of medical practice. Doctors are now the enemies that other healthcare workers must join forces to defeat. But the same people who are after doctors job, when they have patients who are their dear ones, they run straight to the doctor. They don’t assume to know anything anymore.

 

The usual excuse those who begrudge the doctor give is “it is what happens in the US and the UK.” Just because the white man does something does it make it right? Abortion and homosexuality are the norm in many developed countries, why are we not following them? If you are doing the right thing you can stand-alone. We must stop copying the West, or making references to them. They are not smarter, or greater than us. They can learn from us. 

 

But you might be tempted to think that those who begrudge the doctor are actually after his role, or position. But it is far from it. The truth is that money is what they seek. They think that by doing those work the doctor does it will equate them with the doctor and a justification for greater pay package. If a nurse or a pharmacist, or a laboratory scientist or a physiotherapist earns more than a doctor that ends the grudge against doctors. The doctor can keep his title with all his work!

 

By Dr. By Cosmas Odoemena

Guardian

 

About the author:

Dr. Odoemena, a medical practitioner, lives in Lagos.