THE TROUBLE WITH THE NIGERIAN HEALTH SECTOR
For a longtime now I have come across so many articles and reports in the national dailies and in online social media on the rife in the health sector which centers mainly on the row between doctors and non-doctors working in the healthcare system. Most of these reports and articles, mostly lopsided, have one common denominator, presenting the Doctor as an enemy of the people and the manner of their submissions is such as to draw undue sympathy from the unsuspecting public. But for the neutral members of the society who have had cause to have sufficient contact with the hospital environment, I’m not talking of some quasi journalists, they need not be told, if there are, who the Angels and Demons are.
This article is not aimed at indicting or exonerating any of the two combatant parties as both have had a fair share of the blame, and honestly, the deplorable state of our healthcare system is not as a result of the performance of the health workers, but it is a component of an overall failed system called Nigeria which the current government is still trying to salvage amongst other difficult challenges. Considering the lines along which the divide has been made, I shall delve into an inquest of some of the key issues at stake, mostly those that affect the general public, and this I will do by placing the Nigerian Doctor on one side to be reviewed alongside a few of the numerous “health professionals” working in the healthcare system with due consideration to the most important person in the system, the Patient. I shall concentrate mostly on the tertiary healthcare institutions where the bulk of the rivalry is most felt.
The Patient and the Hospital:
Let us begin from the beginning. A healthy person falls sick and needs to regain his health and function properly. He says to himself, “I don’t feel well enough, I need to see a Doctor. May be I should go to the hospital tomorrow”. He sets out of his house with this principal aim. On getting to the hospital, he first gets to the reception, obtains a card at the Out Patient Department and then proceeds to see a Doctor (usually a Medical Officer) if his condition is one that necessitates a Specialists attention, he is then Referred to another Doctor, the Specialist (Consultant) for further treatment. On getting to the point of referral, the Record staff assist him in opening a folder containing case notes, and in the process of this, a Doctor (Consultant) is assigned to him. The entire process of obtaining a card and folder have no direct effect on the patient’s condition but help ensure proper documentation and recording within the hospital. He is then directed to the designated Specialist or Consultant Clinic where he is received by a Nurse who does further documentation and records his vital signs which may or may not be repeated by the Doctor. Then the patient enters the clinic to see the Doctor, his primary aim for coming to the hospital ab initio.
The Patient, the Doctor and Other Health Workers:
The Doctor begins by taking a complete history of the patient which includes his current complaints, previous health challenges, living condition, social habits, family history, drug history, financial capacity, religious and cultural beliefs, and then proceeds to do a complete physical examination of his entire body system, at the end of which the Doctor would have verified the patients complaints and identified any other problems unknown to the patient, before arriving at a Provisional Diagnosis. He then counsels the patient, draws up a treatment plan, which is to be strictly adhered to provided the patient is within the hospital environment, and automatically takes full responsibility for any problems encountered along the line. He finally schedules him for a follow-up visit to ascertain his response to treatment. This process of history taking creates a personal relationship between the Patient and the Doctor and this is where the confidence of a patient on the Healthcare system of a Nation is built; the Doctor-Patient Relationship.
The treatment plan of the Patient, drawn by the Doctor, may or may not include; the investigations (or tests) both laboratory or radiological to be carried out, the drugs to be dispensed and the appropriate prescription, the additional care to be rendered outside the basic nursing care and the treatment orders to be followed, some of which he does himself (or via his subordinate Doctors) and others by the Nurses. There is no stereotyped outline of what must be done for every patient; investigations to be carried out, treatment to be administered or drugs to be prescribed lies solely at the discretion of the Patient and his Doctor.
Apart from the Nurses, all other “Health Professionals” come into patient care when the Doctor’s plan involves them. Clearly, a patient has no business with the Radiographer if the Doctor’s plan does not involve radiography, neither does he have any business with the Pharmacist if the patient does not require any drugs, of course, not every patient require drugs. Therefore, it is safe to assert that if Patient Care is the sole interest of everybody in the Health sector, then the Doctor takes the Central stage in this service to Patients and must carry the Nurses along at every point in time, and together they look out for any other “Health Professional” that should be roped into patient care. Why then should the Doctor take the Central stage? Very simple. He has been trained thoroughly to do so. Invariably, the Doctor is naturally the undisputed leader of the Health team and only two classes of people can challenge this standing; the criminal minded ones pursing their selfish interests and the dim-wits incapable of any logical reasoning.
On the Headship of the Hospital:
Over time, the functional head of the tertiary hospital setting has been the office of the Chief Medical Director, CMD, and part of the Act establishing the hospitals specified that this position be held by a Medical Doctor. However, there has recently been a loud cry from other “Health Professionals” under the auspices of the Joint Health Workers Union (JOHESU) for the chance to also partake in the “enjoyment” of this office, as if to say it is a political office, a “National Cake” which should be shared equally to everyone in the scene, whereas, it is the most sensitive of all positions in the hospital setting, one with huge implications on the health of patients. The Medical Doctors on the other hand, insist that the office of the Chief Medical Director and the headship in general, of the Hospitals is their exclusive reserve.
How true is this claim by the Doctors? Again, it is very simple. Healthcare is all about patient care, and in rendering care to the patient who is the main focus of everyone, the Doctor is the arrow head. He brings together the activities of all in the health care delivery system to bear fruit on the health of the patient. He has a broad-based and yet in-depth medical knowledge that enables him to function as a leader in patient management and take responsibility for the outcome. It is then indeed a funny ideology to expect the Doctor to maintain leadership of Patient Management and then cede the leadership of the Hospital Management to a Non-Doctor. Right thinking people would agree that whoever takes the blame should take the lead. Leadership is about responsibility, and Doctors embrace such responsibility mainly as it involves lives which they have sworn an oath to protect.
Furthermore, JOHESU, a body comprising of other “health professionals”, support staffs and in fact all in the Hospital setting except Doctors, claim to be equal and allied to Medicine. But my question is, how is the clerical staff allied to Medicine? How can a support staff head the core members of the organization? Also, why should a “profession” that is “allied” to Medicine surmount Medicine? Can a Non-Lawyer become the Attorney General of the Federation? Why isn’t the office of the Vice-Chancellor made open to every staff in the University system since ASUU and NASUU both consist of “professionals”? How would ceding hospital leadership to JOHESU improve the health indices of our country? These are people that do not deal directly with patients, people that do not really understand the agony of patients which Doctors do. The saddest part is the extent they can go to press home their irrational demands. We have a documented occurrence of how they turned off power supply to the Intensive Care Unit during a JOHESU orchestrated strike action in a southeastern Teaching Hospital leading to death of patients on life support. This was an attempt to frustrate the Doctors’ effort to keep hospital services running while they were “striking”. How can people who have displayed this level of irresponsibility be allowed to head the Health sector? Again, God forbid!
It is a common saying that Doctors are “proud”, and I insist, they have very just reasons to be, and when it comes to arrogance, the patients can tell who amongst Doctors and Nurses are more approachable. Doctors are a select class of elite and comprise the best brains of the society. Yes, the entry requirements into the profession and the medical training ensure that only the best emerge as Doctors. As such, the government has to understand that any arrangement that sees a Non-Doctor in a sensitive position to head Doctors in any Health related issue would be met with fierce resistance and the never ending tussle it will ensue will have detrimental effects on our nation’s healthcare delivery. In the interest of peace and decorum, the Federal Government has to dig in and ensure that the status quo is been maintained. The ear that will hear needs not be the size of a raffia palm.
On conferment of Consultancy on other “Health Professionals”:
[b]A Consultant (Medical) is the title for a senior hospital-based physician or surgeon who has completed all of his/her specialist (Residency) training and has been placed on the specialist register (Fellow) in their chosen specialty. This level of Doctor joins the Civil service as a Consultant and automatically leads a team of Doctors comprising Residents, Medical Officers and House Officers who train under him.
Currently, there has been an outcry by JOHESU to also be awarded Honorary Consultancy based on the fact that Doctors are been appointed as Consultants, why not they too. The concession of the government to this particular demand has led to the entire hospital going berserk in some centers. This was done against the warning of the Nigerian Medical Association that the introduction of such “alien” practices would be detrimental to the lives of patients and the results are showing.
At the Nnamdi Azikiwe University Teaching Hospitals, it is been said that a “Consultant Pharmacist” invaded the wards with his team, cancelling patients prescriptions and also demanded that a Consultant Cardiologist remove a key drug in an inpatient prescription, on grounds that the drug has some known adverse effects. Another report has it that in Abuja University Teaching Hospital, the Ante-Natal Clinic was invaded by Nurses who decided to consult patients and make prescriptions, of which the Doctors left the clinic and the Patients were confused. Patients who sought to see their Doctors were told that there was a “Consultant Nurse” who does whatever a Consultant does. Also, in University College Hospital, Ibadan, stories had it that a Consultant Plastic Surgeon was barred from reviewing the surgical wound he created post-operatively because a “Consultant Nurse” had reviewed the wound earlier and was satisfied with her findings.
Let us address one of these occurrences. It is grave ignorance for a Pharmacist to tamper with a drug prescription simply because he has looked through his drug formulary and has identified a known adverse effect of the drug when he/she has no knowledge of the processes involved in the making of diagnosis and prescriptions. Patient management is highly individualized. To make a prescription, the Doctors put many things into consideration viz; patient’s history and examination, financial cost of the drug, benefits against the risk of using the drug, other drugs to be administered etc. Sometimes the side effect of a drug is the desired effect needed in one patient but would remain a serious adverse effect in another patient. But no, the Pharmacist didn’t think in that line before cancelling prescriptions. I am not saying every doctor’s prescription is infallible. No. But if a pharmacist wishes to express concern over a patient’s prescription, he should discuss with the Doctor to sort out their concerns.
This whole consultancy for non-doctors arose as a result of their quest to have better remuneration. I am not opposed to better remuneration for other health workers, but looking for cheap means to it at the expense of the lives of patients is grossly unacceptable. Why would you want to be a Specialist (Consultant) when you have no specialty, or you have a specialty in an area whose service is not needed? Even if a non-doctor must be a consultant that does not automatically make him/her a Doctor. We all know how to become a Doctor and age is no barrier.
If non-doctors must immutably be made consultants, their duties and jurisdictions must be clearly spelt out and understood by all involved. A Consultant Nurse should be confined to Nursing Practice and she will be expected to enhance it, not to invade Medical Practice. She must ensure that the management plan of a Doctor is properly carried out, even if he is a House Officer. Unfortunately, the idea of non-doctor consultant emanates from the desire of these other “health Professionals” for position and better pay than the desire to meet any specific needs. For instance, a ward Nurse that does her duties properly becomes a Consultant, what extra services and improvement does that bring to nursing care? The fact that there exist non-doctor consultants in a few foreign countries does not explain why the government should channel huge sums of money into the payment of honorarium to consultants that add nothing to the existing system but chaos. The NMA have identified these unhealthy health policies and should do all it can to prevent it from killing Nigerians.[/b]
On relativity of Wages:
Another very important object of discord is the demand by JOHESU for a unified salary scheme for everyone in the health sector and that will see a close approximation of the eventual earnings of all in the sector. What else can be sillier? Need I remind us that in every organization there is usually an established strata. Even in heaven, there are Angels and Arch angels, and the angels are content with their positions and would not want to usurp the duties of the Arch angels either. People cannot obtain different qualifications, different expertise, subserve different needs and end up earning similar pay. No. That cannot happen. Why would a non-specialist insist on being paid specialists allowance? Why would a Non-doctor terrorize the government because he wants to be paid like Doctors? Where in the world is that obtainable? Relativity is sacrosanct and must be reflected both on the basic salaries and all allowances.
Granted. Doctors are few. Very very few. The World Health Organisiation recommends that a Doctor should consult not more than seven patients in a clinic session and should pay maximum attention to their needs, but our environment see us in a situation where a Doctor consults over 40 patients in one clinic session, yet, he is underpaid compared to his colleagues even in nearby Ghana. There are less than 30,000 Doctors currently practicing in Nigeria subserving over 170 million Nigerians, and there is a dire need for more, but that will not push the Medical schools to take in everybody and churn out unqualified people as Doctors, neither will the Nigerian Doctor allow a Non-Doctor to tamper with the lives of patients. Doctors swore an oath to preserve lives and the NMA must see to it that the lives of Nigerians are safeguarded. If the Hippocratic Oath is to be taken serious, then the NMA must win this battle.
More often than not, we are clear on the knowledge that it is injustice to treat equal people unequally, but it fails to come to our minds that, it is graver injustice to treat unequal people equally. This is not pride, it is a statement of fact. Doctors and Non-doctors in the Health sector are not equal and they cannot be treated as equal. There is a reason why some students work harder than others to become Doctors. Some sat for JAMB several times to achieve that, although many fail to do so and even some do fail out of medical school and end up as “other Health Professionals”. To eventually anticipate to be rewarded equally with those who triumphed where you failed is simply madness. The government must see to it that relativity is maintained. For if a Nurse or Pharmacist consults patient, not regarding quality of the consult, earns equally with a Doctor and even get a chance to head the Doctor, why then would one need to work harder to become a Doctor when he can easily become a Pharmacist? Tampering with relativity is a conscious attempt at breeding mediocrity, again at the expense of lives. If the Nurses and Pharmacists accept to be paid equally with the Lab “Scientist” and Janitors, it’s their own cup of tea, but paying Doctors and Non-doctors equally? God forbid!
On the Physiotherapists’ demand to make first contact with Patients:
According to Prof. K. E. Obidike, there are three reasons why patients go to see Doctors. Firstly, is to ascertain the causes of their complaints and resolve them. Secondly, is to identify any other health problems unknown to the patient, and again, resolve them timely, and finally, to have a baseline documentation of the patient as a reference for subsequent health issues. The second reason especially, answers the question as to why a Physiotherapist cannot make first contact with patients. Medicine is holistic, and the initial assessment of a patient takes the entire body system into account not just the presenting complaints. Therefore, Physiotherapists should remain Physiotherapists and should come into action when consulted. Simple.

On adoption of Foreign Healthcare Structure:
The fundamental idea behind the establishment of Tertiary Healthcare centers (Teaching Hospitals) in Nigeria was primarily for training of Medical Practitioners, Research, and provision of specialized healthcare at very affordable rate. It is not a business venture, and if this aims and objectives are to be met, then the hospital must be made to operate under the very Act that established it. Comparing our Healthcare practices with that of foreign nations without a review of the aim and objectives viz-a-viz that of our country is practically insane. Granted, a few hospitals in Canada are headed by Non-Doctors, and there are few Non-Doctor Consultants with well-defined jurisdictions in a few foreign countries, but that does not in any way directly improve their health indices. After all, high quality health care is still not affordable for a large proportion of Americans despite their very potent health insurance system.
Our very first interest should be to assist the government, which some members of the health sector have chosen to distract, to ensure there is affordable healthcare services to all its citizenry, seek ways of improving the training of the medical personnel and carry out Research programs that will elevate the quality of healthcare delivery in our own nation. Yes. We can go abroad and observe what obtains from there, but instead of disrupting order in the already existing system, by trying to blindly implement it over here, we can see how best to fit a few of them into our system and get the best out of it. The Government should concentrate on policies that will better the lives of the larger population of Nigerians, not those that pacify some disgruntled group of individuals fighting for position and their own other personal interests.
There are many other issues that do not only need Government attention, but also its speedy response. Some of these areas include: the appointment of Directors in the hospitals which distorts the chain of command in the hospitals, induces anarchy and expose patients to conflicting treatment and management directives; the passage of the National Health Bill, and extension of Universal Health Coverage to cover 100% Nigerians and not 30% as currently prescribed by the National Health Insurance Scheme; the appointment of the office of the Surgeon General of the Federation alongside many other pressing needs. These are health issues of paramount importance and the Government cannot afford to be lackadaisical about them. No. Not this time.
My Recommendations:
First of all, JOHESU is an amorphous body comprising of different entities with varying agitations, concerns, qualifications, expertise, and eligibility status and should not be confronted in that front by the government. Our government has to recognize the various constituents independently and verify their individual complaints as some parts of it have no moral standee to withdraw its services because of the unmet demands of another. For instance, The Medical and Health Workers Union (MHWU) comprising of Clerks, Messengers, Record Officers, Admin staffs, Janitors, Engineers, Security etc., an association of different people with absolutely no training in any Health related courses should not dare to aspire for headship positions in the hospital let alone been prevented from doing so. We do not have to give reasons why they should not. Therefore, the five different associations and unions under JOHESU should be made to make their specific submissions independent of one another for clarity.
Secondly, the Nigerian Labour Congress and Trade Union Congress should look beyond Unionism and focus on the ultimate goal of everybody in the health sector which is adequate Health care for the Nation. They should relinquish their parochial stand in the dispute between JOHESU and NMA, and as well desist from all forms of hooliganism and attempt to bully the Government and NMA on this matter.
Finally, the Government should resist all attempts to coerce it into yielding to the demands of one party in the dispute when the matter is still in court. There should be absolute regard for the Rule of Law. And all previous “concessions” should be stalled, and pending till a decisive ruling by the court.
We can go on and on to address so many other issues in the health sector that require attention but I have decided to throw light at just some parts of it before the Doctors under the auspices of the Nigerian Medical Association, an association of all certified Medical Doctors practicing in Nigeria down their tools as proposed come July 1st, 2014. Before the health of the nation would be thrown into the hands of Non-Doctors in the Health sector that usually prefer the exclusive services of Doctors when they and their loved ones take ill. Before the general public begin to lash out on Doctors and blame them for lives lost as a result of the forthcoming massive industrial action. The onus lie on the general public to call out on the Government to resolve these life threatening issues before the Doctors take to this hurtful last resort of theirs.
God bless Nigeria.

the above article i copied from a friend. its a long article but i implore you to read and digest it so you can get the salient issues and make an informed opinion.thanks and god bless


the 3 or 4 paragraphs that i bolded in the article(with the heading "on confernment of consultancy on other health professionals") is NMAs grouse with the issue of consultancy. the NMA has no business with what the other health professionals want to call themselves BUT IT BECOMES OUR BUSINESS WHEN IT BEGINS TO AFFECT PATIENT MANAGEMENT AND MAKE NO MISTAKES ABOUT IT,IT WILL!! believe it or not,the NMA is the only party in this drama that cares about the patients. when you make every chidi,kunle and adamu consultant in the health sector,YOU ARE BREEDING CONFUSION. NMA has vowed to resist it in the interest of nigerians.this struggle looks superficial to the average nigerian but we doctors are are already seeing the FUTURE,one that will be full of anarchy. we implore the general public to think deeply before they JUDGE & KILL us..

these same nigerians screaming 'CRUCIFY THE DOCTORS" will be the same people to turn around tomorrow and blame us for allowing this confusion to stand.as usual no one will point a finger at the governemnt. we are too docile for that. i beg every 'right-thinking" nigerian to support the NMA in this struggle. you will NOT regret it. but if you think johesu have a case and that NMA is pursuing trivial things,no wahala.

Consultants and Chief Medical Officers in other Government Hospitals in the Developed World (International best practices/standards).

We do not need to travel far and wide to know what is happening in other parts of the world because the world has become a global village, all thanks to information technology.
The conflict in Nigeria health sector has tugged me to search for what is obtainable on the key warring issues in other developed countries. Ideally the Nigeria Health system format is supposed to be compared with that of the Britain(not the American’s) since Nigeria adopted and is using the British educational/health systems; however reference has been made on American health system in this write up, for obvious reason. I deliberately sourced for all information from current and popular international encyclopedia and/or professional websites not hosted by medical doctors.

Medical/hospital Consultant
The term or title “consultant” is coined from consultation. It is wise to see the standard definitions of medical consultation; which are:
Medical consultation is a formal meeting with a medical doctor for discussion or the seeking of advice….{ www.en.m.wikipedia.org/consultation(medical)}.
It is also defined as a procedure whereby, on request by one Physician, another Physician reviews a patient’s medical history, examines the patient and makes recommendation as to care and treatment….. ( www.medical dictionary.freedictionary.com/medical consultation).

In the UK, Republic of Ireland and parts of the commonwealth countries Medical Consultant is the title of a senior hospital-based physician or surgeon who has completed all of his/her specialist training….. {www. en.m.wikipedia.org/consultant (medicine) , www.medical dictionary.thefreedictionary.com/consultant(medicine), www.gapmedics.co.uk/difference between consultant and a doctor in a hospital }

Consultant Pharmacist
In America Pharmacists are broadly grouped into two:
1. Health system pharmacist
2. Consultant pharmacist
The health system pharmacist is hospital-based pharmacist that provides care to patient on healthcare team. They undergo residency training but are not awarded the title of consultant….(www.asph.org).

Consultant Pharmacists are pharmacist that work as private pharmacist for individual elderly persons or is employed to work in old people homes(institute) to enhance quality of care for all old persons. They are non-hospital staff and do not undergo residency training but write preparation/recertification examinations. They are also called senior care pharmacist… (www.ascp.com).

In USA Consultant Nurse is a registered nurse who uses expertise as a healthcare provider and specialized training to consult on medical related legal case. They assist attorneys in reading medical records and understanding medical terminology and healthcare issues to achieve the best results for their client. They are non-hospital staff….( www.en.m.wikipedia.org/nurse consultant)

Chief Medical Director (Office)
This title is used in many countries for the senior government official designated as head of medical services, usually at the national level. He advices and leads a team of medical experts on matters of importance. { www.en.m.wikipedia.org/chief medical officer, medical dictionary.thefreedictionary.com/chief medical officer, www.ehow.com/chief medical officer, www. gov.uk/government/people/sally-davies}

Surgeon General
In the United States and many areas of the British Commonwealth, this title refers to a physician commissioned by government and entrusted with the public health responsibilities.
In Uk Surgeon General is the senior medical officer of the British Armed Forces… ( www.en.m.wikipedia/surgeon general UK/USA).

Hospital Chief Executive Officer is the highest management position within a hospital in the capitalist countries. He or she is expected to have masters in business Administration, masters in healthcare Administration etc….( in Nigeria such a position is designated as Director of Administration in Teaching Hospitals)……www.degreetree.com/how to become a hospital ceo.

Health Care Professionals are divided into two broad groups:
1. Core Healthcare Professionals
2. Support (Allied) Healthcare Professionals
The core professionals are doctors, nurses and pharmacists….others, except these three, are allied professionals…… (www.wikipedia.org/allied health professions)

I wish this could make it to the front page so that the general public will know what this strike is about. Rather than all the lies and half truths making the rounds.

JOHESU. Any counter argument.

I just wish somebody who is not a member of the health sector can write about the challenges facing the health sector after thorough investigation. Any other article coming from any member of the health sector will definitely be biased. So, I have stopped reading articles written by a health worker. It is always the same story, with the writer skewing in favor of the profession to which he/she belongs.


http://www.nhscareers.nhs.uk/explore-by-career/nursing/careers-in-nursing/nurse-consultants/
http://www.nursing-career-hub.com/Nurse-Consultant.html
http://www.idph.state.ia.us/hcci/consultants.asp
http://work.chron.com/clinical-nurse-consultant-13912.html
A nurse consultant must not be a legal nurse consultant. The first link I have shared is from UK which we copy. Check who a nurse consultant is and what he/she does in NHS and other countries.

Someone (probably a Nigerian doctor) asked this question in Linkedin, and he got answers from people from different countries. here is the link. https://www.linkedin.com/groups/Hello-guys-What-are-job-2547386.S.5795719019684200448

http://www.wisegeek.com/what-is-a-laboratory-consultant.htm

.

@phantom. So many words, so much tedium and yet you fail to convince the reader that you're not yet another sentimental health worker, in your case so disgustingly skewed in the favour of medical doctors. I do not work in the hospital and that alone hasn't stopped me from making the following observations:
1) When medical doctors go on strike (which they do with about the same consistency as you blink) the other health workers have never been known to initiate a counter strike with no other motive than to thwart the demands of the medical doctors. How come the medical doctors feel they have the right to hold the entire nation to ransom just because the demands of the other health workers were favourably considered by the government? This is a very bad precedence medical doctors are establishing; even if they return happy from this strike, what should stop JOHESU from not staging their own counter-counter strike?
2) Whenever an argument (valid or not) is raised perceived by other health professionals and considered to be against the Nigerian medical doctors, the medical doctors immediate try to explain it away by saying the attitude of these other health professionals stem from their anger at not being able to enter or complete medical education. This sounds very ignorant, naive and stupid for anyone to say considering that everyone has his flair and personal reasons for choosing either nursing, anatomy, medicine, or philosophy. And in fact, most brightest minds will be drawn to basic sciences such as mathematics, statistics, physics, law, chemistry, and engineering courses because these require more analytical reasoning and creative mind than medicine which most of the doctors scale through by dumb memorization (a.k.a. cramming).
3) Nigerian medical doctors seem to have an unusual disease- the compulsion to dictate the remuneration, professional development, as well as the fate of all other health professionals. This is both arrogant and absurd considering that each profession is properly autonomous. Medicine is a profession. Nursing is another. So is Pharmacy and Medical Laboratory Science. Just the same way the other health professionals have no business with the way things are run within the medical profession, the medical doctors should stop poke-nosing in the affairs of the other professions
4) Medical doctors (perfectly exemplified by the illiterate who wrote the main article on this thread) have a knack for playing down on the roles of the other healthcare professionals. You went about boring us with how important the medical doctor is in patient management, after attending to your patient Mr Doctor, don't you go home to sleep while the nurses stay awake with the patient attending to his every need? And yet you think patient care is all about you. How about the countless number of cases where medical doctors have been reported to err in writing drug prescriptions; if the pharmacists aren't there to save the day (which they usually do without feeling the need to shout it on the rooftop), how many more patients do you suppose you would have murdered? And yet, to you patient management is all about you, and you alone.

This is the right time the Nigerian public should rise up and demand what they deserve. Be it medical doctors, nurses, pharmacists, scientists, they are all intended to serve the interest of the public. And we are not as dumb as these professional clowns would want to portray us. We are Nigerians living in Nigeria and we sure know how to interpret the goings-on. The committee that granted Johesu's demands were not health professionals, they were Nigerians who used their discretion to judge the reasonableness of their demand. And the on-going NMA's strike is nothing more than calling the bluff of the Nigerian public, that we are not capable of deciding on such basic and plain things as this.

@jide olubiyi, I am surprised at the vitriol that accompanied your reply, cos why call whoever wrote the article 'illiterate' or calling the article 'disgustingly skewed'?
But before I digress let me say one or two things addressing what you said... I'm using the tertiary Healthcare system as a case study
1- About nurses being on night duty: do you know that nurses work shift duties of either morning, afternoon or night shift per day, with the hours being 8am-2pm, 2pm-7pm and 7pm-8am respectively and an equal number of days off as the consecutive night duties. So if a nurse did night duty for four days, then she is off for the next four days.
But Doctors don't do shift 1st and foremost, and whenever they are on call, ie staying throughout the day and night at the hospital for a week and sometimes months, they still come to work the very next day.

2- it seems you only see or hear whenever NMA go on strike because when JOHESU went on theirs, I don't think you made this kind of comment... They Cited so many things about what was being done for doctors and not for them. In fact almost all the reasons for their strike was doctor related... That doctors are allowed to be head of hospitals, why not them too, doctors skip a level in salary grade, why not them too, doctors are called consultants, why not them too. So many trivial things...

3- On cramming : If you would be truthful to yourself, even in your secondary school the brightest minds in science class wanted to be doctors... Vis a vis Lawyers for Art class! Medicine is a field which requires only the best minds for adequate patient care, that's why the requirements are so stringent and the training comprehensive. I wonder if putting together different symptoms and sign, accurately interpreting them for the correct diagnosis of myriad illnesses is now considered as cramming.

4- I wonder who you personally go to see whenever you have an illness, or a relative of yours comes down with a complication of an illness. I hope not a doctor!

5- I just wish this will enter front page so the public can see this instead all the misinformation being dished out to them by all the numerous paramedicals!

What happened to the links shared about Consultants in other field? did you choose to ignore that (the truth) just to attack somebody?

benjichuks: @jide olubiyi, I am surprised at the vitriol that accompanied your reply, cos why call whoever wrote the article 'illiterate' or calling the article 'disgustingly skewed'?
But before I digress let me say one or two things addressing what you said... I'm using the tertiary Healthcare system as a case study
1- About nurses being on night duty: do you know that nurses work shift duties of either morning, afternoon or night shift per day, with the hours being 8am-2pm, 2pm-7pm and 7pm-8am respectively and an equal number of days off as the consecutive night duties. So if a nurse did night duty for four days, then she is off for the next four days.
But Doctors don't do shift 1st and foremost, and whenever they are on call, ie staying throughout the day and night at the hospital for a week and sometimes months, they still come to work the very next day.

2- it seems you only see or hear whenever NMA go on strike because when JOHESU went on theirs, I don't think you made this kind of comment... They Cited so many things about what was being done for doctors and not for them. In fact almost all the reasons for their strike was doctor related... That doctors are allowed to be head of hospitals, why not them too, doctors skip a level in salary grade, why not them too, doctors are called consultants, why not them too. So many trivial things...

3- On cramming : If you would be truthful to yourself, even in your secondary school the brightest minds in science class wanted to be doctors... Vis a vis Lawyers for Art class! Medicine is a field which requires only the best minds for adequate patient care, that's why the requirements are so stringent and the training comprehensive. I wonder if putting together different symptoms and sign, accurately interpreting them for the correct diagnosis of myriad illnesses is now considered as cramming.

4- I wonder who you personally go to see whenever you have an illness, or a relative of yours comes down with a complication of an illness. I hope not a doctor!

5- I just wish this will enter front page so the public can see this instead all the misinformation being dished out to them by all the numerous paramedicals!

jide olubiyi: @phantom. So many words, so much tedium and yet you fail to convince the reader that you're not yet another sentimental health worker, in your case so disgustingly skewed in the favour of medical doctors. I do not work in the hospital and that alone hasn't stopped me from making the following observations:
1) When medical doctors go on strike (which they do with about the same consistency as you blink) the other health workers have never been known to initiate a counter strike with no other motive than to thwart the demands of the medical doctors. How come the medical doctors feel they have the right to hold the entire nation to ransom just because the demands of the other health workers were favourably considered by the government? This is a very bad precedence medical doctors are establishing; even if they return happy from this strike, what should stop JOHESU from not staging their own counter-counter strike?
2) Whenever an argument (valid or not) is raised perceived by other health professionals and considered to be against the Nigerian medical doctors, the medical doctors immediate try to explain it away by saying the attitude of these other health professionals stem from their anger at not being able to enter or complete medical education. This sounds very ignorant, naive and stupid for anyone to say considering that everyone has his flair and personal reasons for choosing either nursing, anatomy, medicine, or philosophy. And in fact, most brightest minds will be drawn to basic sciences such as mathematics, statistics, physics, law, chemistry, and engineering courses because these require more analytical reasoning and creative mind than medicine which most of the doctors scale through by dumb memorization (a.k.a. cramming).
3) Nigerian medical doctors seem to have an unusual disease- the compulsion to dictate the remuneration, professional development, as well as the fate of all other health professionals. This is both arrogant and absurd considering that each profession is properly autonomous. Medicine is a profession. Nursing is another. So is Pharmacy and Medical Laboratory Science. Just the same way the other health professionals have no business with the way things are run within the medical profession, the medical doctors should stop poke-nosing in the affairs of the other professions
4) Medical doctors (perfectly exemplified by the illiterate who wrote the main article on this thread) have a knack for playing down on the roles of the other healthcare professionals. You went about boring us with how important the medical doctor is in patient management, after attending to your patient Mr Doctor, don't you go home to sleep while the nurses stay awake with the patient attending to his every need? And yet you think patient care is all about you. How about the countless number of cases where medical doctors have been reported to err in writing drug prescriptions; if the pharmacists aren't there to save the day (which they usually do without feeling the need to shout it on the rooftop), how many more patients do you suppose you would have murdered? And yet, to you patient management is all about you, and you alone.

This is the right time the Nigerian public should rise up and demand what they deserve. Be it medical doctors, nurses, pharmacists, scientists, they are all intended to serve the interest of the public. And we are not as dumb as these professional clowns would want to portray us. We are Nigerians living in Nigeria and we sure know how to interpret the goings-on. The committee that granted Johesu's demands were not health professionals, they were Nigerians who used their discretion to judge the reasonableness of their demand. And the on-going NMA's strike is nothing more than calling the bluff of the Nigerian public, that we are not capable of deciding on such basic and plain things as this.

@phantom. So many words, so much tedium and yet you fail to convince the reader that you're not yet another sentimental health worker, in your case so disgustingly skewed in the favour of medical doctors. I do not work in the hospital and that alone hasn't stopped me from making the following observations:
1) When medical doctors go on strike (which they do with about the same consistency as you blink) the other health workers have never been known to initiate a counter strike with no other motive than to thwart the demands of the medical doctors. How come the medical doctors feel they have the right to hold the entire nation to ransom just because the demands of the other health workers were favourably considered by the government? This is a very bad precedence medical doctors are establishing; even if they return happy from this strike, what should stop JOHESU from not staging their own counter-counter strike?
2) Whenever an argument (valid or not) is raised perceived by other health professionals and considered to be against the Nigerian medical doctors, the medical doctors immediate try to explain it away by saying the attitude of these other health professionals stem from their anger at not being able to enter or complete medical education. This sounds very ignorant, naive and silly for anyone to say considering that everyone has his flair and personal reasons for choosing either nursing, anatomy, medicine, or philosophy. And in fact, most brightest minds will be drawn to basic sciences such as mathematics, statistics, physics, law, chemistry, and engineering courses because these require more analytical reasoning and creative mind than medicine which most of the doctors scale through by dumb memorization (a.k.a. cramming).
3) Nigerian medical doctors seem to have an unusual disease- the compulsion to dictate the remuneration, professional development, as well as the fate of all other health professionals. This is both arrogant and absurd considering that each profession is properly autonomous. Medicine is a profession. Nursing is another. So is Pharmacy and Medical Laboratory Science. Just the same way the other health professionals have no business with the way things are run within the medical profession, the medical doctors should stop poke-nosing in the affairs of the other professions
4) Medical doctors (perfectly exemplified by the illiterate who wrote the main article on this thread) have a knack for playing down on the roles of the other healthcare professionals. You went about boring us with how important the medical doctor is in patient management, after attending to your patient Mr Doctor, don't you go home to sleep while the nurses stay awake with the patient attending to his every need? And yet you think patient care is all about you. How about the countless number of cases where medical doctors have been reported to err in writing drug prescriptions; if the pharmacists aren't there to save the day (which they usually do without feeling the need to shout it on the rooftop), how many more patients do you suppose you would have murdered? And yet, to you patient management is all about you, and you alone.

This is the right time the Nigerian public should rise up and demand what they deserve. Be it medical doctors, nurses, pharmacists, scientists, they are all intended to serve the interest of the public. And we are not as dumb as these professional clowns would want to portray us. We are Nigerians living in Nigeria and we sure know how to interpret the goings-on. The committee that granted Johesu's demands were not health professionals, they were Nigerians who used their discretion to judge the reasonableness of their demand. And the on-going NMA's strike is nothing more than calling the bluff of the Nigerian public, that we are not capable of deciding on such basic and plain things as this.

jide olubiyi: @phantom. So many words, so much tedium and yet you fail to convince the reader that you're not yet another sentimental health worker, in your case so disgustingly skewed in the favour of medical doctors. I do not work in the hospital and that alone hasn't stopped me from making the following observations:
1) When medical doctors go on strike (which they do with about the same consistency as you blink) the other health workers have never been known to initiate a counter strike with no other motive than to thwart the demands of the medical doctors. How come the medical doctors feel they have the right to hold the entire nation to ransom just because the demands of the other health workers were favourably considered by the government? This is a very bad precedence medical doctors are establishing; even if they return happy from this strike, what should stop JOHESU from not staging their own counter-counter strike?
2) Whenever an argument (valid or not) is raised perceived by other health professionals and considered to be against the Nigerian medical doctors, the medical doctors immediate try to explain it away by saying the attitude of these other health professionals stem from their anger at not being able to enter or complete medical education. This sounds very ignorant, naive and stupid for anyone to say considering that everyone has his flair and personal reasons for choosing either nursing, anatomy, medicine, or philosophy. And in fact, most brightest minds will be drawn to basic sciences such as mathematics, statistics, physics, law, chemistry, and engineering courses because these require more analytical reasoning and creative mind than medicine which most of the doctors scale through by dumb memorization (a.k.a. cramming).
3) Nigerian medical doctors seem to have an unusual disease- the compulsion to dictate the remuneration, professional development, as well as the fate of all other health professionals. This is both arrogant and absurd considering that each profession is properly autonomous. Medicine is a profession. Nursing is another. So is Pharmacy and Medical Laboratory Science. Just the same way the other health professionals have no business with the way things are run within the medical profession, the medical doctors should stop poke-nosing in the affairs of the other professions
4) Medical doctors (perfectly exemplified by the illiterate who wrote the main article on this thread) have a knack for playing down on the roles of the other healthcare professionals. You went about boring us with how important the medical doctor is in patient management, after attending to your patient Mr Doctor, don't you go home to sleep while the nurses stay awake with the patient attending to his every need? And yet you think patient care is all about you. How about the countless number of cases where medical doctors have been reported to err in writing drug prescriptions; if the pharmacists aren't there to save the day (which they usually do without feeling the need to shout it on the rooftop), how many more patients do you suppose you would have murdered? And yet, to you patient management is all about you, and you alone.

This is the right time the Nigerian public should rise up and demand what they deserve. Be it medical doctors, nurses, pharmacists, scientists, they are all intended to serve the interest of the public. And we are not as dumb as these professional clowns would want to portray us. We are Nigerians living in Nigeria and we sure know how to interpret the goings-on. The committee that granted Johesu's demands were not health professionals, they were Nigerians who used their discretion to judge the reasonableness of their demand. And the on-going NMA's strike is nothing more than calling the bluff of the Nigerian public, that we are not capable of deciding on such basic and plain things as this.

and of course you went ahead and wrote an article filled with the very same emotions and sentiments you accussed me of. funny. when you start asking the right questions,i ll take you up. till then,you just passed through this thread.

jideolubiyi: @phantom. So many words, so much tedium and yet you fail to convince the reader that you're not yet another sentimental health worker, in your case so disgustingly skewed in the favour of medical doctors. I do not work in the hospital and that alone hasn't stopped me from making the following observations:
1) When medical doctors go on strike (which they do with about the same consistency as you blink) the other health workers have never been known to initiate a counter strike with no other motive than to thwart the demands of the medical doctors. How come the medical doctors feel they have the right to hold the entire nation to ransom just because the demands of the other health workers were favourably considered by the government? This is a very bad precedence medical doctors are establishing; even if they return happy from this strike, what should stop JOHESU from not staging their own counter-counter strike?
2) Whenever an argument (valid or not) is raised perceived by other health professionals and considered to be against the Nigerian medical doctors, the medical doctors immediate try to explain it away by saying the attitude of these other health professionals stem from their anger at not being able to enter or complete medical education. This sounds very ignorant, naive and stupid for anyone to say considering that everyone has his flair and personal reasons for choosing either nursing, anatomy, medicine, or philosophy. And in fact, most brightest minds will be drawn to basic sciences such as mathematics, statistics, physics, law, chemistry, and engineering courses because these require more analytical reasoning and creative mind than medicine which most of the doctors scale through by dumb memorization (a.k.a. cramming).
3) Nigerian medical doctors seem to have an unusual disease- the compulsion to dictate the remuneration, professional development, as well as the fate of all other health professionals. This is both arrogant and absurd considering that each profession is properly autonomous. Medicine is a profession. Nursing is another. So is Pharmacy and Medical Laboratory Science. Just the same way the other health professionals have no business with the way things are run within the medical profession, the medical doctors should stop poke-nosing in the affairs of the other professions
4) Medical doctors (perfectly exemplified by the illiterate who wrote the main article on this thread) have a knack for playing down on the roles of the other healthcare professionals. You went about boring us with how important the medical doctor is in patient management, after attending to your patient Mr Doctor, don't you go home to sleep while the nurses stay awake with the patient attending to his every need? And yet you think patient care is all about you. How about the countless number of cases where medical doctors have been reported to err in writing drug prescriptions; if the pharmacists aren't there to save the day (which they usually do without feeling the need to shout it on the rooftop), how many more patients do you suppose you would have murdered? And yet, to you patient management is all about you, and you alone.

This is the right time the Nigerian public should rise up and demand what they deserve. Be it medical doctors, nurses, pharmacists, scientists, they are all intended to serve the interest of the public. And we are not as dumb as these professional clowns would want to portray us. We are Nigerians living in Nigeria and we sure know how to interpret the goings-on. The committee that granted Johesu's demands were not health professionals, they were Nigerians who used their discretion to judge the reasonableness of their demand. And the on-going NMA's strike is nothing more than calling the bluff of the Nigerian public, that we are not capable of deciding on such basic and plain things as this.

My dear, its not just lyk dat... u dnt take decisions on issues dat affect more dan one person without involving other parties involved... Are u aware that there are doctors (pathologists) in the labs also, doctors (radiologists) in the imaging section, etc. so, it is wrong for d govt to take decisions in favour of johesu wifout exploring how it affects NMA... wat we r sayin z simple, most of these policies breed trouble in d system, n u wnt be thr to weather d storm wen it starts... johesu z preocuppied by just getin a higher title and salary not how to improve patient care...