creativeEngr:

I'm afraid you're just beating around the bush and stating the obvious in your reply... Except you're from another planet, even a learner knows there is no sector of Nigeria that is functioning and from my comments including those from previous posts, you should get a better perspective on this - https://www.nairaland.com/creativeengr/posts

Let's stay within the issues please..

1. It's hypocrisy of the highest grade, coupled with arrogance when the same people who play a major role in killing the health sector also turn around to hold everyone ransom for more pay, more titles, etc. PENGASSAN doesn't embark on strike action like NMA, ASUU do incessantly, if that's worth anything sir... Anyways, I guess the hypocrisy is still justified in Nigerian context since we are all living under failed political leadership...

2. Thankfully, an article currently on the front page (i.e. last paragraph especially) that highlights my thoughts and concerns too... https://www.nairaland.com/1809328/nma-strike-nurses-perspective. Would like your response on this article...

3. The real issues behind the strike have more to do with the quest for a larger slice of the national cake not professionalism. I really don't blame doctors for asking for more, it's the system of governance and our society at large... the same society that gives Doctors the illusion that their course is the most difficult and as such, they feel they are doing us all a favour bbecause they chose to study medicine...

NMA hardly go on strike and the strike isn't really about the national cake. The article you referred to is still a perspective. It depends on which side of the divide you are.
It's not the society that told Doctors theirs is a difficult one. It's actually difficult. At least Guinness book of world record seems to think so

@Yomi007. You obviously don't know what you talking about.

kmariko:

That is UK, in some other climes, A nurse practioner, a Physician assistant or and advanced Pharm.D or Nurse can see you first before the MD... It is the choice of the patient not the doctor who the patient sees first...
Medicine is a product and like any product it is the patients to choose and not be forced into a choice they dont have to make.

in nigeria, we legally have what we call CHEWS and nurses in primary healthcare, they do phc work because doctors are not enough to cover rural and unreachable areas. Same happens in u.s. patients dont decide, they use what is available because in the end govt has to make sure some form of aid is available.
CHEWS (maybe ur idea of an assistant) have a rigid guidelines book they work with for diarrhoea, cough etc... I've never heard them agitating or wailing in nigeria like u guys because they know exactly what their role is...google it.
getting a pharmd or whatever does not endow u with the necessary skills to see pts... boldly post your qualifications on a sign board near to a hospital with a qualified physician and let the patient choose like u said...

kmariko:

That is UK, in some other climes, A nurse practioner, a Physician assistant or and advanced Pharm.D or Nurse can see you first before the MD... It is the choice of the patient not the doctor who the patient sees first...
Medicine is a product and like any product it is the patients to choose and not be forced into a choice they dont have to make.

and something else I dont understand Why this sudden fixation on doing something that is not in your scope? Roles of pharmacists and nurses are defined... simple.
maybe the people in the NHS trust in uk are fools for running their working system the way it is.... insurance is universal, peop,e are well taken care of the right people so nobody cares about msc or phd, they just want to know ur training and whether you are licensed to do some certain things... guess nigerians have their own style of legalising quackery

warrior01: Hate doctors? The fact is those people in Nigeria that parade themselves as Doctors, don't know what it really means to be a mreal doctor. No ethics, no compassion and no proffessionalism. All we have is a bunch of greedy people that is full of unnecessary pride. If you doubt me, why do our people rush to India for proper treatment?

Just a few bad eggs! Nigerian doctors are the best; it's just that we don't have faith in them. SENTIMENTS

Onlinebizexpert: Shebi policeman and soldier name military personnel

But soldiers have better equipment and packages than the police why is thast in thought their training is almost the same..........




The day craze enter policeman head na the day he go wan comparer with soldiers....unto say dem be equals

Na that day he go know say SAMBISA FOREST and POLICE CHECKPOINT no be the same thing

What am I saying........there must be hierarchy


Doctors can't do without nurses

Nurses cannot survive without doctors


I just pity the patients because this power tussle no be today e start' .......you can Google Florence nightingales gbege with doctors during the world war

Why didn't you compare soldiers, air force and navy with reference to how the defence minister is appointed??

[quote author=Onlinebizexpert]Shebi policeman and soldier name military personnel

But soldiers have better equipment and packages than the police why is thast in thought their training is almost the same..........




The day craze enter policeman head na the day he go wan comparer with soldiers....unto say dem be equals

Na that day he go know say SAMBISA FOREST and POLICE CHECKPOINT no be the same thing

What am I saying........there must be hierarchy


Doctors can't do without nurses

Nurses cannot survive without doctors


I just pity the patients because this power tussle no be today e start' .......you can Google Florence nightingales gbege with doctors during the world war
U r right we all nid each oda 2 function.Buh d truth b told nurses can't take d place of a doctor no matter wat! D developed countries we r trying 2 copy dere r certain criteria a medical personnel must have 2 become a consultant! Wen we copy we shuld copy in d right way not cutting corners

DebateNigeria:
Hey bro, good morning. How was your night.

Good how about you

dumodust:
and something else I dont understand Why this sudden fixation on doing something that is not in your scope? Roles of pharmacists and nurses are defined... simple.
maybe the people in the NHS trust in uk are fools for running their working system the way it is.... insurance is universal, peop,e are well taken care of the right people so nobody cares about msc or phd, they just want to know ur training and whether you are licensed to do some certain things... guess nigerians have their own style of legalising quackery

Sir quackery is simply when you are performing something beyond your training as defined the LAW in your setting
If a nurse or whatever gained additional training as defined by the law governing their place of abode then are not quacks
Probably on a few years you will call computers quacks for both performing diagnosis and minor surgery

dumodust:
in nigeria, we legally have what we call CHEWS and nurses in primary healthcare, they do phc work because doctors are not enough to cover rural and unreachable areas. Same happens in u.s. patients dont decide, they use what is available because in the end govt has to make sure some form of aid is available.
CHEWS (maybe ur idea of an assistant) have a rigid guidelines book they work with for diarrhoea, cough etc... I've never heard them agitating or wailing in nigeria like u guys because they know exactly what their role is...google it.
getting a pharmd or whatever does not endow u with the necessary skills to see pts... boldly post your qualifications on a sign board near to a hospital with a qualified physician and let the patient choose like u said...

Patients I can assure you go to people they can
1. Trust ...people still go to native doctors

2.. Afford..
3./available...Aka the local pharmacy

4 recommended by friends etc.

So the psychology of a patient choosing a healthcare provider is like choosing any other product in the market

infolekan:

And those laws that are not uniform is what you want to bring to Nigeria?
Traditional birth attendants are empowered by law to take simple deliveries of pregnant women inNigeria in RESOURCE POOR settings.......so someone on the internet shouldn't get confused and think that's the norm.
In United States(New York).....nurses with Doctorate degrees in Nursing care are allowed to see patients in emergency care and treat the ones that won't need specialist care in places where there are no GP. And yes ...the United States don't have enough Doctors. It's already a source of debate over there at the moment and that's a well developed settings.
We're doctors not lawyers and you give be giving examples of international best practices not based on some states in us. Check the UK, check Germany, check RSA. Don't throw a Minnesota law at a country.

People live in those states...California or Texas for example has more population than most European countries.. Does that mean that their laws don't count. Nearly 40 million people live in California nearly as the same as Poland...more than all the Scandinavian countries combined and their laws don't count?

warrior01: Hate doctors? The fact is those people in Nigeria that parade themselves as Doctors, don't know what it really means to be a mreal doctor. No ethics, no compassion and no proffessionalism. All we have is a bunch of greedy people that is full of unnecessary pride. If you doubt me, why do our people rush to India for proper treatment?

Exposing ur Ignorance and lack of decorum

PerfectFortune: The OP may claim not to be biased in his judgment but in my opinion, he is.

To begin with, I don't think ppl hate Drs (cos it's a title anyway) but the attitude of the holder of the title. For your information, majority of the ppl don't like Nurses either part of the reason which has been stressed out already by the OP but they don't often disturb us with Strike actions and selfish demands.

I am not saying there are no competent health care providers(Drs) in the country,I have a quit no of them as friends but the majority of them are incompetent.

I can safely say 70 percent of the so called Drs are incompetent but they want to be treated as gods.

Majority of the Drs working at various govt owned hospitals also work elsewhere either at their own private hospitals or paid private hospitals all to the deteriment of the poor masses who frequent the govt owned hospitals.

In most govt owned hospitals, you hardly find a Dr that practise the true essence of the profession but those who are arrogant, selfish and complete cheats.

Take the FMC Ebute Meta, Lagos for instance, patients rush to the hospital as early as 5.30/6am to pick nos so they can be attended to and return home early enf as nobody likes going to the hospital anyway. The Drs stroll in around 9.30/10am with no apology to the anxious long waiting patients (since they beliv they shld be worshipd) and by 1pm they stop consultation till the next day to resume at their various private hospitals.

If I should start talking about their level of incompetence, the whole page will not contain it . There are even several occassions where they were corrected by Nurses (on medication prescriptns).

In simple terms, ppl don't hate Drs but the attitude of the holder of the title. They are arrogant, selfish, incompetent, cheats and the big bang, "Killers" going on strike to divert patients to their private hospitals.

I keep saying it, herbalists are better than most Nigerian Drs..

May your generations Never produce a Doctor.... May Herbalists reign in ur lineage.
Did I hear you say 'Amen'?

Justin Kennedy JustKen Nwachukwu
Jul 2 · Edited ·
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)

....shared from Felix Archie
Pardon the long post!

kmariko:


Sir I beg to disagree, In california Pharm.Ds with advanced training can see patients not just drugs ( a new legislation )

Secondly, a doctor does not have to countersign a prescription written by a physician assistant. Some physician assistants own their clinic and a collaborative MD ( who are just there on paper).

No... Nurse practioners are not the only ones that can replicate doctors,. they do not replicate doctors but function within the limitations of their training just like doctors.

It will be nice if you can read up on each states specific laws.... they are not uniform.

Lastly, it does not matter the field a lot of work is required in training in any professional field, it is not limited to health care.

thanks

Well, we learn everyday, and I have tried to search for the new legislation that makes pharmacists able to see patients in California. If you have the link to that info, I wouldn't mind to be educated on this.

And within certain limits, and also with additional training, I think it is reasonable for pharmacists to be able to prescribe certain things. However, in countries where that can happen, there has to be a way of enforcing laws to make sure they do not go beyond their scope of practice and that patients are protected.

In Nigeria, you don't even know if the person claiming to be a Doc in front of you is adequately qualified. Adding to that mess will definitely be a problem. Nigeria's health sector has a lot of problems and it is the people who suffer.

PAs (physician assistants) can not bill by themselves. If I said they can't prescribe, I apologize. They definitely have limited prescriptions rights.
About owning a clinic, anybody can own anything, but you have to operate within the limits of the law and as a PA, you always need to have a supervising physician.

4. Change without regulatory effect amending subsections (c)-(d) filed 8-7-2013 pursuant to section 100, title 1, California Code of Regulations
(Register 2013, No. 32).

1399.545. Supervision Required.
(a) A supervising physician shall be available in person or by electronic communication at all times when the physician
assistant is caring for patients.
(b) A supervising physician shall delegate to a physician assistant only those tasks and procedures consistent with the
supervising physician's specialty or usual and customary practice and with the patient's health and condition.
(c) A supervising physician shall observe or review evidence of the physician assistant's performance of all tasks and
procedures to be delegated to the physician assistant until assured of competency.
(d) The physician assistant and the supervising physician shall establish in writing transport and back-up procedures
for the immediate care of patients who are in need of emergency care beyond the physician assistant's scope of
practice for such times when a supervising physician is not on the premises.
(e) A physician assistant and his or her supervising physician shall establish in writing guidelines for the adequate
supervision of the physician assistant which shall include one or more of the following mechanisms:
(1) Examination of the patient by a supervising physician the same day as care is given by the physician assistant;
(2) Countersignature and dating of all medical records written by the physician assistant within thirty (30) days that the
care was given by the physician assistant;
(3) The supervising physician may adopt protocols to govern the performance of a physician assistant for some or all

I just copied a part of the PA(physician assistant) code of conduct from California.

It is true that each state might have slightly different rules, but the backbone is always the same with variations from state to state.

The only people besides MDs who have limited ability to diagnose and treat are Nurse practitioners and they are adequately trained for that role, with limitations, and they do NOT parade themselves as doctors or compete to earn Doctors wages.

That being said, it only makes sense that if you increase a Nurse practitioners wage, you have to also increase a Doctors wages appropriately.
Our Government or whoever is making these decisions is the one causing all these problems. If you increase JOHESU, you have to increase CONMESS.

They tried separating them, but they are tied together.

dakotchic: Justin

Thanks for all that info.

The big reason besides pay differences for not duplicating titles to avoid confusion for patients and others.

In developed worlds, you have to identify your function to every patient - Doctor, nurse, nurse assistant, physician assistant, nurse practitioner etc.

Even Pharm. Ds do not identify themselves as Doctors because of the potential for confusion. The ones that have clinical roles will tell patients that they are pharmacists.
But the envy and the love of titles in Nigeria is just unbelievable.

Also duplication of all these names will encourage quackery. And by the way, why do we need more "consultant" titles. The only thing I can see is for increased paychecks or aspiration towards some benefits for medical consultants.

The consultants we have haven't even cured malaria. It is still the biggest killer of children in Nigeria. Women die like chicken from childbirth!!! Simple preventable things we never do!!!

ziga:

Thanks for all that info.

The big reason besides pay differences for not duplicating titles to avoid confusion for patients and others.

In developed worlds, you have to identify your function to every patient - Doctor, nurse, nurse assistant, physician assistant, nurse practitioner etc.

Even Pharm. Ds do not identify themselves as Doctors because of the potential for confusion. The ones that have clinical roles will tell patients that they are pharmacists.
But the envy and the love of titles in Nigeria is just unbelievable.

Also duplication of all these names will encourage quackery. And by the way, why do we need more "consultant" titles. The only thing I can see is for increased paychecks or aspiration towards some benefits for medical consultants.

The consultants we have haven't even cured malaria. It is still the biggest killer of children in Nigeria. Women die like chicken from childbirth!!! Simple preventable things we never do!!!

Exactly! My point being that no other consultants work in hospitals apart from doctors. By the way consultant nurses already exist in many HMOs in Nigeria and that is where they are needed. And then the specialist nurses especially midwives work in rural areas in Nigeria like in the health centers etc

dakotchic:

Exactly! My point being that no other consultants work in hospitals apart from doctors. By the way consultant nurses already exist in many HMOs in Nigeria and that is where they are needed. And then the specialist nurses especially midwives work in rural areas in Nigeria like in the health centers etc

You guys may also want to check this out https://www.nairaland.com/1809881/nurse-version-hippocratic-pledge

kmariko:

Patients I can assure you go to people they can
1. Trust ...people still go to native doctors

2.. Afford..
3./available...Aka the local pharmacy

4 recommended by friends etc.

So the psychology of a patient choosing a healthcare provider is like choosing any other product in the market

You just answered some questions yourself without knowing it... what you listed are the reasons for universal insurance and globally Accepted guidelines to ensure uniformity of standards and safety of citizens. That is why responsible governments make sure the patients are seeing the right people by having the right legislation and arresting criminals. I agree with the cost aspect, costs differ worldwide but some treatment have no substitutes and any other person tampering with the patient may actually on the long run in terms of recovery time (morbidity), life (death) and economically (cost to the nation because of loss of manpower). I'm not against alternative care, I gave examples using CHEWS and we also have trained traditional birth attendants to ensure universal healthcare are standards are maintained in remote and unreacheable areas
an msc and phd are strictly academic (thesis, dissertations in a particular limited aspect) and even the title 'professor' though it connotes an authority on a subject, does not confer special skills that are needed on the field. The best surgeons are not necessarily academics and doctors also refer based on reputation.
you see the havoc that these unregulated options including churches have caused, you will understand. Doctors by law of mdcn dont advertise... but these charlatans go about misinforming people with loudspeakers. When it is bad, they will come and die in the hospital and another man's deeds now count against the doc when they die.
In summary, it is the responsibility of govts to protect there citizens even when they want to harm themselves... even if a consenting adult refuses treatment, he should be by law bound not to subject his dependants like innocent children to his ill informed decisions. For foreign doctors to train in another country, the local med council sets exams both theoritical and practical to test your suitability for practice in their country... your degrees dont count then. Doctors get suspended etc for malpractice, that is tbe example of regulation
case comes to mind about a child that died at home because the parents didnt believe in orthodox care and were praying till it got too bad to salvage. The child died and I think they were charged for manslaughter or something... and they lost custody of other kids

: I 'm enjoying our discussion, no beef

ziga:

Well, we learn everyday, and I have tried to search for the new legislation that makes pharmacists able to see patients in California. If you have the link to that info, I wouldn't mind to be educated on this.

And within certain limits, and also with additional training, I think it is reasonable for pharmacists to be able to prescribe certain things. However, in countries where that can happen, there has to be a way of enforcing laws to make sure they do not go beyond their scope of practice and that patients are protected.

In Nigeria, you don't even know if the person claiming to be a Doc in front of you is adequately qualified. Adding to that mess will definitely be a problem. Nigeria's health sector has a lot of problems and it is the people who suffer.

PAs (physician assistants) can not bill by themselves. If I said they can't prescribe, I apologize. They definitely have limited prescriptions rights.
About owning a clinic, anybody can own anything, but you have to operate within the limits of the law and as a PA, you always need to have a supervising physician.



I just copied a part of the PA(physician assistant) code of conduct from California.

It is true that each state might have slightly different rules, but the backbone is always the same with variations from state to state.

The only people besides MDs who have limited ability to diagnose and treat are Nurse practitioners and they are adequately trained for that role, with limitations, and they do NOT parade themselves as doctors or compete to earn Doctors wages.

That being said, it only makes sense that if you increase a Nurse practitioners wage, you have to also increase a Doctors wages appropriately.
Our Government or whoever is making these decisions is the one causing all these problems. If you increase JOHESU, you have to increase CONMESS.

They tried separating them, but they are tied together.

I'm quoting this full post (check previous) to buttress my point

Cmanforall:

May your generations Never produce a Doctor.... May Herbalists reign in ur lineage.
Did I hear you say 'Amen'?

Fruit of a devil. Your prayers are yet to come to pass and you are cursing yourself cos I know you are not aware that "He who curse me shall be cursed forever".

To educate you a bit, there are well educated herbalists who are even profs. The fact that they choose the herbal side of medicine dosnt make them less educated and part of their practice are also recognized which is why student midwives are made to study how to deliver a baby the herbal/traditional way by sending them to "Agbebi/alagbo" (tradition birth attendants). Medical students do the same while on rural posting.

Unfortunately the sarcasm (herbalists being better than most Nigerian Drs) is right owing to the level of incompetence and unprofessionalism displayed by most of them.

Get educated before cursing your unborn generations, half baked infant.

Oga Ziga how you dey?
Don't waste too much time on that guy. He's learning capriciously. Next time he addresses you he will use some of the points you made as a reference without knowing it. He lives in a state where PAs are MD and NPs are independent. Oh don't forget he thought hospital CEOs are cmds.
But I give it to him for being ignorant and loud.
You can imgine him in a paramedics meeting! !

ziga:

Thanks for all that info.

The big reason besides pay differences for not duplicating titles to avoid confusion for patients and others.

In developed worlds, you have to identify your function to every patient - Doctor, nurse, nurse assistant, physician assistant, nurse practitioner etc.

Even Pharm. Ds do not identify themselves as Doctors because of the potential for confusion. The ones that have clinical roles will tell patients that they are pharmacists.
But the envy and the love of titles in Nigeria is just unbelievable.

Also duplication of all these names will encourage quackery. And by the way, why do we need more "consultant" titles. The only thing I can see is for increased paychecks or aspiration towards some benefits for medical consultants.

The consultants we have haven't even cured malaria. It is still the biggest killer of children in Nigeria. Women die like chicken from childbirth!!! Simple preventable things we never do!!!

New california law on pharm.Ds

Section 4052.6 is added to the Business and Professions Code, to read:
(a) A pharmacist recognized by the board as an advanced practice pharmacist may do all of
the following:
(1) Perform patient assessments.
(2) Order and interpret drug therapy‐related tests.
(3) Refer patients to other health care providers.
(4) Participate in the evaluation and management of diseases and health conditions in collaboration with other health careproviders.
(5) Initiate, adjust,or discontinue drug therapy in the manner specified in paragraph (4) of
subdivision(a) of Section 4052.2.
(b) A pharmacist who adjusts or discontinues drug therapy shall promptly transmit written notification to the patient’s diagnosing prescriber or enter the appropriate information in a patient record system shared with the prescriber, as permitted by that prescriber. A pharmacist who initiates drug therapy shall promptly transmit w ritten notification to, or enter the appropriate information into, a patient record system shared with the patient’s primary care provider or diagnosing provider, as permitted by thatprovider.
(c) This section shall not interfere with a physician’s order to dispense a prescription drug as written, or other order of similar meaning.
(d) Prior to initiating or adjusting a controlled substance therapy pursuant to this section, a pharmacist shall personally register with the federal Drug EnforcementAdministration.
(e) A pharmacist who orders and interprets tests pursuant to pa ragraph (2)of subdivision
(a) shall ensure that the ordering of those tests is done in co ordination with the patient’s
primary care provider or diagnosing prescriber,asappropriate, including promptly
transmitting written notification to the patient’s diagnosing prescriber or entering the
appropriate information in a patient record system shared

dumodust:
You just answered some questions yourself without knowing it... what you listed are the reasons for universal insurance and globally Accepted guidelines to ensure uniformity of standards and safety of citizens. That is why responsible governments make sure the patients are seeing the right people by having the right legislation and arresting criminals. I agree with the cost aspect, costs differ worldwide but some treatment have no substitutes and any other person tampering with the patient may actually on the long run in terms of recovery time (morbidity), life (death) and economically (cost to the nation because of loss of manpower). I'm not against alternative care, I gave examples using CHEWS and we also have trained traditional birth attendants to ensure universal healthcare are standards are maintained in remote and unreacheable areas
an msc and phd are strictly academic (thesis, dissertations in a particular limited aspect) and even the title 'professor' though it connotes an authority on a subject, does not confer special skills that are needed on the field. The best surgeons are not necessarily academics and doctors also refer based on reputation.
you see the havoc that these unregulated options including churches have caused, you will understand. Doctors by law of mdcn dont advertise... but these charlatans go about misinforming people with loudspeakers. When it is bad, they will come and die in the hospital and another man's deeds now count against the doc when they die.
In summary, it is the responsibility of govts to protect there citizens even when they want to harm themselves... even if a consenting adult refuses treatment, he should be by law bound not to subject his dependants like innocent children to his ill informed decisions. For foreign doctors to train in another country, the local med council sets exams both theoritical and practical to test your suitability for practice in their country... your degrees dont count then. Doctors get suspended etc for malpractice, that is tbe example of regulation
case comes to mind about a child that died at home because the parents didnt believe in orthodox care and were praying till it got too bad to salvage. The child died and I think they were charged for manslaughter or something... and they lost custody of other kids

: I 'm enjoying our discussion, no beef

Crux of the argument is that the prefrence to engage the services of any of the healthcare workers for their services lies on the ADULT patient not on the directive of any of the professioanl. secondly insurance is a choice in many places UNLESS where the government mandates it ---thus removing individual ability to control their healthcare decisions....The famous steve jobs was basically self treating his pancreatic cancer..

Most professions ( including prostitution) are regulated to protect the general public---- the regulation is merely a limitation in areas of practice as defined by ones training within the local laws. But it is not the function of other professionals to regulate how people within or related profession organize themselves... that is the function of legislation by elected officials... If MDs feel others are enchroaching on their field all is required is formulate a bill and push it through legislation... USA went through this period when physician, nursing practioners were being introduced, it was through legislation that it was watered down to the effect that there must be collaborative engagement with MDS..not that the Physician Assistants cant do it alone.
Again , physicians resisted immunisation in the pharmacy, New York state was the last that allowed it after the local AMA lobbied against it through their representatives....Now most immunisations in the US are being done in the local pharmacies very soon this will be followed by lab test.... a pilot program is being carried out in Nevada as we discuss.

kmariko:

New california law on pharm.Ds

Section 4052.6 is added to the Business and Professions Code, to read:
(a) A pharmacist recognized by the board as an advanced practice pharmacist may do all of
the following:
(1) Perform patient assessments.
(2) Order and interpret drug therapy‐related tests.
(3) Refer patients to other health care providers.
(4) Participate in the evaluation and management of diseases and health conditions in collaboration with other health careproviders.
(5) Initiate, adjust,or discontinue drug therapy in the manner specified in paragraph (4) of
subdivision(a) of Section 4052.2.
(b) A pharmacist who adjusts or discontinues drug therapy shall promptly transmit written notification to the patient’s diagnosing prescriber or enter the appropriate information in a patient record system shared with the prescriber, as permitted by that prescriber. A pharmacist who initiates drug therapy shall promptly transmit w ritten notification to, or enter the appropriate information into, a patient record system shared with the patient’s primary care provider or diagnosing provider, as permitted by thatprovider.
(c) This section shall not interfere with a physician’s order to dispense a prescription drug as written, or other order of similar meaning.
(d) Prior to initiating or adjusting a controlled substance therapy pursuant to this section, a pharmacist shall personally register with the federal Drug EnforcementAdministration.
(e) A pharmacist who orders and interprets tests pursuant to pa ragraph (2)of subdivision
(a) shall ensure that the ordering of those tests is done in co ordination with the patient’s
primary care provider or diagnosing prescriber,asappropriate, including promptly
transmitting written notification to the patient’s diagnosing prescriber or entering the
appropriate information in a patient record system shared

Thank you for the info.

These are the duties of a clinical pharmacist. And I have worked with a few excellent ones.

Their role is not supposed to compete with the roles of a Medical Doctor. Rather, it is complimentary. The Doctor is still the primary care giver and that is why everything still has to go through him from what I can read up there.

And as long as the patient's well being is the ultimate goal, and people practice within the scopes of their practices, everything works fine.

Also in developed countries, people are judged and held responsible when they go beyond their responsibilities.

In Nigeria, we don't even know if the so called Doctor is a real Doctor. We haven't fixed basic problems yet.

Nigerian Docs feel like a lot of other professions are encroaching into their duties. And this is very true.

In Nigeria, anybody can walk into a pharmacy and pick up so many potentially harmful drugs without even being diagnosed.

We are all responsible for the mess, but we need leaders who can lay down rules for us to follow. Unfortunately, they are the ones that have muddled things up and allowed the encroachment which has led to this mess.

In Nigeria, everybody is a "Doctor" in his own right.

kmariko:

New california law on pharm.Ds

Section 4052.6 is added to the Business and Professions Code, to read:
(a) A pharmacist recognized by the board as an advanced practice pharmacist may do all of
the following:
(1) Perform patient assessments.
(2) Order and interpret drug therapy‐related tests.
(3) Refer patients to other health care providers.
(4) Participate in the evaluation and management of diseases and health conditions in collaboration with other health careproviders.
(5) Initiate, adjust,or discontinue drug therapy in the manner specified in paragraph (4) of
subdivision(a) of Section 4052.2.
(b) A pharmacist who adjusts or discontinues drug therapy shall promptly transmit written notification to the patient’s diagnosing prescriber or enter the appropriate information in a patient record system shared with the prescriber, as permitted by that prescriber. A pharmacist who initiates drug therapy shall promptly transmit w ritten notification to, or enter the appropriate information into, a patient record system shared with the patient’s primary care provider or diagnosing provider, as permitted by thatprovider.
(c) This section shall not interfere with a physician’s order to dispense a prescription drug as written, or other order of similar meaning.
(d) Prior to initiating or adjusting a controlled substance therapy pursuant to this section, a pharmacist shall personally register with the federal Drug EnforcementAdministration.
(e) A pharmacist who orders and interprets tests pursuant to pa ragraph (2)of subdivision
(a) shall ensure that the ordering of those tests is done in co ordination with the patient’s
primary care provider or diagnosing prescriber,asappropriate, including promptly
transmitting written notification to the patient’s diagnosing prescriber or entering the
appropriate information in a patient record system shared

Did you understand your own postings about 5 b,c, and da)?
Every one of those function's relate back to the primary care provider(physician). Pharmacist with your attitude would be in much trouble with the patient primary care provider in CA as you can see.
Your duties and functions as a pharmacist remains as an adjunct to therapy initiated and recommended by the physician, who may in some cases chose other forms of therapy, bypassing the pharmacist in some cases. Such as in radiation, electrical, or even psychotherapy. Your importance as a complimentary part of the whole world of therapy certainly doesn't increase by how much agitation you make, but by your relevance to the overall picture of patient care.
As a physician, I know when to ask for a pharmacist during my rounds, and when it's not even necessary. Deal with it, or go to medical school like other pharmacists who think they got it going on!

PerfectFortune:

Fruit of a devil. Your prayers are yet to come to pass and you are cursing yourself cos I know you are not aware that "He who curse me shall be cursed forever".

To educate you a bit, there are well educated herbalists who are even profs. The fact that they choose the herbal side of medicine dosnt make them less educated and part of their practice are also recognized which is why student midwives are made to study how to deliver a baby the herbal/traditional way by sending them to "Agbebi/alagbo" (tradition birth attendants). Medical students do the same while on rural posting.

Unfortunately the sarcasm (herbalists being better than most Nigerian Drs) is right owing to the level of incompetence and unprofessionalism displayed by most of them.

Get educated before cursing your unborn generations, half baked infant.

Rat.... If e dey pain you say you no be Doctor, go hug Transformer.... As you show hatred for Doctors, so shall doctors lack in ur lineage... #MUST YOU HATE? JAMB form still dey... Mongoloid

Cmanforall:

Rat.... If e dey pain you say you no be Doctor, go hug Transformer.... As you show hatred for Doctors, so shall doctors lack in ur lineage... #MUST YOU HATE? JAMB form still dey... Mongoloid

If you are a Dr then you are one of those bringing disgrace to the profession considering your level of dumbness. The NMA should be ashamed of you. You cannot even argue objectively without raising curses on your generation.

If you are not then your life is just complicated beyond remedy or hope.

Go and die!

PerfectFortune:

If you are a Dr then you are one of those bringing disgrace to the profession considering your level of dumbness. The NMA should be ashamed of you. You cannot even argue objectively without raising curses on your generation.

If you are not then your life is just complicated beyond remedy or hope.

Go and die!

I don't have time to waste with you.... Find ur mates under the bridge or in the markets walking naked... You are below human IQ

naijaking1:

Did you understand your own postings about 5 b,c, and da)?
Every one of those function's relate back to the primary care provider(physician). Pharmacist with your attitude would be in much trouble with the patient primary care provider in CA as you can see.
Your duties and functions as a pharmacist remains as an adjunct to therapy initiated and recommended by the physician, who may in some cases chose other forms of therapy, bypassing the pharmacist in some cases. Such as in radiation, electrical, or even psychotherapy. Your importance as a complimentary part of the whole world of therapy certainly doesn't increase by how much agitation you make, but by your relevance to the overall picture of patient care.
As a physician, I know when to ask for a pharmacist during my rounds, and when it's not even necessary. Deal with it, or go to medical school like other pharmacists who think they got it going on!

Sir, Am neither a physician , a pharmacist, a nurse etc... am just a human being if you can possibily see me as such.( your preogative i might add) And as a perosn sharing the planet earth with you I have as much stake in it as you are in spite of my dropping out of class 3... It is one of those ironies of life that learned ones have to share the same space with illiterates like me...
If you like, I proffer my sincere apologies for polluting the spaces that should only be used by the learned ones...

Have a great day

kmariko:

Crux of the argument is that the prefrence to engage the services of any of the healthcare workers for their services lies on the ADULT patient not on the directive of any of the professioanl. secondly insurance is a choice in many places UNLESS where the government mandates it ---thus removing individual ability to control their healthcare decisions....The famous steve jobs was basically self treating his pancreatic cancer..

Most professions ( including prostitution) are regulated to protect the general public---- the regulation is merely a limitation in areas of practice as defined by ones training within the local laws. But it is not the function of other professionals to regulate how people within or related profession organize themselves... that is the function of legislation by elected officials... If MDs feel others are enchroaching on their field all is required is formulate a bill and push it through legislation... USA went through this period when physician, nursing practioners were being introduced, it was through legislation that it was watered down to the effect that there must be collaborative engagement with MDS..not that the Physician Assistants cant do it alone.
Again , physicians resisted immunisation in the pharmacy, New York state was the last that allowed it after the local AMA lobbied against it through their representatives....Now most immunisations in the US are being done in the local pharmacies very soon this will be followed by lab test.... a pilot program is being carried out in Nevada as we discuss.

I'm not against other professions but I'm against spilling without regulation unto things that they are not supposed to do... vaccinations have a strict regime and for the sake of its promotion, pharmacist s can administer it. My problem is with diagnosis, primary pt care...
u cant spin from a drug focussed training to understand other issues, pt care is way beyond drugs, most pts think u must prescribe something for them... seeing someone who trained in drugs will always lead to a drug related solution and the inability to detect when something else is going badly wrong. The medical training is an apprenticeship handed over generations, cultures with continuous evolution till this point... pharmacists et al have their own roles and training, they dont cross and shouldnt because no msc or phd can teach u clinical skills learnt by being actively involved in pt care from undergraduate education to residency and onwards, the magnitude of the experience is beyond books and titles... that is why I wonder why we love titles so much. I for one dont love the doctor tag, it puts a lot of strain on me socially.
acquiring another degree makes u better in your field (like specialist nurses trained in icu care, renal care, theatre etc) not to cross lines and acquire roles you werent trained for ab initio

PerfectFortune:

If you are a Dr then you are one of those bringing disgrace to the profession considering your level of dumbness. The NMA should be ashamed of you. You cannot even argue objectively without raising curses on your generation.

If you are not then your life is just complicated beyond remedy or hope.

Go and die!

and guess who the perfect role model is? Mr go and die... hilarious ... your case dey complicated o, very