About two months after calling out its members for a nationwide strike, the Nigerian Medical Association appears to be divided on whether to suspend the action or not.

A press conference that was scheduled to take place on Sunday was put off for undisclosed reasons.

The Secretary-General of the association just came and apologised to journalists, promising that the association would call them soon.

He said, “Please, bear with us. We will call you in 48 hours time.”

But an emergency meeting of the NMA leadership, which kicked off by 3pm, was still ongoing as of the time of this report (6:20 pm).

The NMA had been on strike over some irreconciliable differences with the Federal Government.

The PUNCH was informed that at the meeting attended by some past presidents of the NMA, there were disagreements on whether to shelve the strike or not.

Among those at the meeting were three past Presidents of the association: its immediate-past President and a delegate to the ongoing National Conference, Dr. Osahon Enabulele; another past President of the NMA, Dr. Omede Idris; and Kogi State Commissioner for Health, Dr. Prosper Igboele.

Others who were said to be at the meeting include a member, Board of Trustees of the NMA and Emir of Songa, His Royal Highness Haliru Yahaya; the Registrar, National PostGraduate Medical College, Prof. Wole Atoyebi, and a former leader of the Medical and Dental Council of Nigeria.

A source said, “The NMA leadership is divided on the strike; while some, led by its current President, Dr. Kayode Obembe, are pushing for the suspension of the action, others said they would not suspend the action when the Federal Government has not listened to them.

“If we suspend the action now, the present government and even subsequent governments won’t take us seriously any time we declare nationwide strike again. That is the major issue, and not any insinuation that somebody has been settled.”

The President of NMA, Obembe, had a few weeks after his election, premised the strike on the failure of the Federal Government to address the doctors’ demands, saying there was no going back.

The NMA had sent 24 demands to the government, including discontinuation of recognition of non-medical doctors as directors and consultants.

The demands also include appointment of a Surgeon – General of the Federation, payment of clinical duty and hazard allowances and withdrawal of the Central Bank of Nigeria’s circular on medical laboratory equipment.

“The NMA is taking this painful route because our silence and gentle approach to these contending issues have been taken for granted. We have to take this action in order to save the health care delivery system from anarchy that is palpably imminent. We hereby appeal to all Nigerians for their understanding and call on government to meet with our demands,” he stated.

Obembe had stated that the failure of the government to address NMA’s demands had left the association with no other option than “to call all its members to down tool in order to press home their demands.”
http://www.punchng.com/news/doctors-disagree-over-strike/
http://www.thisdaylive.com/articles/doctors-strike-nma-split-over-decision-to-call-off-strike/185275/

Its not unexpected. I think the leadership of nma should adopt additional means to press further on our demands. it'll very disheartening if we are unable to achieve anything out of this struggle, the end of which will put the health sector in serious mess. Ppl seem nt to knw the implications of some of these demands, I wonder who will prevent some male nurses who are already being addressed as doctors in some places from opening a specialist hosp(we have some of these illegal hospitals already) and even attempt surgeries when they become consultant. A consultant lab scientist can comfortably prescribe antibiotics based on the report of MCS of the sample brought to him without good knowledge of principle of antibiotics.

^^^ You are very very correct...... I know a theatre nurse that owns a very big hospital....... If NMA allows the FG and co to get away with the recognition of non-doctors as medical consultant will turn the health sector into animal kingdom

Are you guys still of the opinion that a man should not become a specialist in his field simply because their is potential for abuse? Whatever happened to the concept of stringent regulation of practise?

29 states voted for continuation of the strike. the other 7 states had outgoing chairmen who could afford to be bribed just because they were leaving office in a few days but thankgod the NMA chairmanship in those states have been swept up by NARD.
for the first time in the history of NMA, radical resident doctors are heading the NMA in many states.
consultants are being pushed to the background.

meanwhile in other news,NARD rising from their NEC in Enugu, have released a communiqué, vowing to continue the strike if NMA suspends its strike.
so even if NMA calls off, NARD will continue. remember both strikes were called a day apart and have been running concurrently ever since.


n/b: it appears the nonremunerative demands have all been met by govt.
the monetary issues seem to be what's still holding the strike.

i thought dey said some of NMA demand has bn met. And i remember NMA president sayin dt dey will call off d strike if some of d demand has bn met. one of d demand dt i tink has bn met is discontinuation of other health workers as consultants and directors.
so all dz while u guys av not achieve anytin, dz is d best time for u guys to call it off. wat has bn done cant b undone. d issue of consultancy for other health workers cant b reverse. d earlier u guys know d beta for u. and if FG try to b funny others wont just sit back and watch.

Nigeria health system is finished Nma strike today Johesu strike tomorrow Fg please privatise the health sector

I think the issue of consultancy and director for other health workers were referred to the Yayale committee which has always been the case, meanwhile, status quo remains. Office of surgeon general and NHB are said to be legislative issues. Monetary part of the demand can be met after CB. So they should stop saying that the issue of consultancy and directorship have been reversed.

sogodihno: i thought dey said some of NMA demand has bn met. And i remember NMA president sayin dt dey will call off d strike if some of d demand has bn met. one of d demand dt i tink has bn met is discontinuation of other health workers as consultants and directors.
so all dz while u guys av not achieve anytin, dz is d best time for u guys to call it off. wat has bn done cant b undone. d issue of consultancy for other health workers cant b reverse. d earlier u guys know d beta for u. and if FG try to b funny others wont just sit back and watch.

A house divided by itself can never stand. So NARD is now above their master. NMA go soon scatter. Meanwhile, the issues on consultancy and directorship of JOHESU were still referred to the Yayale committee. So don't say that they have been reversed. FG has still not withdrawn the CBN power given to MLSCN on importation of IVD. issue of surgeon general and NHB are said to be legislative issues, which we all know where legislators stand on SG. As for the monetary aspect of their demand, that is their business as it doesn't concern JOHESU

phantom: 29 states voted for continuation of the strike. the other 7 states had outgoing chairmen who could afford to be bribed just because they were leaving office in a few days but thankgod the NMA chairmanship in those states have been swept up by NARD.
for the first time in the history of NMA, radical resident doctors are heading the NMA in many states.
consultants are being pushed to the background.

meanwhile in other news,NARD rising from their NEC in Enugu, have released a communiqué, vowing to continue the strike if NMA suspends its strike.
so even if NMA calls off, NARD will continue. remember both strikes were called a day apart and have been running concurrently ever since.


n/b: it appears the nonremunerative demands have all been met by govt.
the monetary issues seem to be what's still holding the strike.

I really don't expect all drs to agree non the strike issue I myself have some reservation in some points on the demands.

However majority carries the vote.

However I am of the opinion that the strike should be called of whenever they have achieved whatever it is they are fighting for.
No half measures so as to avoid an industrial action in another 2 months.

IMO.

..

I really don't know what could make some persons reason upside down. The issue of Consultancy for other health worker has already been handled by the court in favour of JOHESU but the MDCAN has appeal the court submission. So it is extrajudicial for FG to entertain it at all.

The issue of directorship is a function of the scheme of service for individual profession. Mind u these are documents that have been gazetted. The NMA expects the govt to reverse itself not minding the fact that they are legal documents and the consequences too lethal.

I do not know why we continue to beat about the bush on these very clear issues.

i could be wrong but the agreement was that anyone can be a consultant. however, if you want to utilize the title in a hospital, you must be registered with MDCAN.

Says who? So if a clinical pharmacist becomes a consultant, he will have to register with medical and dental consultants of Nigeria? what has Dentists and Drs got to do with a pharmacist? I am not sure your source is right since the court has ruled and the Yayale committee are yet to submit their report.

Leopantro: i could be wrong but the agreement was that anyone can be a consultant. however, if you want to utilize the title in a hospital, you must be registered with MDCAN.

prettyprettywow: Says who? So if a clinical pharmacist becomes a consultant, he will have to register with medical and dental consultants of Nigeria? what has Dentists and Drs got to do with a pharmacist? I am not sure your source is right since the court has ruled and the Yayale committee are yet to submit their report.

Right on point. Kudos.

It is rather unfortunate most of the guys we join issues with on this forum know next to nothing. How can a consultant in other health profession register with MDCAN.
I laugh in Latin.....

I am just wondering if students are exposed to other thing at all apart from medicine and NMA in medical school. Content of some reasonings here call for a lot of worries.

Guys pls break your shells and read wide. Your whole life is far more than medicine and brouhaha on who gets this or that.

They should let anyone who wants become a consultant in the hospital. But on one condition he has the same responsibilities as every other consultant. Run his own clinics,make diagnosis, treatment plan and monitor his patients till they are discharged. Presently once a patient is registered to a consultant he takes responsibility for treatment outcome for that patient. If he is a surgeon and the patient requires a cardiologist, no cardiologist can just walk up to that patient unless he recognizes the need and invites one, if he invites a cardiologist and does not agree with the cardiologist on a treatment plan it is his decision and he takes responsibility for it. Likewise he decides which investigations to do for his patient, nobody can just walk in and start investigating his patient and expect him to work with those results. If unfortunately the patient dies it is on his record. Now if the new consultants come into the system they should be ready to work like that not expect a doctor consultant to see patients make a diagnosis and hand over to him for him to "consult" then back to the doctor to monitor and continue management when he has finished what he considers his work. Let the hospital have nurses clinics, pharmacy clinics, laboratory clinics, physiotherapy clinics and let the patients choose whom they want to see.

allycat: They should let anyone who wants become a consultant in the hospital. But on one condition he has the same responsibilities as every other consultant. Run his own clinics,make diagnosis, treatment plan and monitor his patients till they are discharged. Presently once a patient is registered to a consultant he takes responsibility for treatment outcome for that patient. If he is a surgeon and the patient requires a cardiologist, no cardiologist can just walk up to that patient unless he recognizes the need and invites one, if he invites a cardiologist and does not agree with the cardiologist on a treatment plan it is his decision and he takes responsibility for it. Likewise he decides which investigations to do for his patient, nobody can just walk in and start investigating his patient and expect him to work with those results. If unfortunately the patient dies it is on his record. Now if the new consultants come into the system they should be ready to work like that not expect a doctor consultant to see patients make a diagnosis and hand over to him for him to "consult" then back to the doctor to monitor and continue management when he has finished what he considers his work. Let the hospital have nurses clinics, pharmacy clinics, laboratory clinics, physiotherapy clinics and let the patients choose whom they want to see.

Nigeria is not the first country to have other health workers as consultants, neither will it be the last. We will still run our healthcare system like other advanced nations who have different consultants in the hospitals . A patient's medical care will be under the care of a consultant Dr, where as a patient's nursing care will probably be under the care of a nurse consultant, if that is how we want it, or better still, the other consultant will be invited when his/her expertise is needed(e.g consultant pharmacist), if anything goes wrong, then the hospital will know if it is from nursing care, medical care, or otherwise . Saying that other consultants should admit and discharge their own patients makes it sound like you are in competition or dragging something with somebody.If that is the case, Consultant Drs should be ready to admit, nurse their own patients 24/7, conduct their own lab test, produce and dispense their own drugs, do their own physiotherapy as well as their own radiography. Let all man be on his own. Don't think that the care of patient starts and ends with a Dr. We all have our licenses to defend, and who ever is implicated in the death of a patient will face the consequences which may include revoking their license. I have never seen where a Dr takes the blame of a nurse's mistake. It doesn't happen and will never happen. We all take responsibility for our actions and that will not change if others become consultant. REMEMBER INTERNATIONAL BEST PRACTICE is what we all want.

allycat: They should let anyone who wants become a consultant in the hospital. But on one condition he has the same responsibilities as every other consultant. Run his own clinics,make diagnosis, treatment plan and monitor his patients till they are discharged. Presently once a patient is registered to a consultant he takes responsibility for treatment outcome for that patient. If he is a surgeon and the patient requires a cardiologist, no cardiologist can just walk up to that patient unless he recognizes the need and invites one, if he invites a cardiologist and does not agree with the cardiologist on a treatment plan it is his decision and he takes responsibility for it. Likewise he decides which investigations to do for his patient, nobody can just walk in and start investigating his patient and expect him to work with those results. If unfortunately the patient dies it is on his record. Now if the new consultants come into the system they should be ready to work like that not expect a doctor consultant to see patients make a diagnosis and hand over to him for him to "consult" then back to the doctor to monitor and continue management when he has finished what he considers his work. Let the hospital have nurses clinics, pharmacy clinics, laboratory clinics, physiotherapy clinics and let the patients choose whom they want to see.

The patient is not property of anybody. It is absurd to say Consultant physician own the patient. Nobody own the patient in 21st century health care delivery. The organogram of medical care see Patients occupying the middle position with all health professionals including physician surrounding in a networking pattern. The focus is on the patient. It is system that never give room to any ownership of anybody. You are called to play whenever your expertise is required.
In the teaching hospital 2-3 consultants may be comanaging a patient with Nurses playing an all time role and Physiotherapist called upon for physio and pharmacist always on ground to provide drugs and ensure quality control and dosage appropriatness. .medical lab sciencetists provide investigation that informs diagnosis and choice medications.

The construct that placed ownership of patient to the consultant that first see the patient is a fallacy and a creation of NMA. It is not known to modern medical practice.

Not all patients require admission and nursing care, not every patient requires physiotherapy or laboratory tests or X-rays or drugs. It is the doctor that determines what they need and when they need it. In secondary and tertiary health care settings the patient is under the care of a Consultant who is responsible for everything concerning the patient. Who gets the blame if something goes wrong and is patted on the back when the patient does well. That's why we say we own the patient! This is world standard. In America the equivalent is Attending Physician.
Also in Nigeria the role of Hospital consultant remains the same wether in government or private practice. Has anyone stopped pharmacists or nurses or laboratory scientist from bearing consultant outside the government hospitals. The truth is it's just the title and allowances people are interested in nothing more.

Google the words Hospital Consultant and then educate me on how many times it refers to any other person but a physician ie medical doctor. Yes there are Consultant Pharmacists, Consultant Nurses, Consultant Physiotherapists, Consultant Laboratory Scientists all over the world but international best practice is that when the word consultant is mentioned in relation to a hospital it means a particular cadre of doctors.

allycat: Google the words Hospital Consultant and then educate me on how many times it refers to any other person but a physician ie medical doctor. Yes there are Consultant Pharmacists, Consultant Nurses, Consultant Physiotherapists, Consultant Laboratory Scientists all over the world but international best practice is that when the word consultant is mentioned in relation to a hospital it means a particular cadre of doctors.

This argument has been explained over and over again and the response is international best practice.

I have asked before what is it a consultant nurse pharmacist or lab scientists want to do that the title consultant would change that they aren't doing now.

Logic dictates that if a title would improve your service then you haven't been giving your best before.

Secondly in the HOSPITAL SETTING do these international best practice consultants exist?

bumfem:

The patient is not property of anybody. It is absurd to say Consultant physician own the patient. Nobody own the patient in 21st century health care delivery. The organogram of medical care see Patients occupying the middle position with all health professionals including physician surrounding in a networking pattern. The focus is on the patient. It is system that never give room to any ownership of anybody. You are called to play whenever your expertise is required.
In the teaching hospital 2-3 consultants may be comanaging a patient with Nurses playing an all time role and Physiotherapist called upon for physio and pharmacist always on ground to provide drugs and ensure quality control and dosage appropriatness. .medical lab sciencetists provide investigation that informs diagnosis and choice medications.

The construct that placed ownership of patient to the consultant that first see the patient is a fallacy and a creation of NMA. It is not known to modern medical practice.

the consultant owns the patient but not in the construct you put it. all over the world, the standard practise is you present at a hospital,you are seen by a doctor who determines your line of management. if enquires are made about your healthcare, you are directed to that hospital and to that doctor. if the doctor determines he requires a specialist input, he would refer you to a consultant. when the need of the consultant is complete, he will transfer your case back to the first doctor that saw you.

that is the concept of ownship and is also why when you are asked to get a medical report for any requirement, you are asked to get a doctor to sign it because it is assumed he is in charge of all your health related issues.

in south africa, the nurses are so well taught about health issues that they can write and dispense antihypertensive drugs. i was so happy when i heard it because they know the signs, what to give and when to refer to the doctor when complications arise. so in that setting, i would support a consultant nurse and would work with them.

but in nigeria, i so afraid of what nurses have done. some older nurses i respect but the others......

Leopantro: i could be wrong but the agreement was that anyone can be a consultant. however, if you want to utilize the title in a hospital, you must be registered with MDCAN.

not MDCAN but the person must possess an MDCN license. what else does it mean?

Why won't they be interested in the title and allowances? I'm sure that is also why the Drs are trying to prevent that so as to enjoy alone. You said that not every patient requires admission, lab test, drug and physio. So what will happen to those that require it? The consultant Dr should be ready to select his patients that don't require the above services while the others should deal with those that require their services if that is what you want. Abroad, patient care is a team work, but that doesn't stop anybody from becoming a specialist/consultant in their own field. It's the Nigerian Drs's selfishness that is preventing that kind of collaboration

allycat: Not all patients require admission and nursing care, not every patient requires physiotherapy or laboratory tests or X-rays or drugs. It is the doctor that determines what they need and when they need it. In secondary and tertiary health care settings the patient is under the care of a Consultant who is responsible for everything concerning the patient. Who gets the blame if something goes wrong and is patted on the back when the patient does well. That's why we say we own the patient! This is world standard. In America the equivalent is Attending Physician.
Also in Nigeria the role of Hospital consultant remains the same wether in government or private practice. Has anyone stopped pharmacists or nurses or laboratory scientist from bearing consultant outside the government hospitals. The truth is it's just the title and allowances people are interested in nothing more.

Since you agree that there are other consultants, then where do you want them to bear the title, in their kitchen? where will a consultant nurse and lab scientist bear their title if not in their own territory? Google the word "registered nurse consultant", and see if anything will pop up, where they work, and the scope off their practice, since you so much like google. We are not doing popularity contest to know who appaers more on google. All we want is evidence based practice.

allycat: Google the words Hospital Consultant and then educate me on how many times it refers to any other person but a physician ie medical doctor. Yes there are Consultant Pharmacists, Consultant Nurses, Consultant Physiotherapists, Consultant Laboratory Scientists all over the world but international best practice is that when the word consultant is mentioned in relation to a hospital it means a particular cadre of doctors.

it exists oo. In Uk, they are all called consultant. Drs and nurses. It just shows that you are a specialist in your field. Hence they put your title before and after the the word consultant. USA do not use the title consultant, they have their own special name (attending, APRN/specialist nurses). Since Nigeria is using the same word as the UK, why will it be restricted to Drs alone? And yes, they have been doing the same work, they just want recognition and appreciation for services rendered

armadeo:



This argument has been explained over and over again and the response is international best practice.

I have asked before what is it a consultant nurse pharmacist or lab scientists want to do that the title consultant would change that they aren't doing now.

Logic dictates that if a title would improve your service then you haven't been giving your best before.

Secondly in the HOSPITAL SETTING do these international best practice consultants exist?

The designation consultant is not a title it is a job description. The terms Matron, Sister or Staff are not medical terms, but anybody coming to the hospital and hearing those terms automatically knew they were referring to a Nurse. Before the recent change in nomenclature a Matron was the most senior nurse in a hospital while a Consultant was a senior doctor leading a team of doctors and responsible for patients under his care. Now nurses in Nigeria no longer want to be Matrons or CNO's but would rather be consultants. Maybe doctors should stop answering consultant and use the American appellation Attending Physicians. I am sure in 10 years time nurses will now say Attending is the peak of a nurses career. Or we will now have pharmacist and physiotherapist now saying they want to be Attending pharmacists and Attending Physiotherapist.

I really believe they should privatize health care in Nigeria, we would suffer for a while but in time a lot of the malaise of the health sector will cool down. That way if a hospital requires the services of a consultant nurse or doctor or pharmacist or whatever they will advertise for one and employ whomever they wish. Doctors will also learn that in order to get along you must specialize if not you remain redundant.

prettyprettywow: it exists oo. In Uk, they are all called consultant. Drs and nurses. It just shows that you are a specialist in your field. Hence they put your title before and after the the word consultant. USA do not use the title consultant, they have their own special name (attending, APRN/specialist nurses). Since Nigeria is using the same word as the UK, why will it be restricted to Drs alone? And yes, they have been doing the same work, they just want recognition and appreciation for services rendered

this is from the link which you posted and i thanked you earlier for.

I really think that one should
be
careful to assume where the
shoe
pinches on someone else's
feet! I
have practiced in Nigeria and
now
in the US and as strongly as I
have
felt about the state of the
healthcare system in Nigeria, I
have refrained from making
sweeping statements. The
health
system in Nigeria is not the
same
as that in the UK or US.
Nurses in
the US can become Nurse
Practitioners after doing a
doctorate and do see patients
but
they are not called
Consultants.
Physician assistants love their
jobs
because they get to see
patients
but their is still oversight from
a
physician. You may provide
consulting services to an
insurance
company but that does not
make
you a medical consultant the
way
the term consultant is used in
Nigeria.
In all, we should remember
that
team work is what makes a
healthcare system work. The
FG
has conveniently used the
current
state of animosity to foster
divisions and the members
keep
seeing evil in each other
instead of
joining hands to fight for a
sustainable health system for
everyone to work together
without
fear and for the good of the
patient. Remember you also
could
be a patient one day and all
you
would want is the best hands
treating you.
Hospital administration: hot
issue.
In the US, many hospitals are
out
to make money and the CEO
may
not be a doctor. However,
there
are executive medical
directors
who are physicians and in
charge
of the medical side of things.
In
Nigerian State Hospitals, there
is
no fracas about who is in
charge, I
suspect many of these issues
occur
in our teaching hospitals, and
I
may be wrong....... There is a
DA in
charge of Administration,a
CMAC in
charge of clinical services and
the
CMD is the equivalent of the
EMD
here. If there is a board to
whom
the CMD is answerable,it
allows for
checks and balances and helps
everyone feel they have voice.
I am
not sure that the clamor to be
CMD
by ancillary staff is legitimate
based on the healthcare
system we
run in Nigeria. It's just a
different
chain of command as
compared to
what obtains in the US where
you
have a CEO who usually is
someone
with a Healthcare MBA, who
actually sometimes is also a
doctor.
One last point, every
profession
has value. If you see value in
what
you do, you are content within
its
provisions for career
development
and seek to excel at it. If you
are a
nurse, nurse with all your
heart;a
doctor,be your best at your
profession, a lab scientist ,
produce
consistent accurate results, a
pharmacist,help in picking up
drug
errors and we can all ensure a
safe
system for patients.

prettyprettywow: Why won't they be interested in the title and allowances? I'm sure that is also why the Drs are trying to prevent that so as to enjoy alone. You said that not every patient requires admission, lab test, drug and physio. So what will happen to those that require it? The consultant Dr should be ready to select his patients that don't require the above services while the others should deal with those that require their services if that is what you want. Abroad, patient care is a team work, but that doesn't stop anybody from becoming a specialist/consultant in their own field. It's the Nigerian Drs's selfishness that is preventing that kind of collaboration

This argument is lacking. What do you mean enjoy entitlements. Those entitlements have been there ever since why now try to use a short cut to achieve it.

Yes everyone is important but every team has a captain
Even here its team work except now members of the team don't want their roles any more. .

prettyprettywow: Since you agree that there are other consultants, then where do you want them to bear the title, in their kitchen? where will a consultant nurse and lab scientist bear their title if not in their own territory? Google the word "registered nurse consultant", and see if anything will pop up, where they work, and the scope off their practice, since you so much like google. We are not doing popularity contest to know who appaers more on google. All we want is evidence based practice.

You cannot say you don't know the setting in which these consultants exist where best international practices reign supreme.