joshuapharm: *patient comes into the pharmacy coughing profusely*
patient: Good morning sir, pls can i get a drug for my cough?
Pharmacist: I'm sorry, im not a medical doctor, pls go to the hospital
patient: Ive been to the hospital, the queue is crazy plsss
Pharmacist: Once again, im not a medical doctor, the load of pharmacology and clinicals i did in pharmacy school is not enough pls go to the hospital..
Next day,
*patient comes in holding tummy and screaming*
Pharmacist: Pls go to the hospital oo because i dont know which kind of pain it is..
*patient keeps crying and gruntling*
patient: pls give me a drug to relieve me, i'll go to the hospital afterwards
Pharmacist: Im not a doctor, i dont want to do the job of a doctor so plsss.. its not my fault..
Is this the kind of pharmacy practice you want us to run in Nigeria? When will our medical doctors come off this abysmal ignorance about the pharmacy profession? Why the hate? Cheers!

The solution here is to make sure the Doctors that are trained in Nigeria, stay around to practice in Nigeria. (At least 30% - 40% of Nigerian trained doctors leave to work in foreign countries)

You can only do that by being more competitive. Provide better remuneration and better facilities.

The long term solution will be to train more Doctors in Nigeria. And you do that by going to medical school to learn about diagnosis, and after diagnosing, you ask for the help of a well trained pharmacist in deciding on medication choices for your diagnosis.

ziga:

The solution here is to make sure the Doctors that are trained in Nigeria, stay around to practice in Nigeria. (At least 30% - 40% of Nigerian trained doctors leave to work in foreign countries)

You can only do that by being more competitive. Provide better remuneration and better facilities.

The long term solution will be to train more Doctors in Nigeria. And you do that by going to medical school to learn about diagnosis, and after diagnosing, you ask for the help of a well trained pharmacist in deciding on medication choices for your diagnosis.

Long time Dr ziga. What happened to the 'medical advise' thread on the health section frontpage?

A patient comes into a pharmacy or to see a nurse and says I've got "pile" and is given drugs for "pile". He feels better but six months later the bleeding per rectum gets worse and he finally sees a doctor who does a rectal examination and feels a mass per rectum. Unfortunately by this stage it is advanced.
Or a 50year old man looses his voice so is given lozenges and antibiotics, no examination of the larynx, when he starts to feel breathless he is treated for asthma, till he sees a doctor, ENT specialist who looks into his voice box and sees an advanced tumour. At this stage it's too late for any curative treatment.
Or a mother brings a 1 year old with a fever and antimalarials are prescribed. It's not until the ears start discharging does anyone realize he actually had an ear infection, by this time the eardrum is ruptured and the child may be hearing impaired for life.
Or a patient with a leg ulcer that a nurse has been dressing in her home for months without ever checking her blood sugar or doing a biopsy. It may be diabetes or even cancerous.
It's only when the treatment has failed for months that they are sent to hospital and when such patients develop complications who blames the pharmacy or the nurse or the lab guy that initially managed after doing a test. All blame goes to the doctor.
These are just examples of the kind of things we see on a daily basis.

ziga:

The solution here is to make sure the Doctors that are trained in Nigeria, stay around to practice in Nigeria. (At least 30% - 40% of Nigerian trained doctors leave to work in foreign countries)

You can only do that by being more competitive. Provide better remuneration and better facilities.

The long term solution will be to train more Doctors in Nigeria. And you do that by going to medical school to learn about diagnosis, and after diagnosing, you ask for the help of a well trained pharmacist in deciding on medication choices for your diagnosis.

Bro, I love to diagree with training more Doctors as a solution. All around the globe, Doctors are either in short supply or concentrated in commercial centers hence as years role into years other health workers were trained to provide services to people in those communities Doctors decided to abandon. Canada is worst hit because the rate at which they churn out medical graduates is abysmally low coupled with stiff competition in their postgraduate training, close to 20states in United states have granted Pharmacist the prescribers role because Doctors don't like working there. This problem seems more deeply rooted than we think.

minkawe:

Bro, I love to diagree with training more Doctors as a solution. All around the globe, Doctors are either in short supply or concentrated in commercial centers hence as years role into years other health workers were trained to provide services to people in those communities Doctors decided to abandon. Canada is worst hit because the rate at which they churn out medical graduates is abysmally low coupled with stiff competition in their postgraduate training, close to 20states in United states have granted Pharmacist the prescribers role because Doctors don't like working there. This problem seems more deeply rooted than we think.

I agree that training more Doctors wouldn't fix all the problems. However, it will fix most. Also, like I said, the remuneration has to be competitive. (or else we will continue to train Doctors for countries that appreciate them better). I also agree that there is a role for "properly trained" advanced providers in medicine. Nigeria is however not ready for that.

In Nigeria, I'm sorry to say that the standards of education has fallen so much that well trained professionals in most fields are in short supply(including docs) The educational system is collapsing. Hospitals are overstretched.

We don't even have a system of verifying whether the so called "Doc" treating you is a real Doctor. Everybody believes he can diagnose and prescribe better than a Doc that was trained for 6 years. And there is no system to keep that in check.

It is like saying that we need more policing agencies in Nigeria after the police, army, lastma, VIAO, customs etc. First, we need to regulate what we have otherwise we will just kill more Nigerians.

In developed countries that you used as examples, they have tried to maximize their ability to train and utilize Docs before they resorted to utilizing TRAINED advanced providers (which could be pharmacists or Nurses). And their activities are regulated.

In Nigeria, we can't regulate our Doc practices and make sure they all do the right thing yet. How will adding more untrained health workers to that pool help innocent patients?

If the FG is interested in the health of the people, we already have programs that can be utilized to ensure healthcare in remote areas.

ziga:

I agree that training more Doctors wouldn't fix all the problems. However, it will fix most. Also, like I said, the remuneration has to be competitive. (or else we will continue to train Doctors for countries that appreciate them better). I also agree that there is a role for "properly trained" advanced providers in medicine. Nigeria is however not ready for that.

In Nigeria, I'm sorry to say that the standards of education has fallen so much that well trained professionals in most fields are in short supply(including docs) The educational system is collapsing. Hospitals are overstretched.

We don't even have a system of verifying whether the so called "Doc" treating you is a real Doctor. Everybody believes he can diagnose and prescribe better than a Doc that was trained for 6 years. And there is no system to keep that in check.

It is like saying that we need more policing agencies in Nigeria after the police, army, lastma, VIAO, customs etc. First, we need to regulate what we have otherwise we will just kill more Nigerians.

In developed countries that you used as examples, they have tried to maximize their ability to train and utilize Docs before they resorted to utilizing TRAINED advanced providers (which could be pharmacists or Nurses). And their activities are regulated.

In Nigeria, we can't regulate our Doc practices and make sure they all do the right thing yet. How will adding more untrained health workers to that pool help innocent patients?

If the FG is interested in the health of the people, we already have programs that can be utilized to ensure healthcare in remote areas.

Well, FG did not create the chaos in the health sector to start with, so why do you think they are not interested in the health of the people. The issue as I said in my previous post is that the health sectors has too many stars that want to be reckon with whereas the hospital setting avails doctors alone such opopportunity.
Also, your comparison or analogy using paramilitary did not suffice, because various paramilitary outfit are created day in day out with ex-men running some wonderful outfits, then also training a military personnel is not as demanding as training Doctors, so recruitment is a lot more easier than churning out medical graduates.

minkawe:
Well, FG did not create the chaos in the health sector to start with, so why do you think they are not interested in the health of the people. The issue as I said in my previous post is that the health sectors has too many stars that want to be reckon with whereas the hospital setting avails doctors alone such opopportunity.
Also, your comparison or analogy using paramilitary did not suffice, because various paramilitary outfit are created day in day out with ex-men running some wonderful outfits, then also training a military personnel is not as demanding as training Doctors, so recruitment is a lot more easier than churning out medical graduates.

If you really think the training of Doctors is demanding, why do you think you can transform people who haven't been trained in the same way to easily work as Doctors.

In countries where they use Advanced providers as diagnosticians, they are well trained.

For instance a nurse practitioner is firstly trained as a nurse, and then they go through an 18 to 24 month program where they undertake clinical rotations in Doctor's offices to learn the art of medicine.

I'm just saying that If we want to do something, we have to do it right!!!

Why are we trying to implement things we don't understand?

I have worked on both sides... so I'm talking from experience.

ziga:

If you really think the training of Doctors is demanding, why do you think you can transform people who haven't been trained in the same way to easily work as Doctors.

In countries where they use Advanced providers as diagnosticians, they are well trained.

For instance a nurse practitioner is firstly trained as a nurse, and then they go through an 18 to 24 month program where they undertake clinical rotations in Doctor's offices to learn the art of medicine.

I'm just saying that If we want to do something, we have to do it right!!!

Why are we trying to implement things we don't understand?

I have worked on both sides... so I'm talking from experience.

So, you think the gridlock situation we have currently in the health sector is the best. As much as I'm in total agreement with you on training and the quality of training, Sir, do you think these fighters see it along that line of thought, rather people believed they're being repressed by Doctors. If Laboratory scientists could be bold to usurp authority of Pathologists, what are we then saying; the workings of things in health sector is not really clear too many, rather many believe Doctors are only protecting their selfish interests.

minkawe:
So, you think the gridlock situation we have currently in the health sector is the best. As much as I'm in total agreement with you on training and the quality of training, Sir, do you think these fighters see it along that line of thought, rather people believed they're being repressed by Doctors. If Laboratory scientists could be bold to usurp authority of Pathologists, what are we then saying; the workings of things in health sector is not really clear too many, rather many believe Doctors are only protecting their selfish interests.

Sir,

It is not only the Doctors that are protecting their "selfish interests".

But, regardless of what people may say or think or make others believe, the truth is the truth.

Because one sure way to destroy the health sector and any other institution for that matter is when we start to make decisions based on feelings and not based on the truth.