long number of academic study does not translate to cash.

if you want money as a medical doctor, sit down and plan how it will work out not you looking for salary.

As long as you remain an employeee

sly-k:

long number of academic study does not translate to cash.

if you want money as a medical doctor, sit down and plan how it will work out not you looking for salary.

This is true for medicine as it is for engineering, law, pharmacy etc.

The injustice the Nigerian doctor faces goes beyond the inadequate absolute take home pay. The state has failed to recognize the peculiarity of the job with respect to its demand not just on expertise but also on the time of the doctor.

When other care providers close at the end of a day or night shift, the doctor doesnt have that luxury. He closes at 4pm but he is mandated to do a second job called 'call' that lasts longer and can be more tedious.For this he is given a little stipend which makes his take home just a little above that of the other more important members of the healthcare delivery team- I mean nurses, pharmacists, optometrists,etc.

For this usually they will go on strike and get across the board wage increase by a government without a health care plan, policy or vision of any kind.It is for this reason these group of proffessionals are much better paid than their peers in countries with similar GDP (at the expense of doctors). It is for the same reason that Nigerian nurses in Government hospitals earn more than PHD holders in Universities and before a bachelor degree holding teacher can hope to earn a fresh nursing graduate salary he needs to work for 10yrs.

In Nigeria, every healthcare provider wants to be a medical doctor but not all want to go to medical school.The unions and lobbyists of some of these fields are so brazen.Some  have forced the arm of the NUC backward to approve needless 6yr programmes for optometry and pharmacy and then arrogate to themselves the title Dr.Those who spent 4yrs reading these courses a few years ago and left with bachelor's degree who were 'dr' (with lips covered by closed hands) are now being publicly addressed as such. Optometrists now get paid call duty. You wonder, for emergency lens?

In the final analysis, every failure can be traced to one thing that we have distinguished ourselves in-that is corruption. One aspect of this argument I however don't subscribe to is making doctors the chief managers of hospitals. This practice cannot be justified by any sound logic and for Christ sake it hasnt worked in the past.It should be left to managers the way it is done in the States and elsewhere.

Agaba my guy,
Please don't take this the wrong way but you really sound like someone I would enjoy talking with.
again note my choice of words, talking with, not to.
Pls believe me when I say I am not being sarcastic
My A level scores or Jamb scores are irrelevant but I can assure you that everywhere I have been, I am usually in the top 5%!
I am also a member of MENSA so make we leave that one for one side.
Pre-science? i don't even know what that is.
I have a friend who is in GP training in 9ja and she will probably take offence at your statement that even though not much training is given to the GP in naija. (Again you have a misunderstanding of medicine and medical practice. There is actually a college of GPs with a residency programme in 9ja!)
You don't need a high IQ to study medicine so I agree with you there. I have a friend who left medicine after 2nd MB as well. And yes, he passed the exam!

With regards to litigation in medical practice in 9ja, it is my most ardent prayer that litigation levels rise in our country. This is the only way to rid the profession of quacks. A doctor is not God and should be accountable to his patients. I agree that the level of enlightenment of the general populace should rise but that na matter for another day.

I recall quite clearly that the fight for call duty allowance wasn't just about doctors' allowances. A major issue was funding of the health sector which the media didn't report. I attended a few of those ARD meetings in those days and had a first hand view of the demands of the ARD. You may not believe this but a major problem then was that 'medical elders' had their own agenda. That is why the NMA has not done anything. The CMDs and Health ministers always are out t line their own pockets because of the 9ja expectation that anyone in a position of authority or influence must come out a wealthy man.

A lot of our problems are inter-related and a microcosm of the greater society.

Tafa Balogun said something when people were complaining about the corrupt nature of the police. He said 'you don't find angels in hell'. Again, i am digressing and I apologise profusely.

Your exchanges with karl ken represent what I hope 9ja will turn to. You guys hit the nail on the head and hopefully, this will trickle upwards or downwards as the case may be.

Pennywise, nuff respect. However, who says a doctor can't be a manager? It's all about having the aptitude for it. We have had brilliant CMDs just as we have had awful ones.

I don't expect personally to get rich from my medical practice. However, I expect medicine to afford me the ability to feed, accommodate and transport my family in the way they deserve without any need to resort to underhand practices or combine 2 medical jobs. I invest carefully in the financial markets and THAT is how I fund my excesses.

Nuff said, for now

@Kongi
Your observations are noted my friend but if everyone had the business acumen of Adenuga or Ekene dili chukwu (late Chief Ilodibe), there wont be need for business schools.

Kongi

My A level score stuff was not directed at you. sorry I made I did not make myself clear. i was actually refering to the guy who was talking about high IQ.

I think your approach is different and you have just proved me right that those who are good do not come across as arrongant as the high IQ boy.

I have not read your last reply though.

Kongi:

Agaba my guy,
Please don't take this the wrong way but you really sound like someone I would enjoy talking with.
again note my choice of words, talking with, not to.
Please believe me when I say I am not being sarcastic
My A level scores or Jamb scores are irrelevant but I can assure you that everywhere I have been, I am usually in the top 5%!
I am also a member of MENSA so make we leave that one for one side.
Pre-science? i don't even know what that is.
I have a friend who is in GP training in Nigeria and she will probably take offence at your statement that even though not much training is given to the GP in naija. (Again you have a misunderstanding of medicine and medical practice. There is actually a college of GPs with a residency programme in Nigeria!)
You don't need a high IQ to study medicine so I agree with you there. I have a friend who left medicine after 2nd MB as well. And yes, he passed the exam!

With regards to litigation in medical practice in Nigeria, it is my most ardent prayer that litigation levels rise in our country. This is the only way to rid the profession of quacks. A doctor is not God and should be accountable to his patients. I agree that the level of enlightenment of the general populace should rise but that na matter for another day.

I recall quite clearly that the fight for call duty allowance wasn't just about doctors' allowances. A major issue was funding of the health sector which the media didn't report. I attended a few of those ARD meetings in those days and had a first hand view of the demands of the ARD. You may not believe this but a major problem then was that 'medical elders' had their own agenda. That is why the NMA has not done anything. The CMDs and Health ministers always are out t line their own pockets because of the Nigeria expectation that anyone in a position of authority or influence must come out a wealthy man.

A lot of our problems are inter-related and a microcosm of the greater society.

Tafa Balogun said something when people were complaining about the corrupt nature of the police. He said 'you don't find angels in hell'. Again, i am digressing and I apologise profusely.

Your exchanges with karl ken represent what I hope Nigeria will turn to. You guys hit the nail on the head and hopefully, this will trickle upwards or downwards as the case may be.

Pennywise, nuff respect. However, who says a doctor can't be a manager? It's all about having the aptitude for it. We have had brilliant CMDs just as we have had awful ones.

I don't expect personally to get rich from my medical practice. However, I expect medicine to afford me the ability to feed, accommodate and transport my family in the way they deserve without any need to resort to underhand practices or combine 2 medical jobs. I invest carefully in the financial markets and THAT is how I fund my excesses.

Nuff said, for now

OK accepted I do not have an understanding of the medical practice based on the fact that I do not know they have a college of GPs in naija. (I know quite well medical practice is a 'cult' esp in naija)I do not know how long that has been. I know things are changing. thank God.
Once more, the pre-science and A-level thing is not about you OK . . .you be the man. Prolly you are one of those guys in NN who talk about stock and investment. You need to get there. much info.
Now I am not gonna say more because you actually buttressed some of the facts I marshalled out. So we are saying the same thingy.
Thanks for wanting to talk with me but unfortunately I am one of those bad 'talkers'

I graduated in 2005, and i didnt state that Doctors are responsible for providing infrastructre for hospitals.

Doctors don't have to be dependent on salaries. The problem is doctors who put money before the welfare of their patients always end up being unethical. That is not the way its meant to be and that is not situation in other countries.

If the true value of health care as a "business" was applied, and the average man was made to pay for it, how many will be able to afford it. The health of the people is the responsibility of the government, and the true practise of medicine does not leave room for the doctor to be money oriented. So, who takes care of the doctor's welfare.

Think about it, if you get advise from a lawyer, you have to pay for it. But how many of you have ever paid a medical doctor for some health advice he gave in passing.

Agaba my guy, you are indeed right when you say we are saying the same thing.

Medical practice in 9ja is indeed a cult. Thankfully, things are changing. Yes I am a member of the 'cult' by virtue of my training and connexions but one day, the cult will wake up and smell the coffee.

Pennywise, business schools are not for the Adenugas or the Ekene dili Chukwus, they are for the me and yous of this world who need to be schooled in the art of making money.
Adenuga, Aliko and co don't need to go to business school to learn how to make money.

Ziga bros, with the advent of NHIS in 9ja as well as private medical insurance, healthcare is a business! i dont wanna advertise on this site but there are very competitve private health insurance schemes which are run as a business. Things will change in 9ja hopefully very soon. Some people have taken the 1st step. Funnily enough, they are not doctors but have the foresight to see what the country will need from healthcare services in the very near future.

Currently, it is targetted towards the higher end of the market although the prices are reasonable enough to appeal to the middle class. I must confess i was involved in the execution of this dream while still in 9ja and things are moving very well.

Abuja, Lagos and PH naturally are the hub of the business but I hope the intention of a national spread is realised very soon.

They pay their doctors reasonably well. At least, while I was there, the salaries were comparable to federal govt rates. Still not the best but we need to atart somewhere.

God bless 9ja

Agaba, my apologies once again if I have been too forceful or even unpleasant in my arguments

Kongi

nuff said!

I see that we are all saying the same things but from (very) different perspectives/points of view . . .

I believe very strongly in the business side of medicine, it's quite interesting!

I guess business models can be drawn up providing quality healthcare at (relatively) cheap competitive prices, afterall what price value can we place on a human life?

Kongi:


Agaba, my apologies once again if I have been too forceful or even unpleasant in my arguments

Kongi,

Not at all. You were only being assertive in trying to push your point just like I was . That does not translate to aggression.  Nothing do you man.
We pray naija will improve.

@ Agaba n Konji;nuff respect! .My medical training in Nig. wasn't easy for the family and I knew the effort I put in to pass the exams.Much is now expected of me.I must make them proud and in this practice too.I will have to invest in non-medical ventures but the initial capital will come surely from this 'rubbish' practice.

Kongi:


Pennywise, [b]business schools are not for the Adenugas or the Ekene dili Chukwus, [/b]they are for the me and yous of this world who need to be schooled in the art of making money.
Adenuga, Aliko and co don't need to go to business school to learn how to make money.

Ziga bros, with the advent of NHIS in Nigeria as well as private medical insurance, healthcare is a business! i don't want to advertise on this site but there are very competitive private health insurance schemes which are run as a business. Things will change in Nigeria hopefully very soon. Some people have taken the 1st step. Funnily enough, they are not doctors but have the foresight to see what the country will need from healthcare services in the very near future.

@Kongi

Your comment will suggest that rather than employ business/hospital mgt trained people we should rely on a supernatural means of identifying the likes of Adenuga and Aliko that at the minimum will not run our hospitals aground before employing.

The truth is- that you can remove a goitre with your eye closed does not mean you can manage people and resources with the same dexterity because you are not so trained. Many of these super CMDs venture into private practice but fail woefully and fold up.The headship of these hospitals is partly responsible for the fratricidal wars going on be it doctor vs doctor or doctor vs others in these hospitals.So unnecessary.

For NHIS, this is the biggest on going fraud in the health sector at the moment.It is likely going to continue for sometime because the Nigerian masses are at the recieving end and afterall what is 5% of the basic of the average worker's salary? And in what way has it affected the average M.O remuneration? Zilch! In the meantime let the party continue for the 20 or so odd HMOs registered by it.

With respect to the private medical Insurance (HMOs) being used by some elite companies though better than the NHIS, the income by most of the providers actually depreciated not increased.The whole idea was to enhance income so that they can pay well and improve on the quality of services. Most of the money goes to the middlemen. Before they came in, no substandard practice could hope to get a decent retainership anyway. Now the HMOs play providers one against another and then pay starvation capitation.Who suffers?To every rule there is exception. The employer paying the money should feel the pulse of his employee.

In fact to cut a long story short, NHIS not be silver lining for doctor pay.Na cesspool. Big can of worms.

karl ken:

@ Agaba n Konji;nuff respect! .My medical training in Nig. wasn't easy for the family and I knew the effort I put in to pass the exams.Much is now expected of me.I must make them proud and in this practice too.I will have to invest in non-medical ventures but the initial capital will come surely from this 'rubbish' practice.

Non-medical ventures =good
Rubbish venture . . .naaaaaaaaaaaaah. I feel your pulse sha

@Pennywise.
Not at all o. Supernatural means of identification ke?
What I mean is that the fact that you are doctor doesn't preclude your being a good manager of men and resources.
Some succeed in business without any schooling while some need to be taught either formally or informally.
Richard Branson very easily springs to mind.
Again, I digress and once again, I apologise.

As per NHIS, I had a discussion with a very senior NHIS chap a few years ago and I let my feelings known to him. The way the NHIS was structured in 2005, hospitals were being made to bear the cost of providing healthcare to the populace rather than the government. God knows why we don't pay pur taxes to these hospitals then.
I am not sure if things have changed as I haven't kept up with things in that sector but I keep hoping for the best

@Agaba, thanks for understanding

Really is good to hear some ppl talk about medicine and the pay of its practitioners. Th e truth of all is that in any profession, there are always those that end up being not so happy and fulfilled. We can spend eternity talking about the pay of docs but let's not forget that in the community of docs lies a lot of differences in skills. There is money in surgery not just medicine. I know docs in our country that take at 800000 monthly aside other allowances and i have also heard of those that get as low as 40000 but not 18000. I believe no doc with the right qualification and repute will take that low. What many ppl don't know is that some ppl we think to be docs are not really what they claim. Maybe they have had their licences witheld or have a very bad medical record of employment. I magine 8 of ur patients dying out of ten. No good hospital will take you. As much as i love medicine i don't practice for peanuts. If i think i can't get enough pay in my country, i'll go elsewhere. That's where we have the problem. Most of our indigenously trained docs are educationally inadequate to get a job in better countries so they claim they want to stay here.

obi647:

Really is good to hear some people talk about medicine and the pay of its practitioners. Th e truth of all is that in any profession, there are always those that end up being not so happy and fulfilled. We can spend eternity talking about the pay of docs but let's not forget that in the community of docs lies a lot of differences in skills. There is money in surgery not just medicine. I know docs in our country that take at 800000 monthly aside other allowances and i have also heard of those that get as low as 40000 but not 18000. I believe no doc with the right qualification and repute will take that low. What many people don't know is that some people we think to be docs are not really what they claim. Maybe they have had their licences witheld or have a very bad medical record of employment. I magine 8 of your patients dying out of ten. No good hospital will take you. As much as i love medicine i don't practice for peanuts. If i think i can't get enough pay in my country, i'll go elsewhere. That's where we have the problem. Most of our indigenously trained docs are educationally inadequate to get a job in better countries so they claim they want to stay here.

8 patients dieing out of 10 .

@Kongi
I hear you my brother. Adenuga and Aliko might fail woefully as CMD for all we know.

The NHIS is good to the extent that it has offices around the country into which are employed paid Nigerians.Unlike the NHS the NHIS has been reduced to a regulating commission.The responsibility of enroling civil servants mins, agencies and parastatals has been ceded (!) to registered HMOs among which the NHIS in its infinite wisdom divided enrolees. This presupposes at once that no more HMO is welcome!!

These HMOs are required to have offices in all the six geo zones but most of them have nothing save for gsm nos and of course account nos with which deductions of workers salaries are siphoned. Providers get nothing hence workers get nothing. Meanwhile colossal deductions are being made. Your senior NHIS friend will give you details. At the same time some desperate providers are knifing themselves over the few enrolees earlier made.

In summary Nigeria is way too low on the human probity index required for a health Insurance on a scale the NHIS portend. Unfortunately like the Land use decree, everyone concur it does more harm than good but no one has the courage to do sth about it. NHIS is enriching HMOs and impoverishing doctors.

Hmmmmm!!!!!! No wonder why the Economists say that human wants are insatiable. I used to envy doctors cos i knew they are rich. But because i cant stand the sight of blood so i never wanted to study medicine. I studied Engineering and went for NYSC and there my envy for docs increased. The only doctor that was with us, a lady was earning 70k while we were paid 5k each. Since doctors can still work with oil industries or any where else, the issue of Doctors being under paid is wrong cos as many Engineers, Accountants,Economists etc are earning much so are many docs. And there are still some that are even jobless. WHAT ONE EARNS BE YOU DOCTOR, ENGINEER OR WHATEVER IS A MATER OF DESTINY. In any thing you want to do dnt place money first else you might not see it. Some teachers are millionaires mind you

hmmmm

Drs pay .Some of us have been in the static private practice for years.The initial idea of making some money to assist the family and off to UK/US for residency is defeated.Reason no bulk cash to sponsor the ideal programmes.

idupaul,r u for real?so u expect a doc that has put in so much effort to live on a meagre salary abi?na waoh!

, even here in small namibia, No doctor will work for less than US$3500 per month. and there are not enough doctors anyway

The truth is that what is happening in the health sector showed total decay in Nigerian system. Medical doctors want to be everything,.Imagine a medical doctor also function as an administrator, this was caused by Dr. rasome Kuti, today they take bias decision that will favour only medical doctors,imagine a medical director say other professionals are employed at the descretion of the medical doctor.
Here medical doctors claim they are trained to do the job of the medical lab scientist, the job of the physiotherapist, the phamacist,the optometrist,the administrators,etc,infact they are trained to do everything.have you ever wondered why things are not moving here.round pegs in a square hole.

pennywise showed that he does not know what optometry is all about, he should get the official govt. act on optometry and educate himself well,it will help him a lot and others, Optometrists does not only give glasses, he does all type of eye examination, he is trained to treat ocular accident as clearly enshrined in optometry act,so if you treat accident why will you not be paid for it, Optometrist also help the ophtahlmologists in co management, a lot of systemic problems ,like high blood sugar, high BP, hiv(cytomegalovirus/cmv can be detected by the optometrist via routine test .

If the councils that regulate optometric education, pharmacist,medical lab,etc want their trainining to be 10yrs what is the problem of medical doctors with that.
They want to dominate and regulate others so things are not moving well,they want increase in their salary but fight others from having good pay,thank God they are failing there , they can only suceed in doing it for some time,but after a while they always loose.An average Nigerian medical doctor is selfish,think he is God,but when they come oversea where rule of law prevail they will maintain .

Who answers doctor is it their problem, afterall what they have is bachelor of surgery and medicine, they and the optometrist whose qualification is Doctor of Optometry who supose answer Dr.
All their struggle/wars to kill optometry and other professions just dey make optometry strong.Educated patients know who to meet.

optometrists also treat ocular dss and infection,infact the difference with opothalmologists is surgical procedure .some diploma in opthalmology ( a 24 months programme) holders also call themselves opthalmologists,very funny.

i guess it's only private hospitals that pay drs. up to 800,000. does anyone have an idea of how much federal teaching hospitals pay? maybe the problem is due to the cheap cost of healthcare,

i'm scared reading fru what some fellas pasts , i earn 200 000 Naira a month over here as a laborer I'm thinking of coming over to finish with my medical course in order to be a responsible guy with brighter future , I hope u folks en nor gonna scare me away

I've read thru the entire post, and have to conclude that most non-medics don't have a complete understanding of the imminent crisis in the Nigerian health sector.
If you understand, that just like other sectors in Nigeria, the problem of the health sector is one of chronic underfunding, you'll understand that doctors' pay is only the least of our problems. When the government announces that they will increase health workers' salary, know that they are running away from the more costly and painful real solutions.
There are not enough standard hospitals, where standard investigations can be carried out by sufficiently qualified personnel. This statement sums up our health sector problems.
Try to imagine Nigeria with as many high quality hospitals, as say the UK. No, say 10%. Before some of you point at hospitals like UCH here, I'll immediately counter by saying that I trained there, and I know that it's a big joke to even attempt to lump UCH with such hospitals. How many successful open heart surgeries are done in the whole of Nigeria? How many successful bone marrow transplants? Also remember that you'd need the equivalence of hospitals as 'advanced' as UCH in at least every state in the federation.
Also, you can not seperate the health sector from the overall economy. While I was a student, sometimes entire operation lists were cancelled because of the absence of electricity; and no water in the operation suite. Remember that the patients affected would probably have had to wait for months, and this would sentence them to further weeks/months of waiting.
As regards lab investigations, the equipment just isn't there.
Finally the issue of training. Find out about the stiff competition involved in postgraduate training exams in Nigeria, and finding a residency placement. There simply aren't enough places. And again, the solution to this is painful & costly, spend billions of naira in producing more standard hospitals where more doctors can be trained. Those in the health care sector will know that we have a gross shortage of specialists, esp. those like ophthalmology; and even those as crucial as O&G.
I hope we will focus on the real problems. Other than that, we will continue to run in circles. Doctors would probably be paid more, but patient care would in fact decline.

our problem in health sector is just what is happening in the whole place, we now move in a catapillar motion,without movement,when only the purported head want to grow but fight the other part of the body from growing a disease condition will emmerge .

majority of the well paying jobs are in the medical fields, medicine isn't a profession you enter for the money tho. . well in Nigeria the only doctors that are payed well are the doctors that work for the federal govt and the doctors that work for oil companies

America's Best-Paying Jobs (Top 5) '09

1. Surgeons ($206,770)
2. Anesthesiologists ($197,570)
3. Orthodontists ($194,930)
4. Obstetrician and gynecologists ($192,780)
5. Oral and maxillofacial surgeons ($190,420)

Click here for full list of America's best-paying jobs
http://www.forbes.com/2009/05/04/america-best-paying-leadership-careers-jobs-slide_14.html?thisSpeed=15000

Docs are going on strike in two weeks, Asking for250k,400k,700k,and almost 1mil for ho,r,sr and cons respect. Lets see if it works, But frankly,in naija,i think its impossible.

strike is their tool,but it works here because government is infiltrated with a lot of medical doctors,imagine minister of health and the minister of state (health) are medical doctors,all the head of department are medical doctors,it is happening in miinistry of health (not ministry of medcine),is there any state where medical doctors are not fighting other health care professionals,yet they want to grow,and you see them write useless cominique about the state of health in Nigeria,funny set of people.once it is okay for the medical doctors all is well with the health system,they do not want other field to develope,but who is suffering ,the nation and its people,have you wondered why a medical doctor went to read medical record and came back to fight that he will be the head of another profession while still employed as another professional,it is simple, if he want to be a medical record officer,he will start as a medical record officer level 8,and if he want to be a doctor he start from where he was before going back to school,there is a chief medical record officer,but medical doctor want to head medical lab dept,they tried to head pharmacy department when they are not pharmacist,i think they are experimenting it now in nafdac,but it failed in hospital,medical doctors fought so that call duty allowance for vetinary dr.will be stoped ,but it failed after much trial, even in delta they tried to stop allowance of med lab scientists but lost,they are not optometrist,and cannot even supervise an intern optometrist but want to supervise even a chief optometrists in optometry!what a funny country.

medical doctors went on strike in kenya, govt sacked them enmass and employed new doctors,they cried wolf and went back to beg but it was too late,in anambra state they went to strike and after deceiving themselves they went back to work,the truth is that most medical drs need government window,if they are curtailed they will learn.no profession is not important,somebody is researching day and night for drug to take care of various dss,those people are not crying or fighting others but because you have the privildge like others to prescibe the drug you think others are not important.our health system will never grow until administrators take over the running of hospital as it is done in all developed world,it was like that in Nigeria until Dr.Ransome kuti scattered everything and made med.dr the head,today the head is growing and fighting other parts of the body from growing,if this is not corrected,the body will die and the head will die too,because it cant work alone,what is the head without the hands,legs,spinal cord,eyes,mouth,etc.
we need to tell ourselve the truth,we are not growing as a nation,our health need drastic political intervention otherwise we will be fighting for contis,mss,etc but none of our co workers will see us with good eye and will only laugh with u because he want to pretend but will look the other way even if you are dieing,there is a lot of acrimony here,caused by the medical drs who are so selfish,if you fight that vet drs should not be paid call,you might be a victim of swine fever etc and die of it,you fight taht lab people should not be given their due alllowance one day you,your son,relations.etc might be involved in a situation that require quick medical lab tests to help in treatment,death may occur.if you fight the optometrist from doing their job and giving ocular first aid to ocular accident and ocular emmergency patients as duely enshrined in the constitution of this great country Nigeria ,one day you might have need for such intervention in which every second counts and might loose your vision ,many have died because of these politics ,let us move this country forward health need no ploitics.