sexylogan:

That's where you are in the dark, my dear. Let me try to enlighten you.

Some nurses decided that since medical doctors become consultants, they too must become consultants (not considering that

the doctor's residency programmes have a strict curriculum with fixed clinical and practical rotations, and standard exams upon

the completion of the specified rotations)... but I digress.

As I was explaining, the nurses awarded themselves with "consultant" titles and in some teaching hospitals, would refuse to join

Doctors (consultant) ward rounds but rather do their own "ward rounds" with student nurses afterwards. When I heard this I was

like "WTF?"

Doctors' Ward rounds, in an Ideal situation, are meant to have a representation of all the health personnel involved in the medical

management of a patient ie. Doctors, Nurses, Pharmacists, Medical Lab scientists, etc. but the Doctor leads the rounds because

the patients are His. The doctor sees the patient in the OPD, the doctor admits, the doctor sends the patient for investigations

and the doctor writes out the management plan, the doctor prescribes, and when the patient's condition has improved to satisfactory

levels, the doctor discharges the patient.

Now, I'm a firm believer of division of labour. Every health personnel should do what he/she was trained to do. I will not do a nurses'

work, and she shouldnt do mine. The management of a patient is Multi-disciplinary and any attempt to cross over and do another

professionals work is the reason why there is chaos in the health sector today. I respect every health professional and I have no

grudges towards nurses, pharmacists and others. Each groups work is tasking in it's own way.

Concerning JOHESU, well, with the understanding I have, the greatest bone of contention isn't skipping of grade levels. It's

leadership positions such as Chief Medical Director that they want to be eligible for...a position that has been exclusive to doctors.

My take on the issue is this...scrap the title of "Chief Medical Director" and "Medical Director" as hospital heads and give it to

administrators. Being a doctor doesn't guarantee that you will run a hospital efficiently and in most cases, we doctors have been

discovered to be the worst administrators.

Let's allow Public/ Business Administrators to be in charge of running hospitals while doctors, nurses, pharmacists, medical lab scientists, etc

tend to patients.

I rest my case.

octopaul:

Doctor, please write out a proper management plan for knee osteoarthritis. One that your untrained physiotherapist can carry out without thinking for himself.
I am waiting.

phantom: o please don't be shallow.what is the wonderful thing your physiotherapy does for a progressive degenerative condition like osteoarthroses other than marginal palliative care. the pain is still managed by nsaids or in the case of drug induce gastritis, COX inhibitors.these are all prescribed by a doctor and I choose when and when not to involve YOU the physiotherapist in the management of the patient. that is the crux of the matter.

Morotov1: This is ego talking.....right because a physician trained and board certified will know that in treating anything joint, there is conservative, surgical and rehabilitation....so relying on only NSAIDS, STERIODS AND COX INHIBITORS is not a good management plan. Please, this is one of the global best practices we are begging for.

Morotov1: This is ego talking.....right because a physician trained and board certified will know that in treating anything joint, there is conservative, surgical and rehabilitation....so relying on only NSAIDS, STERIODS AND COX INHIBITORS is not a good management plan. Please, this is one of the global best practices we are begging for.

Morotov1: This is ego talking.....right because a physician trained and board certified will know that in treating anything joint, there is conservative, surgical and rehabilitation....so relying on only NSAIDS, STERIODS AND COX INHIBITORS is not a good management plan. Please, this is one of the global best practices we are beggings for.

phantom: you are missing my point. I DECIDE when the treatment will be conservative,surgical or rehabilitative.don't you get it? any patients you see, I SEND TO YOU. its not arrogance but fact! no offense.

phantom: you are missing my point. I DECIDE when the treatment will be conservative,surgical or rehabilitative.don't you get it? any patients you see, I SEND TO YOU. its not arrogance but fact! no offense.

phantom: nobody goes to the physiotherapist FIRST except as part of a treatment plan INITIATED by a doctor. do most Nigerians even know who a PT is and what he does?

phantom: nobody goes to the physiotherapist FIRST except as part of a treatment plan INITIATED by a doctor. do most Nigerians even know who a PT is and what he does?

bumfem:

Lier ,Lier !! Lier !!! Physiotherapists are neuro musculoskeletal practitonals. They have the right to practice independently in Nigeria and exwhere in gov't hospitals and physio own clinics . Patients see Physiotherapists by medical referrals or by self referrals. No law stops patients from see physio on first contact in nigeria. In Canada and exwhere across the globe Physiotherapists are designated primary health provider. I mean in Canada and,Aussie UK and many developed countries in the world .Physio status in these climes are not by fiat. It is a product of comprehensive empirical studies regards physio relevance and importance at primary health. It is also a function of robustness of physio training and scope especially in musckuloskeletals . They are only second to orthopeadic surgeon in ability and competence in identifying musculoskeletal diseases and movement disorder. So they are recognized in western world as first class physical diagnosticians in modern medical practice .

So we are not talking about claims born out of emotion and hate and not by serious empirical evidence . I notice you are ignorant of lots of thing outside your medicine. And pls retrain from reacting to every comment. We all know in parts. Do not be jack of all trade.

Just my 2 naira.

phantom: neuro musculoskeletal practitioners o dear! . what will one not hear on nairaland? lol

octopaul:
You are now trying to hide your ignorance behind emoticons cos a layman put some words together in a syntax you don't agree with? Now I see the genius in you.

bumfem:

I actually wanted to write that physiotherapists are experts in neuromusculoskeletal disorder . I am quite sure of what I put in there. In other words Physiotherapists are practitioners of movement dysfunction .

U definitely cannot know beyond your level of exposure . Not really mean to insult you @phartomm but that is the hard truth.

thank you @octopaul for coaching him quite well.

allycat: My dear colleague Phantom, don't worry when the new order of medicine in Nigeria takes over a patient who has just had a stroke and is comatose and having seizures will be rushed to the lab or is it the pharmacy or is it the physiotherapist. Oh I forgot the Nurse consultant will put her in a bed and start administering her drugs. After all who needs a silly Consultant Cardiologist or Neurologist. The Consultant radiographer will see the patient and decide for himself if he or she needs a CT scan or an MRI or a Ct angio and when the results come out he will send them next door to the pharmacist to prescribe. The fact that someone wrote" most Nigerians know what a stroke is or can even diagnos it themselves" shows you how shallow that persons knowledge is. By the time a stroke victim is fit for physiotherapy, the acute phases are usually over or do the physiotherapist now have a management for ischemic strokes. It is obvious the person who wrote that does not know how strokes usually present because there is no way a patient in the acute phases of a stroke will be in any condition to take himself or herself to a physiotherapist. Are the neuro muscular PRACTITIONALS, now the ones that manage the cardiac issues associated with strokes or seizures or those in comas.
The reason Doctors are defending their turf so hard is that on a daily basis we are confronted with patients who have seen a "doctor" somewhere and have been mismanaged. After these people have mismanaged, delayed diagnosis etc when the patient dies or there are complications who bears the blame the actual Doctors.

Morotov1: Oh please, what other management do you give to a CVA patient whether hemorrhagic ( cerebral aneurysm etc) or ischaemic after the initial stabilization.?? Most people don't have stroke at the hospital but at home only to be taken to the hospital when the deed has been done where the condition is confirmed, patient stabilised and send for rehabilitation. While some people opt for the hospital route , some go straight for rehabilitation. And to think that a stroke victim takes himself to the hospital is funny .....well maybe in mild cases.
Don't attack my knowledge but the Nigerian factor, ever done a survey research This is not textbook version but Nigerian reality.

allycat:
Thank God you know that after a stroke the patient is taken to hospital and the condition confirmed , patient stabilised and only sent for rehabilitation. Your words not mine.

allycat: In the developed world where people respect their boundaries and there are strong regulating bodies, yes physiotherapist do have some measure of indigence and may be the person of first contact for people with neuromuscular injuries. But in Nigeria with physiotherapist that who believe they can handle conditions like strokes on their own it will be a recipe for disaster. The doctor cannot do everything on his own nd that is why you have doctors referring patients for physiotherapy, sending them to radiographers for radiologic investigations which will aid our diagnosis admitting in wards for nursing care and prescribing drugs which are dispensed or where necessary compounded by pharmacist. The problem now is other health care professionals now want to consult and diagnose and manage patients beyond their scope of training.

phantomm: you can see you really don't know what's going on. the radiographer ONLY images the patient. by virtue of their training they CANT interprete results. any that does us committing an illegality. the lab scientist tests samples and concludes that he found A,B& C in a certain blood sample and that A is sensitive to nitrofurantoin,B is sensitive to ciprofloxacin and C is sensitive to nystatin. left to the lab guy he will give those drugs to cure the patient BUT the doctor by virtue of his training matches the lab result to the history he got from the patient and his examination of the patient. if the doctor feels the patient has disease X and from what he learnt in school, disease X does not occur with A,B & C in blood, he will ask for a repeat lab $
test.the doctor is trained to tie up many things.

pfijacobs:
Who be dis fool? Comparing johesu to nasu? U dey madt? Check ur hierarchy wella men in d faculty of medicine, there is medicine as a dpt, physiotherapy, dentistry, and so on so why d stewpid analogy? U just hatin and dey aint ranting! Jusy forget it... Ur pharoahtic monopoly is over... In luth here a microbiologist is d provost so get ur info ryt... Re.tarded ass.hole

armadeo:



the office of the minister of health. HMMMMM!!!! Let me see


the minister of health oversees all federal ministries concerning health issues, therefore all federal hospitals report to him and who reports from the federal hospitals the CMDS.

now the medical training is one of chain of command hope you see where this is going?



to further explain the Cmds after meeting with all professionals in his setting report to another Dr who by virtue of his training make an informed report to the president on health issues or doesn't that make sense.

The same goes for commissioners, this is all about head of the medical team. okpari nothing more nothing less.

armadeo:


dude i already used that link above to buttress my point. it never said the dg MUST be a pharmacist and that's the LAW. The man is a doctorlawyer and has a phd in pharmacology. the only issue you have is that he is a Dr.




as another poster said assuming this fellow had a pharmacy degree first then proceeded to do medicine will this come up



please. call a cutlass a cutlass

armadeo:


dude i already used that link above to buttress my point. it never said the dg MUST be a pharmacist and that's the LAW. The man is a doctorlawyer and has a phd in pharmacology. the only issue you have is that he is a Dr.




as another poster said assuming this fellow had a pharmacy degree first then proceeded to do medicine will this come up



please. call a cutlass a cutlass

Morotov1: Oh please, what other management do you give to a CVA patient whether hemorrhagic ( cerebral aneurysm etc) or ischaemic after the initial stabilization.?? Most people don't have stroke at the hospital but at home only to be taken to the hospital when the deed has been done where the condition is confirmed, patient stabilised and send for rehabilitation. While some people opt for the hospital route , some go straight for rehabilitation. And to think that a stroke victim takes himself to the hospital is funny .....well maybe in mild cases.
Don't attack my knowledge but the Nigerian factor, ever done a survey research This is not textbook version but Nigerian reality.

Morotov1: My point is there are exceptional cases ......and rehabilitation is a major part of the getting well process in a post-stroke patient, you won't allow the muscles to atrophy.

toysleek:
You just confirmed what i wrote.. The lab scientist can interprete the results of tests done..What to do with the results, is now left to you.

PharmGreg:
bro, thats just a one of the duty of the health minister.
.
And, all what u said there can be done by any of the professionals.
.
.
What about this other function below which the minister performs in one of its departments?
.
The department of Food and
Drugs Services formulates
national policies, guidelines
and strategies on food and
drugs, and ensures ethical
delivery of pharmaceutical
services nationwide. The
department sponsors the
National Institute for
Pharmaceutical Research and
Development and the
National
Agency for Food and Drug
Administration and Control,
and acts as regulator through
the Pharmacist Council of
Nigeria, the Institute of
Chartered Chemist of Nigeria
and the Institute of Public
Analyst of Nigeria.
.
http://en.m.wikipedia.org/wiki/Federal_Ministries_of_Nigeria
.
Going by what you said about report, here, the Pharmacist will report to a Physician(Health Minister) who know just a little about the NAFDAC. Does that make sense?