…No, we own the patient –NMA
Unlike his medical colleagues, the Chief Medical Director (CMD) of University College Hospital, Ibadan, Prof. Temitope Alonge, has said that the title of ‘consultancy’ in a teaching hospital should not be reserved for doctors alone. He however, explained that the terminology which could apply to other professional bodies that have got to a certain level in their career should not be confused with that of a consultant doctor which is based on years of practice in a particular specialty.

Prof Alonge who is also an Orthopaedic surgeon, divulged this to newsmen during a media parley in Lagos recently.
In the recent times, the issue of consultancy has caused quite a controversy in the medical sector, with the dispute largely blamed for the unresolved industrial actions, the consequential death tolls and the decay in the sector.

While other health professionals such as Pharm. Olumide Akintayo, the President of Pharmaceutical Society of Nigeria (PSN), has argued that the title “consultancy” as well as the position of directors, are applicable to other health professionals, a member of Nigerian Medical Association (NMA), Dr. Olubunmi Omojowolo told National Mirror that this cannot work in a teaching hospital. “Yes there are consultant nurses and pharmacists in other countries but that is only in private hospitals, it cannot work in a teaching hospital”, he said.

Report has it that the hornets’ nest was stirred when consultant nurses and pharmacists were appointed at UCH and other teaching hospitals, a development that did not go well with the doctors.

According to the Medical and Dental Council of Nigeria (MDCAN), the situation became unbearable when, “consultant nurses prevented surgeons, who performed surgical procedures on patients from inspecting the surgical wounds of their own patients.” In a press conference at Ibadan, the President of MDCAN, Dr Olusegun Ayodeji Oluwole narrated how a Consultant Plastic Surgeon was barred from reviewing the surgical wound he created post-operatively because a “Consultant Nurse” had reviewed the wound earlier and was satisfied with her findings. Also at the Nnamdi Azikwe University Teaching Hospital Awka, a “Consultant Pharmacist” was reported to have invaded the wards with his team, canceled patients’ prescriptions and demanded that a Consultant Cardiologist remove a key drug in an in-patient prescription, on grounds that the drug has some known adverse effects.

On the heel of these developments, the NMA commenced an indefinite strike after issuing a 24-point demand to the government, one of which include the discontinuation of non-medical doctors as Directors and Consultants in a teaching hospital.

Pledging its resolve to continue the strike despite the Ebola outbreak, and the recent sack of 16,000 resident doctors, the NMA president Lagos branch, Dr. Kola Ojo, insists that the title of ‘Consultant’ in medical practice is reserved exclusively for a doctor that has gone through a minimum of six years postgraduate academic training.

According to him, the patient is traditionally registered under a consultant, who owns the patient and reserves all rights over the patient.
However, in a shift from the doctor’s sacrosanct view, Prof Alonge of UCH Ibadan explained that the premier teaching hospital does not concentrate effort to one cadre of medical profession alone. “Let me say that in UCH, we don’t discriminate and we implement government directives to the letters. The Federal Government has issued a mandate that everyone should get to the peak of their career”.

He expressed the view that other members of the health sector have the right to be made directors in teaching hospitals explaining that “very soon, we are going to have directors of pharmacy, nursing, physiotherapy at UCH. All of these people are Level-17 officers and we must give them their due rights”.
While reacting to the incident of ‘consultant nurses’ and ‘pharmacists’ which has its root from UCH, he explained this as a confusion of terminology, “It was an unfortunate scenario when the hospital introduced, without the consent of the ministry, the issue of consultancy in other areas.

I think the terminology is what is confusing the entire public because when the patients come they don’t have an idea that Consultancy, by virtue of professionalism is different from a consultant in a particular specialty based on years of practice as a doctor. But I think a particular committee is addressing the terminology”

Professor Alonge lauded the efforts of specialized pharmacy also known as “clinical pharmacy” adding that no one can question their approach to care. “If you send a prescription to the pharmacy department and the drugs are not compatible, the pharmacists will comfortable write on the prescription back to you, asking you to kindly review the prescription or ask for a discussion.

“That is called clinical pharmacy. Otherwise, a young doctor, by virtue of the limited experience in particular area may want to mix drugs not deliberately but out of the fact that he has not had deep experience enough to know the limitation. But the pharmacy will not say I don’t want to give you the drugs, rather he will write to the doctor, so we have a good working relationship with our pharmacists,” he said.

He also narrated his own experience in 1995 while practicing as an orthopedic surgeon, “having written a prescription of antibiotics, the pharmacists called me – ‘can I have few words with you?’ He explained that the prescription may need to be reviewed but I informed him that the patient has an acute infection and I needed to contain it as soon as possible and that is why I have extended the prescription beyond the routine to 10 days. And that was accepted because it was a straight logical discussion”
Prof. Alonge advised that everyone should know their limitation and other profession should also be respected.
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Pastor prof Alonge always supporting d truth since 1914.