…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.

http://www.medicalworldnigeria.com/2014/08/consultancy-not-for-doctors-alone-says-uch-cmd/