Events over the past months and years has given me the impetus to write this article based on a purely objective and unbiased point of view. Before i begin, I will like to reiterate two things; first, I am a practising pharmacist in Nigeria but currently undergoing a masters degree programme here in Australia with the hope of full registration by next year. Second, this article will be a lengthy one so you need a bit of patience to go through my points. I may however tend to lean towards the pharmacy point of view (for obvious reasons).
The term “International best practices” has been bandied around by both the NMA and JOHESU in their quest for superiority in the health sector so I would juxtapose the ideas of this phrase in Nigeria with what truly obtains here in Australia.

1. There is ABSOLUTELY NO NEED for other health care consultants (pharmacists, nurses, med lab scientists, physios, etc) in hospitals.
I recently concluded a placement in one of the hospitals here in Sydney and on the second day after commencing, I asked my preceptor “How many consultant pharmacists are employed in the hospital?”. Her reply was simple. “In hospitals? No. We do not need them”. And rightly so because all they need are well grounded and extremely knowledgeable clinical pharmacists who are assigned to particular wards. In other wards, you have a pharmacist in charge of and responsible for all medication and medication related intervention in a particular unit. My preceptor is a year younger than I am but when it comes to medication issues especially as it relates to her unit (Neurology and Medical Assesment Unit) she is extremely brilliant, simply because she is specialized in that aspect. That is what we require; specialization, not necessarily with the name tag “Consultant”. The same goes for other health care workers with the nurses having the designation “Nursing specialist”. Some of them are even more highly specialized as seen with the Drugs and Alcohol Nursing specialists

2. The patient belongs to EVERY MEMBER of the health care team
Another contentious issue. We often hear that the patient is registered under a particular consultant and thus that consultant owns the patient. True. Even “truer” however is the fact that other health care members who attend to that patient also own the patient. In other words, the patient belongs to the members of the health care team treating the patient. “How does the pharmacist or physio or Med lab scientist contribute to the patient’s treatment?’’.Oh!!!! A whole lot. I was amazed at the contribution of the pharmacists in patient healthcare. Did i have to be? No because it is what they do. They go on ward rounds, review each and every patient, intervene where such is needed and make recommendations. These people know almost everything about their patients!! If they notice any unusual error or problem with a patient's medications or observable side effects, they page the doctor or team currently attending to the patient. Infact in my short stay, I helped prevent complications from arising when an old woman with a history of penicilin allergy was changed from IV ceftriaxone to Augmentin Duo forte tablets which the doctor had prescribed probably due to oversight. The unity and relationship between all health workers is what we really need in Nigeria. Of course you still have some consultants (doctors in this case) who overlook what the pharmacist has recommended at certain times but whatever happens to the patient henceforth is the responsibility of the doctor as long as the pharmacist has documented the intervention. The dietician, occupational therapists also play very significant roles in the management of a patient if their services are required especially in the case of geriatrics. The take home point here is, UNITY!!!!

3. The Government takes Health care very seriously
Certainly not the case in our country. Once a patient is admitted, (and as long as you have your medical insurance), EVERYTHING is free; medications, food, laboratory tests and so on. They have a unified payment system for payment of salaries with relativity as regards your work description (though I do not think JOHESU has asked for same pay with NMA members). The government understands the important role of health care workers and as much as possible, try to keep them “comfortable” within their budget. They ensure the hospitals have all required machinery and equipment for proper functioning. Throughout my stay in Nigeria, I never saw any hospital with a pneumatic tube system, yet these are basic things over here.

I can go on and on. But the bottom line here is that all stakeholders have to come to a round-table. Let each profession recognise the importance of the others. Let the doctor do his/her job and collaborate with other healthcare team members with the patient being uppermost in his/her mind. Let the nurse do same. Allow him/her go for relevant courses and apply what has been learnt to patient care. Let the pharmacist go on ward rounds, review patients and make proper interventions as his job description entails(in addition to dispensing of course). Same goes for the medical laboratory scientists and physios. Let the government open its eyes and do its duties as regards proper health care delivery
At the end, let the welfare of the patient be the primary reason we have chosen our jobs and lets eschew bitterness, greed and selfishness.

views and comments are highly welcome..