₦airaland Forum

Why are people insulting the poster, he went to an American website and culled figures and even gave a link for people to check.

Maybe doctors should relinquish the title consultant and since everyone is quoting America use the term Attending.

I rest my case, it makes no sense preaching to the deaf!

tohpahz: pharmacists dispense doesn't mean they cant prescribe.. their original job description before Nigerian bullshit altered it, is to prescribe.. please do tell me the difference between dispensing nd prescribing... 2. please tell me?/if a pharmacist normal work is to dispense nd dey studied drugs. y dd dey study drugs? to sit down nd b giving drugs... haba!!!
in an orderly system, the doctor examines with d nurse. draws findings sends patient for lab tests nd xrays.. sends symptoms nd lab test to d pharmacist who reviews it. nd. mks a prescription. which d nurse administer

I have to laugh in Spanish, where did you watch this fantasy movie. Even in the Uk which you are quick to direct us to Pharmacist just got the license to prescribe in 2006 - and that was due to a shortage of primary health care physicians. In the USA they have not yet been granted this license. Nairaland is a great place to come to for comic relief!

Sorry the iPad keeps auto correcting and I am typing with 2 two year olds climbing all over me and punching buttons while I type.

And please don't try to be smart by half and mention vets, they are vet inward MEDICAL doctors.

Let me give you a simple assignment. Google the word honorary consultant,if you can find anywhere where it refers to a non medical doctor let me know. Note I did not say honorary medical consultant, just honorary consultant. As I said how can someone who knows nothing about a prefers soon want to head it, they will just kill it with ignorance.

The iPad auto corrected to cushiness. If you want insult me and call me quack, as I said nowadays when I see patients who are suffering from side effects of drugs that are supposedly prescription drugs that they bought over the counter from pharmacist I have no sympathy for them. If you are stupid enough to buy drugs prescribed to you by a faceless nameless person you met online then you deserve anything you get. If a doctor does this, prescribe online for a patient he has never clerked or examined, he or she deserves to have his license revoked. If a pharmacist does it and other pharmacist applaud him it says a lot about the profession.

There is no West african college of medical laboratory science. The MOU for the creation f that college was just signed in September 2013. It has not been created yet.

Please they should state how much they pay Honorary consultants in their teaching hospitals .

As I said imagine someone who doesn't have an idea how medical education is carried out now wants to head a teaching hospital.I didn't say the others do not need a hospital to do clinicals not necessarily a teaching hospital. If a hospital does not have lecturers from the university as honorary consultants it will loose it's accreditation as a teaching hospital and become a specialist or general hospital. That is also why they are overworked, they do the job of a full consultant and that of a lecturer. The hospital gets the service of a consultant and pays only some allowances which is about half what they would pay a full consultant and the honorary consultants salary even when you add the clinical supplementation is not more than the full consultant.

Training of all other medical personnel can take place outside a teaching hospital. It is only medical students that require a teaching hospital for their clinicals . The pharmacist, medical laboratory scientist, radiographers and nurses are employed by the teaching hospital purely for service, they are not employed by the university to teach and then seconded to the hospitals as is the case for medicine. Even where a University runs those courses their lecturers remain university staff and do not work in the hospitals. I hope you are aware that the salary of an honorary consultant level for level is almost the same as that of a full time consultant. They collect their salary from the university and the teaching hospital pays them a clinical supplementation that makes it at par to a colleague who is purely clinical. Unlike what many JOHESU members think consultants are not paid 2 salaries. As I said the average honorary consultant is an academic, he would do less work and with less stress if he remained a clinical specialist only.

I am addressing this because one of the demands by JOHESU is that teaching hospitals should employ their own consultants and not use honorary consultants because according to them the honorary consultant does not concentrate on his job in the teaching hospitals and shares his attention with the university.
So let me start by saying a teaching hospital is an institution set up for the clinical training of medical personnel which may be doctors, nurses, pharmacist, radiographers and medical lab scientist. However in Nigeria most were set up to train Medical Doctors. Correct me if I am wrong but there is no teaching hospital in Nigeria that is not affiliated to a Faculty of Clinical sciences of a College of medicine but there are many which have no college of nursing,pharmacy or medical laboratory science. Now a lecturer in the clinical sciences of a college of medicine must be at least a fellow of a post graduate medical college. It is with this he is now appointed an Honorary Consultant by the teaching hospital. As an honorary consultant, he runs, clinics, admits patients,if a surgeon operates and then he teaches. He teaches medical students and post graduate medical personnel known as residents. There are some consultants employed by the teaching hospitals but not by the University and these are supposed to be strictly for patient care and are not officially involved in teaching undergraduates, but do teach residents. So while the Hospital consultant does one job the Honorary consultant does two.
If someone now says teaching hospitals should do away with honorary consultants who are the teachers, what that person is saying in essence is scrap teaching hospitals and make them Specialist hospitals. However in Nigeria most consultants who are academically inclined prefer to be lecturers and prefer to be staff of university teaching hospitals where there is an academic atmosphere and people are constantly rubbing minds and interacting. That is why most of our specialist hospitals are specialist in a name only, they do not attract the kind of personnel they would have liked.
This is one of the reasons Doctors are fighting and striking. If people who do not even understand the reason why teaching hospitals are set up and staffed the way they are, now want to head teaching hospitals, there will be anarchy in the system.

I am a consultant in my field of medicine and I think twice about prescribing Prednisolone because of its potential side effects if not properly monitored. Also when stopping the drug it has to be tailed off, so imagine my shock when I saw someone prescribing online Prednisolone tabs one daily, no duration, no dosage. So if the patient finds a quack to sell him Prednisolone without a prescription he may end up with either 2.5 or 5 or 10 mg. When he gets cataracts or adrenal failure or cushiness disease Sheba it's one useless doctor like me he will rush to and expect miracles. And yes I said quack because no well trained pharmacist will sell these drugs to anyone off the street without a valid prescription. It's before I used to have pity on such patients now when I see them I ask them why they don't go back to the initial "Doctor", why come to me now there are complications that most times are irreversible. From the replies to the doctor pointing out what is wrong here, I am justified in my attitude. Please go and read the Doctors thread an tell me how many times you see them actually prescribe drugs for patients they have not seen.

. What you should be concerned about is the jungle medicine still being practiced in Nigerian teaching hospitals and many other cases of malpractice and negligence (documented by Olatunji Ololade in the Nation of 5th April, 2008), where doctors spent one month diagnosing a brain tumour as a sinusitis problem

I highlighted that statement because the same thing happened to a close friend of mine in University of Maryland Medical centre in the almighty USA. And mind you she herself is a Consultant Neonatologist.

If a patient dies who is blamed, the doctor. If a patient is mismanaged who is sued, the doctor. If I am the doctor and the buck stops on my table when something goes wrong, then nobody should complain when I say I am in charge. If I see a patient whom I suspect has an ectopic and the ultra sound comes back negative, the PCV appears normal and I fail to follow my clinical judgement and operate on this patient and she dies, who will be blamed ? Me, the Lab Scientist or the ultra sound technician.i gave that scenario because I have seen it played out several times. Lab or X-ray reports are normal but the patient I see in front of me has an obvious pathology. Since I am in charge I act on my clinical knowledge knowing that if the outcome is poor I bear the blame. So if you agree that the buck stops at my table, you have to agree that I am in charge.

When a patient dies who is blamed ? The doctor. When a patient is misdiagnosed who gets the blame? The doctor! Who get sued when patients relations are mismanaged? The doctor. If the buck stops at my table then who is in charge. In 2003 some American doctors did heart surgery in UNTH and some patients died and it was traced to fake medicine. Because the doctors were OYIBO the deaths were not automatically blamed on the doctors and investigations were carried out and it was discovered that the adrenaline supplied by the hospital pharmacy was fake. How many deaths do you think have occurred because of fake drugs and were blamed on the doctor. How many times have Lab scientist or radiographer been held accountable for faulty results when patients died, it's always the doctor that is blame. Once more I say if the buck stops on my table then I am in charge.

The general consensus I get from these threads is that the Nigerian public does not require the services of these idiots called Doctors. So why all the noise, take your sick to the pharmacist, physiotherapist , MLS and nurses, no one is stopping you. After all some years ago Borno state brought in Egyptian technologist who were acting as doctors. Yes people died but it's better than being treated by a lousy Nigerian doctor.In everything in life there is the law of demand and supply if people stop looking for doctors then we(cos I am one) will find our level. Shikena!

There is a thread going on in the health pages now that typifies what doctors are fighting against. It's called " Ask the pharmacist " or something like that. Yes he states he is a pharmacist but when people refer to him as Dr he never corrects them. Then someone wrote in saying they had eczema and he went ahead and prescribed Prednisolone one tablet a day, no duration, no exact dosage. First he didn't examine this patient to know if what the patient had was actually eczema knowing that the average Nigerian calls any unsightly rash eczema.
Is the patient to take 30 mg or 10 mg. what if this patient is also on any other steroid for any other reason, he doesn't know or care since doctors have threads hero she wants to prove pharmacists can do so too. He is also on that thread prescribing anti tuberculous drugs for a patient he has never seen or investigated.Now compare that to the doctors thread how many times do you see them actually prescribing drugs, they usually give general advise and tell you whom to see etc. it's usually some queers looking for relevance that come on those threads and prescribe. This is what JOHESU wants us to sit back and allow to be legalized. When the person uses the Prednisolone and has complications which fool is expected to clean up the mess. Your guess is as good as mine.

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.

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.

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.

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.

Teaching hospitals are set up to train primarily medical doctors and dentist. The honorary Consultant is a lecturer from the College of Medicine who in exchange for using the patients to teach his students, renders service to the patient. Many of the honorary Consultants you see in teaching hospitals would not be there if there was no academic activity going on. The residents on the other hand are post graduate medical doctors. While taking exams of the various post graduate faculties are required to undergo training under specific Consultants who most of the time can only be found in teaching hospitals. The standards of a teaching hospital at least in Nigeria are different from those in general hospitals and other none training institutes for the simple fact that they regularly undergo accreditation by various bodies NUC, post graduate medical colleges etc to retain the privilege to train both medical students and post graduate students. If you take away the teaching aspect from these hospitals they will revert to General hospitals as many of the rare specialist who are academically inclined will move over to wherever training is going on. Presently more private hospitals and private teaching hospitals are beginning to get accreditation to train Medical students both at the under and post graduate levels and there is a quiet but steady drain of lecturers and consultants from the government teaching hospitals to these places. I foresee a future in this country where some specialties will only be found in private institutions and the services will be unaffordable to the average Nigerian. I give an example. In lagos State Health service there were only two cardio thoracic surgeons. Since the last round of strikes and counter strikes one has left for a private institution, and he was the only Paediatric Cardiologist I government employment. And although he was not doing many earth shattering surgeries, the small he was doing made a lot of difference to the lives of many children with heart conditions.
In India the top hospitals we all rush to are all private and most of their post graduate medical training is done in private institutions, the difference there is their health insurance is a vibrant industry. Maybe that is the direction we are heading to.

Yungbitz: [quote author=Maximus
i dont no if u cn help me..4 about 2yrs nw i can smell a tin....it started in my final yr,i had catarh such dat my nose was kinda block..@ wen d catarh cleard up,i could no longer seml anytin..i met a doctor in a clinic n xplained,he was lik it wud eventually stop dat it happens @ times....but til date i stil cnt smell a tin...help if u can..am in Benin

You really need to be examined. There is a good ENT Department at UBTH.

[quote author=Maximus85]Lasuth doctors said unless its a severe case, they are not allowed to refer to the ENT.

You can get a referral from any doctor not neccesary one from LASUTH, take it directly to the ENT clinic in either LASUTH , LUTH or even General hospital Lagos Island. They will give you an appointment which I know will be long but still try and see someone eventually.
And yes Otrivine is easily available from any decent pharmacy.

Sorry I don't do private practice. Still get get a referral either LASUTH or LUTH any doctor can write one for you. Unfortunately ENT equipment is very expensive so unless he/she isn't buying good equipment it is unlikely you will see a cheap one, that's also why the waiting list in government hospitals is soo long.

For the guy with wax it may have to be syringes out first by an ENT specialist and your ear drum examined before the reason for the noise can be determined. Good luck to putting honey and hydrogen peroxide into the ears I am yet to see it work at clearing wax when it is plenty.

There are private ENT clinics one in Ilupeju ,20 Ilaaka street off Coker street Another at 19 Yinusa Adeniji st off Muslim avenue off unity road ikeja. They are not cheap though. Unfortunately unless it's a life and death situation you will be given an appointment if you go to any general hospital.
What you describe sounds like your Eustachian tube , a tube that connects the ear to the back of the nose, is not functioning well so fluid is accumulating in the middle ear. So treatment will be geared at decongesting the nose. Nose drops like Otrivin 2 drops 3 times a day for 5 Days maximum. Nasal decongestants like procold one a night for the same 5 days and then an excercise to allow air into the middle ears and displace the fluid. Hold the nose and close the mouth and then blow your nose for like 3 seconds. You should feel the ear pop. Do this like 10 repetitions 3 x a day.. I didn't examine you so I can't prescribe more. Do this for a week and see an ENT if you still have problems.

I have a solution for this, sack all Nigerian doctors from government hospitals and employ Indian or Egyptian doctors and nurses or better still mandate nurses and pharmacist and lab technicians to take over patient care. After all these people are all humanitarian and will give you free service and the highest quality with substandard equipment unlike we stupid Nigerian doctors. Yes I oh am one of the stupid, useless Nigerian trained doctors and I was sacked by Lagos state 2 years ago so all these kill doctor comments aren't new to me.

Please spare me, If Agbalakas drugs worked, really worked nothing would have stopped people from flocking to him. This is because the best referral in medicine is word of mouth. This would happen even if he was a babalawo. If I get a cure I tell my friend and so on. iIf his drugs really worked his patients would be out there spreading the news till today. Or haven't you heard of people who had cancer 20 years ago coming on air to share the good news and encourage early detection and screening. Or women who had babies by ivf 15,20 years ago coming out on air or in newspapers to tell their story so that others may be encouraged. So where are all those Agbalakas patients that he cured or did the evil eye of the Western world cause their HIV to return?
If Magic Johnson's doctor was a Nigerian by now he would be claiming a cure since they cannot detect the virus in his system presently. However since that is an orderly society till they withdraw his drugs and observe for predetermined number of years and still see no virus he is not considered cured. Or let me use cancer as an example again, all over the world hundred of thousands of people have been treated for cancer and survived, even here in Nigeria we have so many breast or prostate cancer survivors, have you heard any doctors coming out to say they have found the 'cure' for cancer. This is because there are laid down scientific protocols for the discovery of drugs and treatments. It is only in Nigeria people would want to bypass them all and since we have a gullible public they get away with all sorts for some time.
Dr Ibe is a trained scientist and knows the correct thing to do if he has made any discovery, it's only if he has something to hide he would wAnt to avoid proper scientific scrutiny.

This is for mothers of young children, please get rid of any small batteries your child can get access to, if swallowed they can kill. In less than 4 hours they can cause deep burns in the throat which can lead to death from complications. I am just coming from theatre where I removed one from a baby and it reminds me that many parents are unaware of the dangers. For your innocent child's sake do something today.

First question I I would ask you is what are your areas of interest? If for instance you like calculations there are doctors who studied Medical Statistics at masters level and are doing very well in outside this country because there is a demand for them. Do you like IT for instance the field of medical programming is a a relatively new one and growing by the day. During your postings postings , NYSC and house job if you ever get into an area that interests you, find out out all you can about it it because at the end of the day doing what you love is is the only way. New fields fields of medicine are opening up each day day and there are other ties specialties just sitting there.
Have you ever heard heard of Audiological Medicine Medicine before? I ever never heard about it till I was in my my 4th year of residency. It involves hearing loss and it's management and and it is interesting ( to and me) and lucrative.
I can't tell you what what to do but advice you to keep keep an open mind and open your eyes. I I had no no idea what I wanted to do until my house job when I spent spent weeks in my my present specialty and fell fell in love.
No specialty is soft or mediocre and no specialty is easy. Personally I dont like anaesthesiology because I I feel you are are tied to someone else. You work only when a surgeon needs you and and a the the time he or she needs you. But But I have friends who think anaesthesia is the the bees knees.
I I wish you best of luck.