₦airaland Forum

I think the health care system in the country is still stuck in the 18 century not much innovation coming from that sector.

dumodust: please stick to what you know and stop shooting in the dark for answers to things you dont understand... confuse anxiety for indigestion? aggravated simple food poison with bucket load of antibiotics? dude stop trying to impress people by exaggerating, you actually sound weird, no doctor will talk like this, none... the guy you replied is right, stop diverting attention and ranting. a pharmacist trying to treat potentially serious right lower abdominal pain is WRONG! patients may even require emergency surgery and she's there pouring over her EMDEX. anything is possible with abdominal pain, when i say anything, i mean anything.doctors make mistakes just like everybody, they are human too, but your examples are wide off the mark
besides that, second opinion from who? second opinion from a pharmacist about a diagnosis? never heard about that... i can go ask questions at the pharmacy about a particular drug i intend to prescribe but i wont go discussing abdominal pain and it causes with a pharmacist... he doesnt know jack shyte about it and the possibilities

The point of the conversation is not about mistakes in diagnosis... Very common I might add. It is the ability to of different areas to work based on learned aspect of their work. We are not talking about a physician asking an RN about a diagnosis but patients asking others besides MDs about a problem. Please don't confuse the two

DebateNigeria: Beautiful, I agree. But will the doctor have the power to make final decision concerning such patients.
I am not a medical doctor but have friends who are doctors and I used to have ulcer which I am sure the pain is at the upper part of my abdomen. But to my surprise, there was a thread on health section, a pharmacist was consulting for nairalanders and was asked to advise someone with pain on her right lower abdomen, to my surprise, she said it was ulcer. She probably have more knowledge than me, but I am not sure any doctor will make such a mistake.
She tried so hard to show that pharmacists can do it, but she got it wrong. Yo me, that is not clinical pharmacy. I will take time to read about clinical pharmacy and make comments when the time is right.
I agree that the workload is too much. Are you aware that in this country we have CHEWS(Community Health Extension Workers) and they attend to patients and help reduce workload, but they have never been a threat to doctors, pharmacist or others.
The way JOHESU is going about theirs, it's as if they are going to pose as threats...... The patients are at the receiving end.

So also are doctors who confuse anxiety for indigestion or aggravated a simple food poisoning with a bucket load of antibiotics.. It all depends on who you are talking to. BTW there is this thing called second opinion.

DebateNigeria: Most times, they are Vice President of Nursing services... You can re-check. But when it comes to administration, there is usually a meeting. Even when disciplinary actions want to be taken against doctors, I am sure non doctors are made members of such panels.
Yes, even in our hospitals, some nurses rank higher than doctors, eg the head of nursing services or clinical services (if a nurse) will definitely be higher than other health workers (doctors inclusive). But looking at it in a broader perspective, the doctor will always take the lead, from leading the clinics and or ward visits, to making final decisions concerning patients, to administrative hierarchy in the hospital.

..

1. Ward visits are hospital dependent, A pharmacist can initiate a ward visit on his/her own, so also other therapists, they do a permit from anyone as long as they document their findings

2. In modern medicine doctors only make decisions where there compitence lies... in most modern hospitals these days, all the MD does is diagnose and leave the drug, dosage and etc to the pharmacist.... also, Physician assistants even cover for the doctors in most cases.

Things have changed since the 18 century

DebateNigeria: Wow.. You can really drive home your point without being too emotional.
I have been able to witness the schedule of a medical doctor and I was marveled. The next question that came to my mind was what is the life expectancy of an average Nigerian doctor.
Sincerely speaking, those in the teaching hospitals and general hospitals are working like machines.

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I believe that the schedule of a general practioner is so because the NMA wants it as such... Many countries have moved on. in some places there are Nurse practioners, Physician assistants, Advanced Pharm.Ds that see patients, diagonise and prescribe medications. Introduce that in the country and reduce the load with the resultant wider access to health care in the country

DebateNigeria: Exactly my point. Now we are getting somewhere. Most nurses in the USA have MBA yet they will never be head over a doctor. If there is any, let me know.
Point is that if they want to become health managers, no need to practice at all, take management courses, start climbing the ladder ( and off course medical knowledge will be an added advantage).
I know some hospitals own by nurses ( that makes them CEO) but after them as CEO, the next person is the doctor, he earns more, makes decision that others must respect and even the CEO dare not interfere in his management of patients.

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there is no law anywhere that says that because you are promoted to manage an establish you relinquish your practice of your beloved profession.... if there is point it out for me.

DebateNigeria: Exactly my point. Now we are getting somewhere. Most nurses in the USA have MBA yet they will never be head over a doctor. If there is any, let me know.
Point is that if they want to become health managers, no need to practice at all, take management courses, start climbing the ladder ( and off course medical knowledge will be an added advantage).
I know some hospitals own by nurses ( that makes them CEO) but after them as CEO, the next person is the doctor, he earns more, makes decision that others must respect and even the CEO dare not interfere in his management of patients.

what do you mean head over a doctor
So some of the RNs who are vice presidents are not making decisions for doctors. Or that some nurse anesthetist who make operating decisions that the doctors have to abide are non existent
Lastly some nurses earn more than doctors not counting overtime.
So what exactly do you mean by head over.

DebateNigeria: Yes, neither is he a nurse, a laboratory scientist nor a pharmacist. Now who is the next person after him in terms of hierarchy? A doctor.
Please go back to my post to look at the hierarchy.

The point is that a hospital CEO can be anyone with the right managerial skills and have absolutely nothing to do with whether the person is an MD. RN.Pharm.D. etc.
An RN (as an example) with a good managerial skill can still make a good hospital CEO.
Again. Do you mean a Pharm.D (example) with an MBA or PHd in hospital management and a good managerial skill cannot run a Hospital?

Oduduwaboy: In Nigeria , the CEO of hospitals are the CMD / MDs who are responsible for the day to day running of the hospitals.

So a CEO is merely an administrator of an establishment. And to run an establishment depends purely on managerial endowment ... As in degrees in administration. Management . or a natural talent for leadership acquired from experience through the rigorous climb of the coprotate rather. So are Nigerian Hospitals redefing these qualities or taking them to be irrelevant in the management of hospitals.

DebateNigeria: A medical director who reports to a board chairman and must seek approval of such a board before making important decisions

So in Nigeria the Hospital day to day running AKA a CEO must be an MD

Oduduwaboy: this guy , would you please stop confusing people here? The President of Johns Hopkins hospital is a non-doctor .This is comparable to the Hospital board Chairman in Nigeria. However , MD/CEO is a doctor !

Texas children CEO is not an MD please

dakotchic: Ok a pharmacist is the chairman of board of national hospital Abuja. Doesn't that make sense now? The chairman of board is equivalent to the CEO, he and his board members including all the directors make policies concerning the hospitals day to day activities. As expected the CMD- Medical director is a doctor as obtains all over the world. Talk about benchmarking with world's best practices!

Again my question is ...who is in charge of the day to day running of a Nigerian hospital

DebateNigeria: Anytime you look at the leadership always try to look at the hierarchy .... It will help you make a logical conclusion. Also look at my last post and try to work on it. I will be amazed to see a nurse or pharmacist or laboratory scientist who is not a health manager as CEO or CMD or President as you have been posting.

Sir, OK to make it little simpler to understand each other..

Who is in charge of the day to day running of a Nigerian hospital

Shakes85: How many times will you be corrected?

What correction

DebateNigeria: I will look it up. But I am also interested in the hierarchy. For your information, in the Nigerian hospital setting, this is what it looks like,
1. Board chairman (not a medical doctor, probably a politician)
2. CMD (medical doctor)
3. CMAC (medical doctor)
4. dIrector of administration (a public administrator)
5. Head of Pharmacy
6. Head of nursing
Etc

So what is the equivalent of a CEO and or president in Nigerian setting

DebateNigeria: I will look into this

While you are at it sir, look up St. Luke's some of their vice presidents are RNs.

infolekan: Lack of knowledge is dangerous.
Boston Medical Centre is a private medical academic centre.
You'll be surprised that most of those places you mentioned are wholly owned by individuals and corporations so they can put anyone they see fit to head.
And you keep forgetting that Nigeria isn't a Capitalist country and we don't have any centre in the country that can compare to any of these centre's.
It's also one of the leading Medical research institutions in US of A.
We don't have any real research going on in our universities here not to talk of our Hospitals. Need I Say More.

I agree with you am an illiterate that lack basic knowledge of how things work and Nigeria in general still that begs the question . Are those places hospitals where people who are sick go for treatment. Its a simple question by an illiterate like me . if you would kindly proper an answer to my simple question

DebateNigeria: Again, give me a few mins to do my research on this.
Mr. Wallace is nit a doctor neither is he a nurse or scientist or pharmacist. He's a health manager. Now did you read about the leadership of the hospital? After mr Wallace whose not even a health practitioner, the next 3 in the hierarchy are all medical doctors.
I am one of the advocate for non health care providers (health managers) to head our hospitals. But if the leadership must come from amongst the health care providers, then it must go to the doctors as obtained in the USA as you have highlighted.

I will continue to analyze your comments and post my opinion.

So if an RN with degrees in Hospital management and years of management experience to match they should not head a hospital or a health care system because they are healthcare providers right... Is that your basic argument

CEO of Herman memorial Hospital ( one of the largest in Houston) is not an MD



Craig Cordola Named CEO of Memorial Hermann-Texas Medical Center
HOUSTON, TX (September28, 2010)



Memorial Hermann Healthcare System recently announced the promotion of Craig Cordola to CEO, Memorial Hermann-Texas Medical Center, following his successful and widely respected seven-year tenure as Assistant Vice President and then CEO of Children's Memorial Hermann Hospital . Cordola is also the Associate Dean for Hospital Affairs and Community Partnerships at The University of Texas Medical School - Houston. He succeeds Juanita Romans, who is retiring.

He joined Memorial Hermann in 2003 as assistant vice president of operations for the Children's Hospital, with additional responsibilities overseeing volunteer, environmental, facility and chaplaincy services for the Memorial Hermann-TMC. Previously, he worked as A Director of Operations for Texas Children's Pediatric Associates and Texas Children's Hospital after serving in management capacities for other healthcare organizations.

Cordola has served as an adjunct faculty member of the University of Houston Clear Lake Healthcare Administration Program and a board member of the university's alumni association. He holds master's degrees in business and healthcare administration from the University of Houston at Clear Lake and a bachelor's degree in psychology from the University of Texas at Austin. Cordola is a fellow in the American College of Healthcare Executives, and serves on numerous community boards.

President of the Boston medical center is not an MD


Who We Are
About the CEO

Kate Walsh
President and CEO

Kate Walsh, CEO and President of Boston Medical Center, effective March 1, 2010Kate Walsh became the president and CEO of Boston Medical Center (BMC) on March 1, 2010.



Prior to her appointment at Boston Medical Center, Ms. Walsh served as executive vice president and chief operating officer of Brigham and Women’s Hospital for five years. She served previously as the chief operating officer for Novartis Institutes for Biomedical Research.

Ms. Walsh began her career in health care as a summer intern at Brookside Health Center in the Boston neighborhood of Jamaica Plain. Upon finishing graduate school, she held positions in a number of New York City hospitals including Montefiore, Columbia Presbyterian Medical Center, Saint Luke’s – Roosevelt Hospital Center and the New York City Health and Hospitals Corporation. She relocated to Boston and joined Massachusetts General Hospital (MGH) as an assistant general director in medical services and was promoted to vice president of medical services and primary care and then to senior vice president of medical services and the MGH Cancer Center.

Ms. Walsh received her bachelor’s of arts degree and a master’s degree in public health from Yale University. She is a member of the Boards of Trustees of Emmanuel College, the YMCA of Greater Boston, the Boston Public Health Commission, the Massachusetts Hospital Association, the Council of Teaching Hospitals, and the Yale University School of Medicine. She is also a member of the Advisory Board of the National Institutes of Health Clinical Center, the Health Care Institute and the Boston Green Ribbon Commission.

Ms. Walsh, a native of Brookline, is married and has two child

President of the famed Texas Children hospital is not an MD

Mark A. Wallace
President and Chief Executive Officer

Mark A. Wallace was appointed President and Chief Executive Officer of Texas Children's Hospital in 1989, at the age of 36. Under his leadership, Texas Children's Hospital has grown into one of the nation’s largest and most comprehensive pediatric and women’s health care organizations, garnering more than 3.2 million patient encounters annually, achieving international recognition as a referral center and ranking among the best pediatric hospitals in the nation.

Mark A. WallaceIn 2013, Texas Children’s Hospital was once again named as a national leader among pediatric hospitals in U.S.News & World Report’s 2012-13 edition of Best Children’s Hospitals. Ranked 4th among all children’s hospitals nationally and one of only 12 hospitals to achieve the Honor Roll designation, Texas Children’s is the only hospital in Texas – and the entire southern region of the U.S. – awarded this distinction. And it was founded at least 60 years later than all of the other top-ranked hospitals on the list.



Prior to his current position at Texas Children's Hospital, Mr. Wallace was a senior vice president at The Methodist Hospital in Houston, Texas, having both staff-related and extensive line operation responsibilities in a large, tertiary care, teaching environment. Mr. Wallace holds the distinction of being one of the few executives in the country who advanced to fellowship status in the American College of Healthcare Executives (ACHE) at the age of 35. Continuing his involvement with ACHE, he has served twice as president of the Houston chapter.



Mr. Wallace holds degrees from Oklahoma Baptist University and Washington University in St. Louis. He is married to Shannon Baronette Wallace, and they have two children, five grandsons and one granddaughter.

The President of the famed John Hopkins is not an MD

Mr. Ronald R. Peterson
President of The Johns Hopkins Hospital and Health System

A 1970 graduate of The Johns Hopkins University, with a master's degree in hospital administration from The George Washington University, Mr. Peterson is vice chairman of The Governor’s Workforce Investment Board, a member of the Maryland Hospital Association Executive Committee, and holds an appointment to the Notre Dame of Maryland University President’s Advisory Council. He serves as a member of the boards of Big Brother Big Sister of the Greater Chesapeake, the Maryland Business Roundtable for Education, the Living Classrooms Foundation, the Greater Baltimore Committee and the Center Club. Most recently, he completed terms as a member of the Board of Governors of the University HealthSystem Consortium, and the Joint Commission Center for Transforming Health Care’s Leadership Advisory Council.

An MD degree is not a prerequisite to Head a Hospital


Stephen L. Mansfield, PhD, FACHE
President and CEO, Methodist Health System

Stephen L. Mansfield, PhD, FACHE, is president and CEO of Methodist Health System, having assumed the role in 2006. Before joining Methodist, Dr. Mansfield served seven years as president and CEO of the five-hospital St. Vincent Health System based in Little Rock, Ark., and prior to that he held a variety of administrative positions within the Baptist Memorial Health Care System in Memphis, Tenn., for 23 years.

Under his guidance, Methodist Health System has doubled in size and experienced the most profitable years in its history. Methodist has been recognized by Thomson Reuters as one of the nation's top health care performance improvement leaders, and it has earned honors from publications including Modern Healthcare, the Dallas Business Journal, and The Dallas Morning News as a leading employer and recognized as a Best Place to Work. In 2012, Modern Healthcare listed Methodist among the “40 Fastest Growing Healthcare Companies in America.”

Dr. Mansfield holds a bachelor's degree in Healthcare Administration from Ottawa University in Kansas, an MBA from the University of Tennessee at Martin, and a Ph.D. in organizational leadership from Regent University in Virginia Beach, Va. He is an active member of the Dallas Regional Chamber®. Dr. Mansfield is also a member of the board of directors for Dallas County Community College District Foundation; a board member of the Dallas Citizens Council; a board member of the North Texas Commission; a board member of the NRMI of the University of Tennessee @ Martin; a board member of MD Buyline; and a member of the Institute of Healthcare Executives and Suppliers. Dr. Mansfield was named to the 2011 Becker's Hospital Review "Hospital and Health System Leaders to Know" list and was acknowledged by the Texas Chapter of the March of Dimes as Outstanding Volunteer Fundraiser. In 2012, he was recognized with the Ernst & Young

Why FG sacked Enejere as UNN Pro Chancellor.
Posted by: The Citizen in Other News 17 mins ago

The Federal Government suspended and dismissed Dr. Emeka Enejere as Pro-Chancellor and Chairman of Governing Council of the University of Nigeria following evidence that Enejere was polarising the institution, ignoring the instructions of the Minister and ministry of Education as well usurping the role of university management, as he became an Executive Chairman.

Enejere in particular disregarded the instructions of the Minister of Education, Barrister Nyesom Wike to pay the N1.9b earned allowances of university staff as he had taken over the University Bursary. These earned allowances were paid the allowances from December 20, 2013 following the removal of the pro-Chancellor.
The refusal to pay earned allowances made the Ministry of Education and the Vice Chancellor look bad before staff of the University and was even one of the complaints of staff.
The Federal Government appointed Enejere in April 2013 as chair of a Governing Council including one time Speaker of the House of Representatives, Hon. Salisu Buhari. Enejere is an alumnus of the University of Nigeria who also taught in the institution before leaving as Lecturer 1. He is also an indigene of Nsukka.

Since his appointment, suspension and dismissal, the hitherto calm University of Nigeria has been embroiled in turmoil. Host communities of the institution have led protests to the school four times demanding that UNN management led by Prof. Bartho Okolo, as Vice Chancellor should provide power and water to them. Similarly, factions of the Academic Staff Union of Universities (ASUU) and other unions are also demanding the resignation of the Vice Chancellor on the strength of an alleged probe by the Council that the supervising ministry of education has yet to acknowledge.
Investigations show that the Federal Ministry of Education considered Enejere’s chairmanship of the Governing Council as disruptive. The last straw was a demonstration by one of the host communities on December 2, 2013 witnessed by a Federal Government representative on the Council. Her report indicted the Chairman of Council as it showed that the demonstration was sponsored.
Records at the University show that the Pro-Chancellor unilaterally cancelled and suspended appointments/pomotions in the University, a function outside the scope of University Council.

In a memo copied to the Registrar and Controller Personnel Services, Sir Dr. Emeka Enejere, asked University Management to “take note that with effect from the inauguration of Governing Councils of Universities on April 9, 2013 by the Honourable Minister of Education, Professor Ruqayyatu Ahmed Rufai, any employment or appointment not brought before the Council for prior consideration and approval is null and void”.

In consequence, the appointments of two Deputy Vice Chancellors have yet to be confirmed as well as other key staff of the institution.
Enejere’s Governing Council also awarded contracts and instructed either the University Registrar or Bursar to implement. The refusal of the Bursar, Mrs. Chinwe Obi, to honour those instructions she deemed “unusual and not in line with procedure”, fetched her suspension from the Chairman of Council who personally supervised her evacuation and handover from 9pm to 2am on the day of her suspension.
ASUU and some other unions at UNN have been fighting for the return of Enejere as chairman of Council, abusing the Honourable Minister of Education whose ministry initially recommended Enejere’s appointment and later recommended his sack.

Source : http://thecitizenng.com/other-news/fg-sacked-enejere-unn-pro-chancellor/

Sincere 9gerian: My only disappointment is that fuel subsidy was not fully removed. I hope he removes it fully soon so that the sector will be opened up for private sector investment.

Also Boko Haram has been a very huge drawback. I hope we will hear less and less of Boko Haram attacks.

In education, he has to find away to free the federal higher institutions from the evil strangle-hold of labour unions- ASUU, ASUP, et al. All labour disputes and unionism should be localised to individual schools. It is very unhealthy to have labour unions with capacity to shut ALL federal institutions. This can be discussed at the national conference.

PHCN privatisation was the most significant development in 2013 for me. I hope he follows up with transparent privatisation of the refineries.

The railway and road sector bills should be forwarded to the NASS for passage.

Free and fair elections is another very important development under GEJ. I hope he continues on this path and as much as possible institutionalise it so that it will outlive his administration.

For the love of Maupe - I still don't know why the railway bill has not been submitted and passed.
GEJ.. these bills together with PIB are legacy bills. Your name will forever be etched in Nigerian Modern economic transformation once they are passed....

yousee: FYI, the President is bound to operate within the ambit of the laws that govern the country.
The senate is charged with making these laws for the judiciary to work with.

I deliberately used the word acceptable meaning that it has to pass the tests of both houses of assembly before whatever they come up with becomes law.

Comparatively yes - he has done much in a short period.

My biggest disappointment is the judiciary... Without a "functioning" judiciary all his "surgical" undertaking to right the system may come to not when another person comes in.

Seems that much is not being done in that sector.. Yes I know that they are independent. One would have expected GEJ to get some smart legal eggheads " lock them up in a room" until they come up with an acceptable modernized laws and procedures for administering justice for the country.

Democracy thrives on justice aka efficient- effective-transparent legal system.

The big two kahunas that will determine whether GEJ will stay or leave the office are the outcome of the national conference and the census.

Assuming that everything remains the same, retaining the office will require that he wins 25% of the votes in 24 states...

Does the current political equation and the attendant permutation allow him to retain or lose the office with all things being equal.

Who gave birth to those kids....and killing yourself have actually solved the problem of feeding them.
Am sure the government forced him to get married and have 7 kids when he cannot feed himself.

Most of our problems are self induced.

nadias877: it is morally wrong for a public servant of her caliber to expect a formal complaint to verify that some civil servants have not received their December salary. NOI is a liar. my sister works in the ministry of finance and is yet to receive her December salary. will she claim she's not aware of what goes on in her ministry?

What day of the month are civil servants usually paid

Abagworo: Nigeria needs a change of regime. That's the only thing that will save many politicians from being slaughtered in 2015. Obasanjo will however survive as usual because he has exonerated himself by writing the letter.

The only other solution is for Jonathan and other politicians to perform miraculously well in the next one and half years left so that they can win a free and fair election. Rigging won't work in 2015.

It is either you are for democracy or not. You cannot force a "change" on people. It is the people that determines the "change" they want. Your writing reeks of one who likes to force change on people whether they like it or not. Not liking to "change the regime" is a change in itself.

It is not the job of the government to bring the bacon to your dining table. It is you and you alone that can go out there and drag the bacon home, processs it and feed it to the members of your house hold.

The job of the government is to provide you the opportunity to do that. That includes a secure atmosphere, adequate infrastructure etc.