₦airaland Forum

chuksbogus:
A Prof of surgery wrote this

On Doctors, JOHESU, Hospitals (administration, titles & salaries) and the Patients.

What I write here is a brief account of my thoughts.

1. We the doctors have to improve on our human relationship skills. Nothing to do with JOHESU. We relate poorly with ourselves. It took me years to notice this so I was guilty for so long. I cannot say if I am now different but others will judge but I know I have worked very hard on myself.

*We hate the truth especially when we are the slackers and we embrace mediocrity and despise excellence. Yes, you would find diligent doctors producing heartwarming results and the sloppy doctors even unwilling to change. The system supports this.
*check what we do to ourselves when it comes to appointments to posts (legendary) and worse if it is an election
*Why should the Neurosurgeon, Cardiothoracic surgeon, General surgeon and Laboratory Physician or Community health physician earn the same call duty allowances even as doctors? May be there should be a standard call duty allowances and then the quantum of your work or inconvenience on duty should then be calculated further to determine your earnings. Will my colleagues support this? So there would new struggles within.

2. JOHESU May have suffered in the hands of doctors. We despised them, didn't work for their progress until they started having a voice of their own or working for themselves. We resisted the posts of even Assistant Director for Nursing--i saw this as a trainee surgeon in UCH. Now we have Director of Nursing Services. They got these for themselves. How can you be a leader with lack of care for your team members? However, the response from JOHESU has been violent and would be counter-productive in the long haul. May be it is part of negotiation: throw everything in and eventually when the system collapses, you would get something a little more than what you have now. He that is down fears no fall!

*JOHESU has the numbers and more money to get circulars anyhow in a corrupt country. Capitation dues by members staggering. Doctors are fewer, won't pay enough dues etc.

*Respect must be MUTUAL.

*Whether the doctors are good or not, JOHESU thinking that the doctor can be sidelined or rubbished is a suicidal tendency that would bring the house down on everyone. That's where we are now with the current strike.

* A physiotherapist thinking he can function without the neurosurgeon, neurologist or orthotics beats my imagination!

* A Pharmacist or Nurse thinking he can function without the specialist doctors suggests inadequate training (no insults intended).

I have said it too that
*Doctors thinking they can function without the nurse, pharmacist or others is poor, unhelpful or mediocre thinking

3 CMD positions in University Teaching Hospitals. I believe for administrative convenience, a lecturer in a University who is a Honorary Consultant specialist in a University Teaching Hospital has to choose one employer for salaries and wages then he is a staff of the University and he collects allowances in the Hospital where he is labelled no staff. On this account JOHESU says non-staff can not now head the University Teaching Hospital. Who understands the mandate more than a lecturer? I agree you don't have to be a lecturer to understand the mandate but then also you cannot close the door on a lecturer-consultant!

All the arguments of long years in training, go and do JAMB and study medicine, privatise the hospitals (doctors) and we too can cripple services without the doctors or start negotiating how to make degree trainings to be as long as for doctors hence Doctor of Physiothery, Optometry, Doctor of Pharmacy etc are all self-serving.

What's the way forward?
What caused all these?
Where is the PATIENT health and WELLNESS in all these struggles?

The corruption in Government is another issue that makes all these shenanigans possible! Appointments, Discipline, Circulars, discriminatory no work, no pay

These are not questions for one person to answer. I have my idea as but I can be labelled biased because I am a doctor. Suffice it to throw these questions to the public space and hope we shall get some workable, non-emotional or self-serving solutions. We know that these issues are not found in Private Hospitals or outside Nigeria!

Food for thoughts

objective enough. he has an open mind

fitzfrankses7:
I have keenly watched and read how all of you(JOHESU and NMA alike) keep throwing jabs and curses at each other, arguments and counter-arguments on who is right and who is wrong and being quick to yell "International best practice" only when it suits your individual whims and caprices. In the end you're all just a product of a system that failed to teach intra professional tolerance, respect and work place harmony. It beats my imagination to see Med students been taught NMA/JOHESU rivalry (heck I was unfortunate to have emerged from that system but thank God I shed that skin) same goes for students of other equally important health professions; I was even more shocked when two siblings exchanged fisticuffs because of JOHESU/NMA rilvary.
I've been privileged to practice where the patient is truly king and won't hesitate to sue you for all you're worth for unhealthy workplace rivalry/supremacy; so we really had to be a Team-everyone knowing his job description and never claiming to know all. I've learned to love and respect every health worker in my team, because I need them if I'm to offer my best services and if they have a legitimate demand, I support them and vice versa.
If a Surgeon claims he knows better than a Pharmacist or Physiotherapist then he's mediocre and if a Med Lab Sctst or Nurse assumes he knows better than a Physician knows, he's also mediocre. Acrimony like this even leads to intolerance between Surgeons and Physicians so who's fooling who.

rightly written. i think the primary cause of disharmony in d health sector is EGO exhibited by most meds docs which i think is ingrain in d DNA of a black man as is reflected in oda professions. for instance d army sees d police or civilian as lesser human by virtue of d rigors of their training nd finds it fun to hv dem brutalized (as though dt was wht dey were trained to do) at d slightest provocation . the black man is power crazy nd would go at any length for it and most time abuses it when EGO comes first bfr duty. what was supposedly a GOVT vs JOHESU war has turned into NMA vs JOHESU war due to interference by d NMA. this interference by d NMA in matters of oda health professionals is unhealthy and should b resisted. we are all professionals trained to carry out our various duties hving d patient as d center of our interest. why let EGO come in?. d NMA sees johesu's agitation as striping dem of d power dey hv exercised for so long in d health sector which many a tym hv abused it; using it as a tool in suppressing d growth of other health professionals in order to hv dem under their control. A HEALTH INSTITUTION CANNOT EXIST WITHOUT PATIENTS AND ALL PROFESSIONALS ARE EMPLOYED TO SERVE THE PATIENTS AND NONE IS EMPLOYED TO LORD OVER OTHERS . #We can exist in unity and bcom more productive if we do nt put ego first bfr duty. this applies to evrivoda sector in the country #

danilmo:
thanks doctors. this is heart warming..

My love for this profession mehn..

God ll forgive them...

optm, comma see them o

amarabae come and carry ur people o

Lalasticlala, FP material.

lolz this one sweet u abi? good job to the team of med docs. we re first of all humans before we bcame whatever by virtue of our professions.

danilmo:
these guys know the stuff wella,MBBS holder, specialized in it again. hmmmm


OK

imagine if there is association of optometrist ,
then this association deem it fit to work relatively with Opthalmologist, it will b better and accepted..

there will b no point for me to start suffering the one who agreed I know more na. it ll b odd

a human on top will always wana suppress who he think/know he knows more than till the person accept to work relatively with the boss..

Common respect to a senior will settle this..

this will b better than joining johesu,
Doctor s will have no choice than to do to optometry the way they do to other johesuite, coz it's obvious johesu hate doctor and doctor wana do all possible to do d needful on anyone in that association..
but are they ready to accept Opthalmologist know more, I doubt, we are human being.u know the drill

those international guys we are talking made it obvious that doctor is in a better term to treat a patient, they don't build hatred for doctor. rather they love, choose to work with doctor..but in Nigeria, our own johesu will tell u how they always correct a doctor(probably a young graduate) thereby using it to ridicule medics generally..

see Nigeria pharmD telling us only surgery differentiate him, I know u ll never hear that from British PharmD ..
Med lab will tell u them know like a pathologist , now the heat is between them and pathologist as if there consultant med lab can stand with a pathologist in that hospital knowledge wise.

Maybe till the meaning of Medical Doctor sink into johesu head that's wen they will realise the've missed it since..

Take for example in NMA,
a house officer respect register and belief a registral knows more,
a registal belief a consultant knows better, and will always ready to learn from the boss. not d other way round.
so the harmony continue there since respect was given and acknowledged


sometimes ago I was ill and the nurse administering injection to me was so loyal and cool , hearing that am a medic, she was pleased to handle me softly, pet me to eat well, I was happy. the next day I saw a doctor in that health center teaching her some basic skills , i guess the lady nurse was ready to learn and reaspectful..she ll go far than her mate..
meanwhile her mate are somewhere forming beef with doctor

all dsame bro..


enjoy ur day.

lolz .....i don even tire for the argument here..... i hope say bfr u grad, say all health workers wld wrk peacefully so u no go nid to continue the fight for hospital... lolz . do hv a nice day too

danilmo:
pharmacists seems not to have respect, so, the goal is to ridicule the said thing they said they know and teach them better the application which they lack since they wanna bite more than they can chew,
no need saying much, wen a slave /servant wanna raise shoulder than his master the best thing is to place /show him where he belong.

they should go and do the pharmacology sabi in the pharmacautical company,


till all johesu agreed that doctor own and know all in hospital setting than their whole combine, they ll keep having headache and we will keep putting them in good position at ease..

I only pity optometist for stooping so low to join johesu against doctor..

lolz kul down ur temper jare. optometrist dey see pepper fr ophthalmologist hand dey suffer just lyk oda johesu members. i m tired of d inter professional rivalry amongst health wrkers. no one shld try lording over the other. we re all servants to the pts. lolz

danilmo:
childish bah, that has always been the excuse, ave seen many online johesuite claiming Upandan how they know pharmacology than doctor but when challenge come, they shy off and say its childish,

one PharmD even tried me as he claim only surgery differentiate him from doctors, told me to follow him in mail, I did, we only greeted each other, asked him to now provide answer to my clinical question, till today he never say inch,

I just know, this table johesuits are shaking is the beginning of them publicing there incompetence and irrelevancy in health sector..

in our various trainings, we hv areas dt are given more attention because it is more relevant to our primary job spec. there re areas of pharmacology a pharmacist ll do better dan u as well as areas u wld do better due to d attention given in training based on its relevance to carrying out primary duties. a newly grad pharmacist is nt all grounded in evry areas that's why there re consultancy areas to mk dem authority in their chosen area of interest. i think a clinical pharmacologist shld be able to giv answers to ur questions. we all had diff trainings to enable us carry out our specific duties. it's childish trying to mk comparison in order to find out who is better. let's learn to hv respect fr one anoda.

Freddonance:
No need for the argument. simply challenge him in pharmacology & see how u will be humbled.
That's when u will know that every medical doctor knows much pharmacology than u do

i see dis as being childish honestly.

danilmo:
pls which other dept pass thru this pls,

u seems not to understand what the guy is saying ,

couple with the letter by Dr OBAFemi as regards how medical practixe is been done in international country where we got it from,

u guys should just sit and chill..

Enough if this Jor.
so many things taken for granted in this country .

even me i am tired responding......u wanna knw? just tk a form to study courses lyk optometry, pharmacy, physio, nursing , MLS and any oda course u wanna compare wit med surg only den can u confidently mk the claims dt med surg is more difficult dan evry oda. if u ask me, i dnt knw which is more difficult but i knw mine wasnt easy fr me nd i no b dull student

ifeyemi200:
Thank you

your kind is rare Mam.

TempoJames:
I am sure you don't understand why a medical doctor has no license to start a pharmaceutical company and why a pharmacist can't start a hospital.
Your question of why a medical doctor is in better position to head others will only be answered if u do an indept study of course contents of each field. Only then would you know a medical doctor has superior knowledge in all allied-fields as regard patient management. The hospital setting is not concerned about drug production but its use of which doctors have superior knowledge.
The same pharmacology a pharmacist studies for 3yrs(3l to 5l) is what a med doc studied in a year.
In UNN I studied pharmacology for 6months indepth no topic left out with true/false and negative marking and close marking applied with tendency to repeat or fail out if you fail. I exhuasted Tripathi text of pharmacology. Some times Lecturers finished by 9pm and you come back so exhuasted and tired and still have to read against the next day or accumulate work to your detriment.
Medical doctors are trained to carry knowledge in bulk. The same course others spread out and write semester by semester for 3 years is what a med doc exhausts under stress within a year or less and write exams across(not in parts). Those in medlab,medrehab,medradio, nursing will attest to the fact that their semester exams were used as continous assessment for medsurg students. They never wrote Mb. Last time I went to UNTH as visiting pathologist, the above academic regulations still holds true. Go and confirm and check the pass rate of their last 2nd mb and proof me wrong. Last year I heard only 12 out of 60 passed in dentistry others either failed out or repeated. currently they are 150(against 15 qouta) dentistry students and 325 (against 150 quota)medsurg students in YR1 my 2 kid bros are in pharmacy 500L and medsurg 400L UNN. I have first hand info from my colleagues over there too.
I remember in 2nd mb only 141(+resits) out of 335(including dentistry) passed . Abt 102 repeated 3rd yr and 98 failed out. I remember what happened that night the result was pasted around 9pm after 11hr long meeting by faculty boards. Many cried that day. A colleague that failed out even wanted to commit suicide.Tell which other health fields are subject to such truama. Yet you want to be doctors through the backyard without being test/baptized by the fire and ego of MBBS
Idiots!

lolz nd u think d stress is peculiar to med surg? i cnt start telling u my experience tru schl. but u hvnt told hw these has made u better qualified for a managerial position .... any person can own a hospital/ pharmacy but not any person can do d job spec of a pharmacist or a med doc

ifeyemi200:
I just read on the front page of Nairaland that JOHESU claims fresh entry doctors enter the system at Grade level 12,equivalent to CONMESS 3! That is totally false! Fresh level doc enter at CONMESS 2/3 I. e, CONMESS 2 step 3. To break it down further, the basic salary is about 130k per month. It is call duty allowance, which is about 60k which makes it close to 195k,plus other tiny allowances. The other health workers with grievances enter at grade 10 which is equivalent to 166k.

Please, why are they clamoring for parity with doctors? It's just a grade level difference, as in the civil service, after grade 10, is 12, no grade 11. The other health professional run shift duty, and are paid shift duty, off duty as approved. Some of them also receive call duty allowance. They can not receive allowances as doctors, as they do not work the number of hours as doctors. Doctors run 24hr calls i.e if a doctor is on call on a Monday for instance, that doctor comes to work for his morning duty on Monday morning, continues his call duty that same Monday till the next day, you will think that that is the end for the day, but no! A doctor will continue work the next day(Tuesday) to make it about 32hrs stretch! This is because doctors are never enuf, so, they work extra hours. This is not so for other healthcare professionals who work shift duty, as soon as their shift is over, it is till the next day. Not only dat, they have off duty days and are paid for it. So in essence, a doctor, who is on a 24 HR call will work with 3 diff shift nurses in 24hrs!

The ratio of doctors to nurses is far higher. It is usually 6:1. Per time in the hospital, you can only meet 30-40% of nurses on duty. The rest are off duty or not their shift! But when it comes to meetings and gatherings, you see them enmass, herein lies their strength. In the same vane, when Government wants to increase salaries, they find it easier to increase medical doctors' than other health professionals, as testified by the summation of the allocations given to it (it tends to be so enormous, that they eventually shy away from it).

To the other issues JOHESU is clamouring about, like consultancy, it is not any issue at all. If any one has gone through the rigours of training, then, let such a one be conferred the relevant title. However, there should be no conflict of interest.

The heads of hospitals can be anyone who is QUALIFIED, as speculated by the law. Personally, I propose that the Government goes into Public/Private partnership. This will lessen all the issues in the sector.

u re very much objective . i lyk u fr being unbiased

noble4d:
Thanks

it's my pleasure

filleSouriante:
@drsteriod Please what can you say about using medicated contact lenses. I use a photocchromic glasess and due to the fact that my eye balls are thining, I don't use it often which is really deteriorating my sight. Am thinking of wearing contact lenses but I need to know the positive and negative sides so I can weigh my options. Thanks

lolz i think i understood wht u meant by 'ur eye balls re thinning'...contact lenses ain't bad as long as u pay attention to hygiene. you can discuss using it wit ur eye doc

noble4d:
Two drops three times daily

ok. i find it wasteful instilling two drops as d cul-de-sac can't hold much as to taking two drops. it's better increasing frequency of instillation. i wouldn't change ur docs recommendation. if u keep experiencing such, go bk to him/her nd mk ur complaint. diff docs wit diff approach in handling cases. .... but i ll giv u a tip on hw best to use eye drops. Ensure u close ur eyes (not tightly) for smtime upon instilling ur drops so u dnt loose much( tru d lacrimal punctum) and hv it wrk for u. give it sm tym and i believe there ll b improvement else go bk to ur doc.

TempoJames:
The hate began when a pharmacist leaves his/her billion naira worth pharmaceutical firm and tryna head the hospital, when a nurse wants to head doctors, when a medlab scientist wants to head a pathologist, when a radiographer wants to head a radiologist , when a physiotherapist wants to be the CMD. Who started the hate? Idiots!
I am very sure a pharmacist wouldn't like to be paid same as nurses yet they want to be doctors. Hippocrytes!

i see no wrng if a med doc wrks in a pharmaceutical firm and aspires to get to the highest level in d firm if he/she is capable of carrying out d responsibilities demanded of such positions. a pharmacist doesnt aspire to head d med docs as a unit bt can aspire to head health institutions which he/she is part of and besides, dis position requires managerial skill rather dan clinical skill (dis d medical docs in naija has held unto so long as a right) . bro give me logical reasons why u feel a med doc is more suited to head d hospital dan a pharmacist or other health wrkers .

TempoJames:
Doctors will survive in Nigeria no matter the recalcitrance of idiots.

other health professionals wld survive too. how do u relate with other health care professionals in the health institution u wrk? I sense much hate in ur write-ups

Thanks18:
JOHESU AND NIGERIAN GOVERNMENT VS NMA HEALTH BATTLE: THIS IS THE CONCLUSION OF THE MATTER
By Fejiro Oliver
The equal right of all citizens to health, education, work, food, security, culture, science, and wellbeing – that is, the same rights we proclaimed when we began our struggle, in addition to those which emerge from our dreams of justice and equality for all inhabitants of our world – is what I wish for all. Fidel Castro
This is a long write-up for intellectuals who can research and not those who dwell in shallow arguments.
For two years, I purposely stayed away from writing as an individual on issues that bothered about the health sector in Nigeria, to enable me research on the true international best practices and come out with an informed and none bias position. Apart from education and defense, the most important aspect of a country is its health sector. Sadly enough, the sector in Nigeria has been bedeviled by animosity and fierce battle between the two prominent groups, namely; Joint Health Sector Union (JOHESU) and the Nigerian Medical Association (NMA).
JOHESU consists of all workers in the hospitals apart from Physicians and Dentists who make up NMA. I have decided to skip the word ‘doctor’ for a reason, which will be explained later. Nigeria is currently shut down with death toll rising every twenty four hours since JOHESU embarked on their strike last week. Despite the Federal Government refusal to pay them April salaries, they are bent on not going to work, until their demands are met. The argument from both sides is reasonable, depending on the prism through which one views it.
JOHESU is insisting that the FG honors all the agreement it reached with them, especially as it has to do with allowing their members to reach consultancy level, upward review of the CONHESS salary as agreed with FG, retirement age at 65 and few others. NMA on the other hand believes that the increment in salary for JOHESU will place them at par. They have also fought some JOHESU professionals from attaining consultancy status as well as using the prefix ‘Doctor’ before their name.
First of all, who is a Doctor? The word was never a medical word from origin. It is a Latin word from 1300, which means “Church father,” from Old French doctour, from Medieval Latin doctor “religious teacher, adviser, scholar,” in classical Latin “teacher,” agent noun from docere “to show, teach, cause to know,” originally “make to appear right,” causative of decere “be seemly, fitting,” from PIE root dek- “to take, accept”, as defined by etymonline. When the art of healing came into serious practice, the word ‘Doctor’ was used to replace the word ‘leech’, which they were initially called.
It therefore brings us to the argument on those entitled to use the suffix ‘Dr’ before their names in the health sector. First of all, it’s an acceptable fact that no one went to school to study ‘doctoring’. Unlike Engineers who derived their title from their course of study, this is not entirely so in the health sector.
In the school of health or school of medicine, as it’s called in different universities, the courses are Medicine, Pharmacy, Dentistry, Nursing, Medical Rehabilitation or Physical Medicine, Radiography, Medical Laboratory and Optometry. None of these courses is called Doctoring. The word Doctor came to be associated with the art of healing in the medieval period and were initially called Physician and still called so till date. With the advent of Doctor of Philosophy which is the highest level associated with teaching, it later became ascribed to those saddled with the art of healing.
The question now bothers to who is a healer in the health profession and who is a paramedic; a degrading word that has been used many times by Nigerian Physicians to spite other medical workers, who retaliates by calling them Allopathic officers.
In line with international best practices, only the World Health Organisation (WHO) not World Medical Association and International Labor Organisation (ILO) can define the meaning of every profession. In listing structures for each worker, all professionals were listed as ‘Health Professionals’ and not ‘Medical Professionals’. They were divided into two health groups for easy recognition. The first group listed are: Medical Doctors (Generalist Medical Practitioners and Specialist Medical Practitioners), Nursing and Midwifery Professionals, Traditional and Complementary Medicine Professionals, ***Paramedical Practitioners and Veterinarians.
The second group listed Dentists, Pharmacists, Environmental and Occupational Health and Hygiene Professionals, Physiotherapists, Dieticians and Nutritionists, Audiologists and Speech Therapists, Optometrists and Ophthalmic Opticians and Health Professionals Not Elsewhere Classified.
Note that Dentists which is a member of NMA is in the second category and Paramedics in the first category, according to International best practices that we like to flout.
Let us take a look at WHO definition of these core workers in the health sector.
According to WHO, ‘a Generalist medical doctors (including family and primary care doctors) diagnose, TREAT and prevent illness, disease, injury, and other physical and mental impairments and maintain general health in humans through application of the principles and procedures of modern medicine. They plan, supervise and evaluate the implementation of care and treatment plans by other health care providers. They do not limit their practice to certain disease categories or methods of treatment, and may assume responsibility for the provision of continuing and comprehensive medical care to individuals, families and communities’.
Same WHO notes that ‘Nursing professionals provide TREATMENT, support and care services for people who are in need of nursing care due to the effects of ageing, injury, illness or other physical or mental impairment, or potential risks to health, according to the practice and standards of modern nursing. They assume responsibility for the planning and management of the care of patients, including the supervision of other health care workers, working autonomously or in teams with medical doctors and others in the practical application of preventive and curative measures in clinical and community settings’.
Going down to traditional level, WHO was direct when it stated that ‘Traditional and complementary medicine professionals examine patients and prevent and TREAT illness, disease, injury and other physical, mental and psychosocial ailments by applying knowledge, skills and practices acquired through extensive study of the theories and experiences originating in specific cultures. They research, develop and implement treatment plans using applications such as acupuncture, ayurvedic, homoeopathic and herbal medicine’.
For Dentists, the world body noted that ‘Dentists (including dental surgeons and related) diagnose, TREAT and prevent diseases, injuries and abnormalities of the teeth, mouth, jaws and associated tissues by applying the principles and procedures of modern dentistry. They use a broad range of specialized diagnostic, surgical and other techniques to promote and restore oral health’.
According to its supreme definition, ‘Pharmacists store, preserve, compound and dispense medicinal products. They counsel on the proper use and adverse effects of drugs and medicines following prescriptions issued by medical doctors and other health professionals. They contribute to researching, testing, preparing, prescribing and monitoring medicinal therapies for optimizing human health’.
For Physiotherapists, WHO didn’t mince word saying that ‘Physiotherapists assess, plan and implement rehabilitative programs that improve or restore human motor functions, maximize movement ability, relieve pain syndromes, and treat or prevent physical challenges associated with injuries, diseases and other impairments. They apply a broad range of physical therapies and techniques such as movement, ultrasound, heating, laser and other techniques. They may develop and implement programmes for screening and prevention of common physical ailments and disorders. ILO in classifying their job stated that “Physiotherapists and related associate professionals TREAT disorders of bones, muscles and parts of the circulatory or the nervous system by manipulative methods, and ultrasound, heating, laser or similar techniques, or apply physiotherapy and related therapies as part of the treatment for the physically disabled, mentally ill or unbalanced.
For Optometrists, the world body says Optometrists and ophthalmic opticians provide diagnosis, management and TREATMENT services for disorders of the eyes and visual system. They counsel and advise on eye care and safety, and prescribe optical aids or other therapies for visual disturbance.
While this may sound as a thesis, I will leave out what the sacred definition of WHO and ILO gave to the two eyes of medicine, notably Radiography and Medical Laboratory. The reader can Google it up.
By these definitions, five professions TREAT sicknesses and disorders and one provides the drugs or body gel they prescribe, while two gives a clearer picture of the diagnosis through tests and imaging.
They are General Practitioner called Medical Doctor, Traditional or complimentary medicine practitioners/
Homeopathy, Dentists, Nurses, Optometrists and Physiotherapists. Nursing being a unique and distinct profession cannot be called Doctors, but the rest whose primary duties is to diagnose treat and certify fit can be called Doctor if their regulatory body so wish.
On consultancy status, it is criminal for a profession to demand for such almighty position simply because of the years spent in service and not by merit. It’s akin to saying a lecturer can rise to the level of Professorship without studying to get PhD. This is where I disagree with JOHESU. Medical Doctors who are consultants didn’t jump the rope. They went through the rigors of residency training, became fellows and merited it.
Medical practice is not law that is determined by the years of practice which leads to the award of SAN. It is study, quest to break medical grounds and solve the everyday health challenges that the world faces. No amount of experience can totally give clinicians that except devotion to knowledge, which is gained through the appropriate postgraduate school or colleges.
It is however unjust for the current disparity in salaries of the two warring groups. Whoever separated the salary structure into CONMESS and CONHESS is the common enemy that we should be fighting today.
It’s absurd and ridiculous that a House Officer will earn higher than a working class Nurse or any other core medical practitioners, when the difference in study is one year. Only a specialist GP should be allowed to earn more than any other clinician, who refuses to also specialize in his/her own field.
The FG should as a matter of urgency make all health workers one salary structure, and their wages determined by level of qualification and specialty as operated globally. The Ministry of Health should be headed by hospitals administrators and not physicians, just as the hospitals should not also be headed by a Dentist or Nurse.
For heaven sake, it’s a profit making venture and not a professional body that the Medical Doctors heading it have turned it to. Only the Chief Medical Advisory Committee (CMAC) head should be a Physician while the Deputy CMAC should be from other clinical department like Medical Laboratory or Pharmacy.
International best practices that we scream always have proven that the top countries in medical field do not have any health worker as their Minister or Head of health sector. Oh, what about the almighty WHO that defines health, the head is not also a medical doctor, but a biologist. If WHO was a Nigerian union, it’s crystal clear that there would have been strike if a Nurse is appointed the head. What then are we saying?
As for JOHESU, calling off the strike now will forever bring your union to doom. Let the government stop salaries till next year, but do not give in to threats and blackmail. Your requests apart from ‘consultancy by years of service’ are just, and Nigerians are solidly behind you, even though we are the ones that ultimately feel the pain. There’s unity in strength and this is the time to be united. The battle is not against NMA but the Federal Government who reserves the right to implement your demands.
Every profession is independent of each other and this right to decency of work cannot be taken from you, not now, tomorrow or in the future.
To be continued…
These little things matter…
Fejiro Oliver, an Investigative Journalist, Media Consultant and Human Rights Activist is also the Co-Convener of Coalition of Human Rights Defender (CHORD) and can be reached on +2348022050733 (SMS ONLY) or secretsreporters@gmail.com. Engage him on twitter on @fejirooliver86.

dont mind them; na to dey shout international best practice as if their eyes re blind as to see how other health professionals med drs here claim to be useless practice abroad.

phemy2kme:
THE HIPPOCRATIC LOATHE – Flicking the switch

“Declare the past, diagnose the present, foretell the future.”
― Hippocrates

When you step into a room and flick a switch, you either create light or you create darkness, in this quagmire of unnecessary dark rancor let us flick the switch and create light.
International best practice is defined as” A program, activity or strategy that has worked within one organization and shows promise during its early stages for becoming a best practice with long-term sustainable impact. A promising practice must have some objective basis for claiming effectiveness and must have the potential for replication among other organizations”, meaning we will adopt an already developed and proven process or strategy and make it our way of life, in short copy and paste, or we set a precedence of chaos and hope others will copy it as international best practice exported from us to them with love.
Internationally, every professional working in the health sector apart from Medical Doctors and Nurses are referred to as “ALLIED HEALTH WORKERS” who are support staff to the aforementioned, locally in Nigeria they are referred to as “JOINT HEALTH SECTOR UNIONS” (JOHESU) that comprises the bulk of the work force save the Medical Doctors.
When you or your loved one goes to seek medical attention from qualified and well-trained personnel’s, a machinery is set in motion around you, which comprises these support staff and the medical personnel. The record staff opens a new case note for you or extract one you used in your previous visit, he passes this case note on to the nurse, who checks your vitals and gets you ready in the consulting/examination room for the Medical Doctor.
The Doctor asks you series of questions, your answers direct his train of thought, with a few differential diagnoses at the back of his mind, he examines you, which helps him to remove from or add to the list of diagnoses, to rule in or rule out options from this list, he orders for tests ranging from Imaging, body fluids examinations to tissue examinations.
These tests are carried out in different locations by medical doctors / JOHESU members, E.g A radiographer in radiology department will shoot the x-ray as he was trained to do, he will then pass the film, after developing it to the medical doctor in radiology department, who is a specialist to interpret the “picture” appropriately as he was trained to do, this radiographer and medical doctor only knows of your radiological report. You then proceed to the laboratory as directed by the medical doctor in the consulting room to chemical pathology laboratory, medical microbiology laboratory and haematology laboratory, different specialist medical doctors and laboratory technicians in these laboratories will run your body fluids and blood samples as they were trained to do, the medical doctors will write the reports and send same to the medical doctor in the consulting room, the doctors and the laboratory technicians are only privy to the reports obtained in their respective laboratories.
After all these, you will go back to the medical doctor in the consulting room with the gamut of reports, which will help the medical doctor to confirm the diagnosis he had on his mind or which will point him in another direction, after marrying your clinical presentation to the laboratory reports, he will make his choice of treatment, you will get an appropriate prescription detailing name of medication (drug), dosage of medication, mode of administration, frequency of usage and duration of usage of the drug. This is passed on to the pharmacist who will dispense the drugs, identify each one for you, explain mode of administration of each to you, often at times you will have to go back to the nurse for the administration of some of the medications, or to the medical doctor and some will be self-administered by you in your house, after which the records officer files your case note appropriately for subsequent usage, at the center of your care is the medical doctor in the consulting room holding all the pieces together and seeing the big picture, he is connecting all the units to give you a diagnosis and ultimately treatment, no one has the right or training to play this role save the medical doctor. Spending donkey years at the medical doctors’ elbow or shadowing him does not confer on anyone by default the right to play this role, unless you go into a university to study medicine as a course and swear the Hippocratic oath.
Doctors are responsible for protecting your personal information and data, hence the parlance, patient doctor confidentiality and not patient health worker confidentiality.
National Medical Association was founded in 1900 in the United States of America, while the counterpart Nigeria Medical Association was formed in 1951.
Following WWII, healthcare needs and demands increased, the Allied health workers was formed in 1967in the United States to support the work of medical doctors which will allow him concentrate more on diagnosing and shedding some weights to the support workers.
In 1976 the medical and health workers union of Nigeria was formed, which is a precursor to the hydra headed unequally yoked body, dubbed JOHESU.
It is very easy to become a medical doctor anywhere in the world, just meet the admission criteria, in Nigeria, you have to beat the JAMB/UTME cut off point, which Is usually steep, at this point no one clamors for “score parity”, “equity not equality”, everyone keeps mute and follows their chosen paths willfully or fatefully, after 1 year of general courses with other departments, the workload of medicine thereafter is something light but it is not for the faint hearted, in 2 years you finish 3 degree courses, that have students studying them independently for 5 years, following which you cross over to the clinicals where you earn 2 more degrees in 3 years, all these makes up the super degree MBBS (actually 4 degrees in 1).
After the 6 official years in school, 1-year internship and 1 year mandatory service to the fatherland, a medical doctor chooses his path, either he works as a medical officer or enroll for postgraduate study/service (residency), this takes another 6 years on the average of intense postgraduate studies, at the same time you are offering your service as a medical doctor (you are a graduate with a super degree, remember?) to the center where you are undergoing training, this chimera confuses the uninitiated who will call you, a student doctor (what a display of paucity of adequate cerebral functioning), following passing the prescribed professional examinations you become a specialist, you have invested on the average 14 years of your life in knowledge seeking and proper education as a medical doctor.
Let us create darkness on the call for “pay parity”, “equity not equality”, which is double standard anyway, with the definition of international best practice still fresh on our minds, let us turn our searchlights to the medical “eldorados” of this planet, to save time and space we will look at UK and USA.
USA is officially divided into 9 regions;
NC – north central, GL – great lakes, NW – north west, SC – south central, SE – south east, NE – north east, SW – south west, W – west, MA – mid Atlantic,
we will compare the pay of medical doctors with that of pharmacists, optometrists and nurses (they are the highest paid JOHESU units) in these regions.

NB: Pay is average per year for the top earners across the states in each region.

MEDICAL DOCTORS
NW – $ 301,000 GL - $ 303,000
W – $ 290,000 SE - $ 297,000
SW - $ 292,000 MA - $ 282,000
NC - $ 317,000 NE - $ 296,000
SC - $ 300,000

PHARMACISTS
NW - $ 125,850 GL - $ 115,160
W - $ 136,730 SE - $ 117,690
SW - $ 118,360 MA - $ 122,230
NC - $ 113,720 NE - $ 125,680
SC - $ 126,460

OPTOMETRISTS
NW - $ 126,200 GL - $ 113,880
W - $ 115,260 SE - $ 107,200
SW - $ 93,340 MA - $ 127,940
NC - $ 107,360 NE - $ 140,880
SC - $ 118,950

NURSES
NW- $ 75,350 GL - $ 64,430
W - $ 94,120 SE - $ 61,780
SW - $ 97,040 MA - $ 58,760
NC - $ 56,350 NE - $ 60,700
SC - $ 66,350

These figures are self-explanatory, we don’t need a PhD in mathematics or accounting to see the obvious, let us move over to the United Kingdom (UK), this country is, made up of Great Britain, Northern Ireland, Scotland and Wales. We will compare the pay of medical doctors with that of pharmacists, physiotherapists and optometrists in these regions.

NB: Pay is average per year for top and lowest earners (medical doctors) and top earners (JOHESU)

GREAT BRITAIN
Medical doctors
Consultants - £ 82,000
Private practice - £ 103,000
Public - £ 60,000
Residents - £ 40,000

Pharmacists (experienced)
All sectors - £ 50,000
Physiotherapists (experienced)
All sectors - £ 19,000
Optometrists (experienced)
All sectors - £ 44,000

NORTHERN IRELAND
Medical doctors
Junior doctors - £ 34,500
Consultants - £ 84,000

Pharmacists (experienced)
All sectors - £ 33,344
Physiotherapists(experienced)
All sectors - £ 38,077
Optometrists (experienced)
All sectors - £ 48,634

SCOTLAND
Medical doctors
Physicians - £ 67,317
Surgeons - £ 89,325

Pharmacists (experienced)
All sectors - £ 38,653
Physiotherapists (experienced)
All sectors - £ 30,000
Optometrists (experienced)
All sectors - £ 36,521

WALES
Medical doctors
Junior doctors - £ 35,000
Consultants - £ 84,641

Pharmacists (experienced)
All sectors - £ 39,417
Physiotherapists (experienced)
All sectors - £ 38,035
Optometrists (experienced)
All sectors - £ 42,147

Looking at what is being done in the land of the Queen that is attracting so many of well to do Nigerians, politicians and medical doctors, we can see without having a degree in mathematics one of the reasons why we flock that way, for your information, health sector budget in UK for 2018 is £ 124.7 Billion (# 1.7 trillion), another reason we take the leap.
This imbroglio has gone on for too long, we need to put an end to it, there is no where in Gods own world, that the proposed madness is taking place, this situation is taking its toll on all of us, we are Nigerians, we reside in Nigeria, we access healthcare in Nigeria, a group of people should not continue to hold us at ransom and be wasting our lives and the lives of our loved ones because of their own selfish immoral interests.
I am a medical doctor, I chose to be one, I enjoy being one, if I have a second chance at life I will be a medical doctor all over again, I will save as many lives as I can, that is who and what I am, I swore to the Hippocratic oath which you loathe.

DR FEMI OBAFEMI.

re the radiologist/pathologist a supporting staff too? ;since dey aint holding all d piece of info on d pt to come up with a diagnosis as all dey do is interpretation of test results d consulting med requests ; and hence dey shld be as 'useless' (a claim by meds docs ) as oda health professionals making up JOHESU. if dis writeup is subjected to logical reasoning, it fails to prove itself true.

noble4d:
Hello doc. Please how can I manage allergic conjuctivities? I visited different eye clinic, all prescribed Sodium chromoglicate. My eyes are often red and itchy, its embarrassing. I'm just tired of living with reddish eyes.

sodium chromoglycate is used to treat allergy. it is also very important to identify d cause of allergy nd avoid it if possible else u keep having a recurrence due to continual exposure to d allergens. hw do u apply ur drops ?

danilmo:
haaaaaa, even ur pharm D lecturers will b laughing at u or rather I guess ure still in year1 , they don give u hope say no worry, u can also act like a doctor with ur oharm D certificate aside surgery..

am still in year 3 and am sure I gat knowledge of human body more than u , u get luck am not in path and pharm class yet.. yan yan tan..

but still, let's discuss basic knowledge,



1.

An accident victim was rushed to ur shop with saliva dropping out from his mouth , whitish fluid was also seen coming out from his ear,

pharm D, tell us how u ll help this,


2. A student fell from a tree , his right arm was dislocated, he complained of unclear vision after few minute, rushed to ur shop, what could av caused that and how will u correct this

3.
A patient all of a sudden stated having metacapophalangeal joint getting flexed uncontrollable, with deep and long breath as he was rushed to ur shop/pharm shop,

how will u help out immediately ..

4.

a lady complain of infraumbilica pain, cleared she is in her secretory phase of menstrual cycle, so not menstrual pain, what ll u be thinking next in ur mind


5.. oyani at least u should chew this one,
UR brotherwith sign of busted pimples just beneath his nasal nares complained of headaches, blurred vision, restlessness
what and what should come to ur mind,
don't fall my hand o, u should get this, and how will u advise him thereafter..

I give u my drill, am expecting urs. let's start..

go study ur books and focus more on ur graduating. u dnt knw anytin yet in medicine and i can bet my balls if u re being faced wit such cases in reality, u cant successfully manage dem. medical practice isnt abt d theory or pathology u studied in schl. medicine is more lyk apprenticeship; d more practical exposure u get, d better u bcom. dts why u hv to go tru a year of compulsory apprenticeship bfr u cn independently attend to pts. b humble. u may quote books nd cnt do jack. if it were to b by books , d best graduating student shld always come out as d best in clinicals.

TempoJames:
You guys haven't seen anything yet. The same way you guys oppress the microbiologists and SLTs Doctors will keep on being on top of your heads.
Retards!
You ask for liberation when you guys are chief oppressors.
If so then microbiologists(B.sc) should be head of microbiology department and head you guys so that we know job description is perfectly defined. Nonsense!

pls b reasonable. try to b objective rather dan allowing emotions/sentiment becloud ur sense of reasoning. i dnt wrk in d lab nd i do nt knw whts goin on there. i m speaking up against d oppression by med drs on the career growth of other health professionals as it also affects me and negatively impacts d nigerian health sector which is unarguably evident

TempoJames:
browse yayale ahmed comitee . Google is your friend. You will see NMA is boss over all. The other organizations couldn't project a solid point. Infact SLT attacked MLS.

Any SLT or microbiologist working in the hospital lab will know what I am talking about. If at all medical doctors are domineerig over them then it is a payback to what they do to micriobiologists n SLTs

this bossing over is the major cause of disharmony in d health sector. i just see pure arrogance nd ignorance being exhibited by most nija meds drs nd most of their arguments lacks rational reasoning nd intelligence. u can tell from the post by most of them here

danilmo:
u get problem o
av been going through ur comment since, don't lemme ridicule ur optometry for u o..


I Don even forget say that course is still existing.. mtchew

at least that Dr u felt uv corrected can drill u in many part of the body aside eyes or do u even know any other part of the body rather than eyes ni... Eye glass cutter, Don't go and face Aboki that is already taking ur job, Aboki Don dey cut correct eye glass o, hope ure aware..

and ure here feeling flying that uv corrected a medic.. lol

confused johesuite..

wht u just wrote doesnt mk sense and lacks rational reasoning .... mtcheew.

Mrvalent:
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Dear ma/sir , I reported him. thanks and bye �

u stated in ur write dt after killing 2 person hez practicing still. u mean after u had him reported no action has been taken by ur body? mayb just mayb dey re much preoccupied wit matters dt concerns oda health professions dan getting rid of d quacks practicing as med drs which i think deserves more attention. Sir/Ma dnt tk it personal ; i m just being analytical

Freddonance:
That was an oversight

an oversight u say? i knew u wld giv dt as an excuse dt wz my reason fr nt correcting ur use of NPRP. it is rather NPDR. so wld u claim it's an oversight still ?

Mrvalent:
Some of JOHESU'S demands are reasonable but some are far from being reasonable . You want to become consultants, then no problem.Take the UK for instance, there are consultant nurses in the UK who after 1-2 years of further studies become consultants in their fields. To say you want to earn the same salary or even close to the doctors' is far from reasonable. Just talk based on facts, check up the average salary of a consultant Physician and that of a Consultant nurse in the UK and you see that they are far apart. In fact the average salary of a junior doctor,even though lower, comes close to the average salary of a consultant nurse . Same applies to other paramedical professions. In fact such obtains in most parts of the world. Google is your very dear friend. Use it.
To think pharmacists who I venerate so much involve themselves with these people and try to chide the work of a Physician baffles me. Sometimes in life to try to prove your worth is an insult. So I won't scatter ground with examples but understand that the physician knowledge in diseases, interpretation of lab results,diagnosis, treatment plan and management of complications can't be paralleled by any paramedic. I am not even talking about a surgeon now. To tie these things needs deep understanding of sometimes complex concepts which is not acquired by the years of study alone but majorly by the content. I know there are medical schools in Nigeria that produce half baked doctors but that is the same for most other courses including paramedical courses so do not individualize medicine in Nigeria as the only source of half baked graduates.
Sometimes (not everytime) people that blame doctors for the death of their relatives are actually the ones to blame for their nonchalant attitude towards health cos some of these patients are as good as dead. I have seen examples of paramedics even on this thread who claim to be able to manage patients only to kill these patients or to even refer to the physician after its too late. Mind you, the unsuspecting public take these people as medical doctors so all the blame goes to the medical doctors after an unfortunate eventuality. I say with experience that most doctors out there are not actually mbbs graduates. I know a ND holder that now performs appendectomy after years of watching a doctor perform it. He has killed two patients and he is still practising. The unsuspecting public will blame a doctor ''mbbs holder'' for these deaths. Such occurs only in Nigeria.
Now, I am not saying there are no quack medical doctors but so also are half baked graduates in other paramedical courses.
Also, blaming the decadence of the health sector on the leadership of the hospitals being doctors is absolutely misguided in a nation with multisystemic decline. Name a sector in Nigeria doing well in recent times. Education? Defence? God help this country !
I am a graduate of the University of Ibadan and I have written and passed my PLAB 1 exam ,hoping to write PLAB 2 and move to UK in the next two years and leave all these rubbish behind. My fellow medical doctors, I challenge you to take an International exam if you have the capability and leave this country for the wannabe physicians.
P. S .. I support some of JOHESU'S demand and I respect the paramedics. But this envy and not knowing one's place tend to tilt me to the other side.
If you need information on the PLAB process, you can contact me.

clap fr ursef...u knw an ND grad dt parades himself a med Dr nd u hvnt had him reported to ur body nd yet u say med drs re nt to blame. i wld blame as u re aware of such practice nd turn a blind eye yet claiming u hv pt's interest at heart; isnt dt insincerity on ur part? Most of the persons u tink re parading as meds may nt b johesu members. dey cld b sm of d auxilliary nurses trained by ur colleagues. those health professionals in johesu re guided by law in their practice nd hence can b held accountable nd prosecuted if dey practice outside their scope/ wht d law permits

Freddonance:
oh, interesting. tell me the pathology of non proliferative retinopathy (NPRP)

altho this is nt a classroom, there is no disease lyk 'non proliferative retinopathy ' rather it is 'non proliferative diabetic retinopathy'

most submission here by meds is really dumb nd lacks intelligence. i see many saying go and take jamb form nd study medicine. my dear not evri1 wld wanna b a med. wht other professionals are clamoring for is to b given d opportunity to get to d peak of their chosen career as professionals without interference from medical docs using the offices of d minister of health and CMD's to suppress d growth of other professions in d health sector. if u studied medicine good fr u, u shld b more concerned abt carrying out ur duty dan interfering in matters of oda health professions.

ocelot2006:
Okay tell me, which of these roles/professions that make up JOHESU are as rigorous as Medicine & Surgery? Go on, I'm waiting.

one's position on which is more rigorous wld nt hold water until he/she hs gone tru d trainings in al d professions nd only den would such submission as to which is more rigorous b justified.

TempoJames:
JOHESU is already a failure!

Yes, I agree they make up 95% population of health sector but one inteligent head is better than 9 dumb heads. Imagine their chairman was very proud to say "we want to show the FG that we make up 95% of health sector".

JOHESU war will just end up as Biafra agitations and will lead to choas among its members when they come back with unmet demands.

If these demands are obtainable in the top 20 countries with best standards of medical practise I wouldn't be arguing here. Check the CMD and HODs in Hodgkin hospital.

We are short of doctors . Else JOHESU could know that the health care can operate functionally without them. The only people that could survive the revolution are pharmacists as doctors are not licensed to operate a pharmacy. Physiotherapy is a heck in Nigeria. Even Registered nurses indulge in physiotherapy.Doctors can chart TPR,dress wounds, prepare patients for surgery,autoclave instruments and all those stuffs. Recruit as many residents in pathology as possible then medlab sci. could know they are not indispensable. Recruit as many residents in radiology as possible. Only then could JOHESU know that doctors are all round. Doctors don't just want to take their work.


Doctors are just worried about nothing. Increase of salary will even be to doctors' favour. Only then could the relativity makes much sense. Imagine if a medlab sci. earns 200k and a doc earns 300k then FG decides to increase it by 20%. Automatically med lab sci. could earn 240K while a doc earns 360k. you see the relativity shifts from 100k to 120k. So doctors should even support Johesu but on grounds that any increment will be to both parties.

The aspect that is totally unobtainable is the issue of consultancy. It will only amount to heirachical rivalry in superiority of decision to patients' management.

If the public health sector breaks down. Doctors and Pharmacists will survive in the private sector but it will be harsh for other allied field.
A pharmacist will survive in his/her pharceutical shop/company but the bitterness in the sector will result in bizzare laison between docs and other allied fields.
Ofcourse doctors will boom in their private clinics. If they want to use only pathologists in their medical laboratories the medlab sci. will only go jobless. Ofcourse Docs can replace nurses if only they are willing to stoop low and work. Radiologists can fill up the Radiology dept. Physiotherapists may still be needed but can still be replaced afterall physiotherapy is a heck in Nigeria. If docs chose not refer their patients to private laboratory and then make that of private clinics cheap. The health scientist will suffer abjectly in Nigeria.

JOHESU is not an issue. They will come back divided especially when their demands are unmet.


I have never seen a policeman as chief of defence staff. The position automatically belongs to the Army.
I wonder why paramedics chew more than they can bite.

u are just ill informed. those med drs dt own private hospitals, hv u seen any employ a pathologist to run its lab? why don't dey employ their colleagues to do d work of nurses in their hospitals? if they cant do that in their private hospitals, why claim such can be applied in govt hospitals? isn't dt akin to being mischievous? secondly , in line wit best practices, consultancy in oda health professions outside medicine is encouraged and countries where this is obtainable have a very functional health system and there isnt disharmony amongst their health workers. gets urself informed and stop misinforming d public out of ignorance

ocelot2006:
Please do tell how "capital intensive" nursing or being a hospital porters is? Are the requirements for these roles equally or more stringent than that of Medicine & Surgery? Do you have any freaking idea how difficult it is to become a doctor (and this is coming from an engineer)? You folks in JOHESU need to get real cos there can NEVER be any equality between you folks and Doctors. It is the simple reality. Wake up.

is it only nursing nd hospital portals dt mk up johesu? besides u hv no idea on d rigors dey go tru in bcoming one as u do nt hv a first hand experience in d training demands in these professions u term a walk over

greatehis:
rubbish.... is like telling some one who studied accounting in the University to receive more wages than a chattered accountant... professionalism in Nigeria is taking lightly. until your relation is sick in the hospital and there isn't a doctor to tell those idiots what to do, then your brain that seem to have been use to fry akara will find its way back to the empty skull. All my relations abroad buys as low as panadol with them when traveling back because they wont find a pharmacist to just walked in and demand for drugs unless a doctor recommended prescription. Go do you findings, no pharmacist or its likes can ever understands what Doctors are trained to do. forget all those stupid argument. they are help-meet. if you where trained to hold the leg for me to successfully work on it, do we have the same training. i work as an accountant but not chattered, but i have learn to respect the chattered haven gone through some of the classes. if you want to be a Doctor go back to school and stop this parochial argument. when we were young, when u see a Doctor you think they are next to God and are pride to any family were they are from. where did this political JOHASU nonsense came from? After reading microbiology like someone who read philosophy for 4 years you want to be addressed as Doctors and receive their salary.... you must be mad

since u re comparing d nigerian system with what's obtainable abroad which is d best practices, why shld u just tk a one sided analogy dt seems to favour d med drs if u ain't biased in ur submission. that place u re making comparison wit, dey hv clinical pharmacist which d docs here wldnt want, dey hv consultant nurses nd pharmacist aswell which d nigerian med drs re opposed to hving here. infact if we cn operate just as their health system is operated, i do nt think there wld b disharmony in d nigerian health care system . nxt tym try nt b biased in ur submissions. as regards ur analogy terming oda professionals as help meet fr d med dr is faulty. they re rendering their services to d pt nd nt d dr. u shld go get a street person to hlp u do d job dt oda professionals render nd pay dem frm ur pockect if u want sm1 dt wld serve u while carrying out ur duty as a med. all professionals re employed by d govt to serve d pts nt med drs