₦airaland Forum

tohpahz: loyalty nah.... dah highlighted place says.... with loyalty will i endeavour to cooperate with other workers nd professional organizations...

really?

".....and will not take or knowingly administer any harmful drug"

err,miss nightingale,wherever you are,your descendants have been doing the above albeit unknowingly BECAUSE they have refused to stay within their job descriptions.i wish you could resurrect,come to nigeria and see these nurses administer IV drugs in their homes codedly.
you would weep!!
nurses now manage prolonged and difficult labour and only send patients to us after they must have ruptured their uteruses
nurses now run pharmacies
nurses are opening diagnostic centers in town,reading xrays and scanning
miss nigtingale,its hell here in nigeria!

After reading through the article by Alli John Adeolu, Chief Medical Laboratory Scientist of God knows where, I couldn't help but punch my keyboard in response to his distortion of facts. There will have been no need for a reply if it were only for his low quality unreferenced write up. NMA raised 24 demands, but for reasons best known to him, he decided to chose only 4.

I think there is no need for me to respond to the jaundiced comparison of Doctors to either our colonialists/imperialists or Boko Haram, that will be too childish. If one finds it difficult to differentiate civility from primitiveness and started comparing Nigerian Doctors with murderous groups, then I guess it is a waste of intellectual calorie to try to reply.

Chief, doctors are not superior to other health workers because the former spent 6 years in undergraduate school, sam sam. Professional superiority arises because of competitive knowledge advantage and nothing else. Even if you extend the study of medical laboratory science to 10 years, its certificate cannot be equivalent to that of MBBS because the curriculum differs, their roles differ. It is not a matter of theology; belief or unbelief.

The FMOH of Nigeria doesn't have directories, but rather directorates and they are 8 and not at least 5 and they are not all headed by Doctors. According to Presidential Committee on a Harmonious Work Relationship Amongst Health Workers and Amongst Professional Groups in the Health Sector chaired by Hon. Justice Bello A. Gusau, "By its approved structure, the Federal Ministry of Health has eight Departments, namely: Department of Human Resources; Department of Finance & Accounts; Department of Planning, Research & Statistics; Department of Procurement; Department of Hospital Services; Department of Public Health; Department of Family Health and the Department of Food & Drugs Services. Of the four Professional Departments, three are headed by medical practitioners while one is headed by a health professional who is not a medical practitioner." Do you propose a JOHESU to head Hospital Services, Public Health or Family Health?

Yes the CMD and the CMAC are doctors, but you failed to mention the latter is a director of clinical services representing all the clinical departments with a single vote just like the director of administration, director of Nursing etc. The CMD is a Doctor because the law said so, you can always go to court if you are not happy about that. No, Doctor mustn't head medical lab scientist, but a Doctor must head clinical laboratory. If you decide to open your private lab, no Doctor will lord over you, but then he won't use results.

Truth is Doctors don't hate you guys to have increase in salary, but their must be relativity otherwise what is the essence of adding quality to patient care? Wages are paid based on intellectual input here on earth, I don't know of other planets. No Sir, thats incorrect, Doctors do not earn a minimum of N250,000 in Federal Institutions and a very senior consultant N500,000. Either you didn't see the circular or you are distorting it. Wouldn't it have been easier to just reproduce it here and compare CONMESS and CONHESS, to see who is cheating who?

I want to believe even a junior staff knows salary is divided in to basic salary and allowances. Federal Ministry of Education pays lecturer-Doctors basic salary while Federal Ministry of Health pays them call and specialist allowance. Does that constitute double salary? You see, don't dabble in to something you have no knowledge of. Have you ever read the responsibility of a Consultant? Do you imagine the fellowship is just for his immediate environment and his services not required in the periphery? Please check the geographical radius a consultant is suppose to rotates.

Since you are not a constitutional lawyer, why don't you allow a competent court of law interprets what medically qualified means. Shikenan. You insinuated medically qualified applies to you, thats delusional. Read the act for the appointment of CMD again or get a translation.

You carelessly define the word consultant without a single reference in the hope the gullible and lazy populace wont crosscheck. Both Advanced learners English dictionary and Merriam Webster dictionary have two similar definitions for the word. As per the latter thus;
1. A person who gives professional advice or services to companies for a fee.
2. A hospital Doctor of the highest rank who is an expert in a particular area of medicine.

Let me attempt to explain one demand called consultant/specialist in clinical practice. In summary all doctors have the basic undergraduate degree called MBBS (Bachelor of Medicine, Bachelor of Surgery); which of cos currently is a misnomer since the course covers many specialties apart from the traditional Medicine and Surgery. In those days doctors were either physicians or Barbers (Surgeons). Now after the basic degree, you can divide doctors broadly in to two; Medical Officers and Consultants/Specialists. In between you have House Officers/interns and Residents (Specialists in training). To be a specialist, requires an average of 6 years in an accredited health institutions. Ours is not the traditional PhD cos of the complexity of human diseases and the need for clinical knowledge. Thus it is a unique training combining theory and clinical skills at the same time. Example, one cannot have a PhD in Neurology, in fact its impossible cos of the numerous neurological conditions afflicting human populace ranging from infectious, inflammatory, degenerative, neoplastic, traumatic, metabolic etc with further subdivisions. Another example, one will attempt to have PhD in a degenerative disease called Dementia. I say attempt cos its not even practicable due to its numerous causes. To be a Neurologist, one must be drilled first in all medical specialties for at least 24 months and then in human neurological clinical conditions in the remaining time including a thesis in one of the entity. The other arm is Medical Officer who chose not to specialize rather improve themselves either through academic degrees or just progressed through conventional civil service. The hierarchy is thus in descending order; Consultant > Residents > Medical Officers > House Officers in terms of professionalism and quality of patient care. Specialists are suppose to see complicated cases or those with potentials to cause complications and or cases requiring advance care; there is no need for a consultant to see controlled uncomplicated hypertension or diabetes mellitus, uncomplicated malaria, typhoid, pulmonary tuberculosis etc. Now is it fair to compare a medical consultant with someone who did 3 year diploma course with 1-2 year post basic studies or even that with academic PhD? In the tertiary hospital, a Consultant is the final refined touch of any patient management. He owns the patient, leads the unit, teaches medical students and mentor residents. So if someone say has an MSc in iron deficiency anaemia and PhD in hemoglobinopathies (assuming not just theoretical academic degrees), will he then be appointed as a Senior Resident and Consultant Hematologist respectively? What if someone present with hemophilia or leukemia? Ok I hear you say no big deal, there are others that will specialize in those areas. That is correct, but how many consultants are you going to have in hematology, 1000? Thus in a hospital you will need like 500,000 consultants to manage just one centre! This of course is not practicable and that is why medical postgraduate training is very different and unique. It may interest you to know Medical Officers whatever their qualifications or years of experience are not candidates for CMD in the tertiary institution or even the secondary centers in the presence of a consultant. Again the position of a consultant itself has legal implications when it comes to litigation, autopsy or as expert witness. Patient care is under the consultant playing the central role not because of anything but for his strategic knowledge advantage. There is no need for a consultant to be in the primary health centres. So if the FG appoints other health workers as medical consultants, imagine the confusion. What role will they play, what value will they add to patient care? Let me elaborate on this, a lab scientist will insist a patient to use an antimicrobial drug based on laboratory drug sensitivity pattern irrespective of clinical outcome whereas a Consultant Medical Microbiologist or Physician will not so long the patient is responding to the initial empirical drug treatment even if the pathogen shows antimicrobial resistance on the plate. Another example is physician will not treat as emergency isolated case of hyperkalemia without cardiovascular examination and ECG even if scientist suggested such. Chest pain with rise in cardiac enzymes doesn't necessarily mean Myocardial Infarction.

There is an old age rivalry between Doctors and other health workers that can be traced right from undergraduate level. You may not have noticed it or probably studied outside the country, but it was there. Not only among them but surprisingly even among lawyers. There is this childish debate about who is learned. This gradually turned in to envy and now dangerously in to enmity. Just read their comments, articles or interviews, you can't possibly missed the unmistakable deep seated frustration and hatred. People have no qualms spreading falsehood among unsuspecting populace just for financial gains. The funniest thing is that those people bring their family and relatives to see Doctors (they never entrust such burden on their colleagues) and the elite promoting the discord all have Personal Physicians. Am not aware of personal this or personal that, but then I know very little. Again when you go to the private clinic and NGOs, everybody conforms to ethics, isn't it a wonder? Why then do we have confusion only in the tertiary health institutions? Everything is about money. Ok suppose one of them is appointed a consultant, what will be his job description, what input will he make in patient care? Some even want to be appointed directors at grade level 17, imagine. As a Doctor with MBBS my entry point is grade level 12 and 15 as a specialist, imagine how many directors a teaching hospital will have in the next 6 years or so. What will happen to other civil servants who have reached level 17 but not yet directors? What will happen to other workers with same qualifications who are not even suppose to reach directorate level?

You seem to be fascinated with USA and UK model of health system where you were eager to emphasize the qualification of hospital CEOs. Yes they do have non Doctors as ministers of health, but you failed to say they equally have office of the Surgeon General and Chief Medical Officer as well. Ironically you are not that keen to borrow their leaf on privatization of hospitals because of cost, but in actuality it is the fear of loosing your fight. Why not go all the way and clone their system here? You have to understand theirs is a capitalist economy and thus putting a non Doctor up there doesn't mean anything. A Doctor will always put patient first in his policy, obviously this is against the fundamental of capitalism.

By Ibrahim Toli

After reading through the article by Alli John Adeolu, Chief Medical Laboratory Scientist of God knows where, I couldn't help but punch my keyboard in response to his distortion of facts. There will have been no need for a reply if it were only for his low quality unreferenced write up. NMA raised 24 demands, but for reasons best known to him, he decided to chose only 4.

I think there is no need for me to respond to the jaundiced comparison of Doctors to either our colonialists/imperialists or Boko Haram, that will be too childish. If one finds it difficult to differentiate civility from primitiveness and started comparing Nigerian Doctors with murderous groups, then I guess it is a waste of intellectual calorie to try to reply.

Chief, doctors are not superior to other health workers because the former spent 6 years in undergraduate school, sam sam. Professional superiority arises because of competitive knowledge advantage and nothing else. Even if you extend the study of medical laboratory science to 10 years, its certificate cannot be equivalent to that of MBBS because the curriculum differs, their roles differ. It is not a matter of theology; belief or unbelief.

The FMOH of Nigeria doesn't have directories, but rather directorates and they are 8 and not at least 5 and they are not all headed by Doctors. According to Presidential Committee on a Harmonious Work Relationship Amongst Health Workers and Amongst Professional Groups in the Health Sector chaired by Hon. Justice Bello A. Gusau, "By its approved structure, the Federal Ministry of Health has eight Departments, namely: Department of Human Resources; Department of Finance & Accounts; Department of Planning, Research & Statistics; Department of Procurement; Department of Hospital Services; Department of Public Health; Department of Family Health and the Department of Food & Drugs Services. Of the four Professional Departments, three are headed by medical practitioners while one is headed by a health professional who is not a medical practitioner." Do you propose a JOHESU to head Hospital Services, Public Health or Family Health?

Yes the CMD and the CMAC are doctors, but you failed to mention the latter is a director of clinical services representing all the clinical departments with a single vote just like the director of administration, director of Nursing etc. The CMD is a Doctor because the law said so, you can always go to court if you are not happy about that. No, Doctor mustn't head medical lab scientist, but a Doctor must head clinical laboratory. If you decide to open your private lab, no Doctor will lord over you, but then he won't use results.

Truth is Doctors don't hate you guys to have increase in salary, but their must be relativity otherwise what is the essence of adding quality to patient care? Wages are paid based on intellectual input here on earth, I don't know of other planets. No Sir, thats incorrect, Doctors do not earn a minimum of N250,000 in Federal Institutions and a very senior consultant N500,000. Either you didn't see the circular or you are distorting it. Wouldn't it have been easier to just reproduce it here and compare CONMESS and CONHESS, to see who is cheating who?

I want to believe even a junior staff knows salary is divided in to basic salary and allowances. Federal Ministry of Education pays lecturer-Doctors basic salary while Federal Ministry of Health pays them call and specialist allowance. Does that constitute double salary? You see, don't dabble in to something you have no knowledge of. Have you ever read the responsibility of a Consultant? Do you imagine the fellowship is just for his immediate environment and his services not required in the periphery? Please check the geographical radius a consultant is suppose to rotates.

Since you are not a constitutional lawyer, why don't you allow a competent court of law interprets what medically qualified means. Shikenan. You insinuated medically qualified applies to you, thats delusional. Read the act for the appointment of CMD again or get a translation.

You carelessly define the word consultant without a single reference in the hope the gullible and lazy populace wont crosscheck. Both Advanced learners English dictionary and Merriam Webster dictionary have two similar definitions for the word. As per the latter thus;
1. A person who gives professional advice or services to companies for a fee.
2. A hospital Doctor of the highest rank who is an expert in a particular area of medicine.

Let me attempt to explain one demand called consultant/specialist in clinical practice. In summary all doctors have the basic undergraduate degree called MBBS (Bachelor of Medicine, Bachelor of Surgery); which of cos currently is a misnomer since the course covers many specialties apart from the traditional Medicine and Surgery. In those days doctors were either physicians or Barbers (Surgeons). Now after the basic degree, you can divide doctors broadly in to two; Medical Officers and Consultants/Specialists. In between you have House Officers/interns and Residents (Specialists in training). To be a specialist, requires an average of 6 years in an accredited health institutions. Ours is not the traditional PhD cos of the complexity of human diseases and the need for clinical knowledge. Thus it is a unique training combining theory and clinical skills at the same time. Example, one cannot have a PhD in Neurology, in fact its impossible cos of the numerous neurological conditions afflicting human populace ranging from infectious, inflammatory, degenerative, neoplastic, traumatic, metabolic etc with further subdivisions. Another example, one will attempt to have PhD in a degenerative disease called Dementia. I say attempt cos its not even practicable due to its numerous causes. To be a Neurologist, one must be drilled first in all medical specialties for at least 24 months and then in human neurological clinical conditions in the remaining time including a thesis in one of the entity. The other arm is Medical Officer who chose not to specialize rather improve themselves either through academic degrees or just progressed through conventional civil service. The hierarchy is thus in descending order; Consultant > Residents > Medical Officers > House Officers in terms of professionalism and quality of patient care. Specialists are suppose to see complicated cases or those with potentials to cause complications and or cases requiring advance care; there is no need for a consultant to see controlled uncomplicated hypertension or diabetes mellitus, uncomplicated malaria, typhoid, pulmonary tuberculosis etc. Now is it fair to compare a medical consultant with someone who did 3 year diploma course with 1-2 year post basic studies or even that with academic PhD? In the tertiary hospital, a Consultant is the final refined touch of any patient management. He owns the patient, leads the unit, teaches medical students and mentor residents. So if someone say has an MSc in iron deficiency anaemia and PhD in hemoglobinopathies (assuming not just theoretical academic degrees), will he then be appointed as a Senior Resident and Consultant Hematologist respectively? What if someone present with hemophilia or leukemia? Ok I hear you say no big deal, there are others that will specialize in those areas. That is correct, but how many consultants are you going to have in hematology, 1000? Thus in a hospital you will need like 500,000 consultants to manage just one centre! This of course is not practicable and that is why medical postgraduate training is very different and unique. It may interest you to know Medical Officers whatever their qualifications or years of experience are not candidates for CMD in the tertiary institution or even the secondary centers in the presence of a consultant. Again the position of a consultant itself has legal implications when it comes to litigation, autopsy or as expert witness. Patient care is under the consultant playing the central role not because of anything but for his strategic knowledge advantage. There is no need for a consultant to be in the primary health centres. So if the FG appoints other health workers as medical consultants, imagine the confusion. What role will they play, what value will they add to patient care? Let me elaborate on this, a lab scientist will insist a patient to use an antimicrobial drug based on laboratory drug sensitivity pattern irrespective of clinical outcome whereas a Consultant Medical Microbiologist or Physician will not so long the patient is responding to the initial empirical drug treatment even if the pathogen shows antimicrobial resistance on the plate. Another example is physician will not treat as emergency isolated case of hyperkalemia without cardiovascular examination and ECG even if scientist suggested such. Chest pain with rise in cardiac enzymes doesn't necessarily mean Myocardial Infarction.

There is an old age rivalry between Doctors and other health workers that can be traced right from undergraduate level. You may not have noticed it or probably studied outside the country, but it was there. Not only among them but surprisingly even among lawyers. There is this childish debate about who is learned. This gradually turned in to envy and now dangerously in to enmity. Just read their comments, articles or interviews, you can't possibly missed the unmistakable deep seated frustration and hatred. People have no qualms spreading falsehood among unsuspecting populace just for financial gains. The funniest thing is that those people bring their family and relatives to see Doctors (they never entrust such burden on their colleagues) and the elite promoting the discord all have Personal Physicians. Am not aware of personal this or personal that, but then I know very little. Again when you go to the private clinic and NGOs, everybody conforms to ethics, isn't it a wonder? Why then do we have confusion only in the tertiary health institutions? Everything is about money. Ok suppose one of them is appointed a consultant, what will be his job description, what input will he make in patient care? Some even want to be appointed directors at grade level 17, imagine. As a Doctor with MBBS my entry point is grade level 12 and 15 as a specialist, imagine how many directors a teaching hospital will have in the next 6 years or so. What will happen to other civil servants who have reached level 17 but not yet directors? What will happen to other workers with same qualifications who are not even suppose to reach directorate level?

You seem to be fascinated with USA and UK model of health system where you were eager to emphasize the qualification of hospital CEOs. Yes they do have non Doctors as ministers of health, but you failed to say they equally have office of the Surgeon General and Chief Medical Officer as well. Ironically you are not that keen to borrow their leaf on privatization of hospitals because of cost, but in actuality it is the fear of loosing your fight. Why not go all the way and clone their system here? You have to understand theirs is a capitalist economy and thus putting a non Doctor up there doesn't mean anything. A Doctor will always put patient first in his policy, obviously this is against the fundamental of capitalism.

By Ibrahim Toli

After reading through the article by Alli John Adeolu, Chief Medical Laboratory Scientist of God knows where, I couldn't help but punch my keyboard in response to his distortion of facts. There will have been no need for a reply if it were only for his low quality unreferenced write up. NMA raised 24 demands, but for reasons best known to him, he decided to chose only 4.

I think there is no need for me to respond to the jaundiced comparison of Doctors to either our colonialists/imperialists or Boko Haram, that will be too childish. If one finds it difficult to differentiate civility from primitiveness and started comparing Nigerian Doctors with murderous groups, then I guess it is a waste of intellectual calorie to try to reply.

Chief, doctors are not superior to other health workers because the former spent 6 years in undergraduate school, sam sam. Professional superiority arises because of competitive knowledge advantage and nothing else. Even if you extend the study of medical laboratory science to 10 years, its certificate cannot be equivalent to that of MBBS because the curriculum differs, their roles differ. It is not a matter of theology; belief or unbelief.

The FMOH of Nigeria doesn't have directories, but rather directorates and they are 8 and not at least 5 and they are not all headed by Doctors. According to Presidential Committee on a Harmonious Work Relationship Amongst Health Workers and Amongst Professional Groups in the Health Sector chaired by Hon. Justice Bello A. Gusau, "By its approved structure, the Federal Ministry of Health has eight Departments, namely: Department of Human Resources; Department of Finance & Accounts; Department of Planning, Research & Statistics; Department of Procurement; Department of Hospital Services; Department of Public Health; Department of Family Health and the Department of Food & Drugs Services. Of the four Professional Departments, three are headed by medical practitioners while one is headed by a health professional who is not a medical practitioner." Do you propose a JOHESU to head Hospital Services, Public Health or Family Health?

Yes the CMD and the CMAC are doctors, but you failed to mention the latter is a director of clinical services representing all the clinical departments with a single vote just like the director of administration, director of Nursing etc. The CMD is a Doctor because the law said so, you can always go to court if you are not happy about that. No, Doctor mustn't head medical lab scientist, but a Doctor must head clinical laboratory. If you decide to open your private lab, no Doctor will lord over you, but then he won't use results.

Truth is Doctors don't hate you guys to have increase in salary, but their must be relativity otherwise what is the essence of adding quality to patient care? Wages are paid based on intellectual input here on earth, I don't know of other planets. No Sir, thats incorrect, Doctors do not earn a minimum of N250,000 in Federal Institutions and a very senior consultant N500,000. Either you didn't see the circular or you are distorting it. Wouldn't it have been easier to just reproduce it here and compare CONMESS and CONHESS, to see who is cheating who?

I want to believe even a junior staff knows salary is divided in to basic salary and allowances. Federal Ministry of Education pays lecturer-Doctors basic salary while Federal Ministry of Health pays them call and specialist allowance. Does that constitute double salary? You see, don't dabble in to something you have no knowledge of. Have you ever read the responsibility of a Consultant? Do you imagine the fellowship is just for his immediate environment and his services not required in the periphery? Please check the geographical radius a consultant is suppose to rotates.

Since you are not a constitutional lawyer, why don't you allow a competent court of law interprets what medically qualified means. Shikenan. You insinuated medically qualified applies to you, thats delusional. Read the act for the appointment of CMD again or get a translation.

You carelessly define the word consultant without a single reference in the hope the gullible and lazy populace wont crosscheck. Both Advanced learners English dictionary and Merriam Webster dictionary have two similar definitions for the word. As per the latter thus;
1. A person who gives professional advice or services to companies for a fee.
2. A hospital Doctor of the highest rank who is an expert in a particular area of medicine.

Let me attempt to explain one demand called consultant/specialist in clinical practice. In summary all doctors have the basic undergraduate degree called MBBS (Bachelor of Medicine, Bachelor of Surgery); which of cos currently is a misnomer since the course covers many specialties apart from the traditional Medicine and Surgery. In those days doctors were either physicians or Barbers (Surgeons). Now after the basic degree, you can divide doctors broadly in to two; Medical Officers and Consultants/Specialists. In between you have House Officers/interns and Residents (Specialists in training). To be a specialist, requires an average of 6 years in an accredited health institutions. Ours is not the traditional PhD cos of the complexity of human diseases and the need for clinical knowledge. Thus it is a unique training combining theory and clinical skills at the same time. Example, one cannot have a PhD in Neurology, in fact its impossible cos of the numerous neurological conditions afflicting human populace ranging from infectious, inflammatory, degenerative, neoplastic, traumatic, metabolic etc with further subdivisions. Another example, one will attempt to have PhD in a degenerative disease called Dementia. I say attempt cos its not even practicable due to its numerous causes. To be a Neurologist, one must be drilled first in all medical specialties for at least 24 months and then in human neurological clinical conditions in the remaining time including a thesis in one of the entity. The other arm is Medical Officer who chose not to specialize rather improve themselves either through academic degrees or just progressed through conventional civil service. The hierarchy is thus in descending order; Consultant > Residents > Medical Officers > House Officers in terms of professionalism and quality of patient care. Specialists are suppose to see complicated cases or those with potentials to cause complications and or cases requiring advance care; there is no need for a consultant to see controlled uncomplicated hypertension or diabetes mellitus, uncomplicated malaria, typhoid, pulmonary tuberculosis etc. Now is it fair to compare a medical consultant with someone who did 3 year diploma course with 1-2 year post basic studies or even that with academic PhD? In the tertiary hospital, a Consultant is the final refined touch of any patient management. He owns the patient, leads the unit, teaches medical students and mentor residents. So if someone say has an MSc in iron deficiency anaemia and PhD in hemoglobinopathies (assuming not just theoretical academic degrees), will he then be appointed as a Senior Resident and Consultant Hematologist respectively? What if someone present with hemophilia or leukemia? Ok I hear you say no big deal, there are others that will specialize in those areas. That is correct, but how many consultants are you going to have in hematology, 1000? Thus in a hospital you will need like 500,000 consultants to manage just one centre! This of course is not practicable and that is why medical postgraduate training is very different and unique. It may interest you to know Medical Officers whatever their qualifications or years of experience are not candidates for CMD in the tertiary institution or even the secondary centers in the presence of a consultant. Again the position of a consultant itself has legal implications when it comes to litigation, autopsy or as expert witness. Patient care is under the consultant playing the central role not because of anything but for his strategic knowledge advantage. There is no need for a consultant to be in the primary health centres. So if the FG appoints other health workers as medical consultants, imagine the confusion. What role will they play, what value will they add to patient care? Let me elaborate on this, a lab scientist will insist a patient to use an antimicrobial drug based on laboratory drug sensitivity pattern irrespective of clinical outcome whereas a Consultant Medical Microbiologist or Physician will not so long the patient is responding to the initial empirical drug treatment even if the pathogen shows antimicrobial resistance on the plate. Another example is physician will not treat as emergency isolated case of hyperkalemia without cardiovascular examination and ECG even if scientist suggested such. Chest pain with rise in cardiac enzymes doesn't necessarily mean Myocardial Infarction.

There is an old age rivalry between Doctors and other health workers that can be traced right from undergraduate level. You may not have noticed it or probably studied outside the country, but it was there. Not only among them but surprisingly even among lawyers. There is this childish debate about who is learned. This gradually turned in to envy and now dangerously in to enmity. Just read their comments, articles or interviews, you can't possibly missed the unmistakable deep seated frustration and hatred. People have no qualms spreading falsehood among unsuspecting populace just for financial gains. The funniest thing is that those people bring their family and relatives to see Doctors (they never entrust such burden on their colleagues) and the elite promoting the discord all have Personal Physicians. Am not aware of personal this or personal that, but then I know very little. Again when you go to the private clinic and NGOs, everybody conforms to ethics, isn't it a wonder? Why then do we have confusion only in the tertiary health institutions? Everything is about money. Ok suppose one of them is appointed a consultant, what will be his job description, what input will he make in patient care? Some even want to be appointed directors at grade level 17, imagine. As a Doctor with MBBS my entry point is grade level 12 and 15 as a specialist, imagine how many directors a teaching hospital will have in the next 6 years or so. What will happen to other civil servants who have reached level 17 but not yet directors? What will happen to other workers with same qualifications who are not even suppose to reach directorate level?

You seem to be fascinated with USA and UK model of health system where you were eager to emphasize the qualification of hospital CEOs. Yes they do have non Doctors as ministers of health, but you failed to say they equally have office of the Surgeon General and Chief Medical Officer as well. Ironically you are not that keen to borrow their leaf on privatization of hospitals because of cost, but in actuality it is the fear of loosing your fight. Why not go all the way and clone their system here? You have to understand theirs is a capitalist economy and thus putting a non Doctor up there doesn't mean anything. A Doctor will always put patient first in his policy, obviously this is against the fundamental of capitalism.

By Ibrahim Toli

After reading through the article by Alli John Adeolu, Chief Medical Laboratory Scientist of God knows where, I couldn't help but punch my keyboard in response to his distortion of facts. There will have been no need for a reply if it were only for his low quality unreferenced write up. NMA raised 24 demands, but for reasons best known to him, he decided to chose only 4.

I think there is no need for me to respond to the jaundiced comparison of Doctors to either our colonialists/imperialists or Boko Haram, that will be too childish. If one finds it difficult to differentiate civility from primitiveness and started comparing Nigerian Doctors with murderous groups, then I guess it is a waste of intellectual calorie to try to reply.

Chief, doctors are not superior to other health workers because the former spent 6 years in undergraduate school, sam sam. Professional superiority arises because of competitive knowledge advantage and nothing else. Even if you extend the study of medical laboratory science to 10 years, its certificate cannot be equivalent to that of MBBS because the curriculum differs, their roles differ. It is not a matter of theology; belief or unbelief.

The FMOH of Nigeria doesn't have directories, but rather directorates and they are 8 and not at least 5 and they are not all headed by Doctors. According to Presidential Committee on a Harmonious Work Relationship Amongst Health Workers and Amongst Professional Groups in the Health Sector chaired by Hon. Justice Bello A. Gusau, "By its approved structure, the Federal Ministry of Health has eight Departments, namely: Department of Human Resources; Department of Finance & Accounts; Department of Planning, Research & Statistics; Department of Procurement; Department of Hospital Services; Department of Public Health; Department of Family Health and the Department of Food & Drugs Services. Of the four Professional Departments, three are headed by medical practitioners while one is headed by a health professional who is not a medical practitioner." Do you propose a JOHESU to head Hospital Services, Public Health or Family Health?

Yes the CMD and the CMAC are doctors, but you failed to mention the latter is a director of clinical services representing all the clinical departments with a single vote just like the director of administration, director of Nursing etc. The CMD is a Doctor because the law said so, you can always go to court if you are not happy about that. No, Doctor mustn't head medical lab scientist, but a Doctor must head clinical laboratory. If you decide to open your private lab, no Doctor will lord over you, but then he won't use results.

Truth is Doctors don't hate you guys to have increase in salary, but their must be relativity otherwise what is the essence of adding quality to patient care? Wages are paid based on intellectual input here on earth, I don't know of other planets. No Sir, thats incorrect, Doctors do not earn a minimum of N250,000 in Federal Institutions and a very senior consultant N500,000. Either you didn't see the circular or you are distorting it. Wouldn't it have been easier to just reproduce it here and compare CONMESS and CONHESS, to see who is cheating who?

I want to believe even a junior staff knows salary is divided in to basic salary and allowances. Federal Ministry of Education pays lecturer-Doctors basic salary while Federal Ministry of Health pays them call and specialist allowance. Does that constitute double salary? You see, don't dabble in to something you have no knowledge of. Have you ever read the responsibility of a Consultant? Do you imagine the fellowship is just for his immediate environment and his services not required in the periphery? Please check the geographical radius a consultant is suppose to rotates.

Since you are not a constitutional lawyer, why don't you allow a competent court of law interprets what medically qualified means. Shikenan. You insinuated medically qualified applies to you, thats delusional. Read the act for the appointment of CMD again or get a translation.

You carelessly define the word consultant without a single reference in the hope the gullible and lazy populace wont crosscheck. Both Advanced learners English dictionary and Merriam Webster dictionary have two similar definitions for the word. As per the latter thus;
1. A person who gives professional advice or services to companies for a fee.
2. A hospital Doctor of the highest rank who is an expert in a particular area of medicine.

Let me attempt to explain one demand called consultant/specialist in clinical practice. In summary all doctors have the basic undergraduate degree called MBBS (Bachelor of Medicine, Bachelor of Surgery); which of cos currently is a misnomer since the course covers many specialties apart from the traditional Medicine and Surgery. In those days doctors were either physicians or Barbers (Surgeons). Now after the basic degree, you can divide doctors broadly in to two; Medical Officers and Consultants/Specialists. In between you have House Officers/interns and Residents (Specialists in training). To be a specialist, requires an average of 6 years in an accredited health institutions. Ours is not the traditional PhD cos of the complexity of human diseases and the need for clinical knowledge. Thus it is a unique training combining theory and clinical skills at the same time. Example, one cannot have a PhD in Neurology, in fact its impossible cos of the numerous neurological conditions afflicting human populace ranging from infectious, inflammatory, degenerative, neoplastic, traumatic, metabolic etc with further subdivisions. Another example, one will attempt to have PhD in a degenerative disease called Dementia. I say attempt cos its not even practicable due to its numerous causes. To be a Neurologist, one must be drilled first in all medical specialties for at least 24 months and then in human neurological clinical conditions in the remaining time including a thesis in one of the entity. The other arm is Medical Officer who chose not to specialize rather improve themselves either through academic degrees or just progressed through conventional civil service. The hierarchy is thus in descending order; Consultant > Residents > Medical Officers > House Officers in terms of professionalism and quality of patient care. Specialists are suppose to see complicated cases or those with potentials to cause complications and or cases requiring advance care; there is no need for a consultant to see controlled uncomplicated hypertension or diabetes mellitus, uncomplicated malaria, typhoid, pulmonary tuberculosis etc. Now is it fair to compare a medical consultant with someone who did 3 year diploma course with 1-2 year post basic studies or even that with academic PhD? In the tertiary hospital, a Consultant is the final refined touch of any patient management. He owns the patient, leads the unit, teaches medical students and mentor residents. So if someone say has an MSc in iron deficiency anaemia and PhD in hemoglobinopathies (assuming not just theoretical academic degrees), will he then be appointed as a Senior Resident and Consultant Hematologist respectively? What if someone present with hemophilia or leukemia? Ok I hear you say no big deal, there are others that will specialize in those areas. That is correct, but how many consultants are you going to have in hematology, 1000? Thus in a hospital you will need like 500,000 consultants to manage just one centre! This of course is not practicable and that is why medical postgraduate training is very different and unique. It may interest you to know Medical Officers whatever their qualifications or years of experience are not candidates for CMD in the tertiary institution or even the secondary centers in the presence of a consultant. Again the position of a consultant itself has legal implications when it comes to litigation, autopsy or as expert witness. Patient care is under the consultant playing the central role not because of anything but for his strategic knowledge advantage. There is no need for a consultant to be in the primary health centres. So if the FG appoints other health workers as medical consultants, imagine the confusion. What role will they play, what value will they add to patient care? Let me elaborate on this, a lab scientist will insist a patient to use an antimicrobial drug based on laboratory drug sensitivity pattern irrespective of clinical outcome whereas a Consultant Medical Microbiologist or Physician will not so long the patient is responding to the initial empirical drug treatment even if the pathogen shows antimicrobial resistance on the plate. Another example is physician will not treat as emergency isolated case of hyperkalemia without cardiovascular examination and ECG even if scientist suggested such. Chest pain with rise in cardiac enzymes doesn't necessarily mean Myocardial Infarction.

There is an old age rivalry between Doctors and other health workers that can be traced right from undergraduate level. You may not have noticed it or probably studied outside the country, but it was there. Not only among them but surprisingly even among lawyers. There is this childish debate about who is learned. This gradually turned in to envy and now dangerously in to enmity. Just read their comments, articles or interviews, you can't possibly missed the unmistakable deep seated frustration and hatred. People have no qualms spreading falsehood among unsuspecting populace just for financial gains. The funniest thing is that those people bring their family and relatives to see Doctors (they never entrust such burden on their colleagues) and the elite promoting the discord all have Personal Physicians. Am not aware of personal this or personal that, but then I know very little. Again when you go to the private clinic and NGOs, everybody conforms to ethics, isn't it a wonder? Why then do we have confusion only in the tertiary health institutions? Everything is about money. Ok suppose one of them is appointed a consultant, what will be his job description, what input will he make in patient care? Some even want to be appointed directors at grade level 17, imagine. As a Doctor with MBBS my entry point is grade level 12 and 15 as a specialist, imagine how many directors a teaching hospital will have in the next 6 years or so. What will happen to other civil servants who have reached level 17 but not yet directors? What will happen to other workers with same qualifications who are not even suppose to reach directorate level?

You seem to be fascinated with USA and UK model of health system where you were eager to emphasize the qualification of hospital CEOs. Yes they do have non Doctors as ministers of health, but you failed to say they equally have office of the Surgeon General and Chief Medical Officer as well. Ironically you are not that keen to borrow their leaf on privatization of hospitals because of cost, but in actuality it is the fear of loosing your fight. Why not go all the way and clone their system here? You have to understand theirs is a capitalist economy and thus putting a non Doctor up there doesn't mean anything. A Doctor will always put patient first in his policy, obviously this is against the fundamental of capitalism.

By Ibrahim Toli

a debate? .....with who? this criminally minded FG.? these thieves who can't debate to save their lives want to debate with doctors?? loooooool
prof chukwu,when you and your dumb president are tired of fooling yourselves, nobody go tell una to arrange una house. debate my foot....lol
this I.diotic minister who made a fool of himself when he announced to the whole world that the strike would end last week monday only for him to wake up on Tuesday to even more deserted hospitals. clown.

when you are ready to deal sir, you know where to find us.

JP Philips.........flawless opinion as usual. I just wish the average Nigerian had just half your foresight. if they did,we would be in the hospitals working.
there is no doubt consultant nurses and pharmacists exist outside these shores.johesu is quick to throw that in our faces.but they become brain dead when they have to look up the QUALIFICATIONS that go with those posts.

I would appreciate a link from any of them that proves that consultant nurses and pharmacists are HOSPITAL BASED and I would also like a link where the qualifications needed are outlined.

allycat: 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.

that is the point many Nigerians are missing and as irritating and boring as it can be,we have to painstakingly explain to them.
THE BUCK STOPS AT THE DOCTOR'S. after all the English. afterall the tests in the world.after all the xrays.after everything ,the doctor takes the final decision. only he can answer the questions: WHAT IS THE DIAGNOSIS? & WHAT IS THE TREATMENT? at the point that really matters most,all the other health workers fade into the background and the doctor is the person left standing.

Samgreguc: there is difference btw the health team and medical team. Do u knw?
.
.
Secondly, bear in mind that the Physicians wunt have anythg to prescribe when the Pharmacist fails to produce.

yes nothing to prescribe when the INDUSTRIAL pharmacists fail to produce NOT hospital based dispensing pharmacist. after seeing my patient and writing a prescription,she just crosses the road in front of the hospital to a pharmacy and gets her drugs.

..........and please for the record many countries are changing their basic degrees from MBBS to MD. it does not mean a higher degree but just a simple name change believe it or not. I was chatting with a few Australian final yr med students and they admitted it was just a NAME CHANGE seeing as their curriculum remained unchanged.
the ideal thing should be that a research component is added to your curriculum but things have remained unchanged in many countries. please I needed to set the record straight.

YourHealthlabs: If you do a little googling you'll find out that majority of the countries still offering m.b.bs are in asia and africa. It's now seen as a third world med.degree.
Though that doesn't take anything away from smart docz, it's an individual thing.

I only get pissed off when some docz make it seem like "UK and US are falling all over themselves to have Nigerian mbbs docz", nothing can be further from the truth.
Let's protect gullible people from swallowing those lies.

Good morning.

my brother please let's always endeavour to say the truth. even in the 60s and 70s considered the golden years of education in this country,the US or UK never fell over themselves for Nigerian doctors.it has never happened. BUT what still happens today is that no where in the world will you practice with your basic medical degree as an international medical graduate except Trinidad and Tobago (for graduates of UNN,UNIBEN,UNILAG&UNIBADAN). Nigerian medical graduates are not too far behind the Indians when it comes to trashing the USMLE or PLAB. their inability to get residency training placements in their CHOSEN SPECIALITY is far more political(immigration policies,keeping choice placements for american citizens first etc) than quality of Nigerian training.
as a Nigerian doctor,I could pass the USMLE,being in the 99th percentile BUT there are some specialities they won't dare give me like neurosurgery,CTS etc. most of our graduates even with very high scores end up in internal med.,pediatrics or family medicine.
NOTE also that an american doctor must pass our licensing exams here to practice in Nigeria.
this is where you have been mis informing people because it shows you don't even know the purpose of these exams in the first place.
in Nigeria,a patient with chronic cough and weight loss most likely has tuberculosis.in the US,these symptoms most likely mean another disease NOT tuberculosis.
so for me to practice in the US,I must know what diseases are endemic there,their clinical presentation etc
their licensing exams test me on these. that is the purpose.

YourHealthlabs: culled from:
https://answers.yahoo.com/question/index?qid=20131105072323AA1XKYs

brother you posting a link from yahoo answers? are you for real? yahoo answers where any retard can post answers? lol. what is the basic medical degree in the UK and in Australia?
the MD you love so much is the basic medical degree in the US. in the UK which we copy, its MBBS. the MD in the UK is an advanced degree in medicine. please read and understand.

YourHealthlabs: There is no need for long stories. Rush to google and type these words-'Is m.b.b.s an International standard for doctors?"

Come back with the results and enlighten us.

please stop making a fool of yourself.you have always appeared to be one of the reasonable johesuites here.please do some reading and enlighten yourself

Obi411: This is pure emotional blackmail. Too bad that it is coming from one whom lives are entrusted to. What do you make of soldiers whose duty is to protect the very lives that you you betray with their own lives? How many of them have died in the quest? And their bodies are still counting. Yet they are never spoken of, maybe because they never spent 6, or so, years in the university. Or perhaps, they do not pride in the glory of this great responsibility that has been laid on them, as you do now. Understand this: the greatest people on earth are never heard of. Lest you boast in vain glorification of a privilege given to you. Are medical doctors gods? No, they simply are tools in the hand of the Creator. Let them go back to work, knowing fully well that their calling is a service to humanity, which can never be requited fully here on earth. But wait: even a medical doctor earns more than a soldier!

the bolded is the problem with nigerians. 'our rewards are in heaven', meanwhile i buy fuel at the same price as this poster.i buy things from the same market as this poster.my daughter pays the same school fees as this poster's daughter's.

when it comes to treatment we are angels,when its time for you to pay,we metamorphose into demons.
i wish this poster can get to the US or UK and try to access healthcare without medical insurance.

....
please all doctors on this thread shouldnt bother themselves explaining whats going on in the health system.

which public do you expect sympathy and understanding from a public that is largely illiterate??(as exemplified by many people here who dont even know and understand what a 'satire' is)
a people that cant hold their leaders accountable. a public who are ready to stone a little boy to death for stealing 100 naira and then turn around and prostrate before,and worship a mega-thief(a thieving politician,drug kngpin etc) who drives by in his rolls royce.

which public do you want to stand up for you?? the nigerian public People who dont mind spending $600 on a new i-phone than cough out 2,000 naira for a medical consultation.

in sane societies,it is the public that stands up for the doctor.it is the public that would tackle JOHESU but in nigeria its the exact opposite.

the nigerian doctor is unlucky to be burdened with a public that are not just largely illiterate,but also poor. a public who dont know their left from their right.

unfortunately our people think it is the doctors responsibility to guarantee free and standard healthcare.when it comes to the health sector all fingers point to the doctor.no one else.
they dont know that quality healthcare is EXPENSIVE and someone HAS TO pay for it.in civilsed societies,the government pays for it and their people do not take it for granted.

whether nigerians want to believe it or not,the health sector in nigeria like every other sector has crashed because of corruption BUT nigerians have not really felt it. why because the smooth running of things in our hospital is largely due to the SKILLS AND COMPETENCE of the nigerian doctor.how many of you know that many hospitals do not have something as basic as an ultrasound machine.
we see things go down everyday in our hospitals BUT the doctor still tries to give his patient the best.

doctors are ordinary like the rest of you,but you expect extraordinary things from him.infact left to many nigerians,doctors are like priests.we shouldnt be paid. we should just do our jobs with a smile on our faces BECAUSE our rewards are in heaven.
when we complain,you blackmail us with the hippocratic oath you all KNOW NOTHING about.

pray tell,why shouldnt we strike? are you saying we should keep negotiating and signing agreements with a government that has not implemented the MOU it signed a year ago? its not fair!! nigerians should sit back for a moment,leave emotions and sentiments aside and think for once.

jauntty: When I see post like this I just SMH. This is becos at this stage now, we should thinking of the solutions to the decay in our health and stop trying to paint each other in bad light. Like I said before NMA, JOHESU and FG must come together for this to work. Every Profession has its scope of practice based on the Law and the training. So, making a health worker a consultant pharmacist for instance doesn't mean he will start doing what he is not train for or beyond his scope of practice as defined by the law., I don't see the big issue here. That's why I like the American society, even when there r consultants in other health field, each one still know his boundaries. Let me give a practical/ true life example. I am an Optometrist, last year wen I was ill I went to a medical doctor, even though (I study some pharmacology too in school) cos that is his area of specialty. Just few weeks back, a medical doctor came to our eye clinic for some visual issues and I attended to him. So I don't know what is wrong with people in this part of the world.

because as it is now, they do not know their boundaries. that is why nurses are codedly treating patients in their houses,giving harmful IV drugs.that is why the pharmacists or lab scientists have started colluding to treat patients.the lab guys do the tests,the pharmacists treat based on that. it happens and is still happening everyday. let's not deny it.Asking them to be consultants will be asking to legalize the above.don't kid yourself, it will happen. this consultancy they want is not based on advancing their skills but is based on remuneration. simple. the patient is not at the back of their minds.who will suffer? the common man.

MrKodak: U sure say u well? That is if the transgender turns u on bro', there might be something wrong o! Criously though, I hope u aint into men. No matter hw she try, she still looks too manly 4me. See shoulders & legs Abeg not to talk of the voice.

na im make the thing dey fear me.....lol.

........and in other news, Constantine is a sick show! I am not big on horror BUT I might just like this one.

naijababe: I was just going to comment on their weird relationship. You are right, S1 E13 changed my mind a bit and poor Russo

don't worry.by the time you get to season 2 finale, you go know how far. no spoilers....lol

.......and no,the underwoods were not made to look all smart.on the contrary they had formidable opponents or obstacles and their ability to work their way through each is what drives me crazy about it.
what wife would allow a relationship between her husband and a journalist just to FURTHER a political ambition.
in fact Claire appears deadlier and more ambitious than her husband. when frank makes his moves,I go 'hmmm'. when Claire makes hers I go 'haaaaaaa'. she get mind. the show just appears to be one giant chessboard to me....lol.

naijababe: No way near GOT! No one has the monopoly of scheming in GOT, the Underwoods just seem o be the only ones able to it and that is what pisses me off about it

when I mean up there with GOT, I mean the 'class'. on my list, house of cards has completely displaced mad men and scandal. if you love vampire diaries, you will most likely not like HOC.

naijababe: No way near GOT! No one has the monopoly of scheming in GOT, the Underwoods just seem o be the only ones able to it and that is what pisses me off about it

when I mean up there with GOT, I mean the 'class'. on my list, house of cards has completely displaced mad men and scandal. if you love vampire diaries, you will most like not like HOC.

............ and Lucifer thought in his heart, "I will be higher than the most high"....... he ended up getting his a** kicked and got kicked out along with a third of heavens host of angels.

.........man ended up and is still suffering from that sin of pride.
if only Lucifer knew his place!

eejo: then you have no proof fake priscription

my brother these are the UNBELIEVABLE things Nigerians will be seeing once they allow consultancy that is based on remuneration instead of progressive training.pity.

The national association of resident doctors at their just concluded emergency delegates meeting have VOTED that the strike continues.

NMA has its emergency delegates meeting tonight to decide whether to suspend or continue the strike through a VOTING process.
If NMA decides to call of the strike,the resident doctors WILL not resume work as they vowed to continue the strike as a stand alone body.
the struggle continues.........



NMA rising from its delegates meeting vowed to continue.all affiliate bodies except jigawa state nma voted overwhelmingly for the strike.aluta continua

zilch,Nada,nothing. I wonder how Nigerians expect someone who couldn't nothing in his state to do wonders as president? not possible

abuchilag: Why are these doctors playing with the lives of innocent Nigerians......they took an oath abi oaths to sanctity of live....why are they the ones killing those that they are paid to take care of ? These guys(the selfish ones among them) are killers in robes.

The FG should disband that useless and power drunk society. It is obvious that they make more money during strikes as they direct patients to their clinics.

God will save Nigeria

I hope you are one of those who can afford to travel out for healthcare because it makes no sense that after insulting doctors today,you still go ahead and visit any of them for a health issue. the shame will be on you.

your account has been hacked.

Lagos............as usual!