₦airaland Forum

yetseyi:
Are you serious with the bolded . Discard a lab result and continue with an unconfirmed diagnosis, its just painful that patients are always at the receiving end.

So if the lab result doesnt tally with the doctors diagnosis, is there not a possiblity that the doctor made a wrong diagnosis since tests are to confirm his "suspision". Cant he "re- visit" his initial diagnosis.

I want to to please explain the bolded, maybe I m misinterpreting the set of statements I quoted.

elobyobi:
Come and flog me make I see. I pray u don't land into the hands of a "confident quack" who will confidently give u an overdose, like 125mg of digoxin instead of emmm...emmm...I dey come make I go check my book.

Sctests:
These people....
But I take consolation in the fact that you agreed with the bolded. In technology you do more with less.

You see some of you wake up and make loads of noise on this website but in reality you are empty in the skull. A friend from india once told me that in Nigeria there are more butchers in wardcoats than real physicians-but they all have M.B.B.S. If the Nigerian patients know a fraction of their rights many of you would have either stopped practicing and probably go into nollywood, juju music or something. So stop singing the "we-are-fighting-for-the-patient", especially when you want more pay. The patient knows you don't give a fart about him, but sometimes he's not educated enough to know he can send you to jail, when you harm him with your cluelessness and carelessness. He also knows you have no business running his medical tests, recent events in the health sector have enlightened him.

Your noise about not recognizing MLS, starts in your bedroom and ends in your bathroom, the Law is more important that everything you represent. When your mass of flesh decays... whenever it wishes to, the law will still be standing aloof, Gerrit?
You say senators were bribed to enact law that has ensured improvement in our Medical Laboratories? our battle ground against HIV and TB? and saved lives? LWKMD, You should consider going part-time in clowning. It could bring in more bucks who knows?. How much were Scientists earning at that time to be able to bribe Senators?.
Is this how NMA bribes senators so they can regulate the native doctors practicing Traditional medicine?

My history book teaches me that your pathologists always dissociated themselves from the labs when a patient dies and fingers are pointed towards it. Nigerians sat in Abuja, and decided to make a law regulate it and ensure standards, and in their wisdom gave the mantle of leadership to the "Lab guy" who does all the tests and gets all the blames. Your irresponsible pathologists went home and only came when the Scientists have worked so hard to clean up our national medical laboratories to compete with international standards, and make it respectable. Why should you reap where you have not sowed?

NUC is a generalized regulatory body, they can not effectively regulate specialized courses without special inputs from PCN, MDCN, MLSCN, Nursing council. Your physician NUC BOT chairman will not be their forever. Our LAWS will outlive him.

remsonik:
Yes checking books is not a crime. I have seen a surgeon take a 30 mins break before an operation to consult his textbooks.

armadeo:
Now this is disappointing. Checking a book is a crime? If you have never cross checked anything in your career then you have caused harm somewhere.

nobilis:
Did u also read where I said the doctor can send the patient for another test possibly in another lab?
Did you not read that part?

As for the part you bolded, yes. I've seen it happen.
When I was still a student, my consultant sent a patient to for a test. The result was unacceptable to him. He sent the patient for a repeat test. The result still didn't tally with his diagnosis.

He had to discard the lab result and treat the patient based on his own "unconfirmed" diagnosis. The patient recovered. Post-recovery tests proved that the doctor's diagnosis was right all along.

I'm not saying lab tests are irrelevant. I've never and will never say that. But in some cases, a "provisional" diagnosis is more than a provisional diagnosis Especially if you have seen several similar cases in the past. And that will make the test just a formality.
The doctor is not discarding the result out of professional arrogance. No. That's not it. So I guess you misunderstood me.

We treat patients not lab results.

Sctests:
These are the tests that are associated with the conditions your reeled out as not needing lab tests. If a course has to with lives it can not be overrated or irrelevant. When you start your own practice, i'm sure you'll need incantations in place of lab investigations like a magician to you truly are.

1. UTI--- urine m/c/s, urinalysis.
2. Malaria--- M.P smear, malaria molecular tests
3. Pregnancy- HCG test
4. Typhoid- Serolgy
5. Anaemia- Hb tests, PCV, CBC
6. Sepsis- direct gram, blood culture
7. Ureamia-E/U/Cr,Blood urea Nitrogen(BUN), Creatinine clearance
8. Hepatitis- AST, ALT, HCV, HbsAg
9. Immunosuppression-FBC, ?HIV test
10. Renal failure- E/U/Cr
11. Heart failure- Lipids, cardiac markers(troponin), pericardial fluid analysis,
12. Eclampsia-platelet count and function, protein/creatine ration estimation.
14. Sickle cell disease- Genotype, Hb,
15. Schizophrenia- Blood screening for drugs and alcohol to rule out conditions with similar symptoms.
16. Lymphoma- cbc, blood smear, lymph aspiration
18. Increased ICP-Serum bile acid
19. Fracture- Radiography
21. Meningitis- CSF analysis
22. Pneumonia-bacteria sputum culture, influenza test
23. Helminthiasis-stool microscopy
24. PID- HVS m/c/s
26. Multiple myeloma- BJ proteins
27. Diarrhoea- stool analysis,
28. Stroke- PT, INR, for rule outs.
29. Asthma-tests for allergens will help rule out causes
30. Osteomyelitis- blood culture
100. Diabetes- RBS, FBS, gycosylatd Hb

eyinjuege:
Standard world practices does allow you to check to confirm the dosages of drugs in drug formularies. Even abroad, doctors do that regularly. Even pharmacists that are soaked in pharmacology check up side effects and drug interactions. Its called taking your responsibilities seriously. If you are nor sure of something, why shouldn't you check to confirm? Such a person who feels he knows all is a DANGER to all around him. You kill a patient through negligence, you bring everyone in your team down, yes including other drs, nurses, pharmacists etc

yetseyi:
I do not agree with you not at all.

At least I m sure of one, a doctor equal to a biochemist is laughable. So because you did some courses in biochemistry you have as much knowledge as a biochemist no way.

Its just like a biochemist saying he can do the job of a pharmacologist just because he/she did few courses in pharmacology.

Doctors know biochemistry I agree but to say a doctor is equal to a biochemist I disagree completely.

There are reasons why these courses are studied separately.

I was pondering when the issue of consultants for other health workers came up and what came to my mind is a pharmacist is an authority in his field, so is a labscientist, and a nurse. As far as i m concerned pharmacists know more about their own profession than a doctor anytime anyday.

The earlier the doctors realize its about team work and that no health worker is useless all of them have their jobs to do within the hospital the better for Nigeria's health care sector.

Once again i laugh at the suggestion that doctors are as knowlegable in the field of biochemistry like biochemists.

yetseyi:
Are you serious with the bolded . Discard a lab result and continue with an unconfirmed diagnosis, its just painful that patients are always at the receiving end.

So if the lab result doesnt tally with the doctors diagnosis, is there not a possiblity that the doctor made a wrong diagnosis since tests are to confirm his "suspision". Cant he "re- visit" his initial diagnosis.

I want to to please explain the bolded, maybe I m misinterpreting the set of statements I quoted

TCD:
I see a result of potassium 10mmol/l and the patient is alive right there in front of me chewing gworo . the question should be should I throw that result in the dustbin or lagoon?

My patient with renal failure displaying classical clinical signs of uraemia almost at encephalopathy and EUCR comes out normal. I should have left the patient to go home and sleep rather than dialysing just because the lab results came out okay.

look. a doctors clinical instincts and experience comes first most of the time. Labs are there for support.

TCD:
I see a result of potassium 10mmol/l and the patient is alive right there in front of me chewing gworo . the question should be should I throw that result in the dustbin or lagoon?

My patient with renal failure displaying classical clinical signs of uraemia almost at encephalopathy and EUCR comes out normal. I should have left the patient to go home and sleep rather than dialysing just because the lab results came out okay.

look. a doctors clinical instincts and experience comes first most of the time. Labs are there for support.

zeezahbee:
I won't get to a quack because I was even the one that produced the drug, you grab that ? so I don't need to consult a doctor to give me doses, virtually most drugs in Nigeria are OTC and they are suppose to be PO , just the few expensive and less popular ones are kEpt Well it's a talk for another day.

yetseyi:
Ok

I want to ask a question I asked the other guy. Can a doctor give a wrong diagnosis?


Note I am neither JOHESU or NMA just a concerned citizen.

TCD:
Wrong diagnosis occurs with doctors the world over. The human body is a complexity you cannot get it right 100% of the time. thousands of illness mimic each other and that's why there can be as much as 5 differential diagnosis for a single patient. It's not magic or divinity we are performing.

That is why in medical school even in professional exams it's not about if your diagnosis is wrong or right but by how you came upon such diagnosis based on patients history , physical exam and investigation results.

a patient can have pneumonia and you diagnose tuberculosis and you will pass because you were able to reasonably defend your diagnosis, reconciling it either the patients signs and symptoms and offer appropriate treatment while one who gets the correct diagnosis but can't defend it will fail..more emphasis is placed on your clinical deduction.

surgeons the world over make a diagnosis and upon opening up the patient find something else. it doesn't make them bad doctors.

nobilis:
Diagnosis starts before the lab. Not in, or after the lab.

Secondly, a pathologist is always in charge of laboratories anywhere in the world. It is not encroachment, it is how things ought to be. Until Medical Laboratory Scientists in Nigeria learn to humble themselves and work in conjunction with the pathologists, they will always feel cheated and raped.

Know your position in a place and gladly and proudly occupy it. That's the best way to gain pride and recognition for your profession.

nobilis:
I hope you have heard of automated machines that do most of these tests you guys do in the laboratory.

That's all I have to say.

Tomorrow you guys will also blame doctors for the suspension of the MLS program by NUC.
All your woes are caused by the doctor, SMH. It's pitiable.

yetseyi:
I saw that part of going to another lab which I totally agree with.

I am happy you said lab tests are not irrelevant and that test results should not be discarded out of professional arrogance (which I also agree).

But then I also know that two cases that look similar may not be the same illness anyway thank God the patient recovered.

which brings me to one question can a doctor make a wrong diagnosis.

Understand that I do not have anything against you doctors but a family member was wrongly diagnosed, given wrong drugs and almost lost her life due to the side effects of the drugs hence my passion on this matter.

zeezahbee:
Armadeo, did you read the beginning of this argument. How will you be reading out a diagnoses , giving prescription from a book every time a patient is right in front of you. it is different from reading a book before you get to work or during breaks.

If you keep reading it out from the book every time, then there's problem. How many patients will you attend to because you will be wasting time.

dumodust:
Blah blah blah blah... if you were that relevant, you wont have time to be ranting about rape and writing this long drivel. All these jobless people who think the business of saving lives is about lobbying and politics. This is what happens when you use sensitive institutions like public hospitals for mass employment... you invite all the dregs in society in. From you write up, it is obvious that you may not have really worked in a hospital. Lab battle ground against hiv and tb?...hahahahaha ... laughable assertion from somewone who I'm sure diesnt know his way to a tb ward.
You are no where near a pathologist both in intellect, knowledge and workload and as far as hospital lab work is concerned, if I'm looking for who's in charge, its not you. You take responsibility? When The last time I checked, its only doctors that face panels etc
Stop trying to be what you're not, we're so important that we're the cause of all your problems in your deluded half baked mind... let the raping happily continue ... we never cum self

Sctests:
Go back to the link you posted and peruse it
carefully, your asm-ascp website does not say it confers on
you "Medical laboratory Scientist" competencies. Let me quote an excerpt from your source

"Those who pass the exam are certified as a
Technologist in Microbiology (M) or Specialist in Microbiology (SM) by the ASCP and
are issued a certificate with both organizations' names on it."-----http://www.asm.org/index.php/nrcm-cert

Did you notice they were careful not have added the word "Medical"
in front of the "Technologist"? The medico-legal issues surrounding the practice can not
be wished away in countries where they are serious about this practice. Do non-biomedcal scientists(BMS)
in the UK work with patient's samples to achieve results aimed at diagnosis. Do you know that the title "BMS" is a protected title
in the U.K?

Again on your website let's take a look at the functions of a Registered Microbiologist and Specialist Microbiologist.
Is there any job description there with any semblance of working in a Medical laboratory for diagnostic purpose?


You guys have your fields, how many Medical lab Scientists are employed as Food microbiologists, industrial chemists, Environmental biologist and so on?
Do we run the environmental testing laboratories too?. You need to stop seeing the Medical lab Scientist as an ordinary 'Operator' not eligible to differentiate between a hyperglycemic sample caused by DM and a contaminated sample.


Listen the physician's here will click likes and applaud you, but if have any sense of history you will understand
that during the days of biologist/chemist in IMLT, almost every clueless physician will point to the lab and blame it when they butcher a patient.

The lab guys were the fall guys in those days. When a patient dies, it's the lab that delayed results. They prescribe the wrong
antibiotics- "oh that numbskull in the lab didn't run the AST effectively".

Well those "lab guys" have taken responsibility, built capacity, and equipped themselves with enhanced knowledge,
now regulate the laboratory with the full backing of the law. Why should that be a problem? Our national/state hospitals now have very few cases of misdiagnosis traceable to the laboratory. Nowadays, we no longer get frequent finger-pointings for giving bad results and endangering patients as it was in the 70's and 80's, Now we only get finger-pointing for asking to head the medical laboratories we developed-OUR PRIMARY CONSTITUENCIES in accordance with the law. It is a positive turn-around if you ask me.

Wide consultations were made before that ACT was passed as Law, people who thought the "kitchen"/labs should be thrown to the
backyard and blamed it for all their malpractice misfortunes are the ones crying foul today. Our Medical laboratories are getting strengthened,
the Medical Lab.Scientists will keep building capacities through enhanced knowledge and application of same and the patients can only be the greatest winner.

If you are looking to get us back to that age where the "Lab guy" is the fall guy for everyone else and is expected to gladly accept that, then i'm sorry the Law disagrees with you.

In the 50s' and 60's we had medical assistants treating patients because we didn't have enough Physicians, today we have more than ?40,000 physicians.
In the 70's we didn't have enough MLS/Biomedical Scientists. The biologists/chemists without basic knowledge in medical science were drafted in. These were all stop-gap complementary efforts.
Today Nigeria has at least 8,000 Medical Laboratory Scientists. Why go back to the inglorious era?

I am new on this forum, been reading as a guest for months, attracted by lots of misinformation about the MLS profession
and not a reincarnation of anyone. I will also like to meet fellow MLS on these forum. They seem to be very few on this website.

Sctests:
These are the tests that are associated with the conditions your reeled out as not needing lab tests. If a course has to with lives it can not be overrated or irrelevant. When you start your own practice, i'm sure you'll need incantations in place of lab investigations like a magician to you truly are.

1. UTI--- urine m/c/s, urinalysis-YES FOR CONFIRMATION! I CAN TREAT WITHOUT THESE!
2. Malaria--- M.P smear, malaria molecular tests-FOR CONFIRMATION. I CAN TREAT WITHOUT THESE!
3. Pregnancy- HCG test-YES FOR CONFIRMATION!
4. Typhoid- Serolgy
5. Anaemia- Hb tests, PCV, CBC-YES FOR CONFIRMATION BUT I CAN TREAT WITHOUT THESE
6. Sepsis- direct gram, blood culture-YES FOR CONFIRMATION
7. Ureamia-E/U/Cr,Blood urea Nitrogen(BUN), Creatinine clearance-YES!
8. Hepatitis- AST, ALT, HCV, HbsAg-YES!
9. Immunosuppression-FBC, ?HIV test-YES!
10. Renal failure- E/U/Cr-yes for confirmation!
11. Heart failure- Lipids, cardiac markers(troponin), pericardial fluid analysis-NOPE!!! i dont need these to diagnose AND TREAT cardiac failure!
12. Eclampsia-platelet count and function, protein/creatine ration estimation-SO I'LL WAIT FOR ALL THESE BEFORE I TREAT MY PATIENT WHEN SHE'S FITTING AWAY ON MY TABLE?
14. Sickle cell disease- Genotype, Hb-YES FOR CONFIRMATION!
15. Schizophrenia- Blood screening for drugs and alcohol to rule out conditions with similar symptoms-PLS DONT MAKE ME LAUGH!!
16. Lymphoma- cbc, blood smear, lymph aspiration-yes,the pathologists do these,not lab scientists!!!no lab sci. can diagnose blood CA on smears!
18. Increased ICP-Serum bile acid-?i dont need this to diagnose intracranial hypertension!!
19. Fracture- Radiography yes not lab test
21. Meningitis- CSF analysis YES FOR CONFIRMATION!
22. Pneumonia-bacteria sputum culture, influenza test-FOR CONFIRMATION BUT I DONT NEED IT TO START MY PATIENT ON BROAD SPECTRUM.
23. Helminthiasis-stool microscopy-YES DEFINITELY!!!
24. PID- HVS m/c/s-YES TO CONFIRM WHAT ORGANISM IS CAUSING THIS BUT I DONT NEED THIS TO TREAT.JUST THE COLOR OF THE VAGINAL DISCHARGE CAN POINT THE DOCTOR IN A CERTAIN DIRECTION!
26. Multiple myeloma- BJ proteins-YES DEFINITELY BUT ITS THE PATHOLOGISTS WHO DO THIS
27. Diarrhoea- stool analysis.AGAIN,TO CONFIRM THE ORGANISM BUT I DONT NEED IT TO TREAT.
28. Stroke- PT, INR, for rule outs-PLEASE DONT MAKE ME LAUGH
29. Asthma-tests for allergens will help rule out causes-I DONT NEED TO KNOW THE ALLERGEN TO DIAGNOSE ASTHMA AND TREAT IT!!
30. Osteomyelitis- blood culture-NOPE,I DONT NEED THIS TO DIAGNOSE OSTEOMYELITIS
100. Diabetes- RBS, FBS, gycosylatd Hb-YES TO CONFIRM

Sctests:
Go back to the link you posted and peruse it
carefully, your asm-ascp website does not say it confers on
you "Medical laboratory Scientist" competencies. Let me quote an excerpt from your source

"Those who pass the exam are certified as a
Technologist in Microbiology (M) or Specialist in Microbiology (SM) by the ASCP and
are issued a certificate with both organizations' names on it."-----http://www.asm.org/index.php/nrcm-cert

Did you notice they were careful not have added the word "Medical"
in front of the "Technologist"? The medico-legal issues surrounding the practice can not
be wished away in countries where they are serious about this practice. Do non-biomedcal scientists(BMS)
in the UK work with patient's samples to achieve results aimed at diagnosis. Do you know that the title "BMS" is a protected title
in the U.K?

Again on your website let's take a look at the functions of a Registered Microbiologist and Specialist Microbiologist.
Is there any job description there with any semblance of working in a Medical laboratory for diagnostic purpose?

You guys have your fields, how many Medical lab Scientists are employed as Food microbiologists, industrial chemists, Environmental biologist and so on?
Do we run the environmental testing laboratories too?. You need to stop seeing the Medical lab Scientist as an ordinary 'Operator' not eligible to differentiate between a hyperglycemic sample caused by DM and a contaminated sample.


Listen the physician's here will click likes and applaud you, but if have any sense of history you will understand
that during the days of biologist/chemist in IMLT, almost every clueless physician will point to the lab and blame it when they butcher a patient.

The lab guys were the fall guys in those days. When a patient dies, it's the lab that delayed results. They prescribe the wrong
antibiotics- "oh that numbskull in the lab didn't run the AST effectively".

Well those "lab guys" have taken responsibility, built capacity, and equipped themselves with enhanced knowledge,
now regulate the laboratory with the full backing of the law. Why should that be a problem? Our national/state hospitals now have very few cases of misdiagnosis traceable to the laboratory. Nowadays, we no longer get frequent finger-pointings for giving bad results and endangering patients as it was in the 70's and 80's, Now we only get finger-pointing for asking to head the medical laboratories we developed-OUR PRIMARY CONSTITUENCIES in accordance with the law. It is a positive turn-around if you ask me.

Wide consultations were made before that ACT was passed as Law, people who thought the "kitchen"/labs should be thrown to the
backyard and blamed it for all their malpractice misfortunes are the ones crying foul today. Our Medical laboratories are getting strengthened,
the Medical Lab.Scientists will keep building capacities through enhanced knowledge and application of same and the patients can only be the greatest winner.

If you are looking to get us back to that age where the "Lab guy" is the fall guy for everyone else and is expected to gladly accept that, then i'm sorry the Law disagrees with you.

In the 50s' and 60's we had medical assistants treating patients because we didn't have enough Physicians, today we have more than ?40,000 physicians.
In the 70's we didn't have enough MLS/Biomedical Scientists. The biologists/chemists without basic knowledge in medical science were drafted in. These were all stop-gap complementary efforts.
Today Nigeria has at least 8,000 Medical Laboratory Scientists. Why go back to the inglorious era?

I am new on this forum, been reading as a guest for months, attracted by lots of misinformation about the MLS profession
and not a reincarnation of anyone. I will also like to meet fellow MLS on these forum. They seem to be very few on this website.

phantom:
abeg when you people are done arguing,tell me the lab tests that MAKE a diagnoses of
1.schizophrenia(madness,craze,kolo )
2.appendicitis
3.priapism
4.testicular torsion and which lab test will differentiate it from acute epidydymoorchitis
5.Peptic ulcer
6.stroke
7.glaucoma
8.inguinoscrotal hernia
9.intestinal obstruction
10.varicocoeles
11.chronic liver disease
12.congestive cardiac failure
13.ventricular septal defect
14.intestinal obstruction in a child

the doctor is TRAINED TO MAKE A PROVISIONAL DIAGNOSIS BASED ON JUST ASKING THE PATIENT CERTAIN QUESTIONS AND CLINICALLY EXAMINING THE PATIENT. THAT IS THEIR USP(unique selling point).THAT IS WHAT DIFFERENTIATES THEM FROM THE OTHERS.

IF A LAB TEST DOES NOT CORRESPOND WITH THE DOCTORS CLINICAL DIAGNOSIS,IT IS THE LABWORK THAT IS REPEATED
...not the other way around. that is why doctors are special. they have a fairly good idea what is wrong with a patient and only SEND FOR LABWORK TO CONFIRM!!!!! please let this sink in!!!

quote me anywhere,any doctor WHO RELIES ON LABWORK TO TREAT HIS PATIENT IS A BAD DOCTOR!! QED

kinguwem:
You're absolutely correct. Some of these medical laboratory scientists are quacks. They do consultations & prescription of drugs in their offices. Some prefer to be called doctors by clients.

ItsMeAboki:
My friend, don't be naive; automated machines still rely on humans to feed them with information, monitor as well as manage them - like most computers: garbage in garbage out, human intervention is always required or else you are heading straight towards systems failure.
Yeah, I guess by your logic since most modern aircrafts have auto-pilots to fly them, human pilots are no longer needed - LOL.

nobilis:
My final points on this thread (if u lab scientists can tell yourselves the truth),

1.A doctor doesn't need a laboratory test to make a diagnosis.
A doctor makes a diagnosis, albeit a provisional one, before sending for lab tests.
Even you lab scientists working in government hospitals are aware that you will never accept a lab request if it doesn't bear a provisional diagnosis.
How I wish you guys will educate the Nigerian populace about how things actually are.
Quote me anywhere: a doctor who doesn't have a diagnosis, or several differentials in mind after at least, 20 to 30 minutes of interacting with a patient is a certified quack.

2. A doctor doesn't use a lab result to make a diagnosis. A doctor uses a lab test to confirm a diagnosis.
In most cases, when the lab result doesn't tally with the doctor's suspicions, he may have to either order for another test, possibly from another lab, or discard that result and work with his diagnosis.

So everybody should know his position. It is as simple as that.

kinguwem:
You're absolutely correct. Some of these medical laboratory scientists are quacks. They do consultations & prescription of drugs in their offices. Some prefer to be called doctors by clients.