₦airaland Forum

nefertitiram:
In America all hospitals are required under EMTALA law to provide comprehensive treatment to all patients irrespective of their ability to pay.

How do you stabilize a woman in labour without delivering her!

The OP doesn't even want to stabilze any body who cannot pay
One example below:

daretodiffer:
I don't even remember you

bankybobo11:
Okay then. That's good. In case you wantu remember what you caused me, you can go through your mentions for my moniker

EreluY:
Now, you've come full circle to the point I've made, repeatedly, on NL threads over the years. Nigeria is irrevocably doomed. Get out of that sh1t hole, if you can. The earlier the better. It's always been the case from pre-historic times that humans migrate.

And, yes sir, I pay my tax (too much tax is killing me right now but I don't really mind). I never ever discuss cost/funds/money with my GP over the past 20 years or so. Why? I pay my tax and the NHS is effective - simply the best in the world. Doctors in my necks of the wood take their Hippocratic oath very SERIOUSLY. And for those asking what Hippocratic oath means, for the umpteenth time, it refers to an oath taken "by ​people when they ​become ​doctors to do everything ​possible to ​help ​their ​patients and to have high ​moral ​standards in ​their ​work."

snthesis:
dear doctors, the solution is simple

....outsource your debt recovery

get the patient to sign the fees prior to treatment (get all the personal details as well i.e address place of work etc), if he/she fails to honor the agreement, simply hand over the case to debt recovery agents (consider them as modern day bounty hunters)- this agent should collect your fees plus a % for doing the dirty work. the % will be borne by the patient ofcourse. its a win -win situation.
and for the business minded folks- its a bizness opportunity to set urself up as a debt recovery agency... awoof money especially if you are a tout already just make sure you have legal backing.

cc: sofadj , ericlove4all , claremont , glossy6

Originalsly:
Bro...as a doctor he need not get into all those details.... especially in a public forum... patients keep coming for various emergencies, agreeing to foot the bill and skip out after treatment. I doubt whether he held collaterals or he wouldn't be here.... he would've already sold them if they didn't come up with the cash.Most of his patients may really not have the cash at that time but I'm sure their family must have collaterals to cover the bill... whether it be car, house or land.

armadeo:
guy do you think the hospital is a bank.

should he ask for the car papers or land documents before treatment.


i assure you these patients always run. always. then they would gather and do one hell of a naming ceremony for the child.


I dont blame the OP and IMO no blood on his hands.

datigbogirl:
He should tie d patient down ba? You're so funny...ppl dat have no idea about running a hospital or the medical profession will come and be giving you advise on how to run the hospital...even govt hospitals with the best of security experts still have patient absconding under watchful eyes...i mentioned my experience on how a patient called to organize touts dat beat us up and he dropped 2thousand naira as hospital bill and left....you don't know patients at all so pls don't give any advise..

Most of the private hospitals you see functioning well are either being funded by HMOs or have a strict rule when it comes to bills and they usually have their customers like celebrities, politicians etc....e.g Eko hospitals, St.Nicholas, Reddington etc...e[b]ven when you sef enter the place you'll go and find another hospital to go to cos you'll be too intimidated to start acting funny or cause any scene when your bill is presented...some will even size you up and deny you admission if they sense you'll end up being a trouble maker who won't pay..[/b]..you can't blame them cos they're not ready to hear stories dat touch! That wont put food on their tables

beautycrush24:
i didnt say barest minimum to every patient. I mean helpless cases

armadeo:
the bolded is very true. you need to enter some hospitals even with your emergency you will turn back yourself knowing that the trouble you may want to cause over bills will be less than the trouble the hospital will give you.

some would even bounce you sef

EreluY:
Your comment demonstrates a lack of basic English comprehension. I don't blame you but the Nigerian educational system.

allycat:
The hippocratic oath people keep referring too says "the health of MY patient will be my first consideration" emphasis being My. This does not make me responsible for anyone who is rushed into my clinic or hospital.You do not become my patient till I agree to manage your case. So using that to blackmail doctors is a no case submission. If that were the case why don't you put your sick relations on a plane and fly abroad and tell the doctors there to treat you free after all they swore to the same hipocrattic oath.

EreluY:
[b]The vast majority of you on this thread are dead ignorant. The worst ignoramus Nigerians are the degree holders (BA Akungba, MA Ekpoma, PhD Ekpoma/Ibadan/Ogbomoso/Ilorin, or whatever) who I describe as certificated but uneducated and unenlightened. Get out of that zoo called Nigeria, study abroad (and I'm not talking about going to study in Ukraine), gain some practical experience, pass through the overseas experience and let the experience pass through you by allowing it to form and shape your future practice. Those questioning my understanding of what I'm talking about, if after reading my responses on this thread and you still don't have a clue, then go and bow your head in shame and get yourselves a good education. I am sufficiently educated and a fat cat in the city.

Now listen, if you will. In its 2015/2016 prospectus, the University of Oxford states that "Medicine is a vocational degree, which allows you to develop the practical and clinical capabilities specific to medicine, as well as the professional and personal attributes that are necessary to be a doctor." Similar document published by the Yale Medical School states that "Medicine is, first and foremost, a vocation that requires a commitment to professionalism and service humankind." Note the recurrence of, and emphasis on, vocation, in both citations.

Those of you making reference to being asked to pay medical bills in overseas hospitals, thanks for displaying your ignorance. I've lived in the UK for 20 years or so, and have travelled widely across Europe and North America. It's hospital administration that pursues payments (including legal pursuits of non-payments) and not doctors. Even so, it's always after (not before) medical treatment. And, if you were talking about medical treatment and payment in India and Pakistan - that's not my cuppa tea. In sane climes, a doctor or nurse (if caught) would have her/his practice licence revoked for walking/driving past an accident scene without intervening not to mention failing to attend to a patient due to non payment of medical bills.

Further to my claim on the relevance of the the Hippocratic oath "a ​promise made by ​people when they ​become ​doctors to do everything ​possible to ​help ​their ​patients and to have high ​moral ​standards in ​their ​work", the most recent revision (2006) of The Declaration of Geneva (Physician's Oath), as currently published by the World Medical Association, poignantly states: At the time of being admitted as a member of the medical profession:
"I solemnly pledge to [size=18pt]consecrate my life to the service of humanity[/size];
I will give to my teachers the respect and gratitude that is their due;
I will practice my profession with conscience and dignity;
[size=18pt]The health of my patient will be my first consideration[/size];
I will respect the secrets that are confided in me, even after the patient has died;
I will maintain by all the means in my power, the honour and the noble traditions of the medical profession;
My colleagues will be my sisters and brothers;
I will not permit considerations of age, disease or disability, creed, ethnic origin, gender, nationality, political affiliation, race, sexual orientation, social standing or any other factor to intervene between my duty and my patient;
I will maintain [size=18pt]the utmost respect for human life[/size];
I will not use my medical knowledge to violate human rights and civil liberties, even under threat;
I make these promises solemnly, freely and upon my honour."


Note the emboldened phrases or sentences in the Declaration. If you have forgotten the physicians oath you took, that's a reminder.

On a final note, if you entered the field of medicine not considering the fact that it's first and foremost a vocation (just like the priesthood), then get out of it. You have vowed to not only "consecrate your life to the service of humanity," but also ascertain that "the health of your patients will be your first consideration". So, if you fail to attend to a patient for financial reasons and the patient eventually dies due to your inaction, not only is the patient's blood upon you (if you have a conscience), you should be struck off the medical register, prosecuted and sentenced for failing to act professionally. Like the medical vocation, some entered into priesthood (and 'am not talking about pastors in 'Penterascal' churches) thinking it's a bed of roses. Some left on realising that it's a vicarious or sacrificial calling to go and do something else e.g. university lectureships/professorships, etc.

I KNOW THIS IS PROVOCATIVE, YET IT'S NOTHING BUT THE TRUTH. [/b]

This precept, which holds that physicians must care for all that need their care with equal concern and dedication independent of their ability to pay, should be removed as it applies to physicians in private practice, not institutions such as hospitals. Physicians have a right to refuse any patient in a time of non-emergency, even if they do so because the patient cannot pay. While it is admirable when physicians aim to be impartial to patient financial status, the inclusion of this idealized precept ignores current trends in medicine, conflicts with the mutual model of medicine, and – above all – violates physician autonomy.

Firstly, healthcare is increasingly becoming a service-oriented industry, and while health should always be recognized as a common good as opposed to a commodity, the fact that physicians are filling a social need – the common good – as well as the needs of their patients as individuals does not mean that the needs of the physicians can be ignored (Pellegrino, 2008c, p. 414). In the mutual model of medicine, both the patient’s and the physician’s needs are taken into account. Therefore, just as physicians have responsibilities, so do patients, responsibilities such as fidelity, justice (eg. not to abuse malpractice), and to pay their bills. When the physician knows that the patient will violate their covenant, the physician is not obligated to become responsible for them; instead, the physician is obligated to assist the patient in finding another provider. This act of refusing someone before he or she becomes a patient is an exercise of the physician’s autonomy.

Leopantro:
Do you know of the shortfalls of both the original and the modern hippocratic Oath? Much as you are fixated on it, certain portions of it cannot stand in a court of law.
Not this



Kindly refer to this article
https://blogs.commons.georgetown.edu/journal-of-health-sciences/issues-2/vol-6-no-2-july-2012/the-fall-of-the-hippocratic-oath-why-the-hippocratic-oath-should-be-discarded-in-favor-of-a-modified-version-of-pellegrino’s-precepts/

EreluY:
Allycat? if you're a doctor and you swore either or both the hippocratic oath and/or physicians oath, go and have a look at the texts, and come back to tell us about your solemn pledge to consecrate your life to the service of humanity and to maintain the utmost respect for human life whether or not they are your 'registered' patients.

Drfinn:
My noble colleague I feel your pain. It's a reoccurring decimal in every part of Nigeria. The amount of debt owed my facility last year was staggering. I tried severally to recoup always met with pleas and cries.

It takes a doctor with a heart for humanity such as yours to attend to patients before asking for money. It's rather saddening that these patients and their relatives hardly appreciate or seem to reciprocate your kindness. I managed a case of eclampsia last year. D lady was rushed to d clinic while I was in another city. I abandoned every engagement, rushed back and took charge of the situation. Dat was 7months ago. Till date her people are yet to settle their bills.

D one dat hurts was a woman whose child was admitted in a critical condition. After painstakingly taking care of this child. The mother turned around to abuse my workers and vowed never to pay her outstanding bills. Dat was 5 months ago. Till date am yet to c a dime. D list is endless.

Dats why when people bash doctors anyhow I only laugh at their foolishness. They don't know the pains, sacrifice, sleepless nights and inconveniences you endure to see dat another of God's creature recover from whatever malady dat befell dem. The life of a doctor revolves around people. His/her patients.

The failure of society, by dat I mean government, religious organisations, and media to appreciate health is one of the reasons doctors seem to turn the blind eye. The government cares less about the Health and health needs of the citizenry. Primary health care is virtually absent in this country. And where it exists, under funding is a major issue. Religious organisations have taken it upon demselves to play God with people's health. A pregnant woman almost lost her baby simply because her supposed bishop kicked against cesarean section. My boss was helpless. It took wisdom for me to convince her before she accepted. Baby survived was referred to see a neonatologist!

The media seem to glamorise the quackery of herbal practitioners. A day doesn't go by without seeing these evil people on television programs advertising there fake herbs. A woman once came with a gallon of concoction to see me at the clinic. She told me one of these herbal doctors gave her to enable her conceive a boy cos her husband and his people her on her neck. This woman was supposedly educated. I laughed at her folly and counsel her right. Today she's a proud mother of two boys. I believe the media need to downgrade the publicity given these wolves in sheep clothing.

To my noble colleague and all doctors let's continue to be guided by the physician's oath we took. It's a calling. However, let's put measures in place to recoup every penny expended on our patients. It has been my belief that human life comes first. I will continue to uphold the sanctity of human life. And I pray that government, religious organisations, the media and indeed every one join hands in building a health nation. Health is wealth.

sofadj:
In the early hours of today 1:30am, a woman was rushed into the hospital following delivery at the referrral center. Blood had refused to stop gushing out. I did a quick assesment and realised she would need more materials than the hospital pharmacy currently had in store. I could have my staff get from a nearby pharmacy too. However, the husband said he had no money on him and so did the numerous relatives that accompanied. It was indeed a familiar pattern. I decided to let them go. I referred her to a government hospital. Ofcourse they pleaded for me to help but there was nothing I could do. Few minutes after they left - just few metres from my hospital gate, she collapsed. She had lost a lot of blood. I rushed there and rigorously tried resuscitating her right there outside the hospital 2am early morning, but all efforts proved abortive. A young woman of 28years had just died after having her first baby. Screams, wails, cries ensued. I felt bad - this is not why i became a doctor. But her blood is not on my hands.

Her blood is on the hands and heads of all the patients on the ward who can afford to ...

Well i have decided to change the modus operandi of my institution. The previous one has not benefitted anybody. Henceforth if any one comes to my emergency room without a dime. I will not attend to. If such a person dies, the blood is not on my hands, its on the hands of those who have received treatment in the past and failed to pay afterwards.

datigbogirl:
Do you know the kind of stress it takes and d energy it saps out of one just to do my job as a Doctor? So after performing a tasking 4hour operation for peanuts i should still go out and hustle to make actual ends meet and fen come back for another surgery again... Den when i doze off on a patient and forget a forceps in d intestine you'll be the first to call for my Jugular...

Despite the fact i was working alone in d ward seeing 5 different patients at the same time...i was so overwhelmed i forgot to document for a patient what i actually did for him..yet my Oga scolded me and told me i must always document first for each patient i see b4 moving to another patient because d Lawyer will not hear dat one in court oh...he'll look for every means to nail you even though i was trying to save as much people's life by attending to emergencies first b4 documenting.

Even in developed countries Doctors actually practise safety dan compassion now cos the people you're having compassion for will tear you to pieces in d court of law....

sofadj:
I own a hospital in Southwest- (not Osun state Nigeria ...lol). I currently have about 17 patients on my ward each of whom I have admitted at several occasions through emergency. None of these patients has paid upto 30% of his/her bill. Some of them have stayed upto 7 weeks on the ward. I admitted and attended to them based on the fact that their conditions were life-threatening as at the time they came. I made their bill known to them - and they signed before they were treated. But there is a common trend, as soon as they felt relief and became stable they pleaded for their bills to be reduced - this I vehemently refused.

About 4 weeks ago a woman was rushed in with Eclampsia having just convulsed while pregnant and she was unconscious. I promptly took her straight to the theatre without collecting a dime though i had informed the relatives of the charges - #120,000 for her operation and medications. They signed and I carried out the surgery succesfully. Mother and baby survived. Within the following 6-days they paid a total sum of #12,000 and they began pleading to go home for the child's christening ceremony. I looked at them with disdain. Till now, they have only managed to pay a total sum of #14,000.

Another man who was managed for strangulated hernia has only paid 20,000 out of 75,000 bill. And the list goes on. Their failure to pay has made it difficult for the hospital to replace consumables and medications needed to manage other people's condition.
In the early hours of today 1:30am, a woman was rushed into the hospital following delivery at the referrral center. Blood had refused to stop gushing out. I did a quick assesment and realised she would need more materials than the hospital pharmacy currently had in store. I could have my staff get from a nearby pharmacy too. However, the husband said he had no money on him and so did the numerous relatives that accompanied. It was indeed a familiar pattern. I decided to let them go. I referred her to a government hospital. Ofcourse they pleaded for me to help but there was nothing I could do. Few minutes after they left - just few metres from my hospital gate, she collapsed. She had lost a lot of blood. I rushed there and rigorously tried resuscitating her right there outside the hospital 2am early morning, but all efforts proved abortive. A young woman of 28years had just died after having her first baby. Screams, wails, cries ensued. I felt bad - this is not why i became a doctor. But her blood is not on my hands.

Her blood is on the hands and heads of all the patients on the ward who can afford to pay but refused to - on the grounds that - "What will they do?. Her blood is on the hands and heads of the government officials past and present who have made it difficult and impossible for workers to get paid for their work. But the government officials are not the target of this my narrat. It is aimed at those who take hospital healthcare and medical doctors for granted. Those (including myself) who emphasise that doctors should not put money first before treating emergency conditions. In emergency cases, relatives would go to any length through any struggle to get money. As soon as the situation becomes calm, they relax and then they refuse to pay.

Last year a distant relative of mine was delivered of her baby via Caesearian section (in a hospital in Lagos- not mine). They were billed #180,000 which they accepted before the operation. After the surgery, her husband called me and asked how much I charge and i told him. He then began pleading with the management of the said hospital to review his bill. They declined. The husband being who he is, paid #120,000 and absconded with his wife and his newly born son. How he did this, I do not know, but i know that at the christening ceremony a week later, he had two cows slaughtered to celebrate the birth of his first son.

Many times we complain of doctors who ask for charges before treating patients but no one has ever bothered to ask the doctors why they do? Doctors are humans too, we need to pay bills. This is our trade, our profession, our means of livelihood. We have needs too. We can not go to the market place with the ID showing that we're doctors and hope to get food items on credit. We need to pay our children's school fees, we need clothes , shelter etc just as you. Everywhere in the world healthcare is expensive, both services and materials are exepensive. Well we understand that you may not have money. The government should find a way. The government should find a way/policy that ensures that we get our money back after we have rendered our service. In the UK there is the National Health Scheme, in the United states they have health insurance schemes too in addition to Medicare, Medicaid. In Nigeria we have the barely effective, poorly regulated and massively corrupt National Health Insurance Scheme.

Well i have decided to change the modus operandi of my institution. The previous one has not benefitted anybody. Henceforth if any one comes to my emergency room without a dime. I will not attend to. If such a person dies, the blood is not on my hands, its on the hands of those who have received treatment in the past and failed to pay afterwards.