Hairyrapunzel:

Johesu is fighting for equal pay with doctors but are hiding under the guise of fighting for efficient and effective health sector. They want good health sector yet they pose as medical doctors in Nigeria doing what's not their job.
That's how one pharmacist said they can prescribe drugs using kalo or trial and error because they are medical doctors who don't perform surgeries. You guys are the reason Nigeria ranks low in healthcare delivery and the reason is that you claim to see patients yet you don't know jack about diseases.
Do your job the right way and see if Nigeria will not rank high in healthcare delivery. Johesu make up the quacks doctors in Nigeria. Even cleaner dey claim doctor. Be killing Nigerians everyday.

As in ehhh..
I remember the case of an anaethetist technician in a federal hospital who owned a hospital in town. He removed someone's kidney thinking it was an intrabdominal tumour. The patient deteriorated and was finally brought to the federal hospital. The mistake was too grievous to behold that an investigation had to be launched immediately on the status of the said hospital in town. I do not know what finally became of him but I'm pretty sure he got away easily (Na Nigeria we dey)..
I think ignorance and myopic mindset is also the problem in this country.
I have been addressed a nurse many times in clinic while the male nurse I was working with was referred to as the doctor. It was irritating given that I had to politely correct almost all the patients that came into that clinic. The male nurse laughed it off as a joke and subconsciously started overdoing what he was supposed to do. This got me thinking, "it's absolutely possible for any man working in the hospital be it a cleaner, porter or ward maid to pose as a doctor in the society to get extra bucks." Many quacks in the community have not passed through the rigorous medical training.

sogodihno:


This is nonsense.
Nobody own the patient

Really?

When there's litigation, guess who gets hacked. It's always the Doctor, except in rare circumstances.

That is what "owning a patient" means. It refers to taking responsibility, it's not a show of pride

careerwoman:


As in ehhh..
I remember the case of an anaethetist technician in a federal hospital who owned a hospital in town. He removed someone's kidney thinking it was an intrabdominal tumour. The patient deteriorated and was finally brought to the federal hospital. The mistake was too grievous to behold that an investigation had to be launched immediately on the status of the said hospital in town. I do not know what finally became of the porter but I'm pretty sure he got away easily (Na Nigeria we dey)..
I think ignorance and myopic mindset is also a problem in this country.
I have been addressed a nurse many times in clinic while the male nurse I was working with was referred to as the doctor. It was irritating giving that I had to politely correct almost all the patients that came into that clinic. The male nurse laughed it off as a joke and subconsciously started overdoing what he was supposed to do. This got me thinking, "it's absolutely possible for any man working in the hospital be it a cleaner, porter or ward maid to pose as a doctor in the society to get extra bucks." Many quacks in the community have not passed through the rigorous medical training.

When people decide to implement a rare first world occurrence in a third world country, disaster is always the result.
One advanced country appoints consultant technician, and Nigerian technicians demand same. When did one country become international best practice? Why haven't they imported things like locum lab scientist, automated laboratories (that don't require much personnel) , compulsory vetting of lab results by pathologists etc.

We are really interesting

The only way beyond this rift between doctors, nurses, pharmacists and allied health professionals is for we all to look beyond our bad human behaviours - greed, selfishness, ego, pride, and inferiority complex and do our duties with love and passion for patient care..
It's all about the patient at the end of the day. A pharmacist, nurse and an allied health professional cannot do the work of a doctor. A doctor however would not be effective if he decides to do the work of others. There's a reason why these sub sectors in clincal medicine were created. 'Non-physicians' are employed to make the physician efficient in the delivery of his/her services- it's the simple truth (but I know the truth is bitter). Make no mistake, you're the backbone of the doctor and he needs his backbone to care for his patients so he MUST value his backbone. The medical training encompasses all the health professions and that's why when it comes to the head of a clinical team, a doctor is the head anywhere in the world. (N.B administrative services are entirely different from clincal services)

In historical medicine, the physicians were working alone. Producing drugs, learning about the human body through trial and error and dissection of mammals and dead humans. They did virtually everything on their own with the help of an apprentice and maids. This subsequently became ineffective overtime especially due to increased patient load during the WW leading to the birth of nursing services(ask Mama Florence, the founder of modern nursing). With massive breakthroughs in medical science and technology, other areas in medicine were founded and created for one single reason - better patient care.

Now with regards to the administrative part of health services, in my humble opinion I would suggest that administrators are appointed based on their demonstration of verifiable knowledge about hospital administration and management. It's not just about climbing to the peak of your professional career and then becoming automatically fit to become an MD or Director. He/She should have remarkable leadership skills and interpersonal skills that can be verified too.
The poor management of the health system is not because a medical doctor is always appointed the head of admin services. We need to stop being sentimental and look at things critically. It's a constitutional law in Nigeria for a doctor to head the Min of Health so if you want to debate the law then debate it but not at the expense of patients. Unfortunately, Nigeria is an indisciplined country, a lot of people are sitting on jobs that they're less qualified for- from Presidency to lawmakers to civil servants.

In the hospital, I totally support having a hospital board of directors where the head will be purely a hospital administrator (there are master courses on this abroad) with other members from the different departments in the hospital. The CMAC and Head of clinical services will then be qualified medical doctors.
Concerning salaries/monies which is actually the main problem, I personally think our health system is underfunded. All professionals do not get paid based on the amount of work they put in. There's no dignity of labour in Nigeria. The government spends so much on itself than on her citizens. Concerning pay parity, there's no where in the world where pay parity is practiced. It's simple - our training and job description is different with medical/dental training being the most rigorous in terms of course unit load not just duration. In many parts of the world, a B.physiotherapy or BMLS is 4 years not 5.. it's not by duration please. If you need a salary raise, debate for that not pay parity- it's unreasonable..I dislike the fact that other health professionals have to fight for themselves. The doctor being the head of the clinical team should also care for other members of the team and this includes fighting for their selfless interests.

Finally...
The major problem in the health sector today is because some health professionals (doctors, nurses, pharmacists and allied alike) have failed to have mutual respect for each other. For example, the normal practice is for a nurse to set the materials a doctor would need for a procedure. What we see now is that we have to fight for the right thing to be done. Sometimes, I enter a ward and greet the nurse on duty and she would hiss or ignore me (not entirely problem to me). You ask for something and you're ignored or told to get it yourself because you're a young doctor (now, this is a problem). In some centers, they also teach their students to dislike doctors and always be on the defensive side.
This is not to say that there aren't doctors who are badly behaved too as well.
The key thing here is mutual respect
Let's respect each other deviod of any obstacles such as age, gender, long years at work, or ethnicity and work for the good of our patients..A matron taught me a few tricks I needed to be efficient on the ward based on her experience. This doesn't disqualify me from being a doctor or automatically make her the head of a clinical team. I also taught her how to interpret bradycardia or tachycardia on an ECG strip (because she showed interest).
A healthy relationship should exist amongst us. Two wrongs do not make a right.. Love your job.

larrrymore:

140-150k .....abeg which hospital

Federal hospitals..This is based on what I saw on my friend's appointment letter, the gross salary is within that range. However, by the time dues and taxes are deducted from the salary, the net salary drops to 130+ thereabouts.. so I don't know where the person got 110+ figure as the gross/net salary of a post-intern pharmacist or lab scientist on CONHESS scale.

I hope JOHESU doesn't deduct from your salaries too..

Gliding:


Really?

When there's litigation, guess who gets hacked. It's always the Doctor, except in rare circumstances.

That is what "owning a patient" means. It refers to taking responsibility, it's not a show of pride

you are spewing nonsense, for example if a pharmacist make mistake in dispensing in hospital and it affect the patient, let's say the patient die as a result. it's the doctor in charge that will be charge too?

Baba, everyone will bear the consequence of their action, stop making it seem like it's only doctor that can be litigated.

sogodihno:


you are spewing nonsense, for example if a pharmacist make mistake in dispensing in hospital and it affect the patient, let's say the patient die as a result. it's the doctor in charge that will be charge too?

Baba, everyone will bear the consequence of their action, stop making it seem like it's only doctor that can be litigated.

"Spewing nonsense"" I knew you would show your true colors. Most people that don't have facts tend to become abusive.

To reiterate, decisions on patient are taken by the doctor (who is the head of the medical team) and he is responsible for the success or failure recorded.

Someone has to be the head and be held responsible. That's why football coaches are sacked for the team's poor performance. If the head feels someone is misbehaving, he deals with it.

Gliding:


"Spewing nonsense"" I knew you would show your true colors. Most people that don't have facts tend to become abusive.

To reiterate, decisions on patient are taken by the doctor (who is the head of the medical team) and he is responsible for the success or failure recorded.

Someone has to be the head and be held responsible. That's why football coaches are sacked for the team's poor performance. If the head feels someone is misbehaving, he deals with it.

why don't u answer the question and stop beating around the Bush. will a doctor be litigated for a pharmacist mistake? it's yes or no bro.

And sorry for bn abusive

Nigeria Society of Physiotherapy # Fowardedasrecieved . Revisiting The NMA Strike -* The Candid Opinion Of A UK-Based Doctor By *Dr. Ijabla Raymond* Although I practise abroad, I should point out that this strike affects me too. My family and friends all live in Nigeria. I feel compelled to write on this subject because of its seriousness and the dearth of objective analyses on our social media. It is an emotive subject for both *NMA* and *JOHESU* members, and I can understand why punches fly around, but both parties must rise above petty and emotional considerations if we are to find a way forward. For clarification purposes, the *NMA* represents medical doctors whilst *JOHESU* is a union of all health workers who are not doctors. The NMA has a list of *24 demands* but I will limit myself to the most contentious ones. At this stage, it is probably best that I introduce myself. _*I am medical doctor of Nigerian heritage practising in the UK.*_ *WHO SHOULD HEAD THE HOSPITAL* There is no contention – the medical doctor is the head of the *clinical team.* He/she leads the ward rounds, clinics, surgical operations, multidisciplinary meetings and so on because the ultimate and final responsibility for patient care rests in his/her hands. The headship of the hospital is a different matter. This is an *administrative* office, which needs not be occupied by a medical doctor. This job is better in the hands of people who have administrative or business management skills. _This is the case in countries like the UK, Canada and the US,_ which heavily influence our health system. Therefore, it is difficult to reason with the NMA why this job should be the exclusive right of medical doctors. *NON-MEDICAL CONSULTANTS* The doctor-patient ratio in Nigeria is _dangerously low._ In my view, the roles of non-medical professionals such as nurses, physiotherapists, pharmacists etc need to expand to cope with the demands on doctors. It is important that this is done in a _safe way_ by providing the appropriate level of training for these individuals. *This is the case in countries such as the UK, Canada and the US where consultant nurses, pharmacists etc have existed for a few decades now.* I do not see any problem with non-medical consultants as long as these individuals are appropriately trained and can practise both competently and safely within an *agreed framework* . These professionals have separate (but complimentary) job descriptions and their roles are not designed to replace or dispense with the services of the doctor. If this arrangement enhances patient care, then where is the problem with it? The NMA needs to demonstrate to the public and to the government how the creation of these non- medical consultant positions will adversely affect patient care, otherwise, its demands will be perceived as obstructing the professional development of JOHESU members, and I don’t think this is helpful to anybody. *HAZARD ALLOWANCE* The types of hazard and the level to which healthcare workers are exposed vary considerably and depend on the type of job they do. For instance, psychiatrists are hardly exposed to body fluids and their risks for contracting diseases like HIV and hepatitis are much less than for a theatre scrub nurse. The risk of physical assault by a patient is higher for a psychiatrist than for a surgeon. And because psychiatric nurses spend more time with patients, their risks of assault are arguably higher than those of consultant psychiatrists. The people who work in radiology departments such as radiologists, radiographers, nurses, porters and so on have greater exposure to radioactive materials than everyone else in the hospital. The current health hazard allowance of N5,000 is unconscionable – it needs to increase. However, I think it is imperative to get an independent risk assessor for impartial advice. *MISCELLANEOUS* I have read far too many emotional arguments on these issues and very little of an objective discourse. It is important that I draw your attention to a few of these. What has become obvious is the lack of understanding of the *concept of teamwork* . There is a pervasive notion among doctors that the other healthcare workers are there to serve them. JOHESU members think that doctors have become too conceited for their own good and are determined to put them in their “places”. *The most important person in the hospital is the patient* – it is *not* the _doctor_ , _nurse_ , _pharmacist_ or _laboratory scientist_ or anyone else. Every team member is important and must be respected, including the people who do the least clinical jobs like cleaning. I don’t imagine that any hospital will remain open for longer than a week if its cleaners went on strike and dirt was allowed to accumulate to the point where it constitutes a health risk. I have heard so many anecdotal accounts of nurses not joining doctors on ward rounds or pharmacists altering prescriptions without first discussing these with the prescribing doctors or laboratory scientist slapping doctors; and these accounts are being given as reasons why doctors must continue to head hospitals. These are *disciplinary matters,* which should be managed according to existing procedures. These excuses are emotional and should not be used to block the professional development of others. The other reason I have heard doctors give for not wanting our non-medical colleagues to bear the "consultant" title is the fear that patients will confuse them or anybody else in a white-coat for a doctor and give such people an excuse for autonomous practice. This reason is *not good enough* because this problem can be solved by wearing names badges and/or colour coded uniforms. Also health professionals should introduce themselves to patients at the start of consultations. But more significantly, this can be an issue of regulation - any one found to be (criminally) practising over and beyond their job description, competence level or professional registration becomes liable to disciplinary procedures. Our health system suffers from poor regulation. This is why anyone can open a chemist and dole out antibiotics indiscriminately. It is the reason doctors are scared that consultant pharmacists, nurses and physiotherapists will steal their patients. But it is also the reason why doctors may recommend an operation to a patient where none is necessary just so they can charge more. This is a problem that is in urgent need of attention. I hope that this something both NMA & JOHESU will flag up in the near future. Another recurrent theme in these debates is the abuse of junior doctors by both medical and non-medical staff, which appears to be endemic. There is a consistent narrative of junior doctors being asked to do other people’s jobs such as collecting blood from blood banks, taking samples to laboratories etc. In extreme cases, these doctors are asked to undertake non-clinical tasks by more senior doctors. This is simply unacceptable! I think it is fair to place the blame for this at the hands of consultants who are supposed to be responsible for junior doctors. But this in itself is not a good argument for blocking JOHESU members from becoming consultants in their specialties or for stopping them from heading hospitals if they have the right qualifications. I am concerned that the NMA is losing public sympathy. Increasingly, I hear people describe doctors as selfish and heartless. This is very sad and rather unfortunate. They say doctors do not have any motivation to end the strike because patients are forced to pay exorbitant fees to them in their private hospitals. Those patients who cannot afford these fees are left to suffer or die. If the NMA has made any efforts to change this public perception, then these do not appear to have been effective. *CONCLUSION* The current strategy (i.e., recurrent strikes) is not working. Over the last decade or two, the NMA and non-medical health workers (more recently represented by JOHESU) have taken turns to go on strikes. Perhaps, it is time for both parties to sit together, talk to each other and resolve these contentious issues once and for all. _It’s pointless for the government to enter into agreements with one party knowing fully well that the other party will ask for a reversal of those agreements._ I think the time has come to incorporate Ethics, Teamwork and Communications into undergraduate curricula. The various online comments I have read from medical and non- medical colleagues show that whilst many easily mouth off "team work", a practical understanding of what this means is lacking. Disciplinary procedures are there for a reason. They must be followed when necessary. Although I practise abroad, I should point out that this strike affects me too. My family and friends all live in Nigeria. And who says I am not planning to come home to practise? Lastly, we must all be mindful of our own mortality. Most of us will be ill someday. And when this happens, the only thing that will matter to us is to be looked after by caring and competent health-workers regardless of their individual specialisation. We can create that environment if we forget our individual egos and work as a team. *Ijabla Raymond,* a medical doctor of Nigerian heritage writes from the UK. Contact: _ijabla.raymond@facebook.com._

sogodihno:


why don't u answer the question and stop beating around the Bush. will a doctor be litigated for a pharmacist mistake? it's yes or no bro.

And sorry for bn abusive

The answer is staring you in the face bro.
It's in my last post.
Unless you are contesting the headship of the medical team.

Deltayankeeboi:
this jambite. Stop commenting on thread concerning these issues. I have always read your comments on johesu threads, you have never ever made a valid arguement. you only throw insults when you are posed with smart questions. You have never one day argued like an intelligent person. This thread is way above you right now. Stick to your admission seeking first before you argue with those in the labour market. Your mates are not here. Move to the entertainment section. You have nothing valuable to contribute here. All you do is insult those in favour of johesu without making valid objective points. Move away from health section. thank you

so hilarious, as if you have anything to contribute to make the world a better place, coming from someone who doesn't know the difference between a radiologist and a radiographer. it is a sad thing when people choose to continue to be ignorant, thereby disgracing the cyberspace.

Gliding:


The answer is staring you in the face bro.
It's in my last post.
Unless you are contesting the headship of the medical team.

seriously? So a doctor will be held responsible for the mistake of a pharmacist? it's not worth arguing with you, after all, it's a pity. Take care.

omatynx:
The blood of all innocents that has and are still losing their lives because of these selfish humans will be on their head. Their are other better ways this can be done. The so called government officials dont use your services, they go abroad.

May Gods justice prevail on these doctors that swore an oath to save lives but for selfish gain has seen lots of life lost for minor causes.

I am already affect....its quite painful.....

Sorry about that but why mention only the doctors? Are they the ones on strike?? I think u should rather call on JOHESU to be reasonable in her pursuits. Don't put the responsibility of lives lost on Doctors alone, they are not the only health professionals. And one thing I am pretty sure about is that if the population of doctors were adequate, hospitals would run almost as smoothly as ever. The major things that would be needed would be services of private pharmacies, labs and other diagnostic centres. But then, patients will have to pay dearly for those services.
I've witnessed a period during which there was JOHESU strike and patients relatives created a roaster for cleaning the wards although there were not as much as they would have been if there had been no strike.
The truth is that an understanding needs to be arrived at soon by all parties involved in order to prevent the loss of more lives.

Thanks18:
Nigeria Society of Physiotherapy # Fowardedasrecieved . Revisiting The NMA Strike -* The Candid Opinion Of A UK-Based Doctor By *Dr. Ijabla Raymond* Although I practise abroad, I should point out that this strike affects me too. My family and friends all live in Nigeria. I feel compelled to write on this subject because of its seriousness and the dearth of objective analyses on our social media. It is an emotive subject for both *NMA* and *JOHESU* members, and I can understand why punches fly around, but both parties must rise above petty and emotional considerations if we are to find a way forward. For clarification purposes, the *NMA* represents medical doctors whilst *JOHESU* is a union of all health workers who are not doctors. The NMA has a list of *24 demands* but I will limit myself to the most contentious ones. At this stage, it is probably best that I introduce myself. _*I am medical doctor of Nigerian heritage practising in the UK.*_ *WHO SHOULD HEAD THE HOSPITAL* There is no contention – the medical doctor is the head of the *clinical team.* He/she leads the ward rounds, clinics, surgical operations, multidisciplinary meetings and so on because the ultimate and final responsibility for patient care rests in his/her hands. The headship of the hospital is a different matter. This is an *administrative* office, which needs not be occupied by a medical doctor. This job is better in the hands of people who have administrative or business management skills. _This is the case in countries like the UK, Canada and the US,_ which heavily influence our health system. Therefore, it is difficult to reason with the NMA why this job should be the exclusive right of medical doctors. *NON-MEDICAL CONSULTANTS* The doctor-patient ratio in Nigeria is _dangerously low._ In my view, the roles of non-medical professionals such as nurses, physiotherapists, pharmacists etc need to expand to cope with the demands on doctors. It is important that this is done in a _safe way_ by providing the appropriate level of training for these individuals. *This is the case in countries such as the UK, Canada and the US where consultant nurses, pharmacists etc have existed for a few decades now.* I do not see any problem with non-medical consultants as long as these individuals are appropriately trained and can practise both competently and safely within an *agreed framework* . These professionals have separate (but complimentary) job descriptions and their roles are not designed to replace or dispense with the services of the doctor. If this arrangement enhances patient care, then where is the problem with it? The NMA needs to demonstrate to the public and to the government how the creation of these non- medical consultant positions will adversely affect patient care, otherwise, its demands will be perceived as obstructing the professional development of JOHESU members, and I don’t think this is helpful to anybody. *HAZARD ALLOWANCE* The types of hazard and the level to which healthcare workers are exposed vary considerably and depend on the type of job they do. For instance, psychiatrists are hardly exposed to body fluids and their risks for contracting diseases like HIV and hepatitis are much less than for a theatre scrub nurse. The risk of physical assault by a patient is higher for a psychiatrist than for a surgeon. And because psychiatric nurses spend more time with patients, their risks of assault are arguably higher than those of consultant psychiatrists. The people who work in radiology departments such as radiologists, radiographers, nurses, porters and so on have greater exposure to radioactive materials than everyone else in the hospital. The current health hazard allowance of N5,000 is unconscionable – it needs to increase. However, I think it is imperative to get an independent risk assessor for impartial advice. *MISCELLANEOUS* I have read far too many emotional arguments on these issues and very little of an objective discourse. It is important that I draw your attention to a few of these. What has become obvious is the lack of understanding of the *concept of teamwork* . There is a pervasive notion among doctors that the other healthcare workers are there to serve them. JOHESU members think that doctors have become too conceited for their own good and are determined to put them in their “places”. *The most important person in the hospital is the patient* – it is *not* the _doctor_ , _nurse_ , _pharmacist_ or _laboratory scientist_ or anyone else. Every team member is important and must be respected, including the people who do the least clinical jobs like cleaning. I don’t imagine that any hospital will remain open for longer than a week if its cleaners went on strike and dirt was allowed to accumulate to the point where it constitutes a health risk. I have heard so many anecdotal accounts of nurses not joining doctors on ward rounds or pharmacists altering prescriptions without first discussing these with the prescribing doctors or laboratory scientist slapping doctors; and these accounts are being given as reasons why doctors must continue to head hospitals. These are *disciplinary matters,* which should be managed according to existing procedures. These excuses are emotional and should not be used to block the professional development of others. The other reason I have heard doctors give for not wanting our non-medical colleagues to bear the "consultant" title is the fear that patients will confuse them or anybody else in a white-coat for a doctor and give such people an excuse for autonomous practice. This reason is *not good enough* because this problem can be solved by wearing names badges and/or colour coded uniforms. Also health professionals should introduce themselves to patients at the start of consultations. But more significantly, this can be an issue of regulation - any one found to be (criminally) practising over and beyond their job description, competence level or professional registration becomes liable to disciplinary procedures. Our health system suffers from poor regulation. This is why anyone can open a chemist and dole out antibiotics indiscriminately. It is the reason doctors are scared that consultant pharmacists, nurses and physiotherapists will steal their patients. But it is also the reason why doctors may recommend an operation to a patient where none is necessary just so they can charge more. This is a problem that is in urgent need of attention. I hope that this something both NMA & JOHESU will flag up in the near future. Another recurrent theme in these debates is the abuse of junior doctors by both medical and non-medical staff, which appears to be endemic. There is a consistent narrative of junior doctors being asked to do other people’s jobs such as collecting blood from blood banks, taking samples to laboratories etc. In extreme cases, these doctors are asked to undertake non-clinical tasks by more senior doctors. This is simply unacceptable! I think it is fair to place the blame for this at the hands of consultants who are supposed to be responsible for junior doctors. But this in itself is not a good argument for blocking JOHESU members from becoming consultants in their specialties or for stopping them from heading hospitals if they have the right qualifications. I am concerned that the NMA is losing public sympathy. Increasingly, I hear people describe doctors as selfish and heartless. This is very sad and rather unfortunate. They say doctors do not have any motivation to end the strike because patients are forced to pay exorbitant fees to them in their private hospitals. Those patients who cannot afford these fees are left to suffer or die. If the NMA has made any efforts to change this public perception, then these do not appear to have been effective. *CONCLUSION* The current strategy (i.e., recurrent strikes) is not working. Over the last decade or two, the NMA and non-medical health workers (more recently represented by JOHESU) have taken turns to go on strikes. Perhaps, it is time for both parties to sit together, talk to each other and resolve these contentious issues once and for all. _It’s pointless for the government to enter into agreements with one party knowing fully well that the other party will ask for a reversal of those agreements._ I think the time has come to incorporate Ethics, Teamwork and Communications into undergraduate curricula. The various online comments I have read from medical and non- medical colleagues show that whilst many easily mouth off "team work", a practical understanding of what this means is lacking. Disciplinary procedures are there for a reason. They must be followed when necessary. Although I practise abroad, I should point out that this strike affects me too. My family and friends all live in Nigeria. And who says I am not planning to come home to practise? Lastly, we must all be mindful of our own mortality. Most of us will be ill someday. And when this happens, the only thing that will matter to us is to be looked after by caring and competent health-workers regardless of their individual specialisation. We can create that environment if we forget our individual egos and work as a team. *Ijabla Raymond,* a medical doctor of Nigerian heritage writes from the UK. Contact: _ijabla.raymond@facebook.com._

Great words from a great mind.

At the end of the whole show the national universities commission will be the one to blame for the chaos in the health sector in Nigeria. The commission seems to be in an unholy alliance and covenant to destroy the health sector in Nigeria. Their modus operandi is two fold

1. License non value added degrees and programs in the health sector. First they accredited the upgrading of optometry from B.Sc. to Doctor of Optometry. These are doctors whose job is only to prescribe you glasses but have been elevated to a status beyond their service. Next they accredited the upgrading of Medical Laboratories Science to Bachelor degree. The consequences of the upgrading is still ripping the health sector apart till date. Now these same people are proceeding to Doctor if Medical Laboratories Science and nobody can stop then but NUC itself. The Bachelor of Pharmacy degree is now upgraded to Doctor of Pharmacy. So far no value has been added to service delivery in the health sector but rather more rivalry, bickering and poor patient care. Sure we will soon have doctor if nursing, doctor if dental therapy, doctor if Physiotherapy, doctor of radiography. The NUC chaos doesn't stop there. They are busy approving and accrediting Bachelor of Environmental Health Sciences( which later will become doctor if environmental health sciences), Bachelor of Public Health(with no professional training in any health care delivery. These degrees build something on nothing). While the veterinarian graduates with the doctor of veterinary medicine, the real doctor of medical sciences graduates with a bachelor if Medicine and Surgery. The NUC concerns itself with approving degree programs that have no relevance to our peculiar health sector needs or precedence in saner climes. The real number one enemy of the health of the people is the national universities commission.

2.The agency second strategy is to battle to whittle down the status of the Bachelor if Medicine and Surgery degree and by extension the professional fellowship We seems to be winning in the fellowship war front, but u bet you the foe doesn't give up like that.
Our number two enemies are the court of law. Don't be surprised if more court judgements are awarded against the doctors status.

Finally we have the West African health organisation. Pray what is the need for a professional fellowship in nursing? And in Pharmacy? Soon we shall have professional fellowship in medical laboratory sciences. My question is what value will these fellowship add to patient care? Does a hospital need a laboratory scientist or a laboratory technologist! Are scientists health practitioners or researchers? Does a hospital need a researcher or a practitioner? What value does consultant nurse or consultant scientist add to patient care?

Great strides are made in clinical care in EKO hospital, Reddington, First consultants, St Nicholas and Zankli in Abuja. Do these hospitals use or need these consultants to perform? My take is that all these professional upgrading are unnecessary and a waste if national resources.

My suggestions
1. There should be laws specifying what NUC can license. I believe NUC is becoming a danger to the nations health sector and needs to be put in line.
2. There us a need for a health summit to discuss what level of skills are needed in our health sector and what length of training are required. It us evident we can't leave this decision to professional associations as they all have demonstrated irresponsibility and are driven by personal interests. The civil society should be called upon to take decision and chart the way forward. Enough of these shenanigans.

#copied

Revisiting The NMA Strike -* The Candid Opinion Of A UK-Based Doctor By *Dr. Ijabla Raymond* Although I practise abroad, I should point out that this strike affects me too. My family and friends all live in Nigeria. I feel compelled to write on this subject because of its seriousness and the dearth of objective analyses on our social media. It is an emotive subject for both *NMA* and *JOHESU* members, and I can understand why punches fly around, but both parties must rise above petty and emotional considerations if we are to find a way forward. For clarification purposes, the *NMA* represents medical doctors whilst *JOHESU* is a union of all health workers who are not doctors. The NMA has a list of *24 demands* but I will limit myself to the most contentious ones. At this stage, it is probably best that I introduce myself. _*I am medical doctor of Nigerian heritage practising in the UK.*_ *WHO SHOULD HEAD THE HOSPITAL* There is no contention – the medical doctor is the head of the *clinical team.* He/she leads the ward rounds, clinics, surgical operations, multidisciplinary meetings and so on because the ultimate and final responsibility for patient care rests in his/her hands. The headship of the hospital is a different matter. This is an *administrative* office, which needs not be occupied by a medical doctor. This job is better in the hands of people who have administrative or business management skills. _This is the case in countries like the UK, Canada and the US,_ which heavily influence our health system. Therefore, it is difficult to reason with the NMA why this job should be the exclusive right of medical doctors. *NON-MEDICAL CONSULTANTS* The doctor-patient ratio in Nigeria is _dangerously low._ In my view, the roles of non-medical professionals such as nurses, physiotherapists, pharmacists etc need to expand to cope with the demands on doctors. It is important that this is done in a _safe way_ by providing the appropriate level of training for these individuals. *This is the case in countries such as the UK, Canada and the US where consultant nurses, pharmacists etc have existed for a few decades now.* I do not see any problem with non-medical consultants as long as these individuals are appropriately trained and can practise both competently and safely within an *agreed framework* . These professionals have separate (but complimentary) job descriptions and their roles are not designed to replace or dispense with the services of the doctor. If this arrangement enhances patient care, then where is the problem with it? The NMA needs to demonstrate to the public and to the government how the creation of these non- medical consultant positions will adversely affect patient care, otherwise, its demands will be perceived as obstructing the professional development of JOHESU members, and I don’t think this is helpful to anybody. *HAZARD ALLOWANCE* The types of hazard and the level to which healthcare workers are exposed vary considerably and depend on the type of job they do. For instance, psychiatrists are hardly exposed to body fluids and their risks for contracting diseases like HIV and hepatitis are much less than for a theatre scrub nurse. The risk of physical assault by a patient is higher for a psychiatrist than for a surgeon. And because psychiatric nurses spend more time with patients, their risks of assault are arguably higher than those of consultant psychiatrists. The people who work in radiology departments such as radiologists, radiographers, nurses, porters and so on have greater exposure to radioactive materials than everyone else in the hospital. The current health hazard allowance of N5,000 is unconscionable – it needs to increase. However, I think it is imperative to get an independent risk assessor for impartial advice. *MISCELLANEOUS* I have read far too many emotional arguments on these issues and very little of an objective discourse. It is important that I draw your attention to a few of these. What has become obvious is the lack of understanding of the *concept of teamwork* . There is a pervasive notion among doctors that the other healthcare workers are there to serve them. JOHESU members think that doctors have become too conceited for their own good and are determined to put them in their “places”. *The most important person in the hospital is the patient* – it is *not* the _doctor_ , _nurse_ , _pharmacist_ or _laboratory scientist_ or anyone else. Every team member is important and must be respected, including the people who do the least clinical jobs like cleaning. I don’t imagine that any hospital will remain open for longer than a week if its cleaners went on strike and dirt was allowed to accumulate to the point where it constitutes a health risk. I have heard so many anecdotal accounts of nurses not joining doctors on ward rounds or pharmacists altering prescriptions without first discussing these with the prescribing doctors or laboratory scientist slapping doctors; and these accounts are being given as reasons why doctors must continue to head hospitals. These are *disciplinary matters,* which should be managed according to existing procedures. These excuses are emotional and should not be used to block the professional development of others. The other reason I have heard doctors give for not wanting our non-medical colleagues to bear the "consultant" title is the fear that patients will confuse them or anybody else in a white-coat for a doctor and give such people an excuse for autonomous practice. This reason is *not good enough* because this problem can be solved by wearing names badges and/or colour coded uniforms. Also health professionals should introduce themselves to patients at the start of consultations. But more significantly, this can be an issue of regulation - any one found to be (criminally) practising over and beyond their job description, competence level or professional registration becomes liable to disciplinary procedures. Our health system suffers from poor regulation. This is why anyone can open a chemist and dole out antibiotics indiscriminately. It is the reason doctors are scared that consultant pharmacists, nurses and physiotherapists will steal their patients. But it is also the reason why doctors may recommend an operation to a patient where none is necessary just so they can charge more. This is a problem that is in urgent need of attention. I hope that this something both NMA & JOHESU will flag up in the near future. Another recurrent theme in these debates is the abuse of junior doctors by both medical and non-medical staff, which appears to be endemic. There is a consistent narrative of junior doctors being asked to do other people’s jobs such as collecting blood from blood banks, taking samples to laboratories etc. In extreme cases, these doctors are asked to undertake non-clinical tasks by more senior doctors. This is simply unacceptable! I think it is fair to place the blame for this at the hands of consultants who are supposed to be responsible for junior doctors. But this in itself is not a good argument for blocking JOHESU members from becoming consultants in their specialties or for stopping them from heading hospitals if they have the right qualifications. I am concerned that the NMA is losing public sympathy. Increasingly, I hear people describe doctors as selfish and heartless. This is very sad and rather unfortunate. They say doctors do not have any motivation to end the strike because patients are forced to pay exorbitant fees to them in their private hospitals. Those patients who cannot afford these fees are left to suffer or die. If the NMA has made any efforts to change this public perception, then these do not appear to have been effective. *CONCLUSION* The current strategy (i.e., recurrent strikes) is not working. Over the last decade or two, the NMA and non-medical health workers (more recently represented by JOHESU) have taken turns to go on strikes. Perhaps, it is time for both parties to sit together, talk to each other and resolve these contentious issues once and for all. _It’s pointless for the government to enter into agreements with one party knowing fully well that the other party will ask for a reversal of those agreements._ I think the time has come to incorporate Ethics, Teamwork and Communications into undergraduate curricula. The various online comments I have read from medical and non- medical colleagues show that whilst many easily mouth off "team work", a practical understanding of what this means is lacking. Disciplinary procedures are there for a reason. They must be followed when necessary. Although I practise abroad, I should point out that this strike affects me too. My family and friends all live in Nigeria. And who says I am not planning to come home to practise? Lastly, we must all be mindful of our own mortality. Most of us will be ill someday. And when this happens, the only thing that will matter to us is to be looked after by caring and competent health-workers regardless of their individual specialisation. We can create that environment if we forget our individual egos and work as a team. *Ijabla Raymond,* a medical doctor of Nigerian heritage writes from the UK. Contact: _ijabla.raymond@facebook.com._

drI:



Strangely a patient can go to the hospital, see a doctor, get fully treated and leave without the other health workers. Not because they are unimportant but because the doctor has been trained to do everything other health workers can do and much more.
For instance the teaching hospitals are operational and functioning fully while JOHESU have been on strike. We are even carrying out major surgeries without JOHESU. What else is required to prove my point?

The reason any patient will go to whatever hospital without seeing any other health PROFESSIONAL aside the Doctor is condition specific which you know quite well. Take for instance a patients with musculoskeletal deformities or abnormalities needs to see a Physiotherapists, but because most of Nigeria patients/clients are ignorant, they feel/think you have to see a Medical Doctor for everything, in developed climes, the populace would have made a research about their symptoms, presentation and management before visiting any health professional and that is why in those countries, any instance of mismanagement is known by the patients and can sue or be reported to appropriate authorities because he/she is aware of the management beforehand. So your assertion that all patients or supposed patients comes to the Doctor at first contact basis is due to ignorance and so does not hold water.

Hairyrapunzel:


Is prescribing now a job description? For a prescription to be given a diagnosis has to be made. That is an individual is confirmed to have an illness therefore, a treatment plan is laid down. Only the doctor does this.
Pharmacists don't do this, lab scientists don't do this, nurses don't do this, physiotherapists don't do this, radiographers don't only doctors. Try prescribing for an individual that has no prescription from a doctor in developed countries and see if they will not jail you. Are we saying you don't contribute to patient care? It's obvious you guys like twisting things. The doctor makes the decision in managing a patient. He names the disease and lays out the treatment plan. Abi you want to start managing disease you don't know jack about? You make me laugh.
Wanting to do a job that's not your own because you want people to see you as something you are not. Mtcheww. Prescriber of the universe.

What you don't understand is there are conditions amenable to Pure Medicine as well as other professionals too, also when you talk about prescription, prescription is not only the tablet, or ample or what have you, prescription includes ointments, gels and so on. I give you a case scenario this time In Physiotherapy, A HIV patient may develop meningoencephalitis and may worsen over time and come down with Stroke, what you guys do is administer drugs so as to rescue him/her from condition, the Physiotherapist is concerned with rehabilitation to bring the patient to his nearest or same self before the ailment. He clerks the patient (history, assessment, diagnoses, plan of treatment and means of management makes prescription (not necessarily tablet or ample or what have you). So that it is only Doctors that make prescription, diagnosis or plan of management is an understatement.

Solababa91:


The reason any patient will go to whatever hospital without seeing any other health PROFESSIONAL aside the Doctor is condition specific which you know quite well. Take for instance a patients with musculoskeletal deformities or abnormalities needs to see a Physiotherapists, but because most of Nigeria patients/clients are ignorant, they feel/think you have to see a Medical Doctor for everything, in developed climes, the populace would have made a research about their symptoms, presentation and management before visiting any health professional and that is why in those countries, any instance of mismanagement is known by the patients and can sue or be reported to appropriate authorities because he/she is aware of the management beforehand. So your assertion that all patients or supposed patients comes to the Doctor at first contact basis is due to ignorance and so does not hold water.

Your intelligent response is sufficient enough to quench the sheer ignorance. Physiotherapist is part of UK GP practice team for MSK related complaints.

Hairyrapunzel:


At the end of the day both doctor and pharmacist penalized. Not the pharmacist alone. The doctor is always held accountable for his prescription. The pharmacist had a right not to dispense the drug and contact the doctor yet he chose not to do so. He dispensed knowing the drug was wrong. In this case he was not supposed to dispense and was also meant to call the doctor who sent the patient.
A pharmacist can never be penalized alone in these kind of cases. The doctor always goes down.
It is still the doctor's patient because he is charge of managing the case.
This is where team work comes into play. If a pharmacist doesn't feel a prescribed drug is not right, the doctor is contacted and it is at the doctor's discretion to review the prescription. If the pharmacist is not still convinced he has the option of not dispensing gbam.

The supposed or the best practice that you painted up there cannot or do not happen here in Nigeria the Doctor feels he is the boss and therefore his prescription should not be altered, even when sometimes the drug-drug combination might not be right, one of the reasons why a lot of patients die or leave hospitals with conditions they don't come with initially.

Deniceone:

Meaning the patient belongs to every member of the health team. if your mistake costs the patient, you go down for it! Patient belongs to everybody and to nobody!

Don't mind them, on ward basis, the case note is always there to make clarification(s) as to where the mistake emanates. Same Doctors that claim they take responsibility for any mistake done will be quick to point to other Professionals as the origin of the mistake/death (in any case it is) as the case may be but be mute if it emanates from their treatment. Yet they run or tell the public they take responsibilities of any mistake solely.

docadams:


It would also have been more productive for you to find out how a Jehusite came t o be earning N697,02442 at CONHESS 15, a salary level far above that of a Director-General on GL 17 in mainstream civil service. This was made possible because you are attached to doctors.You lots are a bunch of ingrates. Likemany people have posited, all manpower should be outsourced, let's see if your CONHESS 15will earn up to N300,000.

You sound a like bumbling buffoon. You are just an empty 'malaria doctor' that's why you couldn't decipher that the N697,02442 is the 'Proposed' CONHESS 15 salary that your minister of physicians have refused to sign even after agreement.

Finally, Johesu professionals don't earn what they earn because they are 'attached' to you Dr malaria, they earn their keep because it is health sector (their sector) and you are clearly useless without them as they have shown.

NickyT039:

If they can do it, y r all the hospital wards empty. Nigerians shouldn't feel the impact of the strike if doctors are capable of managing the hospital alone

You dey mind the numbskulls?

The most important thing is that is JOHESU won't end this strike without anything tangible. Things cannot be worse than it already is and there is no where to go but up for JOHESU.

Till that 'minister of physicians' comes to his senses hospitals will remain closed.

Hairyrapunzel:

Johesu is fighting for equal pay with doctors but are hiding under the guise of fighting for efficient and effective health sector. They want good health sector yet they pose as medical doctors in Nigeria doing what's not their job.
That's how one pharmacist said they can prescribe drugs using kalo or trial and error because they are medical doctors who don't perform surgeries. You guys are the reason Nigeria ranks low in healthcare delivery and the reason is that you claim to see patients yet you don't know jack about diseases.
Do your job the right way and see if Nigeria will not rank high in healthcare delivery. Johesu make up the quacks doctors in Nigeria. Even cleaner dey claim doctor. Be killing Nigerians everyday.

There is no single group of people who have promoted quackery in the health sector than the physicians. These guys turn their failing hospitals and clinics to fake 'training centres', collecting fees and training fake auxillary nurses, quack lab assistants etc. and even giving them certificates. These quacks then invade the health sector with their quackery, unleashing mayhem on the health of hapless, unsuspecting Nigerians.

We will continue to expose you. You are not talking to mor0ns like yourself.

phase1:


You sound a like bumbling buffoon. You are just an empty 'malaria doctor' that's why you couldn't decipher that the N697,02442 is the 'Proposed' CONHESS 15 salary that your minister of physicians have refused to sign even after agreement.

Finally, Johesu professionals don't earn what they earn because they are 'attached' to you Dr malaria, they earn their keep because it is health sector (their sector) and you are clearly useless without them as they have shown.

Two characteristics of a JEHUSITES
1. Inferiority complex making them to throw insult,tantrums upandan. Only means of debate is to Insult doctors whom they want parity with.
2. Always wandering in thoughts. They can't put their points across without showing signs of mental fatigue.

docadams:


It would also have been more productive for you to find out how a Jehusite came t o be earning N697,02442 at CONHESS 15, a salary level far above that of a Director-General on GL 17 in mainstream civil service. This was made possible because you are attached to doctors.You lots are a bunch of ingrates. Likemany people have posited, all manpower should be outsourced, let's see if your CONHESS 15will earn up to N300,000.

Your height of stupidity and impunity is clearly defined and rated in stammering such blunder that other medical professions in health sector aside physician "earn their wages because they are attached to Dr". The health sector belongs to all citizens, patients group, all health professions and not as arrogantly stated by you. Let the sector be privatize let me know who will pay your big belles consultants nearing a million for doing nothing.

docadams:


Two characteristics of a JEHUSITES
1. Inferiority complex making them to throw insult,tantrums upandan. Only means of debate is to Insult doctors whom they want parity with.
2. Always wandering in thoughts. They can't put their points across without showing signs of mental fatigue.

Three characteristics of NMA
1. Arrogance and egotism as if they are the master and owners of the entire health sector
2. Sheer ignorance, daft and reactive to positive dawn coming to health sector which has been ravaged by their decades of misrule and retrograde steps to oblivion.
3. Poor human relationship skills when dealing with patients, colleagues and other professions in the team

Thanks18:


Three characteristics of NMA
1. Arrogance and egotism as if they are the master and owners of the entire health sector
2. Sheer ignorance, daft and reactive to positive dawn coming to health sector which has been ravaged by their decades of misrule and retrograde steps to oblivion.
3. Poor human relationship skills when dealing with patients, colleagues and other professions in the team

Let me save both of us the stress of this banter. Contrary to what you ignorant lot think, we are for the government giving you a salary raise. Any doctor that says otherwise must be a fake - a JEHUSITES. But of course such approval will automatically trigger another process to our benefit. That is the agreed terms cast in diamond. Happy strike.

[quote author=Solababa91 post=67834730]

What you don't understand is there are conditions amenable to Pure Medicine as well as other professionals too, also when you talk about prescription, prescription is not only the tablet, or ample or what have you, prescription includes ointments, gels and so on. I give you a case scenario this time In Physiotherapy, A HIV patient may develop meningoencephalitis and may worsen over time and come down with Stroke, what you guys do is administer drugs so as to rescue him/her from condition, the Physiotherapist is concerned with rehabilitation to bring the patient to his nearest or same self before the ailment. He clerks the patient (history, assessment, diagnoses, plan of treatment and means of management makes prescription (not necessarily tablet or ample or what have you). So that it is only Doctors that make prescription, diagnosis or plan of management is an understatement.
Hmm

boldest:
these are the kind of doctors of johesu nigeria will be seeing ....meningoencepahalitis becoming worse and turns to stroke just like that ....first of all I doubt if you know the possibilities of various dx in HIv and thank God u attest to the fact that the drug makes d patient better ....so he is alive to visit d so called Dr of physiotherapy ...

that nigga is a consultant o
check google and see what johesu consultant mean


walk out of thread biko..

lot of jobless johesu consultant here,
oh I forgot they are on strike

boldest:
these are the kind of doctors of johesu nigeria will be seeing ....meningoencepahalitis becoming worse and turns to stroke just like that ....first of all I doubt if you know the possibilities of various dx in HIv and thank God u attest to the fact that the drug makes d patient better ....so he is alive to visit d so called Dr of physiotherapy ...

You just displayed your ignorance here while trying to argue fact. And you ended up saying nothing. For your sake, argue with your keyboard by asking google. Ignorance coupled with arrogance and closed mind is worse than death. I am really tired responding to eNMA charlatan like you.

Chartey:

You're wrong about the equivalence of Consultant to CNO. The CNO is a rank attained by years of service same way a doctor without specialist training rises through the normal civil service ranks as CMO, PMO etc. A consultant however is a doctor who has undergone further training of almost a decade called residency to become a highly-skilled specialist.

I never equated them, I only pointed out that they are are independent heads in their professions.