The Complexities of the doctors strike

The Complexities of the Doctors’ Strike. 

By Dr. Goke Akinrogun
17 July, 2014

I must confess the present strike embarked upon by the Nigerian Medical Association (NMA) gives me a gummed-lip on a rather touchy development with all the attendant casualties. What I have resolved is to allow the issues to discuss itself, getting the informed to layout the issues on both sides. As a starter, I am inclined to get across some of the arguments espoused by a popular Lagos NMA activist, Dr. Majolagbe Taofik, posted as “THE NIGERIAN HEALTH SECTOR; JUST BEFORE THE WATERLOO” inwww.tques.blogspot.com . It makes an interesting reading though not necessarily the core-views of this column. 
“It is over two weeks now since the Nigerian Medical Association pulled her members away from work. No doubt NMA received the worst bashing from the general public. This situation is so because people lack depth into the issues that have caused the present action of the doctors and of course the fact that they cannot phantom why the doctors would appear callous as to abandon their patients.
“If we must avoid the impending doom, it is imperative that we take a critical impartial analysis of the present issues, so that we can take decisive steps to avoid the worst coming to being. Rather than just always criticise the doctors for withdrawing services, it is better to first understand the issues dispassionately; next we can then query the decision of the doctors to have taken the strike option to pursue their agitation.
“Without prejudice to any of the disputing sides, I make bold to say that health service requires the collaborative efforts of various professionals and other allied workers whose only goal is to come to a positive outcome of patient care. Every part of this whole has its integral role that it plays and one part may not claim superiority over the others.
“However, in any scenario where we have different people coming together to achieve a single goal, there must be direction and this direction must be provided by leadership. The problem in the Nigerian health sector is that leadership has been misconstrued as superiority and as noted earlier, this problem has been on for decades. I also make bold to say that both sides are guilty of this misnomer.
“Much as we try to have a clear understanding of the distinction between leadership and superiority, we must however be clear as to who is the Captain of the ship. It is commonsensical that only one captain is needed to direct this ship, and anything other than that leads to chaos; which is exactly what we must avoid.
“It is also commonsensical that the best person to captain the ship is the most knowledgeable person about the entire process and without doubt that positions falls to the doctor. That the doctor is the one with the most knowledge of the patient is what the other health professionals find discordant to their ears and this has been the bane of the long standing conflict.  But no one gets annoyed or argue when the lawyer says that he is the only learned person. Why should this concept be a problem within the health sector.
“What the other health workers are asking for is not just a name, but to use and be accorded what is due to the term consultant. Other than that they also believe that it is their right to also head the health team.
“Let all be clear that the term consultant may refer simply to an advisory role between a professional and its client; within the hospital setting however, this is not so. The term consultant refers to a specific role which describes a relationship between a patient and a physician who has completed his specialisation in a particular part of medicine. It is a position of responsibility as well as authority.
“The implication is that if a doctor does not become a specialist, irrespective of many years of practice or getting to the highest position in service, it still does not confer on him the title consultant. What do we then make of a nurse or pharmacist who wants to attain the same status? It has been believed that because these other health workers now pursue postgraduate degrees up to attaining a PhD it is therefore expected that it is okay for them to receive such status. But pursuing an academic career is completely different from specialisation. Even a medical doctor who decided to attain a PhD does not get the title consultant.
“The implication of having other health workers attain the status and role of consultant is that it provides more than one captain to direct the ship. For instance the consultant pharmacist may believe that he is a specialist in the field of drugs and therefore may decide on what drug a patient may or may not be given. Everyone else including nurses and laboratory scientist may decide on themselves what they want or do not want for the patient. There exists no other word for this other than chaos!
“How would a patient get well with conflicting orders? Indeed who would be ready to get on board a ship with more than one captain? Well I wouldn’t, even if the ride is for free.”