The Momentous Times..
My dear Hippocratic sibling,
"Once to every man and nation, comes the moment to decide, in the strife of truth with falsehood, for the good or evil side, some great cause, some grat decision, offering each the bloom or blight, and the choice goes by forever, 'twixt that darkness and that light" James Russel Lowell (1819-1891)
Yes, it is true that we have come a long way of 23 days of total strike, by our own recent standard, at least. It is a time for sober reflection of where we are coming from in order to know where we are and where we are going. We are coming from the glorious height of medical practice we often quote as the good old days. The good old days when a medical doctor, not even the Consultant, enters the ward and the matron in charge rises up to welcome him. The good old days when the Pharmacist courteously seeks clarification on a doctor's prescription. The good old days when the laboratory technologist respectfully brings the prepared slide to the Pathologist for histopathological diagnosis. The good old days when the theatre nurse gowns the surgeon and hands over instruments with a sense of duty. The good old days when the radiographer knows who calls the shot for a contrast study. The good old days when the administrative staff dutifully takes dictation of the letter to be typed for the medical director.
Where are we today? Every paramedic or allied heath worker wants to be a Consultant, a Director and ultimately the Chief Medical Director. The laboratory 'scientist' claims autonomy from the laboratory physician and states allegiance to his or Director or Deputy Director. The nurse on the ward points to where the case note and sphygmomanometer are for the doctor to pick. The student nurse does not want to pour water for a Consultant to wash his hands. The pharmacist tells the patient that the doctor has prescribed a drug that does not work. The physiotherapist tells the patient that the fracture was not properly fixed by the orthopaedic surgeon. Our authority in the Hospital has been eroded by appointments made by Boards of Hospital on the advice of Chief medical Directors. Our brothers in government at various levels have forgotten their Hippocratic source and speak tongue-in-cheek to please their principal in Aso Rock. Our salary relativity have been eroded by MOUs signed and discarded once we leave the negotiation room. Our CMDs refuse to skip salary level for their siblings while they do so for JOHESU. Those and other reasons stated in our 24-point demands is the REASON we painfully decided to withdraw our services from our patients we so much cherish.
What is our vision? Where are we going? Hospitals devoid of anarchy where we practice with peace of mind without the fear of being held hostage by JOHESU and their allies in government. Hospitals where we don't have to say we are in charge because it is obvious. Hospitals where order reigns in place of patients wondering who is the leader. A health sector where the best global practice reigns in place of anarchy and terror. The mission we chose is the withdrawal of service. It was well considered. State delegates debated the how to prosecute it and the members of the NOC, Chairmen of States and FCT and leader of affiliates were loud in saying YES to withdraw our services totally and indefinitely. This is a clarion call not to become weary when we are almost there. We support our NOC and the Negotiating Team at this darkest moment before dawn. We are not swayed by the monetary aspect of our demand, though we do not hate money. We must get all we need to get now that the pressure is on the Government. Failure to get our dues and allowances by accepting promisory notes will result in eternal loss of the glory of the medical profession. We will be worse than where we were before we started. The FGN has a national election to campaign for and win. We are not sure of what February 14, 2015 has in store for us. Are we going to wait for the new budget which will not be passed, from antecedent, before the elections to get our arrears? It will not be wise enough to follow that pathway.
Finally, I plead with our brothers in government at all levels, including all Directors, Director-Generals of parastatals and Hospitals to direct their plea to their principal in Aso Rock to do the needful They should leave those of us who face the ignominy in our Hospitals to prosecute this struggle to its logical conclusion. We knew propaganda will come from all sources. But they should spare us their own pressure and advice at this critical moment. We understand their conflict of interest. They should end up on the positive side of history and posterity and not like the minister of health who ended up ignominously among his Hippocratic siblings. Please pardon my lengthy mail. I just poured out my love and passion for our noble profession which I believe you share with me. The original Greek via Latin word, krisis, means, "decisive moment" , The momentous moment to seize the moment is now! We cannot afford to miss this moment. Crisis reveals character. Victoria est certa.
Your Hippocratic brother,
Dr Adefemi O. Afolabi
Division of Endocrine & Hepatobiliary Surgery
Department of Surgery
College of Medicine, University of Ibadan
University College Hospital
PMB 5116, Ibadan, Oyo State
Nigeria 200001
Tel: Mobile: 234-805-658-9447, 234-803-327-4038
Home:
Office: 234-2-2410088 Ext: 3766 or 2500
Fax: 234-2-2411768
Web:http://www.comui.edu.ng/faculties/clinicalscience/surgery/afolabi
Thursday, 24 July 2014
Tuesday, 22 July 2014
HOW MEDICAL DOCTORS DEVALUE THEIR PROFESSION
A patient calls a Doctor on phone, tells him of some health problems and wants some tests to do or drugs to buy.
The Doc texts him some lab tests to do and asks for no money!
The patient goes to a lab were he pays money and gets the lab tests done.
Patient comes back to Mr Doc who still for free, tells him the drugs to buy for the sickness.
Patient goes to the pharmacy shop where drugs are given to him and he pays them on the spot!
This is common among Nigerian Doctors. Most of us do this on daily basis, and see nothing wrong in it! At times we do it to prove that we know it. Or in the name of friendship or whatever ties. Is this not funny? Nigerians never valued services but only goods. The doctor is a seller of services not goods. Who is still wondering why JOHESU says doctors contribute less and eat more?
The 'experience' the paramedics claim to have got{as the Doctors} were carelessly passed to them by Doctors! If not, why should a lab scientist ask a doctor questions like; ''Dokee which drug I go fit give my sister?, e be like say she get typhoid'' And in most cases, we simply tell them which drugs to use.
The Doctor has made his role appear so simple by the way he transfers his knowledge freely and commonly among the community of health workers. Should this trend continue, the time is soon when only surgeons are distinguished among all hospital workers as everybody does the prescribing.
Doctors should be wiser now!!!
Monday, 21 July 2014
Doctors, Please Stop Corridor Consultations and free Services
Dr Mbu writes from Calabar :
Pls stop Corridor Consultation and free services, that how we lose our respect and prestige.
They said doctors make up only about 10% of hospital workers and as such are a minority in the hospital setting.
Their major man in the house of reps said doctors do nothing and feed fat from the brains of others. That lab scientist make diagnosis for doctors,pharmacists give the patients drugs while nurses care for the patient. His ignorance did not tell him that when a doctor does not see a patient, no test is requested,no prescription is given and no treatment plan is drawn up. In other climes, apart from multivitamins and a few low potency painkillers,you can't buy drugs without a doctors prescription.
The hospital is primarily about a doctor and his patient. Any other person is a support staff and this does not in anyway make them less important as medical practice is a team work with the doctor as a team leader, a major player and the one held responsible should anything go wrong.
This is a bitter truth we must all accept.
No doctor ever claims to be a lab scientist,pharmacist,physiotherapist or nurse yet these groups dubiously claim to be doctors(majority claiming minority). Even orthopaedic technicians and porters claim to be doctors.
When every one is sick,they look for a doctor yet they still say the doctor is proud, arrogant, a usurper and all manner of venom is pour on the poor doctor.
Now that doctors are on strike the hospitals are empty, the majority workforce cannot admit patients,do surgeries etc. Who is fooling who?
Now a lesson to us doctors: since we are too greedy, selfish, hardhearted,callous, and full of ourselves we can never please everyone and we should never try to. Henceforth,no more corridor consultations. Let anyone seeking your medical expertise in anyway pay handsomely for it. Please colleagues don't do anything free for anyone again. You acquired medical knowledge at a great cost so don't dispense that knowledge for free anymore. Our kind and humane disposition has resulted in this rubbing of mud on our faces. Doctors wise up,no one loves you except God.
Sunday, 20 July 2014
If the Government Hospitals are getting worse by the day ,is it Doctors that have been ruling this country too?
Azzez Fashina Wrote..First is, I'm tired of everybody talking about government hospitals getting worse under the management of doctors, citing the UCH/commonwealth example and so on. PLEASE, is everything not getting worse in Nigeria?? Was Nigeria not once the toast of the African continent?? Who are we today?? Is it doctors that have been ruling this nation?? Are our roads not getting worse?? Are there not many government parastatals that were once doing very well and are now failed or gone out completely?? NEPA, NITEL, Nigeria Airways, is it doctors that were managing these too??? Kindly tell me one thing/sector that is getting better in Nigeria. My dear friend, EVERYTHING in Nigeria is declining and the government hospitals are not left out of the rot. It is in NO WAY the fault of any doctor. The government is BAD!!
Secondly, like someone rightly pointed out, lets not mistake the position of CEO of a hospital (like they have in developed nations like the US), for the CMD of a hospital. Anybody can be the CEO but not anyone can be CMD. As fate will have it, the present structure in Nigeria gives the CMD the dual role of being both the chief executive officer (the managerial role) and the chief medical officer (the head of the doctors in the hospital). If this structure is to remain, then the head of doctors can only be a doctor and hence the CMD. If johesu feels strongly against this, then they should be asking for a total change in structure and organogram and not a change in personnel. It doesn't work like that. Not even in the developed nations.
Lastly, I find it very funny when people pick some certain issues and say let's adopt 'international standards' from the western world. It is quite hilarious. For want of time and space I can't go into lengthy explanations but get this please, Nigeria is NOT the US. We can aspire to be like them but let's do it the right way. There is a trend. Its a whole package. You can't just pick out some parts to adopt while neglecting the others. For one, nearly all americans have health insurance. And this singular fact has affected every aspect of their healthcare system from management to the actual healthcare delivery. We have NOTHING! Let's be wise to understand our peculiarity as we aim to copy them. Let's collectively do the right things first!
Steve lemadoro continued....In
Secondly, like someone rightly pointed out, lets not mistake the position of CEO of a hospital (like they have in developed nations like the US), for the CMD of a hospital. Anybody can be the CEO but not anyone can be CMD. As fate will have it, the present structure in Nigeria gives the CMD the dual role of being both the chief executive officer (the managerial role) and the chief medical officer (the head of the doctors in the hospital). If this structure is to remain, then the head of doctors can only be a doctor and hence the CMD. If johesu feels strongly against this, then they should be asking for a total change in structure and organogram and not a change in personnel. It doesn't work like that. Not even in the developed nations.
Lastly, I find it very funny when people pick some certain issues and say let's adopt 'international standards' from the western world. It is quite hilarious. For want of time and space I can't go into lengthy explanations but get this please, Nigeria is NOT the US. We can aspire to be like them but let's do it the right way. There is a trend. Its a whole package. You can't just pick out some parts to adopt while neglecting the others. For one, nearly all americans have health insurance. And this singular fact has affected every aspect of their healthcare system from management to the actual healthcare delivery. We have NOTHING! Let's be wise to understand our peculiarity as we aim to copy them. Let's collectively do the right things first!
Steve lemadoro continued....In
Thursday, 17 July 2014
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.”
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.”
My Dear Colleagues by Dr Lawal Anka
Do not let anyone look down on you. You are the only original in the whole world. You are one of a kind. No one is like you on the face of the earth. No one will ever be like you. You are fearfully and wonderfully made.
Anyone who tries to be like you can only be an Imitation. You are unique, You are special. Never sell yourself short. Never devalue yourself. You are not embarrassment to your profession. Don't look down on yourself.
Your uniqueness means there is something only you can do. There are problems only you can solve. You have something to offer your people.
Your uniqueness means there is only you can contribute to your people/world. You are not here just for decorations or to a while away time. You are not here to escort people. Inside you is the ability to and potential to do remarkable things. To make a difference and become a reference. You are not doing yourself favour when you compare yourself to others.
You can live a life of significance,a life that counts. You can do more than you can. You can win. Confess who you are, not who you are not.
What they say you can not do,you can do. Where they say you can no go, you can go. What they say you can not achieve,you can achieve.
You must believe in yourself. Your believe determines the kind of people you create for yourself. The people can not devalue you if you have confidence in yourself. Your thinking determines the way you acts and the things you do.
Change your associates from so called people and the places you go. Change the things you subject your eyes and ears to. Learn to fill your mind with positive, inspirational, educational, motivational and nourishing mental and spiritual diet.
Others can only frustrates your effort and count you out of the contest of life. Please don't give up on your faith. Don't compromise your stand. Just continue to do the right things and put in your best.
What make you great is not what you have, but what you do. People don't care how much you know, until they know how much you care about them.
You are known by the goodness of your deeds. You can never lose by doing good. Your only opportunity to make a difference is while you as still alive. Don't die with intentions. The best intentions have never won a medal. Only what is done is rewarded.
Don't allow your name to written only as a footnotes in history. You become great by doing great things. Don't forget, the song you don't sing now cannot be sung in the grave, neither can the book you refuse to write or the love you couldn't express. History doesn't make men, men make history.
Your value determines who you are and what you will become in future.
Be kind to yourself, your colleagues, your patients, patients relatives and other hospital staffs. If you are committed to helping and to seeing to the growth and success of others, others will be equally committed to your success.
Anyone who tries to be like you can only be an Imitation. You are unique, You are special. Never sell yourself short. Never devalue yourself. You are not embarrassment to your profession. Don't look down on yourself.
Your uniqueness means there is something only you can do. There are problems only you can solve. You have something to offer your people.
Your uniqueness means there is only you can contribute to your people/world. You are not here just for decorations or to a while away time. You are not here to escort people. Inside you is the ability to and potential to do remarkable things. To make a difference and become a reference. You are not doing yourself favour when you compare yourself to others.
You can live a life of significance,a life that counts. You can do more than you can. You can win. Confess who you are, not who you are not.
What they say you can not do,you can do. Where they say you can no go, you can go. What they say you can not achieve,you can achieve.
You must believe in yourself. Your believe determines the kind of people you create for yourself. The people can not devalue you if you have confidence in yourself. Your thinking determines the way you acts and the things you do.
Change your associates from so called people and the places you go. Change the things you subject your eyes and ears to. Learn to fill your mind with positive, inspirational, educational, motivational and nourishing mental and spiritual diet.
Others can only frustrates your effort and count you out of the contest of life. Please don't give up on your faith. Don't compromise your stand. Just continue to do the right things and put in your best.
What make you great is not what you have, but what you do. People don't care how much you know, until they know how much you care about them.
You are known by the goodness of your deeds. You can never lose by doing good. Your only opportunity to make a difference is while you as still alive. Don't die with intentions. The best intentions have never won a medal. Only what is done is rewarded.
Don't allow your name to written only as a footnotes in history. You become great by doing great things. Don't forget, the song you don't sing now cannot be sung in the grave, neither can the book you refuse to write or the love you couldn't express. History doesn't make men, men make history.
Your value determines who you are and what you will become in future.
Be kind to yourself, your colleagues, your patients, patients relatives and other hospital staffs. If you are committed to helping and to seeing to the growth and success of others, others will be equally committed to your success.
Tuesday, 15 July 2014
The end is truly near by Dr Muhammad Abubakar Yusuf
By now it should be obvious to all JOHESU members and their blind supporters that without DOCTORS no hospital can function and infact they have no job!. All hospitals are empty all over the country. Nurses couldn't do their nursing care because Doctors have not admitted, Pharmacists couldn't dispense drugs cos Doctors haven't prescribed, Lab scientists could not process any sample cos Doctors haven't ordered, Account section couldn't function (No IGR) because Doctors are not working, Record dept are yawning of no work cos Doctors are on strike, the periop nurses could not sterilize instruments cos no operation lists from Doctors, Cleaners couldn't mop cos Doctors are not there to perform procedures, the securities have less work to do cos the hospitals are deserted and so on and on.............. This has glaringly shown how important a doctor is in a hospital setting. Without these supporting staff a doctor can still function but without a doctor they are jobless and that was why when they are on strike they locked up the wards, hide equipments and connived with the securities to repel patients from the hospital entrance!!!
The End is truly Near
The End is truly Near
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