We look for medicine to be an orderly field of knowledge and procedure. But it is not. It is an imperfect science, an enterprise of constantly changing knowledge, uncertain information, fallible individuals, and at the same time lives on the line.
There is science in what we do, yes, but also habit, intuition, and sometimes plain old guessing. The gap between what we know and what we aim for persists. And this gap complicates everything we do----Atul Gawande
Before I begin, please forgive me for this long epistle. The interview was long and it had to be tackled one after another. Until we begin to acknowledge our being indispensible in our career and daily living, we are sure going to meet with a brick wall. When we come to terms with reality that we are not what we really are; we are always going to meet blockades. Yes! when we begin to realize that we only a minute segment of the society vis-à-vis our professional callings, we are going to halt the wheel of progress. Sadly enough, our Nigeria physician have knowingly refused to imbibe this spirit of live and let's live.
My friend Chukwdumebi Onyiuke who works in NAUTH in the pathology department will definitely not be happy with this write up, knowing that it will be one of such hard hitting ones, against her and her colleagues. From people like her who chose to go into pathology, feeling they will forever head the medical laboratory, but were disappointed by the recent court ruling; I'm expecting your darts.
Nigerians truly never took cognizance how those who are graduates of MBBS took them for a ride, who thought we are so ignorant of the working environments in the health, until the August strike of medical and health workers did it dawn on us that unless we stamp our feet on the ground, these people will always see us as morons, fit to come to hospital and believe that they do all the jobs. Truth is that we know what most of the medical professionals do, but we never care as long as the patient is well attended to, but we can no longer keep quiet.
I read with dismay the interview granted a friend, an elder brother, a patriot, an activist and a learned fellow, Dr. Osahon Enabulele to Gbenro Adeoye of Punch newspaper where he derided other health and medical professions, taking them to the cleaners and attributing support staff roles to them. Speaking with Enabule convinces you that there is hope for the Nigerian nation politically, but when he speaks on health issue; there is the clear picture that with men like him in such a sensitive sector, medical practice is in doomed.
The Punch Newspaper is not fooled like most of us; hence they were very careful with their introduction of the interviews by using the word 'physicians' to describe MBBS graduates, knowing full well that there are other groups of 'doctors' in the medical sector. How could Osahon dare to compare the running of the health system with heaven and hell? Little wonder our hospitals headed by them are a complete dose of hell fire for patients. The lines are falling in perfect places. Nigeria do not have a ministry of physicians or hospitals of physicians, but a ministry of health and hospitals, where we have qualified medical and health workers, both clinical and non clinical staff, including administration.
What soul does Osahon refers to in the hospital or health sector that if it stops beating today will result in the death of the industry? Now I believe that he and his colleagues are truly living in the Elizabethan period and Victorian age when medical practice has not evolved to the present level. Osahon dreads the competition in the health sector and thus refers to it 'unnecessary equality'. Thank God, he or any of his colleagues are not the country's President; they would have begun the practice of apartheid. Sorry NMA, this is a civilized world where every professional within a particular field are entitled to equality as well as rising to the peak of their career and if the CMD is one of such, so be it.
I love what Journalist Gbenro asked him if Nurses and Pharmacist who are medically trained cannot manage hospitals better than physicians. Let us rope him in his own words, that hospitals are not purely profit oriented business neither is it about democratic selection/election. If hospitals are not profit oriented, can Osahon and his colleagues open their own hospitals and begin to treat patients free of charge? Why do they insist on payment in private hospitals before commencing treatment and even discharging them when they cannot meet up the payment of the bill? If the hospital is not a democratic environment, but an autocratic setting, why are his colleagues in FMC Owerri shouting that their CMD is treating them unjustly? May I let Nigerians know that their grudge with the CMD is her refusals to allow them write their professional exam six (6) times. How can men/women who cannot pass professional exam maximum of three times carry out treatment on our delicate bodies? Osahon is fit to be in the military since he believes that the hospital is a barrack where democracy is alien.
I write this with the pain of hurting a brother and a friend but Osahon has stretched his luck too far, making unguarded comments without anyone telling him how wrong he is. In Osahon's training, they are good managers of human, material and financial resources; honestly he needs to go for an immediate check-up. Does he mean to insult our intelligence that other medical and health workers cannot manage any of the above mentioned? Soon, he and his bunch of deceitful colleagues will go about telling accountants that they (MBBS) studied economics in school as part of their curriculum, as such they should be allowed to head Micro-finance bank or even CBN, since Nigerians come there to seek for loans in building health facilities. Imagine Osahon calling qualified medical practitioners like nurses, pharmacists etc allied/paramedic health care worker; can someone rush him to Uselu please? Call this an insult but at this moment, he has insulted the generality of Nigerians who know the difference between the term allied and paramedic. I personally challenge them to do a proper research and ask questions on who allied/paramedic workers are. They must be living in the 50s when World Health Organization (WHO) had only medicine as a core course, without the many diversifications we currently have. Let me educate 'General' Osahon a little, who is afraid of competition; that these people you call allied are not allied nor paramedics. They all have assistant such as Science Laboratory Technicians, who assist Medical Laboratory Scientist (MLS).
Was Osahon expecting an MBBS graduate to head the Pharmaceutical Research and Development which is purely a specialty in medical practice? It's akin to telling a Pharmacist to head the College of Surgeons. These physicians should be contented with their work for Christ sake and let other medical and health professionals determine how they want their profession to be. Medicine has grown past the level when Osahon and his clique began practice. We are moving to preventive medicine and these MBBS graduates better know that they better catch up fast or they will be left behind, as there are few people now who go for surgery. You don't always have to keep up with the joneses as our Nigeria physicians are currently doing, by attempting to 'colonize' the laboratory and radiology departments using their little knowledge of pathology and radiology gained during residency.
Osahon insulted our revered Prof. Lambo Eyitayo who has performed better than all the health ministers by saying he learnt from late Prof. Olukoya Ransome-Kuti, who caused all the problems currently tearing the health sector by his obnoxious misinterpretation of the term 'medical'. Does it mean that Lambo has no brain of his own to formulate policy for the health sector that he has to drink from the spring of Olukoya? Please tell us another tales by moonlight.
I agree with Osahon that Hippocrates would be very uncomfortable in his grave in what is happening in Nigeria health sector today. He will be grieved knowing that Osahon and his colleagues have formed a cabal and attempting to form a colony of health workers where physicians are the task masters. Osahon probably did not have the opportunity of learning how medicine came to be, if not he won't come bragging that other medical practice were created by physician. Or probably when the course of medical history was being touched, he was chasing skirts in medical college, if not he would have learnt that medicine began in two ways – therapeutic and drugs. What claim then does him lay hold on that Physiotherapy and Pharmacy evolved from general body treatment. Another lecture for him; therapy, pharmacy and little surgery were together until it became too complex to be handled by one man, considering the technicalities involved, but he can prove me wrong. The real support staffs in the hospitals are the MBBS graduates who cannot operate a hospital/clinic without the help of other medical and health workers, whereas a doctor of pharmacy can operate alone. Osahon should shed this toga of 'these medical workers want to pour sand in my garri'.
The issue of kidnapping cuts across all sector with no one spared, so let him not give us the crap that physicians are being kidnapped. Was an NTA Journalists not kidnapped? Gbenro is not blind to the happenings in the country, as he knows that NMA has made strike a hobby. The only time that Nigerians observed other medical workers strike was this year when the media decided to give them full coverage. If JOHESU is an amalgamation of strange bed fellow as Osahon stated, NMA must be a cabal of selfish fellows bent on holding the health sector to perpetual bondage.
Osahon should stop deceiving and lying to Nigerians that the Pharmacists Council of Nigeria (PSN) do not inspect all pharmacy units of hospitals in the country. Oh no, they do! The court has already ruled on it that whoever owns a hospital or clinic that has a pharmacy department, be it a physician, dentist, vetinary surgeon, physiotherapy or alternative physician must have such pharmacy inspected by PSN, ditto all medical laboratory to be inspected by the Medical Laboratory Council, which is headed by a lab scientist. Why do Osahon and his colleague find it hard to submit themselves to such medical practice if not pride? Nigerians do not just believe that most of the physicians are half baked but we know that they all and other medical workers also fall prey to this.
“That is preposterous, scurrilous and sacrilegious. Ordinarily, I would not have bothered to respond to this question because I am quite conscious of the fact that it was the president of the Pharmaceutical Society of Nigeria (PSN), Pharm. Olumide Akintayo, who arrogantly and mischievously told this lie. However, I am compelled to respond because I think he took his obsessive bitterness, hatred and inferiority complex too far, and certainly without the mandate of his members who are traditionally respected allies of doctors. I must say that Pharmacist Olumide Akintayo instantly lost my respect when he arrogantly told this and other blatant lies against the medical profession. We know he has a penchant to blindly deride and oppose the medical profession”, was a reply to a hard question thrown at Osahon and instead of answering it, he began to lampoon Akintayo. Osahon is the one who took his bitterness so far. The fear of pharmacy being a six years course threatens Osahon and his colleagues. The fear of pharmacy and laboratory test being the pillar of the physician treatment is the phobia that Osahon dreads. While I do not agree that the MBBS consultants are pay millions monthly, I can confirm that they earn over N500,000 and they do not truly merit it, since they rarely work, except in serious cases. The works of the physician are done mostly by the resident doctors who are still in training.
It is a myth that the physicians have peddled for long and we hold it to posterity to answer them straight away, lest someone picks a copy of Punch Newspaper tomorrow and show to our future generation that physicians alone are truly the rightful head of the medical team, when it is NEVER so, but a team effort. Physicians are the bane and problems of the health sector and I owe no one apology, A judge do not need the aid of anyone in the court to pass a judgment, but a physician, physiotherapist and dentist needs the lab result of a pharmacists to begin treatment, the drugs of the pharmacists to get well and the nurse to take care of the patient. Nigerians, wherefore lies this myth?
These little things matter…
Fejiro Oliver, a Journalist can be reached on [email protected] and +2348026797588 (sms only please). Engage him on twitter @fejirooliver86 and Facebook; fejirooliver86.