DABMarkNig2019:

Thats why drs in the western world go for residency immediately they are done with MBBCh/MBBS. Pharmacists are handling some of these chronic ailments as they should be managed. Its up to the drs now to handle more complicated or specialist cases.
Pharmacy residency is also something doctors are fighting so hard in nigeria just like the Pharm. D degree and it shouldnt be so. The plan has been drawn long time ago as far back as 1996 when Abacha was the head of state and facilities like JUTH, ABUTH, LASUTH, LUTH, UCH, UDUTH, UMTH, UNTH and so many other tertiary hospitals are ready to commence the training but with setbacks form the forum of CMDs who of course are medical doctors. Just imagine what the net benefits will be to our health care system and even our medical colleagues.
The health field is evolving and physicians must accept the fact that the dispensers of yesterday are now clinicians...Governments and policy makers in the west knows this and thats the reason why there can be no ward rounds without the pharmacists being part of the team.

The starting point in problem solving in problem definition or formulation. A clear understanging of the issues.

In life there is always a struggle for resources,territory,market share and influence and so it is quite natural for this to happen in healthcare. Just as desertification forces herdsmen down south with aggresssion so in business.
Doctors need to start seeing themselves as businessmen.

So there will be competitiion for market share in response to market forces
Even among specialties Psychiatrists may compete with Neurologists for who should treat epilepsy,parkinsons, etc.
This may not be obseerved in government hospitals but in the private sector youu will see such interspecialty encroachment as medicine becomes more entrepreneurial
So it is normal to expect competiton from other professionals for dfferent kinds of "work". Nurses may want to do more contraception work e.g inserting IUCDs , suturing lacerations and treating traumatc injuries
Psychologists would be looking to compete with psychiatrists physiotherapist with orthopedic surgeons and so on.
Nurses can do colposcopy a procedure which some doctors cannot.

This is simply business and market forces will prevail.

Doctors need to envision the future and upgrade themselves by acquiring new skills that are relevant that give them an edge. e.g doctors will find that they too may have to do ECGs if they want to retain that share of business since almost any clinician can learn how to perfom an ECG in 24 hours,
there are so many procedures in medicine that specialist nurses and other clinicians can perform even if they are not doctors but the reality is a nurse can set up a shop where she runs an antenatal clinic one day, contraception clinic the next day , ECG clinic another day, STD clinic on another and a substance misuse clini making 5 days a week . They can do this independently of doctors 100%
So this is how the market could change in the future in Nigeria.

Doctors need to see the writing on the wall.

There is a battle for the healthcare market and doctors need to become more entrepreneurial and less militant

The funny thing is any person can set up a "shop" having studied the market and then emloying releant professional to provide input. In such a setting there will be more professional independence and of course the responsibility that goes with that. By training many non medics are not used to taking responsibility clinically but that will change and is changing in some centres.
So doctors need to convince the market why they should get more. That is a rational exercise which many doctors are not prepared for choosing rather to continue to invoke claims about how they read bigger books

aribisala0:


The starting point in problem solving in problem definition or formulation. A clear understanging of the issues.

In life there is always a struggle for resources,territory,market share and influence and so it is quite natural for this to happen in healthcare. Just as desertification forces herdsmen down south with aggresssion so in business.
Doctors need to start seeing themselves as businessmen.

So there will be competitiion for market share in response to market forces
Even among specialties Psychiatrists may compete with Neurologists for who should treat epilepsy,parkinsons, etc.
This may not be obseerved in government hospitals but in the private sector youu will see such interspecialty encroachment as medicine becomes more entrepreneurial
So it is normal to expect competiton from other professionals for dfferent kinds of "work". Nurses may want to do more contraception work e.g inserting IUCDs , suturing lacerations and treating traumatc injuries
Psychologists would be looking to compete with psychiatrists physiotherapist with orthopedic surgeons and so on.
Nurses can do colposcopy a procedure which some doctors cannot.

This is simply business and market forces will prevail.

Doctors need to envision the future and upgrade themselves by acquiring new skills that are relevant that give them an edge. e.g doctors will find that they too may have to do ECGs if they want to retain that share of business since almost any clinician can learn how to perfom an ECG in 24 hours,
there are so many procedures in medicine that specialist nurses and other clinicians can perform even if they are not doctors but the reality is a nurse can set up a shop where she runs an antenatal clinic one day, contraception clinic the next day , ECG clinic another day, STD clinic on another and a substance misuse clini making 5 days a week . They can do this independently of doctors 100%
So this is how the market could change in the future in Nigeria.

Doctors need to see the writing on the wall.

There is a battle for the healthcare market and doctors need to become more entrepreneurial and less militant

The funny thing is any person can set up a "shop" having studied the market and then emloying releant professional to provide input. In such a setting there will be more professional independence and of course the responsibility that goes with that. By training many non medics are not used to taking responsibility clinically but that will change and is changing in some centres.
So doctors need to convince the market why they should get more. That is a rational exercise which many doctors are not prepared for choosing rather to continue to invoke claims about how they read bigger books

This is apt...can t agree any less...but at the bolded though

Osak Uwubanmwen from Canada

Copied from his facebook post

ONE FINAL SOLUTION TO THE INCESSANT MEDICAL HEALTH WORKERS STRIKE IN NIGERIA (LONG POST).
Today I have decided to write on a topic I have avoided for a very long time, the incessant medical health workers strike in Nigeria, and I do this with no apology to anyone but rightfully so. First, as a concerned Nigerian and a trained pharmacist living in Canada, My elder brother is a physician with two fellowships in the United Kingdom. Our last born in my family is an optometrist with a Doctor of Optometry degree (OD) in U.K too, and my spouse is a trained Canadian Nurse with specialty and additional certification in Dialysis. The reason I make this declaration is I come from a medical family with all intent and purpose. We, (my brothers) and I got our medical or healthcare degrees from the University of Benin, and we all went to school almost at the same time close to one another. I can say medicine, pharmacy or optometry are hard degrees to earn, they all are and have their peculiarities and challenges. All medical degrees are hard and this is true. One is not talking about a diploma equivalent, I mean an MBBS,
a B. Pharm, a BSc Nursing and an OD. It will also include a degree in medical laboratory or physiology. In all these courses statistically less than half of the class would graduate and earn the degree. In pharmacy school, about one hundred and forty of us started, and just forty-two of us graduated. Some of my classmates were even asked to withdraw after the fourth year when they would at least be getting a degree in many other faculties. It is wrong for anyone to claim that one medical degree is harder than the other. The city I live, Calgary and a neighboring city Edmonton medicine is a three-year degree course, and you only qualify like pharmacy and dentistry after the first degree, and you can have your first degree in any subject area. I am spending the time to disprove some myths so that people can see where I am coming from. When I took the joint admission and matriculation examinations my first choice was pharmacy, my second choice was pharmacy, and my third choice was pharmacy, but the only difference was I also chose Obafemi Awolowo University Ife and the University of Ibadan as new universities of choice if the University of Benin did not admit me. The head of all medical or clinical works should be a doctor (physician) as the doctor owns the patients this is a universal practice and same in Nigeria and Canada, he takes the final decision with the consent of the patients too. But I have unlimited access to these patients as part of inter-collaborative care and network. The patients also give me consent to have assess to medical information relating their diagnosis, medical history including all medications, test, no matter what was done and requested by the physician be it Laboratory work, MRI, X-ray, Ultrasound I can assess and they know this is in the best interest of the patients. I work with the doctors, nurses, laboratory scientist, chiropractor, physiotherapist, the dieticians, etc. to care for these patients. The doctor cannot question my right to assess these patients, and he cannot prevent it, this is how we work and whatever intervention I need to carry out in the best interest of the patient I must inform the owner of the patient the doctor (physician). There is also an advisory intervention(s) that one can only make through the doctors (physician), These I communicate in clear terms to the lead physician and giving clinical reasons why I think this will be in the best interest of the patient. These are all documented the patients would be informed and the physician consequently written to that effect this is often medication and disease based. The physicians love these collaborations and would have it no other way. They see me as a trusted partner, and the healthcare laws recognize these functions and duties protecting everyone. As an Alberta pharmacist, I can write prescriptions sometimes for minor ailments and sometimes for more complex cases like adding a prescription for a lipid-lowering agent to a patient at risk of cardiovascular complications if diabetes or high-risk cardiovascular patient. I have a LAB ID and can request some laboratory test directly. Some of the minor prescriptions I may write are common antibiotics and sometimes medications for cold sore or eye infections. In Canada like America pharmacy has a residency program to specialize in any area of pharmacy of interest like psychiatry, oncology, cardiovascular, nephrology, radio-nuclear pharmacy, transplant pharmacy or others and after the four to six years they become a consultant pharmacist. Many pharmacists run clinics with their physicians who are very busy, most of the prescriptions I see from the anticoagulation clinics are from pharmacists written on behalf of the lead physician who is the head of the team. Pharmacists or nurse clinicians are running many diabetes clinics on behalf of the lead physician who now has time to attend to more complex clinical and complicated medical problems. All these are within the Canadian healthcare setting in my province Alberta. All residents in training in any institution or hospital settings are trained by clinical staff be they physicians, pharmacist or nurses. A sad event I was informed recently was the physicians in a university teaching hospital in Nigeria refused the Doctor of Pharmacy students assess to their patients and thus the ward, sad can only happen in Nigeria. A hospital headed by a physician released a circular to this effect to truncate the Doctor of Pharmacy degree program rotation, sad again. Remember that a poorly trained member of the healthcare team under any specialization becomes a clinical burden to you as head and lead clinician and your citizens. The physician is the head and the others are the neck and body just like any good marriage neither can function well without the other. In the University of Benin pharmacology department is under the school of pharmacy and rightfully so and some of the lecturers are not even pharmacists but pharmacology experts. How would you feel if the pharmacology department under the pharmacy school refused to train the MBBS students or would be graduates in pharmacology a precondition required for an MBBS graduation? The problem of health aggregation and turbulence was created by Professor Ransom Kuti of blessed memory under Babangida regime based on the brain drain of Nigerian trained physicians to Saudi Arabia, United Kingdom, and United States of America etc. but the truth is all healthcare professions in Nigeria is adversely affected by this syndrome. In my class of forty-two graduates over twenty of us are overseas, there are over ten thousand Nigerian pharmacist graduates of Nigeria practicing outside Nigeria, know that there used to be only six pharmacy schools in Nigeria. The nurses are worse off there are more than fifty thousand Nigerian nurses outside Nigeria. In fact, many nurses in psychiatry in Nigeria just use the institutions as a training ground before they move to Australia and United States of America. So, what is the solution let these specializations, all healthcare workers come together and fight the common enemy the government in their divide and rule game? If they come together government would be forced to run health as it is supposed to as done in many countries like even Rwanda. Let each and everyone go negotiate what they think they deserve and none should interfere with another. If you are talking of no parity is that before 1984 of Ransom Kuti or after, please go back and see what was before Ransom Kuti. Since Ransom Kuti left there has not be any peace in our healthcare system. In football a striker can earn more than the team coach based on perceived productivity, wages or salaries should be individualized a transplant or neurosurgeon is the highest earning medical professional I know and not the medical director or clinical director. Today it is ARD, next it is NMA and then JOHESU all strike, strike and, strike. The Nigerian government hospitals operate only six months a year and that has been the case in the last ten years or more. The question is a doctor that graduated ten years ago should earn more than a pharmacist or nurse agreed but should a doctor that graduated ten years ago earn more than a pharmacist or nurse of twenty-five years in the hospital one a consultant and the other a director of nursing or pharmacy services. The position of medical director and head of clinical services should be occupied by doctors yes. However, the head of the hospital should be called Head Hospital Administrator that everyone including the chief medical director will report and answer to too. The Head Hospital administrator different from the head of administration as it is now should be one that specialized in hospital administration with a Ph.D. He or She will work to create a conducive environment for all to function and thrive optimally. At the start of the year, he would ask all that they need, the medical director, the head of the pharmacy, head of nursing, the head of the laboratory, the head of the laundry the head of catering, and others what would they need, and the Head Hospital administrator would put a budget for everything and everyone including quality food served to all worker on call be they physician, pharmacist nurse or laboratory scientist. The opinion that the medical director should be a doctor yes but be dealing with medical and clinical issues only, not funds, money or budget execution. The focus should be on quality delivery like we want a new theatre for renal and liver transplant and the Head Hospital administrator will go raise the fund from government and private sector to provide one. We need that number of a new oncologist or transplant surgeon and the Head Hospital administration go around through a medical recruitment agency to get them the best, only the best. We need support for residency for resident doctors and pharmacists in training and the head hospital administrator gets the budget form them and link with people all over the world to provide quality resources persons. Finally, the minister of health can be anyone that understands how health care works not necessary a physician as this is more a political position and for party members look at the developed countries and tell us how many physicians there are as minister of health? Very few if any, we need their clinical skills in the hospitals and research and not being a political minister. I have seen many good hospitals rise to the occasion headed by a physician and have also seen many hospitals ruined by a physician as head too, so, the fact that a physician is the head of the hospital in real Nigerian terms means nothing and can only be one way to self-preserve and cause accretion in these facilities. Last' year Nigerians spent about one billion dollars on medical tourism and going by these facts as soon as Togo, Benin, Niger, and Ghana get their acts together there may be no need for medical or healthcare workers in Nigeria, this may be exaggerated but a set reality. Today it is India, and as soon as it is near home, people will go across for a holiday and get the world-class treatment they may need and can afford. Wake up Nigeria, and Shalom.#copied#

In a serious organization people do not earn based on when the graduated but what they contribute.
just like passngers in an airplane pay to be moved from point A to B comfortably they will not pay more because the pilot has 20 or 30 years experience.


Health care professionals now need to start asking THEMSELVES what is their contribution to the Revenue of their employer.If in any peculiar situation a surgeon does 100 C/S operations in a year should he earn the same as his colleague who does 12?

Pay should be related to ACTUAL performance and in such a regime people get paid by UNITS OF WORK that the employer gets paid for.

Who gets most does most whether ther are a cook or surgeon.

Paying people by what they know or think they know is foolish.

If you know how to do cardiac transplants but don't do any for me as an employer why should I pay for redundant knowledge, Your knowledge must have economic value to attract money

If a nurse inserts and removes 1000 IUCD devices a year and a Consultant does 100 guess who gets more money?

We need to move away from public sector funding of hospitals and let hospitals learn to operate as businesses especially at the tertiary care level.


Doctors in Nigeria do not get statistics of their performance and productivity

dokxavi:


Yes with all sense of responsibility.

The MBBS in Nigeria licenses a qualified medical doctor to perform whatever surgery without supervision.

Before you commence role of not understanding, notice that MBBS is acronym for Bachelor's in Medicine and Surgery. I hope you see there's Surgery.
Of course,I repeat, medical doctors in Nigeria who are respected, admired and envied,know their limits and can ask for supervision in complicated cases,if necessary or even refer to a specialist. This is Nigeria and it is legal and backed by law.

How would you say this.

MrBigiman:
I weep for this Country. Consultancy for what?, for getting old and close to retirement. Patients will be further Decieved and will die like fowls. A Pharmacist sees a naïve patients, instead of claiming to be a pharmacist, will say I am a consultant, the gullible patient, thinking he means medical specialist may end that session is morbidity or mortality. Shame really, but we are in a confirmed shit hole though.

Close to retirement at age of 40+ ?