Monday, July 7, 2014

IDENTIFYING THE UNDERLINING PROBLEMS OF NIGERIAN PHYSICIANS (PART 1)


After a few days of interacting with some of my medical doctor friends i have finally realised what problems are affecting most nigerian doctors. Note i said most doctors because i know some think differently. But all the medical doctors i interacted with all showed signs of these problems.

So here are the problems i was able to recognise...

Greed: It should actually be greed and selfishness. Greed is when you want to grab and grab and grab and make sure that the other person has nothing left to take. Selfishness is when after grabbing all you are forcefully taken you decide how the remaining should be shared among other people. Case in point (i am quoting from their 24 demands): Appointment of the post of 4 DCMAC in teaching hospitals and 3 in federal medical centres, NMA is opposed to the appointment of directors in other fields in hospital (but is not opposed to appointment of directors of other fields as long as it is not related to healthcare) NMA demands that grade level 12 should be skipped for doctors (they want a new civil service rule as they are not a civil servants because they have and i quote ' superior education'), They demand clinical allowances for honorary consultants to be increased by 90% of conmess, NMA demands that specialist allowance be paid to all doctors on CONMESS 3 (that would be senior registers)and above  and (read this carefully) must be paid its equivalent that is not less than 50% higher than what is paid to other health workers. Then they also want 100000 naira every month as hazard fees and want to determine what an Optometrist or Medical Physicist should be paid. I think with these few demands of theirs GREED AND SELFISHNESS is absolutely clear for all to see. Why dictate how far a person can progress in their career or how much a person should earn when you are not the employer of that person? I really don't get it.

And when i asked one why they are now requesting to be skipped even though according to the Nigerian civil service rule they are already placed on a higher grade level than every other staff and have even skipped the grade level 11, here is the reply given to me:

1st Doctor: 'what skipping? ur pple said they want to skip to 13....imagine a common pharmacist dt stayed inside his/her cubicle dispensing just drugs prescribed by doctors also wants same salary as d doctor...na wao..naija for show' and 

' u rarely hv any contact wth patients,u dnt hv any occupational hazzard such as contacting infection frm patients,u dnt hv any physical contact to patients,u only give drugs based on doctors instructions..so y d enmity or envy....afterall most of u and other members of johesu always pray ur children should be doctors...u rlly need to see these people whenever they hv relatives wth any medical condition or if they themselves need to see doctors ,they will be so humble cos they know our worth. pshewwwww'.

 Please note the agitation of Johesu (Joint health sector union) is not to be skipped to 13, it is to be skipped from 10-12, no other civil servant is placed on level 11 but because we happen to be in the health sector, some people have decided that we should be on 11. The issue was taken to court and Johesu won but the judgement has not been implemented. And then i asked this question ' Who said gl (grade level) 13? I am on gl 10 presently and I sld go to 12 next (after 3 years and promotional interview) but u guys are saying no. Conhess 9 is gl10, conhess 10 is 11 , conhess 11 is 12. We sld go from conhess 9 to 11. What is the problem in dat? Other civil servants skip and no one is protesting. Where did you get your info?'  
 
2nd doctor replied me with 'But if the JOHESU member skips 2 steps, the doctor with similar tenure should skip 3 cos the doctor has to ALWAYS be the head of the medical team'.

Then i said this :' Have u forgotten that other professions in the non healthcare sector skip too if you start from a lower level. Even my dad and aunty (Q.S) in civil service skipped when they reached that level. It is a civil service rule. Get the public service rule book. Except you guys want to pull out of civil service like you asked to pull out of ippis. Because it means you asking the govt to include skipping at anoda grade level apart from 10-12? If that is the case docs can't be employed in civil service anymore. A new service has to be created specially for doctors.

The 2nd Doctor then replied with this:'Actually, i agree with your final summation. A new grading system ought to be created for all health professionals, teachers and police. These are essential service providers (but that's a topic for another day). Let me break it down to you though, if a Dr and another health professional start work the same day, d Dr should start at level 12 and the other professional, level 10. Once appraisal is completed and they're both ripe for promotion, if the other health professional moves to level 12, the doctor should move to level 14 at the same time. The grade difference should be maintained at all times. It's not ego, it is professional courtesy'.

And that concludes that point...

Lack of financial Knowledge: You see from their demands that i stated above it is all about more and more and more money but i might not be a financial guru but i can remember in 'Rich Dad Poor Dad' the author said something about people not getting rich while working for someone or government. You see if you don't plan how to spend your money wisely even if you are paid 10 million you would be BROKE by the 15th day of the month. And that my friends is the simple truth. One doctor told be that with the 'small salary' they get they pay for their training/lectures (majority of them are repaid back the money they spend and if anyone says otherwise i would put up a photo evidence so watch it! Don't expose yourself further) and with the same money society expects them to drive the best cars, wear the best clothes, have the best houses and i am almost lost it. SOCIETY!! Like what the heck?! Because society expects you to do something out of your comfort zone you do then i just have to say it 'YOU ARE FINANCIALLY STUPID!'. You are allowing society to dictate how you live your life and then run into debt. Then i did a random search in the hospital and i saw that majority of them were like that. Society expects me to have a car by now, i get so many 'you have not bought a car and go and buy a car' but you see i cannot afford to buy a car and fund my love for travel with my salary. So what did i do, i chose what i love over society wants me to do. I cannot buy a car that the minute i buy it the value begins to depreciate. You see car is an item that once you buy it depreciate from when you get the car keys and a Land or house is an item that begins to appreciate once you get it (a little financial knowledge for you). And for those who think my travels are cheap, for my two overseas trip (in less than 12 months) i have spent the cost of a fairly used (not rickety)toyota pencil light (please find out how much it is).

Frustration: I realized early in life that if you don't love what you do you would become frustrated. So what do i do? I learn to love anything i do or don't do it. If i was a medical doctor or a nurse, i would absolutely hate it! I am too much of a diva to be either and i am too much of a trouble maker to swallow what my superior says hook, line and sinker. I asked some of the medical doctors a question 'Do you love what you do?', i am still waiting for the answer. From the way they answered some questions or stated their point it was clear that they were frustrated. You see they expected after all their reading/knowledge to be placed on a pedestal and to be 'worshiped' and coming out to the real world they find that they don't receive that then the whole intimidation act starts. You see i have learned to love my job and when i feel a bit down i do other things that i love like writing, baking and applying make up. Yes! I said it. Let me explain why i said that. One of the medical doctor in trying to justify why he cannot earn the same thing as a common pharmacist said this ' Pharm Omowunmi,u of all people should know better cos we were like my sister during service along with other doctors,u remembered ow i prepared for my west african and national primaries,ow i need to read into the night,ow i take books to read at work once i'm less busy,had to travel to ibadan from Akwa Ibom for 2weeks for update course by road and flight,ow i need to travel to ibadan and Calabar for the exams,dis all happened during our service years,all cos i want to go into residency program...during this time,u as a professional pharmacist was busy learning how to do make-up and frying cake and chin chin,though i ate out of it and it was nice........so after i i'v gone thru all dt during service years and im still going thru worse things now,u expect us to be on d same grade or salary or cadre??? pls judge....'. I would like to point out that i started at level 10 while he started at level 12, hmm when am i earning the same salary as him. Even a house officer that is yet to go for NYSC earns more than me and almost more than a senior pharm (at the wrong grade level they are being paid right now). While i was learning make up and baking (and also reading but not like them), i had no intention of staying back in the hospital setting, i was going to go for my master program and there is no way i would know the curriculum of the school that i had not gained admission to. Need i say more...

Ego: While i know that i cannot know everything and i am not afraid or ashamed to ask or say i don't know, majority of the medical doctors i was talking to appeared to feel like they knew everything. Because i don't understand how a medical doctor married to a pharmacist would say this about consultancy in Pharmacy 'She (me) just has to defend JOHESU so she can be promoted quickly to the office and rank of a consultant pharmacist...lol...one love everybody, let's get our footing right.' To say i was shocked was an understatement! I don't need to tell anyone what my first thought was based on the fact that the doctor is married to a pharmacist. I expected much more from the doctor. My reply to that was 'Unfortunately Dr you don't get promoted to consultant pharmacist post, you read, do exams, go for residency, pay for the residency, carry out thesis and defend it. Have you guys even bothered to find out who the consultant pharmacists are? Funny enough the office of wapcp is in the same building as dat of ur west African college in yaba. I still have a long way to go. I am still in part 1 and have exams dis year before i can move to part 2. Presently we have only 3 consultant pharms in uuth who are fellows of the college and are assistant director of pharmaceutical service and have over 15 years experience as pharmacists. Where did you guys get your information?' What is wrong with asking questions?

 My senior colleague told me that some doctor friends of his asked why we wanted to be 'promoted' to consultant pharmacist and given specialist allowance and he explained what i said to my doctor friend and they understood and i am like 'forward thinking Docs'. Then someone said i should click on a link that stated the roles and responsibilities of a consultant pharmacist and said according to the website consultant pharmacists should be in elderly people's homes. Even before i clicked it i knew it was going to be a lie and i was right. I stated wondering what was wrong with their interpretation of simple sentences. Here is the link  www.ascp.com, please do some research of your own. Then another one said 'there is no where it says that a consultant pharmacist should work in the teaching hospital (it changed from not working in the hospital to teaching hospital)'. Before i could supply him with an answer someone graciously supplied this link of what a consultant pharmacist does in Sheffield Teaching Hospital (i think it said TEACHING HOSPITAL and Sheffield is in U.K) http://www.sth.nhs.uk/services/a-z-of-services?id=137... and this link of the different salaries of pharmacists in the U.K
. http://www.prospects.ac.uk/hospital_pharmacist_salary.htm The reply that came from a doctor (married to a pharmacist) was thus:

I have checked the link and have given serious thot to the issue. These are my reflections...
1. There was no mention either it was a permanent, temporary or contract employment.
2. The summary of the role of consultant pharmaci
st is about research. Are you sure Nigerian health sector is ripe for that office in teaching hospitals or somebody just wants an extra qualification so as to drain govt purse...
3. ''Consultant pharmacist'' are already in the country (by virtue of your West Africa fellowship), the main contention should be if they are needed and if they should be employed by teaching hospital. (By the way, are they actually called consultants? or why do they seek the title - consultant?
4. Can we trust the custodian of your fellowship college, that one it is approved, they would not stay doling out by the dozens per day since equity and equality with medical doctors is what they surreptitiously seek.
5. What do you have to say about consultant nurses issue...would they consult on how to nurse patients, or how to treat patients or how to do surgery.
6. Would pharmaceutical companies also employ consultant doctors to help them in the production of drugs in the company.

For your information the WAPCP (West African post graduate college of pharmacists) is not owned by Nigerians it is unfortunate that majority of them don't know that the WAPCP's admin office in Nigeria is located in the same building as that of the WACP (West African college of Physicians and Surgery).

I think i would stop here today but i would be back with a part 2 of my analysis. I expect a lot of insults to be thrown my way (either it is spoken out, written or thought about) but i have heard some throughout last week so i am gradually getting immune to it. A lot of people said i had a lot of time trying to make them see some of their errors and collecting the insults but i wanted to understand what the issue was so that we can know how to solve our differences. I also trusted my friends to have facts to back up their points and demands and civil too. Did i get that? Unfortunately no and as much as i hate to do so i have found myself taking a step back in our friendship. I realized that i need to analyze somethings and put in place some strategies so that i won't get disappointed again because i was really disappointed.

I know it was a long read (i warned you before) but it had to be written (it is almost 5 days of research based on my interactions with some of the medical doctors). Hopefully part 2 would be shorter....hahaha

Thanks for stopping by and apologies to the non healthcare professionals who are my readers.

Luv ya,
Petite Diva

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