Tuesday, July 8, 2014

IDENTIFYING THE UNDERLINING PROBLEMS OF NIGERIAN PHYSICIANS (PART 2)


Hey guys, here is the part 2 of my analysis of the problems of Nigerian Physicians.

Inability to be proactive: I don't know what they are taught in school but majority of them lack the ability to think independently or think ahead. Most of them have this mentality that once my consultant says so, then that is it. I don't see why someone would say that even when it is obvious that something is very very wrong with a prescription. I term it 'a follow follow mentality'. I sometimes think they have been hypnotized.

That trait was very obvious in the way the medical doctors i spoke with answered my questions and even how their NMA rep spoke on Channels TV's Face off. I can count how many times i have heard or read 'there can't be two captains in a ship, can the cabin crew says he or she wants to fly the plane, there is only one pilot in a plane, In UCH Ibadan a professor of surgery told a nurse to clean a wound and she refused, the patient would be confused if another professional is called a consultant, you know the patients does not come to see the other healthcare workers they come to see the medical doctor and my all time favorite the doctor owns the patient'. Like honestly for real?! Oh yeah, there is another statement 'i cannot sell my birthright'. Wow, really guys! While i was asking the doctors, i thought i would get more than that. I don't want to read that online and see that what NMA president (or chairman) quoted in Kaduna is what a doctor in Ife is quoting too. For goodness sake if you want to say that there is anarchy in the health care system give me an example that is not generic. If i want to say some doctors are annoying, i am not going to an instance in Calabar for you i would tell you about the ones i have had encounter with and tell you names and incidents. For crying out loud i am practicing in the hospital so why quote what my PSN president said. You are screaming about others being called a consultant and you don't even know how a consultant pharmacist or nurse becomes one. You sit down and your leaders tell you that it is by promotion and you (in all your smartness) base your judgement on that and begin to jump up and down without researching? Come off it! I expect much more from a set of smart people like you. Enough with the generics and start being innovative. 


Aggression/Insulting attitude: Oh my God, i can't believe that people that should be able to have more tactics in communicating people are so insultive. Once you don't agree with their opinion the insults begins to flow. I don't see why i asked someone to explain why they expect to be skipped after they had passed the skipping grade level and i got this comment 

'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'. 

 Why insult my profession when all i asked was reasons for your demand to skip a grade level. Then one who does not know me from jack while i trying to understand them and state my own points writes 
 ' And this annoying pharmacist #omowumi abimbola osunubi (that is not my surname thank you) will think she knows something about the health sector? Without sounding very rude, I think u know very little. The major clog to progress and peace and stability in the health sector are the pharmacists yet they know very little and are easily the most replaceable in the health sector..the best thing they know how to do is to be marketers and run after doctors to use their drugs. So sad . U go to school for 5 yrs only to become marketers afterwals..any body in the health care can do that..we doctors allowed all this to flourish in first instance.. '. 

 Like honestly who does that? Defend your demands intelligently and don't insult another person's profession or insult me. And they same person i don't know from jack and the first words that i can relate to him is 'annoying' in which my first impression is 'what a very rude person' sends me a facebook friend request and i am like hmmmm. I leave you to guess what i did after. I had to write on my wall warning them from insulting people. I was ready and am still ready to remove anyone that keeps insulting others just to prove that they are right from my life. I can't stand such. It is even worse if it is a fellow medical doctor that doesn't share their views about the rightness of their demands. The amount of insults thrown at their way is incredible. And any media person that does not agree with their opinions is tagged a johesu paid writer. One even insulted Nigerian newspapers after the punch editiorial on sunday was written and published online. And i shook my head. Incredible!

Pride:  It is incredible how much of this trait some of them have. I have said that no one can know everything that is why we learn till the day we die. It is very saddening when you see that a prescription is obviously wrong and you alert the doctor and he tells you 'i have written it dispense as such' and utters statement like 'if the patient gets well he/she should go to church and thank God and if the patient doesn't get well he/she should come back' or 'if the patient dies what is your problem? You won't be held accountable' (despite the fact that if a patient dies because of a drug that was wrongfully dispensed the only person who would be responsible is the pharmacist). These examples are not ones i heard said to someone else, it was personally spoken to me and i was mad! What kind of arrogant statements was popping out of someone's mouth? And on the other hand i have met the sweetest and most understanding doctors who when i show up at their consulting room to clarify something on a prescription would thank me for seeing the error and tease me (they are usually the best doctors one is a professor and another someone who became consultant about 2 years ago amongst others). And they don't act just that way to me (you know i am a diva and people just love me....*battingmyeyes*) but to other pharmacists.

My job involves making sure that the medication i am given to the client (the term has changed, it is no more patient) is going to have the desired therapeutic outcome. So when the client comes i am required as a responsible pharmacist not only to have an idea from the drugs prescribed what the doctor is trying to treat but also to ask the clients questions to ensure that the right drug is given to the right patient for the right ailment and the right time. It makes no sense for a client to come to the hospital to get better and get drugs that make him/her worse. So the pharmacists ask questions and interacts with the client, what we call patient counseling. During this process a lot of drug therapy problems are identified. It is my duty to go and meet the prescriber and notify him of the error and he changes it depending on if it is necessary (if the prescriber has any contrary opinion he or she tries to share it with the pharmacist and they come to an understanding depending on what is the best for the patient). I had to explain all this because we have had so many instances instead of focusing on the well being of the patient because of pride a medical doctor begins to say all kinds of obscenities and begins to say ' you guys are doing your own clerking in the pharmacy ehen? are you now doctors'. So with all i know someone expects me to shove the medications to the client and say 'take this drug 1 tablet every 8 hours and not ask what his or her complaints or not explain what the drug is going to do in his or her body or what the drug is for'. Come on! Give me a break!

Lack of Leadership Qualities:Not everyone is a born leader. All this cry that a doctor is the leader of the healthcare team is all a whole lot of hogwash! A medical doctor is rightfully the leader of the clinical team (no one is disputing that fact) but that does not translate to administrative leadership qualities. Even as the leader of the healthcare team you need to understand that everyone is important. Coming to my pharmacy to tell me that because you are a medical doctor in the hospital, i must attend to your NHIS prescription without any proof that you are enrolled in the scheme and insulting me when i refuse does not speak well of your leadership qualities. The spirit of intimidation that is in most medical doctors is alarming. And when they come to the pharmacy or another department to order the staff member because you are a doctor is a whole lot of bullshit. On my good days i would ignore you, on my moody days i would reply you back. If you think you can force me to do your will you are seriously going something coming your way. Imagine a consultant trying to force an intern to give him drugs that are not covered by NHIS on NHIS cost/bill and when he refused he wanted to beat the pharmacy intern and your issue is because the person is an intern. Or telling me to give drugs that are contra indicated to a disease condition and when after trying to explain why i shouldn't give it you still insist on me giving it but when i tell you to counter sign so that i am in no question held responsible if anything happens, you chicken out and begin to insist you can't sign again. Yeah! real leadershipy (yay! i just made up a word). A lot of doctors have had to be walked out (or thrown out) of the pharmacy and it pains me because i know that they can be better than that.

Recently Channels TV in Lagos decided to have a round table discussion and invited the NMA national chairman, PSN National President, NUAHP rep and an economist. After previously agreeing to show up the NMA chairman sent a message that he had pressing matters to attend on that day of the discussion. And i asked a question 'what pressing matters did he have that day? why didn't he show up so that we can dialogue and understand what the issues are really about since everything they are asking for they claim is for the benefit of the patient?' The patient has a right to know why you are on strike. And here are the replies i received from 2 of them (while reading it, take note that these are supposed to be leaders):

'btw (by the way), does it not make sense to oversee issues that will make the strike come to an end than to waste time with folks who are bent on telling lies to spoil the reputation of doctors. anyway, he featured later at night on channels....check channels you tube and get better education.' and  '
doctors are not cowards, they are bold, their training is better off than any other allied and para health workers. We are trained to be tough and to work under stress, we do not lie to the public, we do not suffer from inferiority complex. and the public knows who is lying, they know who is cheating. They know who should treat them and who they want to see at the hospital. in fact, they know the haters and the ones who are doing everything to equate themselves to the leaders of the health sector.' (this 2 comments were made by a doctor married to a pharmacist). And in my own opinion people who say such are suffering from a major case of INFERIORITY COMPLEX. Inadequacy is written all over those kind of statements.

 Then the other one said '
Besides we don't join issues with para medicals in a FACE OFF as if we live in the wild wild west'. I almost lost it but i had to remind them that great leaders don't think like that. A good leader doesn't believe in shouting every time that i am a leader or preventing the progress of others or believe in favoritism. I was told that the last C.M.D of where i work was an example of a great leader. He was fair and allowed everyone to grow. He believed that people should progress in their careers but he was really strict and kept people on their toes. I actually heard he followed people into the bush when they were trying to run when they noticed he was at the gate and they were late (hahaha). They knew if he was able to see them and know their names, they were sure to receive a query. 

Anyway my reply to them was '
please leave them alone o (i mentioned someone's name who was replying them). They are leaders, superior human beings. I have come to realise that this strike is their greatest undoing. All that was hidden has been exposed. Just imagine the reply 'we don't join issues with para medicals' and that statement is from a supposed leader o. I am wondering which of the greatest leader they have ever seen or read ever uttered that statement. U claim your strike is for the patient's well being and u r unwilling to dialogue. Right! Anybody seeing ego here..... 

I am just imagining Nelson Mandela uttering that kind of statement ........naa! That was an example of a leader. If you claim you don't have time to read leadership books or trainings, buy discs! You have failed as leaders ! Then another answer was he went on air in the evening and doctors are not cowards. I am wondering which brave person runs away from a fight! A fight that that is non deadly unless ur nma president heard that the others were bringing a group of Charlie's angels to kill him.........hahaha that is laughable! Thank God some patients are not illiterates like you guys have portrayed them to be. They can read and can do their research. Honestly you guys have classified them into something else o. Continue with your counter accusations and statements o it is what would be used against you just like the strike. Hahaha...... '

They keep using the words 'Captain/Pilot' to describe their leadership position but if they really knew the whole responsibilities of being a captain or a pilot they would scream it so much. You see in the eventuality of a problem with a ship or plane a captain or pilot is expected to leave the troubled vessel or plane last. He or she must make sure that everyone is safe and if some people are remaining on board he has no justification to abandon the ship or plane. If you have never watched Titanic, watch it you would see what i mean. The Chinese captain of the ship that cap sided and killed over 200 people was arrested for what? Abandoning ship (among other things). You don't do such! You take responsibilities for any mishap. I remember close to the time Obama was to be inaugurated the first time as a president, a plane was forced to land on the sea, the pilot was said to have been the last person to come out of the plane. A true Pilot!

Imagine after so many years of medical doctors heading the administration of the Nigerian healthcare system that is in shambles, they are blaming Johesu for the problems and i am wondering from where. Take responsibilities for your action and admit you have failed and be gracious enough to ask for help.

I was to end the post with what i think is the way forward but i saw this on facebook, posted by a doctor

'Don't try to enslave or blackmail us with the Hippocratic oath; we swore to it, we know it and u obviously know nothing about it. You disrespected this oath with your violation of the patients' trust, your disrespect of the norms and values of the practice of the noble profession, your "meagre donation" as budget for the health sector and your mad craze for "ownership of the patient" for political&financial gains. You chose this route, not us; so, deal with the consequences. It is our legal, professional and moral obligation to, not only give the best of care to our patients, but also to let them know when prevailing circumstances will not allow us fulfill this most sacred of obligations. Fellow doctors, STAND TALL, STAND PROUD, STAND STRONG IN DEFENSE OF THE OATH, THE TRUST OF OUR PATIENTS, THE NOBILITY OF THE PROFESSION AND THE SANCTITY OF THE HEALTH WORKING ENVIRONMENT. ONWARD TOGETHER..'  

And i have decided that there is no need. When someone posts that i have nothing else to say. That person has no clue what that phrase 'Onward together' means! I expect a lot of insults to come my way like i said yesterday but i am not bothered. I am also getting a lot of support from people (that is a surprise to me). From my write up, you know that i didn't manufacture all the statements quoted, if you follow me on my personal facebook page it is there for the world to see. The personal instances i mentioned were documented (unfortunately) because i had to report them (as i was really mad and didn't want to do anything crazy).

The most annoying part of all the pettiness is that there are a lot of absolute fabulous ones that have now been roped into their insecurities. I just hope the fair thinking ones (because a lot of them are biased) are able to help change the mindset of others and help change the profession.  And despite the fact that some of my doctor friends possess some of these issues i have stated, one thing i can say is that they are good at what they do (Do they love their job? Are they fulfilled? I can't say). 

And i also have to say that when you do something stand by what you do or say and if you are wrong admit it, bullying someone into doing what you want is totally wrong. I am referring to going on strike to be removed from IPPIS then going on strike to be added back on the platform. So what are the others that stuck with the program and trusted that the problems would be resolved. Guinea pigs?  And now that the program is stabilizing you are trying to bully your way back because you have seen the benefits. I am sure the association of C.M.Ds won't allow the government to take the doctors back. And you all know why, i don't need to spell it out.

I also sense an iota of fear. What are you afraid of? I have asked this question so many times to my doctor friends and nobody has been able to answer me. How does my being called a consultant pharmacist after i have acquired all that i need to be called one affects your competence as a consultant doctor? NOBODY answered me. They all did as if they didn't read the question. It is not encouraging.

I conclude with this statement made by FUNKE EGBEMODE in the sun newspaper (Nigeria) 'One thing bothers me though. When these doctors resume and find out that 10 of the patients in Ward 6, 5 in Ward 7 and 15 in the maternity ward died while they were on strike, what will they tell God when praying five times a day or when they ‘lift up holy hands’ in church on Sunday?'

Thanks for stopping by and reading my long analysis. I apologize for its lengthiness. Don't worry guys tomorrow we would be on to other interesting things like how i have suffered a major set back on my hair journey. Half of my hair is gone due to the loosening process of my faux dreads (*wailinglikecrazy*).

Please join me tomorrow as i pour out my heart concerning my disappointment and sadness from my setback.

Luv ya, 
Petite Diva...

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