WHY FIGHT DOCTORS OVER LEADERSHIP OF HEALTH?
A“group” has decided to go on strike in the governmentowned hospitals over certain issues of which one of them is the fight for the leadership of the health team. Another is that its members want to earn what doctors earn. Strange things that have never happened anywhere in the world. They have padlocked consulting rooms, operating theatres, laboratories and anywhere any form of health service can be rendered to patients, and even attacking doctors physically who are rendering care to patients. To this amorphous group in an unholy “marriage” characterised by orgy, delusion, inferiority complex, inordinate ambition, unbridled indiscipline and warped logic anyone who works in the hospital can be the Chief Medical Director!
Like I said in my article “Why begrudge the doctor,” published almost four years ago when this same issue reared its ugly head “The grudge against doctors strikes at the concept called public hospital. Only in a public hospital will there be argument about who is in charge, only in a public hospital do you have conflicts of roles or who should be paid more.”
Now, hospital is a kind of business. Anyone who has the money can open a hospital. In Lagos State the Health Facility Monitoring and Accreditation Agency (HEFAMAA) will accredit such a hospital which meets the minimum requirements as long as the operating officer is a qualified medical doctor. The businessperson is then regarded as the proprietor. Anything but this is not allowed. So, while in a private hospital the businessperson is the proprietor, in a public hospital the government is the proprietor for it is the one that remunerates the operating officer (Chief Medical Director). Any place called a hospital whether private or public not headed by a doctor won’t be allowed to operate. So, there is no room for non-doctors to become the chief executive in a hospital setting.
Now, these regulatory bodies not only licence hospitals, they licence nursing homes, convalescent homes, laboratories, physiotherapy clinics, and for pharmacies it is the Pharmacists Council of Nigeria (PCN). In all these places a doctor can’t come there and lead the place. To make it simple, a doctor can’t be the operating officer in a nursing home, or in a convalescent home, or in a laboratory, or in a pharmacy, or in a physiotherapy clinic. But a doctor can be the proprietor of any of them.
Those agitating for non-doctor leadership in a public hospital should instead fight for publicly-owned nursing homes, publicly-owned convalescent homes, publicly- owned laboratories, publicly-owned pharmacies and so on.
To be fair, many “good” nurses don’t agree with this “body”, they still honour the age-long “Hippocratic-Nightingalic” symbiosis.
Healthcare is multidisciplinary, and involves everyone who contributes to the health of the patient. Yet, if there is no arrowhead it leads to anarchy. Imagine where the pilot (doctor) is in a tussle with the medical laboratory scientist or pharmacist (flight engineer) and the nurses (flight stewardesses) on who is in control of a plane in flight. Of course that plane will crash. And that has been the lot of our health sector.
The same people who are fighting for leadership position with the doctor want their children who are science inclined to make medicine their first choice for university education. Some even go as far as saying “medicine or nothing.” Now they want to argue leadership with the doctor through the backdoor. The best way for them is to get their Permanent Voter Cards, join a political party and be voted in as the president of the country. Doctors answer to the president.
It must be stated here that a doctor-leadership is a sine qua non for quality healthcare everywhere and Nigeria is not an exception. Doctors have long years of training in medical school, learning subjects that people study as single degrees. Six years is even too short. That is why they still go further to postgraduate school for almost equal duration of training as in the undergraduate. Those allied disciplines which are mischievous think that by continually lengthening their own undergraduate training it will equate as doctors’. They might as well stare at a one-page tract for six years!
Again, it’s imperative that doctors maintain authority for the care of the patient to ensure safety and overall care of the patient. Doctors must take responsibility in all hospital matters and maintain quality control for non-medical doctors in a hospital setting.
According to a survey by the American Medical Association (AMA), patients also support physician-led team-based care. In a 2012 survey it found that patients overwhelmingly want a coordinated approach to healthcare, with a physician leading the healthcare team.
“Physician leadership of the healthcare team does not mean that physicians must have all the right answers for every task the team needs to accomplish. Rather, it requires physicians to ask the right questions, invite participation, communicate clearly, promote a culture of respect, reward excellence and ensure accountability, among other important leadership skills.” Dr Cosmas Odoemena, medical practitioner, Lagos