After the Easter holidays, we were called back to
school for a program we were apparently expected to do after the 2nd year of our medical school. It was the BTS program, an acronym
for Basic Therapeutic Skills. In this program we were meant to be introduced to
the various aspects of Basic Therapy as relates to the various aspects of
Health delivery in what constituted the Medical team. we would visit the
various Departments in the College of Medicine and the Teaching Hospital and
get acquainted with their various approaches to therapy, that is, taking care
of the sick. The program was meant for 5 professional programs, Medicine and
Surgery, Physiotherapy, Dentistry, Radiography, and Nursing. So we all were
mixed and divided into different groups, so as to help the idea of medical team
sink into our minds, as one of the lecturers said.
Though in all sincerity, I found it difficult sometimes
figuring out the importance of visiting some departments, I mean, sometimes you
had to stand for several hours and yet you could not hear the teacher very
well. The goal seemed to be to get our log books signed and make 75% of the
attendance. But what struck me throughout the whole program was this Medical
Team of a thing. In as much as that was the point of the whole program, there
seemed to be an apparent disagreement to that fact from the very beginning.
First, in the opening ceremony, we had to watch the various representatives of
the various departments come out and brag about their fields and specialties
like they were canvassing for votes. I remember the Physiotherapy
representative was holding a speech and playing the political mantra as though
it were a debate competition where the audience determines the winner.
Something of that nature occurred in my 200 level class where I had to endure
Anatomy, Physiology and Biochemistry tell me that each one of them was the
basis of medicine. I know how almost all the lecturers in Biochemistry would
try to explain why we were desperately in need of his course to progress in
Medicine. Is that really necessary???
Around the same time, I coincidentally overheard a discussion
between a man and a woman while in a queue for the ATM, who I supposed were
doctors discuss the other medical personnel were not in any way compared to
Medical Doctors. To be sincere, this has even gotten to the Students of the
College. From what I have observed, there seems to be this dire need of various
medical and allied medical specialties to find an ‘equal’ ground with Medicine
and Surgery, like they are already assuming an inferiority which they are
offended by. The Pharmacist tries to convince himself of the reason why he is
indispensable, and in fact everybody wants to be indispensable in Medicine, and
worse, a Pharmacist wants to have the same dignity as a Medical Doctor and
still remain a Pharmacist. Even a Medical Laboratory scientist is arguing as to
his ‘equality’ with a medical doctor. This can be sickening at times.
Sometimes this feels to me like a serious defense mechanism
that is really unnecessary. I have come to find out that the students that
behave this way are the ones who actually filled in for Medicine, but for some
reason, they were not admitted into Medicine, and so they had to shop for some
other course, so after feeling some regret in their heart, they try to justify
their position, position which they have
first and foremost acknowledged as somewhat inferior, which then necessitates
the complex. I watched my roommates argue to the point of losing their voices,
as to how Pharmacists and more brilliant than Doctors and how a Medical
Laboratory Scientist can become the Provost of the College of Medicine. It is
not as though the Doctors themselves are exempt from this. Because of all this
indirect hype these departments give to Medicine and Surgery, we have the
students of Medicine feeling that they are over and above every other medical
field and then they treat them like they are also not necessary. The fight goes
both ways.
Typical examples of
these is first, the recent hotel allocation exercise in my school, where we
have students of Medicine, Dentistry, Nursing, Physiotherapy, Medical Lab.
Science and even Pharmacy all in the same College of Medicine with a limited
number of spaces. Who should be given preference? The Medicine and Surgery students
who have to be in the school throughout the year or the other courses who run
semester programs and go home intermittently on holidays? Then, there was a cry
for ‘equity’ and ‘fairness’, words I find difficult to grasp in this situation.
Even after a ballot exercise was conducted for the students, we still saw that
some other department rejoiced when the other department was not favored. It was
almost as if, it was a battle of some sorts.
The second typical example is the on-going Medical
Association Strike which is as a result of the demands of a Union Body JOHESU,
that the Federal Government approve that even Nurses can be Chief Medical Directors
in hospitals, amongst other like demands. Hence, this crave for superiority and
‘equity’ among medical personnel. It is because of reasons like this that I
find it hard to agree with the essence of the Medical team perspective at this
point.
What is my take? In a team, there is still hierarchy and
there is still differentiation, there is still a captain and there is stil the
last man, everybody has his own role to play, the Captain in steering the team
and the others to assist him in their own respective rights. A battle of this
sort should not exist in a medical team, especially where our focus should be
on the health care of the citizens, of the masses, and not our self approval
and dignity. As the various medical personnel now battle for supremacy,with the
Doctors going on strike, poor people are starved of medical attention and
proper healthcare which was the basic reason why there was a medical team in
the first place, I feel the entire Health care or medical team should begin to
get their priorities right.
Secondly, there is no age in this world where a Medical
Doctor would be the same as a Dentist or a Pharmacist, or even a Nurse. There is
no day when they would get the same amount and intensity if training, if that
would be so, then why the different names and subspecialties. I think that everybody has his own role to
play in healthcare which cannot be the same, and that the very epicenter of
healthcare is Medicine and Surgery. This does not mean that the other specialties
are not necessary, they do have their own roles to play, but in a team there
must be a captain, someone who has an idea of basically all the other
specialties in his own right. And this rightly belongs to the Medical Doctor,
this does not mean that the doctor should be indispensable or feel that the
others are useless, after all, a Jack of all trades is indeed Master of none,
the doctor is master of the art of Medicine and Surgery, but in doing that has
the privilege of knowing something about the various areas related to
healthcare, and so he is able to work with Masters of Drugs and Physical
Therapy and Nursing and Medical Laboratory science. When this is done, then,
and only then, do I believe there is a Medical Team.
Too many cooks spoil the broth. And there cannot be many
leaders capable of steering a ship, with no one capable of taking the orders, nothing
will move forward. The Patient is our
primary concern, we are there for the patient and not for the money, not even
for the fame or the dignity. The patient is our dignity, and precisely in the
way we use our part and level of expertise to assist.
By
Chibuzor F. Ogamba,
Department of Medicine,
Lagos University Teaching Hospital (LUTH),
Idi-Araba, Lagos, Nigeria.
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