You and Your Doctor: Modern day Consultation in Nigeria – What you need to know Part 1
(First published on ripoff.com.ng on 15th June 17).
This post starts off a series that should help you make the most out of your doctor and get the best out of your engagements with them - promoting healthcare and wellness.
As we proceed, it should help identify when you are having a useful consultation and whether your investments of time and money seeing your doctor (in most cases) would yield a good return.
Most doctors are a useful resource to have around, especially if you are ill.
They can demystify some of the complicated workings of the human body and possess knowledge about why something in the body might have gone wrong – and how it can be mended.
But seriously, for too long, as things are today, the average Nigerian patient is frustrated with the health system and health care delivery/provision to allow for confidence in medical practice.
That, of course has arisen from several factors which may include the availability of adequate manpower, the availability of adequate equipment, the presence of safeguarding health care policies that drive the promotion of a healthy populace - to name a few.
Today, I must focus on the role of the patient’s knowledge in their health care delivery process because at the very centre of all health care provision is the patient.
My concern is that people are generally ill-equipped encountering their doctors (who should be their advocates and guardians in the most important aspect of life – health) at consultation and have no recourse to compensation if or when the consultation and subsequent treatment fails to deliver.
Well, nothing really can compensate for harm to health from malevolence and malpractice!
The truth is that far too many times, the doctor is however not that advocate or guardian we expect.
Intentionally or not, they may fail in the process of delivering the care that we hope for and entrust in them.
Imagine you purchase a household equipment and find it to be faulty at first use.
You would have no qualms in returning the faulty purchase to the seller and
expect them to refund or compensate you for failing to meet their end of the bargain.
This basic principle may apply to your consultation with your doctor, but health care is considerably different because life (and health) is irreplaceable!
Firstly – it is self-awareness.
As a patient, you are not a victim.
Whether you are making direct payment for your consultation or it is through insurance or it happens to be free, a patient is entitled to certain rights.
Health care is not a privilege.
People should demand and expect to be treated properly by their doctors and any other health care professional.
Somehow however, over time, Nigerians have become too accepting when told that nothing more can be done.
In Nigeria, preventable failure is not ascribed to medical negligence.
Instead, ‘God’s will’ is invoked and apathy takes over – preventing the challenge of the status quo - since nothing can be done to change ‘God’s will’.
Secondly, because human nature is as complex as it is possible, then it should be expected that any professional role will be characterised by people who do not rise to professional quality set as best standards for each role.
Same applies to doctors, nurses, lawyers, accountants, etc.
Therefore, the next place we manage to fail the Nigerian patient is by the absence of an effective regulatory and monitoring service to the medical profession to serve as deterrent to malpractice and negligence.
When I say effective, I refer to an open, transparent, clearly identifiable system or process that allows medical malpractice to be easily identified, reported, investigated, punished, and deterred.
(Well, ‘identified’, to differentiate from random and systematic errors to learn from and address for improvement).
Here’s the complaints/feedback page from the General Medical Council’s website.
The GMC is the UK’s doctor’s regulator and primary tool for patient protection from medical malpractice.
In the UK, presently, it is almost unheard of to practice in any medical field without medical indemnity.
It appears there is a recognition that there will certainly be some time in a course of a doctor’s practicing life where he/she will need to respond to a complaint about his/her method of practice.
In Nigeria, we do not yet require our doctors to hold medical indemnity. This would have a 2-pronged effect on our healthcare provision.
It may help reduce/eliminate quackery - the absence of medical indemnity should mean a doctor cannot practice.
Indemnity allows doctors to face their fallibility and protects the doctors and patients in the event of a negligence case.
Back to the GMC: The council provides a most effective influence on UK medical practice, not only standing as the issuing body of licenses for medical practice, but also as a watchdog over patient’s rights in healthcare delivery.
They take their roles very seriously and the fact that a doctor is required to attend a GMC ‘fitness to practice’ tribunal is a significant event.
Contrast the Nigeria Medical and Dental Council Complaints section on its website found here.
This key role for standing watch over Patient’s rights is handled by the ‘Professional Disciplines Unit’.
In the second paragraph on the webpage, it covers the process of making a complaint about a doctor stating:
‘It is required that both the initial letter of complaint and the comments of the respondent practitioner be rendered in an affidavit form duly sworn to before a Notary Public or Commissioner for Oaths.’
I’m made tired by how cumbersome we happen to make things for ourselves in Nigeria.
This is an obvious bottleneck and constraint to health system improvement and sanctions against potential malpractice and benevolence.
This should be a free and unencumbered service to Nigerians.
Why put someone who is experiencing some angst already – whether from illness mismanaged to themselves or their relatives or loss of a loved one and wanting to make a complaint through the strain of going to swear an affidavit?
I think that this is restrictive rather than facilitatory!
Yes, it is about matters of the law, but, why is it different in Nigeria to say, the UK?
Going by the hearsay accounts of negative medical experience from different sources - from the minor to downright evil and fraudulent, this unit should be the busiest aspect of the MDCN at this time.
But I’m sad to say this may not be the case as genuine complaints give up at the thoughts of futile engagement from the first step.
Many cases end up as tragic headlines or paragraphs on news reports and it all ends there.
But this should not be: the mission of the MDCN – (again as stated on their website is):
“To regulate the practice of Medicine, Dentistry and Alternative Medicine in the most efficient manner that safeguards best healthcare delivery for Nigerians”.
Sad reality though is that many Nigerians do not know where to start when something goes wrong in their medical journey.
MDCN needs to do more to promote its PDU to Nigerians.
It needs to remove the restrictions on access.
It needs a social media presence – it is essential to educate Nigerians and provide guidance – a lot of what flies around as opinion on many platforms are devoid of fact and many people are carried away by misinformation.
As I conclude the first segment on this series, I insist that the education of the populace and empowering people on their rights is crucial to success in health care engagements.
Next time, I’ll talk about what happens in a consultation, and what you should expect in a well delivered consultation with your doctor.
Till then, stay well!
Editing by AskAwayHealth Team Disclaimer All AskAwayHealth articles are written by practising Medical Practitioners on a wide range of health care conditions to provide evidence based guidance and to help promote quality health care. The advice in our material is not meant to replace management of your specific condition by a qualified health care practitioner. To discuss your condition, please contact a health practitioner or reach us directly through info@askawayhealth.org
