The ‘gods’ are not to blame, By Dr. Biodun Ogungbo

The gods are not to blame
The book the gods are not to blame is the dramatic tale of a man Odewale, born with a destiny he tried to run away from. The book was written by Ola Rotimi. I have chosen this title to refer to the destiny of doctors as healers and the representatives of the Almighty, here on earth.
According to the Bible, every work God does, he does through his messenger. Medical doctors are the only certified universal messenger of God in the society. Our destiny is to love and care for our patients and that is something we can never run away from.

Ban on private practice
The government’s recent proposed ban on private practice has been breaking news and many articles have been written about it. It is of course just a proposal, however misinformed it is!
One assumes that the real problem being addressed by the government is the numerous strikes. Unfortunately, the recurrent strikes by doctors and other health workers, is often a result of failed government promises. My opinion which has been stated in many fora is that the problem the government is attempting to tackle is multifactorial.
First of all, we have to accept some basic faults in medical practice. There has been abuse of privileges by some doctors in running parallel practices in private and public practice. Some of course also do divert patients to their private practice. It is at times difficult to appreciate whether this is in the patients’ best interest or the doctors!
Regardless, doctors see the poverty and the helplessness of the common man every day. And when you care for another human being, their problems become your problem as well, hence you share in their laughter, frustrations and sorrow. Competent private practice, therefore provides an avenue to assist patients access quality health care.

The government is to blame
The potential draconian approach of instituting a ban is myopic and fails to recognize, talk less of addressing the core issues. It is akin to the knee jerk reaction of previous governments in announcing the cancellation of residency training for doctors in the public sector. As you know, resident doctors are trained to become consultants and specialists. So, cancelling their training was a stupid idea in a country so acutely short of well-trained doctors.
The real issue is the incompetence and failure in government. Most government hospitals at the Federal and especially the State level are grossly underfunded and poorly equipped. Many are death traps. This results in doctors, particularly specialists, being placed in situations where they are underpaid, poorly supported and still, are expected to produce miracle cures. Many have therefore created safe havens for their paying patients in private establishments.
Another factor is that the doctors are underequipped and cannot practice at a level on par with current standards. Many hospitals lack the basic equipment for training doctors and for treating patients. Imagine that most doctors did not train with basic, standard equipment common to their specialty. So even doctors who have the right attitude and aptitude may still find that they cannot practice at a level close to current best standards in the government hospitals.

Myopic decision making
Banning private practice will possibly fix one problem, but likely create many unintended new ones. This ban will accelerate the further decline of the public healthcare sector. For example, good doctors, who know their worth, will leave the public service to open private facilities. It happened in the past. Many will also swell the numbers of Nigerian doctors traveling for greener pastures abroad.
Right now, the health crisis in Nigeria is unprecedented and a mass exodus is starting. Apparently over 100 doctors have resigned from University College Hospital, Ibadan, this year and 100 from public hospitals in Lagos this month alone. Similarly, 70% of young Nigerian Doctors are making plans to leave for foreign lands and are taking exams to that effect. Reports claim that 660 wrote PLAB (entry exam to practice in the UK) recently and over 1000 have registered for the next PLAB exam.

The man in the mirror
There is a lack of sincerity in government combined with a lack of competent and trustworthy leadership. This level of distrust resulted in many Federal hospitals being open for less than 4 months in total in 2015. The level of distrust and disharmony has led to poor service commitment by doctors and of course, untold hardship for patients. A serious government will understand and address the elephant in the room. The government needs to look in the mirror and appreciate the ugliness in the healthcare sector. Further, appreciating that the man in the mirror is to blame.
You see, the gods are not to blame!

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