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.
