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Monday, 6 March 2017

Why many medical doctors may never be wealthy in Nigeria, by Mazi Anayo Nwosu

By Anayo M. Nwosu

As a new Group Head, Conglomerates & Manufacturing Department in Corporate Banking in my erstwhile bank, I needed to hire sharp young people, train them and mentor them towards achieving the group's assigned targets.

With management's nod, I asked the head of Human Resources to mine the bank's database for job applicants and schedule ten of them who had scaled through the written tests phase, for interview.

I further conditioned my specifications to those below the age of 27 years with high power of numeracy evidenced by a distinction in Maths and also a degree in Natural Sciences.

Dr. Egodimkpa was the first to be ushered in for my interview.

"Sir, I applied to become a banker because  I know I can deliver. Don't mind my course of study; I read Medicine to prove a point. I only wanted to be addressed as a doctor. My father is an accountant and my mother an Economist working in a bank. If you consider me suitable, I promise to do well as a banker..." and the candidate went on and on telling me why I should employ him.

At a point, the young job applicant paused when he noticed that I was lost in deep thoughts. The sharp cessation of his well rehearsed appeal for the job brought me back to the interview room.

Of course, I recommended Dr. Egodimkpa for employment because I knew how mentally processed a medical doctor was. He couldn't have qualified as a doctor if he was not focused or intelligent. And I needed an intelligent staff.

The poor boy wouldn't know he was what I wanted to be but couldn't.

How would he know what I suffered in my futile attempt to achieve his reality which was my truncated dream i.e to become a medical doctor?

My dream to become a doctor was as old as my puberty.

As one entered the senior class in the my secondary school, the brilliant science students would announce Medicine as their preferred course of study in the university while their counterparts in Arts would choose Law.

Even though some equally brilliant science students chose Pharmacy, Engineering or Architecture as courses of study, Medicine was still viewed as the star course just as Law was for Arts students.

I cannot forget a life changing discussion with Izunna, my friend under a Melina tree during recess at Nnewi High School. My life would have been better if that discussion never happened.

I was in the last term of class three enjoying Arts and planned to take Arts subjects in the School Certificate Exams but  Izunna, my friend wouldn't hear of that.

My friend told me that Arts was for those who were not brilliant, those who could not solve mathematics and physics and those lazy novel readers who couldn't overcome their fears of Holderness & Lambert (Chemistry text book), Nelson & Parker(Physics textbook) and Stone & Cousins (Biology textbook).

My friend who was already in class four told me that he had chosen Science and that I should do same to be respected and regarded as intelligent.

And I wanted to be respected and be seen as intelligent hence I chose Sciences.

That was how the dream of becoming a modoctor began.

Izunna too planned to read Medicine but tried as he did, he couldn't make the Medicine's cut off mark at the University Matriculation Exam (UME) organized by JAMB.

I was surprised when my friend came to my house one day to tell me that he had been persuaded to read Microbiology by more experienced old boys and that it would be easier for him to switch to Medicine after the first year which he said was a way to circumvent the high cut-off point barrier to making Medicine through UME.

I was undeterred as I still made Medicine my first choice of course after failing to make it in my first trial.

But two of my friends wouldn't allow JAMB truncate their medical ambitions.

They immediately enrolled into traditional medical training after failing UME once.

They were qualified and commenced practice after two-year  attachment with established dibias and some wireless directions from their ancestors.

Even though I knew some medicinal herbs, I preferred to become a medical doctor to a native doctor but JAMB had become an obstacle.

When Izunna heard of my inability to make the Medicine list after the second attempt, he enjoined me to follow the same route as he did.

I had to apply for a change of course to Microbiology when I failed again to make the cut off mark for Medicine after the third attempt.

That was how I ended up in Microbiology department in the University of Nigeria,Nsukka  (UNN).

Medicine and Pharmacy students and those of Microbiology and other courses in the Biological Sciences faculty did the same but two courses in the first year of study.

While in a crowded class, I would be gaping at my fellow students who achieved what I couldn't and had to live with that complex until I summoned enough courage to psyche myself up to develop love for my own course.

The later stories from friends who deserted Medicine (or who actually had to withdraw after failing pre-clinical exams after second attempts) made the burden of failure lighter for me.

I was to learn that medical students studied as hermits and without distraction. Only a few of them could combine their studies with social engagements .

They read their books the way fowls drink water.

"I thank God that I couldn't make it to read Medicine," I managed to comfort my deflated self on hearing what it took to read the course.

But with what I have seen as an adult many years after, I'm more than ever before, grateful to God that I'm not a medical doctor. Medicine was not made for me.

Why would someone be so intelligent, so painstakingly diligent, suffer through school and wouldn't become wealthy?

Even in the olden days native doctors would usually sit besides the Kings and they were so wealthy as could be seen from the number of wives, farmlands and economic trees they possessed.

Medical practice in Nigeria is still along the line of the colonial government or the missionary way of practice who pay premium on saving lives than to making money.

Hippocratic Oath taken by doctors at the beginning of medical practice which states the obligations and proper conduct of doctors is a call to sacrificial service. It also forbids from profiteering. Doctors not also advertise.

Much saner countries take into cognizance the brain quality, the discipline and great efforts put in by doctors in their training and practice of Medicine by instituting systems to reward hard working doctors. The country would get excellence in return.

Many Nigerian doctors said to be doing well abroad are just reaping from an institutionalized structure put in place by governments that think.

We still see and treat doctors as priests and teachers in Nigeria.

Not all doctors want to earn their rewards in heaven.

Many of them would want to ride new cars, own decent accommodation or become wealthy but are entrapped in a job that would not satisfy their aspirations.

Unfortunately, many universities, except a couple, don't teach our doctors entrepreneurship or business management.

Doctors need to see the business side of Medicine besides attending to patients.

Who says that a doctor cannot be a "doctorpreneur"?

Smart doctors can still make so much money in this economy. All it takes is to study a medical value-chain.

There is money in diagnostic medicine where many medical tests are conducted with interpretations.

Mecure Diagnostics set up by Indians with branches in Lagos, Nigeria is making so much money.

A doctor can set up modern theatre facilities with recovery rooms and complement of theatre nurses on rent and pay basis.

A Plaza-like facility with cluster offices (not hospitals) for specialists like physicians on the top floor, Ophthalmologists on another floor or section and Cardiovascular experts on another side would be a good business for the owner of the complex.

Each doctor's office would consist of a small consulting room and a reception area with a provision for a receptionist usually a medical attendant or nurse.

Patients pay for consultation and may be referred for admission or surgery in a rented or fee paying complex.

This arrangement puts more money in the pocket of a doctor and saves him the headache of managing the entire hospital facilities and at the same time take care of his patients.

This kind of practice extracts excellent customer service practice from doctors and enables them choose their target patients who can pay their bills.

Dentists and Ophthalmologists are already used to this mode of service delivery.

Future rich doctors are those who can innovative or embrace new surgery or laproscopic techniques. A friend of mine is already making so much more from this aspect of Medicine.

Until the government implements or enforces the National Health Insurance Scheme, many privately owned hospitals would still be battling with breaking even.

Unless government officials charged with improving our health care system are stopped from seeking medical treatment abroad, our doctors and our hospitals would remain poor.

I feel sad that no doctor practising in Nigeria could make the list of the top 30 customers in any of the branches of banks in Nigeria. Not even in the bank branches in remote villages.

I have not also visited a Nigerian doctor for the purposes of bank account opening because they cannot help me meet my deposit targets.

On the list my top customers are those former secondary colleagues who were neither very good in Science nor Arts but they eventually made the money the doctors dream of.

What is the value of being so brilliant or intelligent if that could not help one meet one's financial aspirations?

The agony and vengeance on the faces of Nigerian doctors seen clearly when they are on strike are an enough warning for our politicians to seek for medical treatment abroad lest they be fed with horrible stew they make the ordinary citizens consume.

By employing Dr. Egodimkpa, I have settled scores with my brain for not fetching me the required scores
 I needed to read Medicine.

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