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Showing posts with label Doctors. Show all posts
Showing posts with label Doctors. Show all posts

MSF: Medico-Humanitarian Giants!

Medic-ALL(10:04:2015) via AFP


Doctors Without Borders (MSF), whose Kunduz hospital in Afghanistan was hit by a suspected US air strike on Saturday, is one of the largest medical charities in the world, counting more than 36,000 volunteers working in 60 countries.




MSF was founded on December 21, 1971 when a team of French medics and journalists, including humanitarian icon Bernard Kouchner, denounced what they described as a genocide in secessionist Biafra, in Nigeria.

The non-profit provides emergency medical care in war zones, during epidemics and in the wake of natural disasters, and is a self-governed group of 24 associations worldwide, based in Switzerland.


Its stated commitment to caring for patients regardless of race, religion or political affiliation and reputation for working in the toughest of conditions saw it awarded the Nobel Peace Prize in 1999.

In 2014, the charity oversaw 384 projects worldwide, 31 percent of which were linked to armed conflict.

Operations in Sudan, the Democratic Republic of Congo, Central African Republic, Haiti, Sierra Leone, Afghanistan, Niger, Liberia, Ethiopia and Iraq take up just over half of the organisation's total spending.

On its website, MSF says it "rejects the idea that poor people deserve third-rate medical care and strives to provide high-quality care to patients", and is well known for bringing the public's attention to forgotten conflicts through its work.

Last year, the organisation treated more than half a million patients in clinics and hospitals across 63 countries, including 2,200 suffering from the Ebola virus.
It works to combat the spread of diseases such as malaria, with 2.1 million patients treated last year, as well as HIV and cholera, according to a report by the charity.

Another focus is malnutrition. MSF doctors cared for more than 200,000 severely underfed children in 2014.
MSF is funded overwhelmingly by a network of 5.7 million private donors, who provided 89 percent of its $1.44 billion budget last year.


MSF has inspired a number of imitations -- including Hospitals Without Borders and Reporters Without Borders -- groups which set out to improve hospitals in developing countries and to campaign against ill-treatment of journalists respectively.

Medic.ALL.Inc 2015

Nobody wants Surgery!

Medic-ALL(09;16;2015) SURGERY AND ETHICS 

By Kayode Kuku MB;BS

Experiencing medical practice as a student and physician in a “developing” country, I came in contact with a lot of patients who hated to hear of the option of having surgery to manage whatever condition they were being managed for. From the simple surgical procedures (appendicectomies, lumopectomies) to the cesarean-sections for child delivery and even more major surgeries to improve the patients’ quality of life, having surgery was bad news to most.



It was common to associate the phobia for surgery with the level of education of some of the patient, but I later found that even the most learned shared in the phobia apparently. I came to realize that the dislike for surgery was a general phenomenon and this submission was substantiated following my exposure to patients in the developed society, it didnt matter if it was a minor excission procedure or a total knee replacement. The fact is most people would prefer not to have surgery, while some have an outright phobia for surgery.

A while ago I came across the term“Tomophobia” which refers to the fear of surgery or surgical operations. It is considered a social phobia. Tomophobia is said to be caused by a number of reasons, which include: 1) A bad situation or traumatic event occurred in the person’s life as a child involving a surgery; 2) The risks associated with having surgery (i.e., in extreme cases, death); 3) Some are afraid of how their life will be after a surgery (i.e., diet, movement, sex, health, longevity); 4) People are scared of contracting other illnesses or getting sicker after a surgery; 5) Some are afraid of having major procedures like heart or brain surgeries; 6) Some are just  afraid of possible negative outcomes from surgeries (i.e., scars, bruising, or loss of mobility); and 7) While others  just don’t like anything that causes them pain, including surgery. These are only a few possible causes. There are probably hundreds more causes.



The symptoms of Tomophobia typically include extreme anxiety, dread and anything associated with panic such as shortness of breath, rapid breathing, irregular heartbeat, sweating, excessive sweating, nausea, dry mouth, nausea, inability to articulate words or sentences, dry mouth and shaking. Tomophobia is treated counseling, hypnotherapy, psychotherapy, Neuro-Linguistic programming and medicines could also be prescribed.


However, I honestly do not think that majority of the patients I have come across in practice who have either  fled the doctor’s office or cried when given the option of surgery suffer from Tomophobia. For most it’s probably more of a natural feeling of not wanting to be cut with a knife or scalpel, hence the thought of having an invasive procedure coupled with the imagination of a cut through the skin sends shrills down the spine of the patient and gives rise to resulting anxiety. Even after consenting to have surgery, patients experience anxiety. An important step in dealing with surgical anxiety is to become as well informed as possible regarding the illness, prescribed therapies, and surgical treatment. Having a complete understanding of the procedure,the indication, the methods to be applied, and how it is performed can relieve a great deal of worry. An understanding of anesthesia and the low risks of having anesthesia may also help with concerns about surgery. Both the patient and the surgeon have a role to play in this regard. 




If anxiety is caused by a lack of knowledge about the procedure, it is essential that the patient asks questions and finds the satisfactory answers until the decision to have the surgery and the choice of surgeon is fully understood. For many, anxiety is a normal response to being expected to make a life altering decision with minimal information. Once the patient has the necessary facts the anxiety may be relieved. In some cases, anxiety occurs when the patient has no idea of what the surgery entails and is left to imagine what the procedure and the result will be like. The physician performing the surgery can provide a realistic idea of what the outcome of the surgery will be and a typical course of recovery.

Other patients are not comfortable with the idea of surgery, because of the length of their stay in the hospital and recovery time.  This is understandable in the case of patients who have to take time off from their regular work schedule and bear the financial implications of so doing. It is the duty of the managing team and surgeon to adequately counsel the patient on the importance of having the surgery, discuss the possible length of hospital stay and recovery and if applicable, the urgency or not.

The truth is that, doctors have an obligation to help their patients and to refrain from providing ineffective treatments (beneficence and non-maleficence). The goal of medicine is to promote the welfare of patients, and physicians and surgeons possess skills and knowledge that enable them to assist their patients. Due to the nature of the relationship between physicians and patients, doctors are expected to weigh and balance possible benefits against possible risks of an action in the management pf a clinical scenario. What this means is that the best of surgeons know exactly when NOT TO offer or do surgery for a patient. So, patients be rest assured, no real doctor likes to cut you open for the fun of it, ask all your questions to deal with whatever fears you have, the surgeon is always more than happy to answer.

Medic-ALL. Inc 2015!

Refs: Anxiety Disorder. Patient Version. U.S. National Institutes of Health,




National Doctor's Day! Lets Celebrate the Profession!


Medic-ALL (03:30:2015) PROFESSION



Its National Doctors Day today, the 30th of March in the U.S and there truly is a lot to celebrate about the profession that makes it absolutely necessary to have a day set aside Doctors to reflect on the evolution of medicine and appreciate the quality of physician care today.


Doctors have come a long way from the ancient healers they once were thousands of years ago. The profession has survived many transformations with the unfailing commitment to maintaining and improving human health.



The U.S. Senate and House officially declared March 30 as National Doctor’s Day in 1990, however, it’s been celebrated for decades longer, according to the National Doctor’s Day website. In 1933, Dr. Charles B. Almond’s wife Eudora recognized the dedication, discipline, and aptitude that was required of her husband and his colleagues every day in their practice.


The Wonders You Call Doctors
When you feel sick or in pain, whether it's the body or mind, you seek doctors to restore you back to health. Doctors improve the quality and length of life through helping to manage and defeat the many diseases and conditions that plague people all over the world. Doctors reassure and empathize with the "sickest" of patients and comfort those in the most broken conditions. It has to be one of the most difficult jobs anywhere in the world. 


There are challenges facing the world of medicine and particularly doctors today especially as It concerns certain medical conditions with no known cure, but such challenges can only demand more of medicine.It has taken thousands of years to accumulate the knowledgd doctors have today, and modern medicine will continue to improve and ensure a better living and healthier future. 

Ref:Medical Daily

WHAT YOU MUST KNOW BEFORE LEAVING MED SCHOOL!


My people are destroyed for lack of knowledge - Hosea 4v6 (Bible)

How ironic is it that after spending nearly a decade in the fore walls of medical school, medical graduates leave school and yet remain bereft of information that are crucial to them succeeding in the real world.



The truth remains that there are as many reasons people enter into medical school to study medicine as there are to choose whether or not to practice the profession following graduation. 


Read on HERE

Doctors' Handwriting; Why we write the way we write


Medic-ALL(29:08:2014)
by Kayode Kuku MB;BS:
I had just finished discussing with a patient and was documenting away in my usual serious but friendly fashion (stealing glances occasionally), then the patient on her way out after receiving her prescription volunteered "Doctor , you've got a fine handwriting for a Doctor", Thanks, I simply replied in my "humbly" proud tone. It really wasn't the first time I had received such a compliment from a patient, yes it wasn't, but mind you I have also heard nurses complain about my handwriting and some patients wonder aloud, "Doctor, what have you written"?



The horrible handwriting of doctors ,as some describe it, has being widely discussed and condemned by many people outside the profession. While some have come to the conclusion that doctors learn to write in a particular unreadable way while in school , others believe that doctors deliberately write in a certain way in order to conceal the exact content of their prescription from their patients. Even though I do not agree with the myth, that doctors handwriting are terrible I have found in my years of schooling and medical practice that most doctors do not particularly pay attention to how well they write nor spend time trying to write legibly for reasons that will be mentioned shortly. That is not to say that doctors have the best of handwritings in any way, on the contrary in fact.

So the question is , why do doctors write the way they write?

Firstly, the truth is that like many individuals in other professions, some doctors do not have nice handwritings! Having said that, I must point out that many doctors develop "bad" handwritings in the course of their training and get used to it. The reason for this is that most doctors during medical school and before the introduction of softcopy lecture notes took down a ridiculous amount of notes via dictations which were usually delivered at a speed close to that of light, so needed to write fast enough in order to meet up with the pace of the lecturer as was the case during medical ward rounds as well. Our medical school training also involved several clinical examinations in which we had limited time mostly to document our history and findings, we therefore needed the ability to write shorthand or really fast, and hence legibility was sacrificed.
In practice, the average doctor has to contend with an incredibly heavy workload on a daily basis and hence invariably resorts to scribbling.



Frankly, there have been claims that the handwriting of doctors pose a genuine risk to patients as they render medical records unfit for purpose and nurses sometimes find it difficult to decipher instructions written by doctors. From the patients perspective, illegible handwriting can delay treatment and lead to unnecessary tests and inappropriate doses which in turn can result in discomfort and death. Illegible handwriting in medical records can indeed have adverse medico-legal complications.

Finally, inasmuch as some doctors are only a subpopulation of the vast majority of people in the society with poor handwritings, the talk about all doctors having bad handwritings is therefore more of a myth than a fact. It is however important that doctors take the pain to write legibly especially when it comes to important details of a medical record, investigation requests and reporting as well as prescription writing in order to avoid wastes and hazard in medical care and ensure efficient written communication with other health workers.

Medic-ALL.Inc 2014





THE NIGERIAN HEALTH SECTOR: "SOME TRUTHS AND SHAPESHIFTERS" PART 3!


Final Part
By Dr. Jide Akeju

The introduction of an expanded program that involves greater specialization was introduced in the USA, this is generally not a worldwide practice and only one institution in the United Kingdom offers something similar to the Doctor of Physical therapy program popular in the USA. JOHESU affiliates readily point to other climes to justify their demands. It can be deduced that the agitation for a residency program by the NSP has been copied from the USA, it is not what anyone can term as best global practice and regarded as excessive in some climes where masters or PhD programs are viewed as sufficient postgraduate training. Do the NSP have the requisite facilitators and experienced trainers to oversee a qualitative residency program or are they just copying and pasting what is practiced in another place without adequately evaluating the pros and cons?

If residency program is part of the agitations of JOHESU, which of the professional bodies are going to benefit? It is clear the NSP are going to reap significantly. The terminology “Consultant” refers in our system to specialist senior doctors who are appointed to ultimately take responsibility for patient admission and management. They are also involved in clinical training and supervision of medical students and resident doctors. Some of these individuals do have dual appointments in institutions with affiliated colleges of medicine where they also teach students outside of the clinical environment; undertake research and participate in general University duties and activities. It becomes laughable when JOHESU release a statement contesting double salaries given to honorary consultants and allegations that some doctors are so highly paid even more than university professors when in fact a few of them are university professors. The term is consistent with the British system as well as some commonwealth nations.
 It should be easy to understand why some allied healthcare workers are called consultants in the USA where the equivalent of hospital medical consultants and specialists are called “Attending Physicians”. Although Prof. Alonge appeared to support the appointment of consultants from other health workers, he did point to the fact that a discrepancy exist in the interpretation of the term as it affects both groups hence a need to clarify issues. I do not think that is exactly what the deserving members of JOHESU want. They constantly point at what doctors are enjoying and I guess it is those benefits they assume doctors are enjoying that has led to the demand. 

What is the yardstick to determine who and who is deserving of consultancy positions?

 Would it not lead to further rift within the ranks of JOHESU if certain affiliates do not benefit from the consultancy largess?

What would make the non-professional groups inherent in JOHESU undeserving of being appointed as consultants? 

Are the agitators of consultancy willing and competent to shoulder the responsibilities of patient care and the demands of such appointment? 

A hospital consultant position is not a reward for longevity nor is it like the appointment of delegates to a conference. It is not the peak of a doctor’s career, a doctor does not necessarily need to be in a residency program and become a consultant before he/ she can be regarded as successful or accomplished. We should not just simply adopt terminologies that are used in other climes and take them out of context to adopt them in our own system. Nurses have also recently pointed to the appointment of a female nurse as the US Army Surgeon General as validation of their demands.

It is really easy to be awed by such information but what many fail to do is read just a little about the woman concerned Patricia Horoho. It is clear that she did not attain such lofty heights just because of being a member of a gender or profession minority; she is a first class Lieutenant General highly trained and equipped to manage such a responsibility that entails human, material and enormous financial resources. Our people in Nigeria always clamor for equation balancing at the complete expense of competence. Should the JOHESU not demand for better funding and standardized education and training instead of striving for potentially unsustainable projects that could be deflated by politics and underfunding? A fellow named Nwaneri commented on a link to a JOHESU draft on the 20th of January 2014. The man commended the JOHESU executive for their resilience but asked when and if they would also ensure residency training for medical laboratory scientists and BSc nurses. Someone should lodge a requisition for NASU residency quickly.

I searched for a JOHESU website but could not locate any so I turned my attention for a facebook page at least. I did find three (3) affiliated to institutions in Yobe, Gombe and the Federal Medical Center Abeokuta (FMCA). The one for the FMCA had 148 members and one administrator called Otunba Tiamiyu who is also the public relations officer of the Abeokuta chapter of JOHESU. The” admin” seems to be a young man hell bent on misinforming him many members and launching constant abuse at the management and consultants of his institution. The fellow’s command of the English language and utterances is rather appalling and one can only imagine how such a man is responsible for representing the interest of any credible association that includes pharmacists and physiotherapists. He described the resident doctors as toddlers and their protest as senseless; he was reported in the Leadership newspapers (a paper that I think is sympathetic to the mission of JOHESU) on the 26th of July 2014 to say that doctors only jump at strikes to divert patients to their private hospitals in order to charge exorbitant fees. He rejoiced that the public had arisen to curb the excesses of doctors who he accused of behaving as gods. These are the kind of people who peddle all sorts of falsehood and inconsistencies about doctors and the NMA. They regularly accuse the NMA of incessant strike actions and easily forget the many occasions the JOHESU have threatened or outrightly embarked on strike actions that effectively grounded the health sector.

A quick search through Google will produce results that clearly show that the “development” of the health sector has been greatly slowed down by frequent strike actions detonated by the camp of the JOHESU. May 7, 2012; August 21, 2013; January 15, 2014: these are all dates of outright nationwide strikes embarked upon by JOHESU. They have been calling for the sack of the current Minister of health since 2011. They made this demand on the 21st of February 2011 accusing the minister of sabotaging their interests in favor of doctors. They continued with this demand in December 2012 and January 2013. This same minister is currently being hailed for enforcing the sack of resident doctors who are not contesting CMD or director positions with the JOHESU top brass. In a letter dated January 17, 2014 and addressed to the Minister of Health, JOHESU had stated that its good faith, patience and restraint to go on strike had been taken for weakness by the government. I wonder what JOHESU needs to do for the health ministry to sack all medical laboratory scientists in order to restructure the health sector.

JOHESU has claimed that the NMA have no right to negotiate labour disputes for any reason and to embark on strikes which has been supported vehemently by a few supposedly experienced public commentators as well as some journalists who through their reportage express clear partisanship and a clearly lackadaisical approach to their work devoid of intelligent research and fairness. One reporter with the leadership newspaper put up 2 headlines online in the space of less than 30minutes that referred to the same story that aimed to vilify the NMA and doctors. The same JOHESU that claims the NMA has no bargaining right with the FG constantly make reference to a 2009 bargaining agreement that was implemented for doctors but yet to be done for them. The public commentators usually mention that doctors are part of what is regarded as “essential services” that should never go on strike. In a blog post on the 25th of October 2012 titled “The Right to Strike in Nigeria and ILO Principles on the Right to Strike”; Femi Aborishade of the Polytechnic, Ibadan and center for labour studies reviews and appraises the laws guiding strike actions in Nigeria, the principles recommended by the International Labour Organization (ILO) on strike actions and how such affects Nigeria especially the drawbacks. The Committee of Experts and the Committee on Freedom of Association of the ILO appeared to justify the scope of restriction of strike action in “essential services” which was defined in 1983 as those services “the interruption of which would endanger the life, personal safety or health of the whole or part of the population”. The Committee on Freedom of Association described that essential services in the strict sense of the term depended to a large extent on the particular circumstances prevailing in a country and that a non-essential service may however become essential if a strike lasts beyond a certain time or extends beyond a certain scope, thus endangering the life, personal safety or health of the whole or part of the population. The committee considered essential services in the strict sense may be subject to major restrictions or even prohibitions; this is inclusive of the hospital sector; electricity services; water supply services; the telephone service and air traffic control. It is instructive that the ILO’s committee mentioned “hospital sector” and not medical doctors because striking doctors renders all other health care workers redundant likewise doctors left in a health sector paralyzed by absent health workers is also a waste of time and resources. Essentially services in the UK are listed as Emergency services, Armed forces, Health and social workers, Food industry; Agriculture, veterinary and animal welfare; Essential workers at nuclear sites; Water, sewerage and drainage; Fuel and energy suppliers; Public transport,  Licensed taxis; Coastguards and lifeboat crews;  Airport and airline workers; Postal, media, telecommunications; Central and local government workers; Essential financial services staff including those involved in the delivery of cash and cheques; Prison staff; Refuse collection and industrial waste;  Funeral services; Special schools and colleges for the disabled and Essential foreign diplomatic workers. 

If this nation realizes the importance of these diverse industries to the welfare of their people, why do our leaders assume they as politicians are more important that everyone else? 

They utilize divisive tactics to set sectors that ought to be in perfect harmony and operate in unison at each other’s femoral arteries while they simply embark on state funded trips to nations where doctors and health workers are well catered for to even think of strikes for checkup and definitive treatment. Workers who ought to know their services are equally as essential as what doctors provide sit perched on their moral high grounds to condemn doctors for demanding better conditions for the collective health sector while they move around without condemnation when they go on their own frequent strikes that shuts down record offices, morgues, theatres, pharmacies, stores, oxygen supply and wards amongst others. These frequent strikes are generally assumed to be doctors’ strike by the average visitor to the hospital. The mischievous members of JOHESU leverage on this misconception to divert the responsibility from themselves towards doctors instead.

Nigerians have to arise and make concrete demands from their government to improve their welfare. They should not just wallow in the mud and take just whatever crumbs the FG throws at them. The funds meant for developing the health sector to international standards are constantly being squandered and those who ought to know better have chosen not to be enlightened enough to ask the relevant questions and have offered themselves with the associations they represent willingly or otherwise to be tools in the hands of politicians to perpetually impoverish Nigerians

The story in the book of 1kings chapter 3 tells the story of 2 characters; prostitutes who had babies. One woman canvassed for the living baby to be split down the middle while the other only wanted the integrity of the baby. The king in his wisdom judged rightly and awarded the baby to the true mother. The NMA is asking for the status quo to be maintained while JOHESU wants what they deem are their rights and privileges. This is not to say doctors are immune to blame in all that has transpired but the truth is that the things demanded for by the JOHESU if granted would largely plunge the health sector into further crises that may not even involve the NMA. The Nurses, pharmacists and physiotherapists would become consultants; directors would emerge and then a number of the “patch patch” members would be left stranded or with crumbs. The pharmacists and physiotherapists know that they cannot embark on any effective strike to get their desired consultancy status and residency programs without the foot soldiers that would lock the doors and grind federal institutions to a halt. These unfortunate ones will realize albeit too late that they were only used and deceived with promises of better welfare packages and wage grade level increases. Some of them may never get to those grade levels by virtue of their limited educational qualifications and poverty of additional training irrespective of the years of service they offer.

The FG approved huge benefits and amnesty for reportedly surrendered militants from the Niger-Delta region. Some of these individuals have been widely reported in the local media to be on training or academic programs overseas. This is not entirely true as many Nigerians from a certain geopolitical region of Nigeria favored by the incumbent have flooded choice institutions across the world for undergraduate degrees in the stead of these militants and to the detriment of the nation’s tertiary educational sector. It is shocking that Nigerians are unmoved by the nonchalance of the FG to ensuring equity and providing even good facilities within the country. It is not surprising that government runs like normal despite the onslaught of misguided insurgents in the northeast and the over 130days of secondary school girls stranded in captivity. It is baffling that some Nigerians find it convenient to tolerate the idea of the President Jonathan's reluctance or refusal to visit his troops in the north east of Nigeria despite having the resources to do so in a flash. 

Why do some Nigerians who are supposedly educated find it very appropriate to berate doctors who insist on certain minimum standards before the strike is called off or before moving all out against the Ebola scourge? For them and some health workers, it is all about a Hippocratic Oath they seem to know nothing about. Nurses also have their oath but conveniently forget it when it comes to vilifying doctors. Is it only doctors that take oaths before embarking on their assignments? Did President Jonathan recite a poem at his inauguration?

Dr. Jide Akeju 
Senior Resident
Jideakej@gmail.com

Medic-ALL.Inc 2014

NMA Strike: New Salary structure to take off in Jan 2015


BusinessDay(25:08:2014)
The House of Representatives in Nigeria on Monday disclosed that the new salary structure for doctors would be reflected in the 2015 budget and takes effect from January 2015.

Ndudi Elumelu, chairman, House Committee on Health, gave the assurance while reacting to the resolution of the Nigerian Medical Association (NMA) to suspend the 55-day old nationwide strike on Sunday.



According to him, the parties during the reconciliatory meetings attended by Federal Government’s team resolved “that the Federal Ministry of Health will grant the request of NMA for a new circular as demanded by NMA.

“That the Federal Government shall pay two months’ salary arrears to members of NMA on or before August 31, 2014; that balance of salary arrears would be reflected in the 2015 budget and paid to members of NMA.

“That the new salary structure of medical doctors would be reflected in the 2015 budget and medical doctors will begin to get the new salary structure effective from January 2015.”

During the overview of the suspended industrial action declared by the association, Elumelu stressed the need for the Federal Government and organised labour unions to honour various agreements reached in the bid to forestall future strike action and ensure industrial harmony in various sectors of the nation’s economy.

“One of such lessons is the need to obey agreements. The law is pacta sunt servanda meaning: agreements must be obeyed. If parties had obeyed previous agreements executed between NMA and representatives of the Federal Government, the strike would have been averted. The lesson to learn here is that we must at all times obey contents of agreements freely entered into in order to avert crisis,” Elumelu said.

The lawmaker, who expressed displeasure over the unpatriotic attitude of the association towards the plight of the citizens in the face of the outbreak of Ebola virus and other life-threatening diseases that claimed the lives of several Nigerians during the strike period, noted that NMA “acted contrary to the revered oath of the medical profession and the code of medical ethics (2004) for medical dental practitioners in Nigeria.

“The leadership of NMA has been described as unpatriotic even by other Nigerian doctors as well as members of the public in view of various health challenges confronting the nation and the scourge of Ebola virus disease, which erupted during the strike period. Patriotic Nigerians both home and abroad have passionately condemned the action of the current leadership of the NMA. Comments have been heard and read from various media platforms concerning the …actions of the NMA president,” he said.

Source: Business Day

Doctors' Spouses: What's Not to Like?


By Parker Brown via Medpage Today:  


When it comes to domestic life for physicians, things have changed since an oversexed and gory 1971 film with Gene Hackman called "Doctors' Wives" featured as one of its taglines, "Doctors' wives have everything. Except husbands."

It turns out that there are, actually, documented cases of successful physician marriages. And some of those marriages are examined in a qualitative study in Academic Medicineby researchers from the University of Michigan Medical School.

They found four strategies for success for couples in which at least one partner was an academic physician:

  • Have shared values
  • Rely on mutual support
  • Recognize the role of each family member
  • Acknowledge that being a physician brings a benefit to the relationship

Those strategies weren't always easy to coax out of the 25 participants, though.

"The interviewer really had to work," said one of the authors of the study, Monica L. Lypson, MD, the assistant dean for medical education at the school and a practicing internist. "People ... love to complain."

But by doing an appreciative inquiry, focusing on the positive aspects only, the investigators found that there are indeed benefits to being in a relationship with a physician.

The Study

One of those significant advantages is money (which, if popular culture is any guide, can't buy happiness but can buy bacon, which is pretty close), the study found.

"My husband is a doctor," said Lypson. "So what we do is throw money at the problem. We don't have to get into who cleans the house."

Lypson said the idea for the study started when a medical student asked her how she went grocery shopping. Lypson, pregnant at the time, was a little insulted. "Well, I get in my car and drive to the store."

But the student was really asking how she managed her work, her patients, her relationships -- and how her relationship with her husband fit into all that.

Out of the interviewees, 12 were female and 13 were male. They had been married an average of 15.8 years.

Three of the participants were non-MD spouses of a physician, while the other 22 were physicians; of the latter, 10 were in a dual-MD relationship. And 40% of them got married while in residency, while another 40% were in medical school when they got married. Kids came later -- 52% of them had their first child during practice.

Included as limitations were the fact that all participants were involved with an academic medical center and the authors explored only the positive aspects of physician marriages.

Several of the participants noted the importance of support from extended family, said Lypson and her colleagues, Rachel Perlman, MD, and Paula T. Ross, PhD.

One interviewee said, "My dad saved my marriage a couple times, which was remarkable, because he was kind of a sh*tty father." During his internship year, his son and wife got sick and had diarrhea when he was on call. He called his father for help, so the dad flew in and took care of the family for 3 days.

Partners In Hardship

Helen Cappuccino -- one of several physicians MedPage Today interviewed for this story -- is an MD at Roswell Park Cancer Institute. She's had six children with her husband, a spine surgeon and team physician for the Buffalo Bills.

"When our fourth child was born, I was already pretty good at it," she said. When she was 8 1/2 months pregnant, it was her chief year as a general surgical resident and she was determined to do a surgical procedure she had been waiting to do despite a fourth-year resident eagerly waiting to step in.

But after a pre-operative medication issue, the surgery was delayed a week. "I always joke that I had my legs crossed that whole week," she said. But she made it, and after the surgery, "I walked from the OR upstairs to deliver our baby," she said.

"The biggest benefit is having somebody who understands what you've gone through and what you go through on a daily basis," said David Sandberg, MD, a pediatric neurosurgeon at the Children's Memorial Hermann Hospital, where he works with his wife, Amy Schefler, MD, a pediatric ocular oncologist. "It's very rewarding to have somebody go through that journey with you who understands it," Schefler said.

They were married while Sandberg was in residency -- the only honeymoon they had was when they got to hang out in the surgical room together.

Kim Boggess, MD, is a professor of maternal-fetal medicine at the University of North Carolina (UNC). Her husband is also an MD and a professor at UNC in the gynecology oncology program, and Boggess says that makes for sometimes interesting conversation.

"One particular dinner table conversation involved talking about a fairly graphic surgery involving the vagina and cervix," she said.

They were unaware that their two kids, ages 14 and 11, were sitting at the table "with their mouths gaping open in shock at our candor." That led to a family pact that the doctors wouldn't use the "V word" at the dinner table again.

In cases where there's only one physician in the relationship, one spouse can get free medical advice.

"I've completely convinced my husband of using alcohol-based wipes," said Michelle Barron, MD, a professor in the division of infectious diseases at University of Colorado Denver. On her first date with her now husband, they went out for ice cream. She watched nervously as the ice cream from the cone dripped down around his hands, and as soon as they got back to the car pulled out her alcohol wipes to clean him off.

"He's in management, always shaking hands," Barron said, before proudly adding, "But he hasn't been sick in years."

Mixing Home and Work

Things can sometimes get messy when family relationships become business ones as well.

Steven Peltz, a certified healthcare business consultant, said he was doing an operational review for a young male dermatologist. Peltz told him that the lady at the front desk was too tough on her colleagues, aggressive with patients, and had poor interpersonal skills.

"I know," said the doctor. He then asked Peltz to fire her, a task Peltz declined. When Peltz asked why he couldn't do it himself, the doctor said, "Because she's my mom."

On the other hand, one married couple -- ZoAnn Dreyer, MD, a pediatric oncologist at Texas Children's and Jeff Dreyer, MD, a pediatric cardiologist at the same hospital -- frequently shares patients; they say they enjoy working together. To avoid confusion, patients refer to ZoAnn Dreyer as "Ms. Dr. Dreyer" or "Mama Dreyer" and Jeff Dreyer as "Papa Dreyer."

But for Aruna Ganju, MD, a professor of neurological surgery at the Northwestern University of Feinberg School of Medicine who is married to a plastic surgeon, the one time she and her husband shared a patient ended in an argument. She prefers those two worlds stay separate for now.

Medic-ALL.Inc 2014

Presidential Order and A Populace At Risk!


Medic-ALL (17:08:2014)
It is no longer news that the President of the Federal Republic of Nigeria in his "wisdom", last week Wednesday came up with the most bewildering and drastic of responses to the now over 6-week old nationwide doctors strike by the Nigerian Medical Association (NMA), by indefinitely suspending residency training in the country and the subsequent termination of the appointment of about 16,000 doctors presently enrolled in specialist training in the country.



While I was not particularly shocked to hear the news, I continue to be burdened by the consequences of such an action in the light of the sorry state of the health sector presently. It will be interesting to see what the Government has up it's sleeves in the coming days, weeks or even months, in terms of filling the huge vacuum left by the sacked resident doctors who make up about 60% of registered doctors presently practicing in the country. There is no doubt that the plan of employing locum doctors on a 6-month contract basis alone will not suffice for a populace that has being hugely under-served even in the prior era.

That's true , there's the Nigerian populace!!...A Population Base of 167,000,000 who should be perhaps as worried as I am. They should actually be asking how the Government intends to provide access to adequate specialist medical care if specialists will no longer be trained by hospitals they pay taxes to maintain. Nigerians should be wondering if the Government is going to bring in foreign expatriates (like was once done!) to fill up the hole it would have created in the  sector and at what cost adequate healthcare would now be available to the masses. Whether the Government will pay more to maintain the expatriates than it would have to meet some of the demands of the striking doctors and upgrade infrastructure in our fast-rotting away medical schools built in the 1960s and '70s would also be a valid question at this time.



I do think that it is extremely important that the Nigerian people understand the intricacies of this "remarkable" Presidential order especially in a country such as ours, where a striking majority of our elected leaders and their families seek medical attention for as little as a running nose outside the country. It becomes even more necessary for the populace to be aware of the possible ripple effect of such a decision as made by the Federal Government standing in the coming weeks to months and should subsequently begin asking the questions that really matter, as it stands logical that only the wearer of a tight pair of shoes knows for sure where it hurts.

While the Nigerian Medical Association have openly condemned the obnoxious sack and are ever resolute to challenge the order, I strongly believe, that the Nigerian populace have even more to fight for, not just in response to this preposterous directive but for the quality of healthcare they deserve in every single part of the country.

Medic-ALL.Inc 2014




Nigerian Government Supends Residency Training

(THEWILL)14:08:2014 – President Goodluck Jonathan Wednesday suspended the Residency Training Programme for medical doctors in Nigeria indefinitely and sacked Resident Doctors in all federal government owned institutions.
The President’s directive follows the protracted industrial dispute between doctors under the auspices of the Nigeria Medical Association (NMA) and the federal government over pay and poor funding for government owned health institutions.
An internal memo to all heads of federal tertiary health institutions signed by the permanent secretary in the Ministry of Health, L.N. Awute, on behalf of the Minister of Health, directed them to sack all Resident Doctors in their facilities with immediate effect and directed that measures be taken to restore full medical services in their hospitals.


A member of the board of the NMA has described the sack of resident doctors and the suspension of the Residency Programme as a knee jerk reaction to the dispute between the federal government and the NMA.
In a reaction to the development, the official who asked not to be identified in this report told THEWILL that an emergency session of delegates has been called by the NMA to deliberate on the development adding that a formal statement condemning the decision of the president will be issued momentarily.
The official said the President targeted the weakest link amongst doctors by going after thousands of the residents adding that with their sack those hospitals no long qualify as teaching or specialist hospitals because you cannot operate them without residents and consultants. “It is just like you cannot have a school when there are no students and teachers” the official said.
“We have been through this before at least twice. Government never learns. The action of the President is disappointing. Instead of addressing the serious issues we want dealt with the President is escalating the problem,” the official added.

A Dying Health Sector...


Medic-ALL (14:08:2014)
"Work Hard and Get Out" !!! Said in the meanest and most scary tone I have heard in a surgery lecture room. Those were the words of one of the foremost Plastic surgeons in West Africa to my graduating class after a tutorial class on the eve of our final medical school exams. As puzzling as those words may seem, I was perfectly in tune with the heartfelt and sincere burden on the mind of this very senior colleague that would have prompted him to render such counsel to a focused group of medical students on their way into the real world of medicine in a country like ours.

This was a class that had to spend an extra 6 months in school, because of a strike action by resident doctors in the state to challenge the decision of the State Government to pay less than the stipulated CONMES(Consolidated Medical Salary Scale) approved by the Federal Government to it's doctors, in spite of the obvious fact that these doctors are overworked as compared to their Federal counterparts due to a perennial under-staffing. At the time the State Government eventually went ahead to issue sack letters to the doctors (including residents and Consultant specialists) in the state and employed contract medical-officers in their place. The sack-scare paid off and the strike was subsequently called off ,but the state doctors never got a decision in their favor.



Fast-Forward to 2014 , and its a nationwide strike by the Nigerian Medical Association to challenge certain Federal Government health sector policies which the body believes does not augur well for the future of the sector in the country as well as to see the implementation of other demands summed up in the union 23-point demand sent to the Federal Government a few weeks before embarking on a withdrawal of service.



The strike has lingered on for weeks , despite the outbreak of the deadly Ebola virus in the country and  several meetings have being held among the various stakeholders to ensure a resolution of the issues surrounding the 45-day old strike, no positive conclusions are yet to be reached. There have being rumours regarding how the Federal Government will choose to tackle the problems in the barely thriving health sector, including reports indicating that the Government was planning to privatise the Public Hospitals (including Teaching Hospitals!). This of course raised several questions and sparked debates particularly as it relates to the Act that created Teaching Hospitals for the primary purposes of training and research as opposed to Private Hospitals which are more or less profit-making establishments.

An authoritative answer to these questions was received earlier today in the form of a Federal Government directive suspending residency training (training of doctors into specialists) in the country indefinitely and the immediate sack of the doctors presently in residency training. While the directive was said to be for the purpose of appraising the problems in the health sector, many are wondering if this drastic step would not leave the health sector in shambles!...and hoping that this is not the "Beginning of the End" of Nigeria's already "Frail" health sector as we know it.



Genuine Questions Arising?

Did the Federal Government take this decision in order to force the hand of the striking doctors to come to a compromise?

Was the decision taken to weaken the resolve of the NMA (Nigerian Medical Association) , keeping in mind that it is believed that the NARD (National Association of Resident Doctors) serves as the mitochondria of the sister body?

Is this a way of pitching the doctors against each other (as was the case between the Lagos State resident Doctors and the locum doctors employed on contract during the CONMESS struggle)? Moreso as the Presidency has ordered immediate employment of locum doctors on a contract basis.

Is there still anything to fight for as far as the Nigerian Medical Association (NMA) are concerned?

In a country where the health sector already suffers a huge shortage of personell, particularly doctors ,thanks to the daily mass exodus of Nigerian doctors to countries were they are perhaps more appreciated(40,000 on the United States halth care system). Will such a decision force many more out of a system that seems to be in need of help as it is?

How well can the health sector thrive without specialist training?

What is the future of medicine and healthcare in this country?

Where do we go from here?....

Medic-ALL.Inc 2014






Nationwide Doctors' Strike Continues!!!


Medic-ALL (09:08:2014)
In the midst of controversies and conflicting reports over the suspension of the nearly 6weeks old nationwide strike by the Nigerian Medical Association (NMA), The National President of the body, Dr. Kayode Obembe earlier in the week tendered his resignation.

Dr. Kayode Obembe

Obembe had on Thursday announced the suspension of the strike action embarked upon by the union following the appeal by the government sequel to the outbreak of the Ebola Virus Disease in the country.

However, the Lagos State chapter of the union said the suspension of the strike was not agreed on by the leadership of the NMA at its meeting on Thursday.
Ohembe’s full letter, titled: Clarification, reads: “There has been a request for clarification about the two postings from the NMA secretariat on the NMA blog.
“I want to make it categorically cleared that I stand by the very letter of the document that I signed – THAT THE STRIKE WAS SUSPENDED.
“And since upon my INTEGRITY AND HONOUR, I cannot continue to drive the doctrine that ‘STRIKE CONTINUES’, I hereby tender my letter of resignation as NMA President”.


It should be recalled that Dr. Obembe had, a few weeks after his election, premised the strike action on the failure of the Federal Government to address their demands saying there was no going back, the NMA subsequently sent 24 demands to the government including discontinuation of recognition of non-medical doctors as Directors and Consultant title to any other health worker, other than medical doctors before embarking on the withdrawal of service on the 1st of July.

The demands also include appointment of a Surgeon – General of the Federation, clinical duty and hazard allowances and withdrawal of the Central Bank of Nigeria circular on medical laboratory equipment.

Meanwhile, there are strong ndications that the  Joint Health Sector Union (JOHESU) are threatening to commence an industrial action if the Government goes ahead to accede to the demands of the NMA.

While the country's health sector continues to be in a state of turmoil as the doctors' strike clocks day 40, more suspected cases of the Ebola epidemic continue to be discovered, with 139 persons presently under surveillance, we can only hope that sooner than later ,all the authorities concerned particularly the Federal Government will come to favourable and healthy compromise.

Medic-ALL.Inc 2014



Ebola Outbreak:Death toll Rises


Medic-ALL (7:00pm 06:08:2014)
As the deadly Ebola virus continues to ravage the African continent, the disease has now claimed at least 932 lives according to the World Health Organization(WHO).

Reports also reveal that there were 45 deaths from the deadly virus between last Saturday and this Monday in West Africa as the number of new cases rose to 108.



Meanwhile, sadly the 2nd death from the virus on Nigerian soil occured as the nurse who treated the Liberian-American who traveled to Nigeria late last month was feared dead earlier today.

Doctors and healthcare workers on the frontline have been the hardest hit during the outbreak, which continues to claim lives in Guinea, Liberia and Sierra Leone. Authorities in West Africa said they were considering applying for an experimental drug used on two Americans to treat the doctor who headed Sawyer's team and is now battling the virus herself.

Medic-ALL.Inc 2014

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