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EDUCATION
Nigeria: If You are Looking for Money, Don't Come In Medicine - Prof. John Obafunwa
Posted by: administrator (Jan-21-2009)

Sola Ogundipe & Chioma Obinna
20 January 2009
________________________________________
interview
Lagos Chief Coroner, Lagos State University Teaching Hospital (LASUTH) and Provost, Lagos State College of Medicine (LASUCOM), Prof. John Obafunwa, is a man of many parts and of many words.
As Nigeria's only forensic pathologist to-date, Obafunwa may not be your average, everyday doctor because he has a conservative view of issues about the medical profession, but he certainly knows his onions.
To a large extent, Obafunwa prides himself as a member of the "old Breed" moreso as he shares the views of the Medical Elders Forum.
Since he qualified as a medical doctor at the age of 21, his reasoning level has always been different. He is one who beleives as a doctor that he must never allow "society to affect his job". He avows: "If you are looking for money don't come into medicine. If you are in medicine and you stumble on money, good luck."
In this enlightening no-holds-barred interview with Sola Ogundipe & Chioma Obinna, he gives a rare insight into the man behind the mask of Chief Coroner.
Exerpts:
Prof. John Obafunwa
"Perhaps I am not the average doctor. I have a conservative view of things when it comes to the profession. To a large extent I share the views of the Medical Elders Forum. An average Nigerian doctor is a product of Nigeria society. I qualified in medicine at 21 but my reasoning level was very different. Like I have always told our young ones that are coming up that you must never allow the society to affect your job. If you are looking for money don't come into medicine. If you are in medicine and you stumble on money, good luck. Yes, we expect so much like every other professional. Yet we spend so much time training.
Agitations by doctors
We need at the same time to be very compassionate in whatever we do. Few days ago, I was arguing with some doctors, some of us agree some disagree. All you need to do is to turn the table around if you are to be the patients, would you want to be treated this way?
If that patient were to be your wife or your husband, your child, your brother, or sister would you be happy to have that kind of treatment? Regardless of how much we expected things from the system. Regardless of how badly the system has treated us.
Imagine having an accident along Lagos/ Ibadan express road and you are taking to a nearby government hospital without anybody knowing you only to be told that the doctor has gone home to a private hospital trying to make more money because he has to take care of his family.
How will you feel? Just turn the table around. And that's why I always advertise among our colleagues do whatever you have to do. We have always gone on strike. I remember strikes from the time of my entering medical school. I don't want to mention names of those in charge at that time. What have we benefited from the strike?
How much of that means have we acquired by virtue of a strike? I believe we can probably achieve more without necessarily embarking on strike action. I would want to believe that the system of establishment perhaps would one day appreciate whatever we have to do. Infact I hope that one day, it would be the members of the public who will be the one telling the government why don't do this or why don't provide this instead of it being the other way round. Yes, we all shop in the same markets. We send our children to the same schools. Perhaps we can still function in different approach.
Challenge to Lagos state
We should properly bear in mind particularly, in Lagos state is that the population of Lagos state is very large. We are witnesses to the fact that there was a problem between Lagos State and Federal government government quoted a particular figure compared to what the disparity is in Lagos state. All the doctors in general hospitals in Lagos State will probably be more than doctors in Kogi State or whatever state.
Putting everybody together and by the time you look at the population of doctors in government employment in Lagos state I don't I will be too wrong to say that the population will be more than four or five adjoining states put together.
In other words, the overhead, that the state government has to take care of is going to be far bigger than the overhead of any other state. What the government will have to pay now is going to appear little compared to many of these other states. It will be something to compare how much comes to each of these states from the federal purse.
I believe that Lagos state government is under a lot of stress. I am not saying this because I am here as Provost but because I am an ordinary person. Can we improve on certain things? Yes, but maybe something is wrong with the methodology.
Like one other thing that I do say and some people might not be happy with it. We need to appreciate the fact that we are part and parcel of the team. If we move into some other areas, it could be easy to identify a major profession. In the healthcare sector government needs to be very careful in whatever it does, because before you know it, other members within the healthcare sector will start agitating for this and for that. If you are not careful, the whole system will become paralysed.
I want to believe that government is trying to look at the entire sector and see whatever that could be done or whatever they can do. So in agitating we need to bear that in mind. We need to pay a little attention to certain things and that will hopefully minimise the level of rivalry, the level of interest and we can handle things better.
Migration of doctors.
I don't have the figure as to how many people are employed or leaving. I am not too sure it is a major problem but today, we probably know how much we are going to be paid before we accept the job. And my attitude to this that I find it very convenient to accept that it would be very unfair to try to make it an issue down the line.
I know how much I was earning when I was abroad and when I was coming back home I knew I was going to take a pay cut. I wasn't bordered because I was prepared for it. Maybe that was not a very good example but the fact that people come into the system and decide to move abroad for example is understandable and I will be the last person to say people should not move abroad.
I will encourage it because when you go abroad, you probably acquire some other threats. You will see how certain things are done. If you are required to be at your desk or see patients at 6:30 in the morning you are going to be there.
I know that you may not face the issues of water and light. But you probably understand the level of practice. And if you trained 10 doctors and eight of then opting to go abroad honestly, personally I won't be bordered because I know that somewhere down the line those people or most of them will come back. I know number of people in my class who are outside.
Lagos has its own peculiar problem. We do have problems even attracting doctors from other areas. People think of the chaos in Lagos, traffic in Lagos. They don't want to come to Lagos. It is like in the areas where they were they are well settled.
You have to force them to say look things could be better. If the federal government recognises the peculiarity of Lagos and decide to assist the state government accordingly, yet we might still have what you called general remuneration for everybody.
With the help of federal government if we have what we might call the Lagos factor you in addition to cushion whatever that will be paid out to people as a kind of incentive to attract them to the place there is nothing wrong with that but the only thing is that government needs to be very careful because of the interest of other health care workers.
At some point, even in the medical school we have tried to improve on the remuneration to bring to virtually at the same level with the federal universities in an attempt to attract people to the place. There are certain allowances that Lagos State university has brought at the same level. Although the Federal level again are trying to further increase whatever salary people are getting which adds to the strain on Lagos state government
I will therefore appeal to the Federal government to assist the state recognising the peculiarity, the population of people and healthcare workers.
Brain drain
I don't believe is a serious problem and in any case, this issue of people in medical school thinking of moving into other profession is nothing new. Why am I saying it is nothing new, When I was studying medicine in 1979, some of us thought we could move into accounting because we thought we could make more money as accountants.
Later we changed our mind to continue with medicine. Today we are accomplished in one way or the other as physicians. So it is nothing new. People in the banking, oil the make a lot of money. When I tell some individuals what my pay as a professor of medicine they just laugh and say you mean that is you earning?
Perks
There are no perks sir. The salary of an average professor in this university at this point in time with all the allowances every thing put together the take home pay is between N250,000 and N280,000 per month. Because you are an honorary consultant to the hospital and that will earn you a little over a N100,000 per month and maybe that will take you up to N370,000 that goes to the average professor and a consultant. You have seen the office of the provost, there is nothing spectacular.
Handling patients
I believe society perhaps should become more educated. People don't attend to patients on time and tried to exploit the patient let the patient be bold enough to speak with him let relations be bold enough to speak. Questions should be asked.
This doctrine of the lord giveth and the lord taketh and again, you don't want to be seen as being critical to another professional or being responsible for whatever happens to another professional you just accept it. Few days ago, a colleague of mine just called me to say oh I just lost somebody. I asked what exactly happened. He told me the story, I said one or two things to him, eventually, he agreed with me to do an autopsy. We did the autopsy.
Until we learn to start asking questions, until we learn to start seeking information, nothing will be changed from outside and even in the inside. But by doing what we have to do, we will hopefully improve on the quality of the services and that will affect every health care worker not just doctors. Until we question the people prescribing, and treating in one small chemist or one small pharmacy in the backyard, and the questions are being asked for every health care worker nothing will be involved.
Teaching doctors on how to be good managers is not part of the school curriculum for now. Do we need it? Yes we need it. As a matter of fact, in my manifesto three years ago, I made mention of this.
At some point I went as far as picking a doctor in one private hospital to coordinate this issue of medical student and doctors alike all these other skills yet is not a medical curriculum for now. We can organise private lectures by people in the business world to come and talk to us, unfortunately it did not materialise.
Just recently, I was talking to another doctor who has veered into consultancy and I am expecting him next week to give a talk to our students on any interested topic. I believe we will get there and I believe that my colleagues will support anything that will modify the medical curriculum to reflect what you have just said, because the truth of the matter is that we need to prepare them for life outside the medical school.
We need to start thinking outside the doors even if they will decide to go outside the profession they need that managerial skill. They need that accounting skill. They need how they can relate to the customers."

 
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