Nigerian Medical Association (NMA) has picked holes in the government’s mandatory treatment of gunshot victims and other emergency cases, saying the policy failed to state who would pay the bill and that many divisional police officers nationwide are yet to be educated on this.

Oyo State NMA Chairman, Dr. Damilola Lewis, while pointing out the lapses at the association’s 2009 Physician’s Week in Ibadan, on Tuesday, said: “One question which our distinguished lawmakers have, however, failed to provide a workable answer to is: who pays? The government knows that this is clearly outside our purview.”

According to him, “if an emergency is brought to any hospital with a trained doctor at the head, we are ready to attend to such patients and render professional duties, but that is where it ends.”

Dr. Lewis, declared that the government owed the society a lot to make its policies work and called for a conducive environment for medical profession in ensuring emergencies in the nations’ hospitals were safely handled.

He emphasised that unlike in the past, when medical personnel had sufficient facilities to tackle the challenges in Nigerian hospitals, it had become imperative for all stakeholders to jointly tackle emerging challenges in the health sector.

Meanwhile, a consultant surgeon and chairman on the occasion, Dr. Olusola Akute, raised the alarm on the upsurge of cases of foreign quacks in the medical profession.

According to him, “we now have Indians coming openly to the corridors of our hospitals to poach patients for hospitals in India. They are no longer content with referral of patients.”

Dr. Akute asked medical doctors to be more proactive and be ready to play a key role in the implementation of medical policies in the nation.

http://www.tribune.com.ng/21102009/news/news13.html

Our health care system is a mess!

^^ . . . and what are your recipes for cleaning the mess?

What does he mean by who will bear the cost? Every doctor is mandated by the ethics of the profession to administer first aid to any patient before referral to a more 'appropriate' health facility. This means that if an okada rider has an accident in front of a St Nicholas Hospital, he would and should be treated there and when stable, be transferred to the General Hospital or any other facility he can afford.

So many innocent people have died from gunshot injuries and I think priority should be on saving the life

I'm not sure if there's a private healthcare insurance in Nigeria but i think to survive in an unpredictable country like ours one need to have a private health insurance, despite NHS being free here i still have my private health insurance and so do many UK residents especially if you'll require some specialist treatment or investigation, you never know

All,

You have to understand the dilemma of the doctors. The government should commit to pay health care cost for the first 48 hours of treatment because treatment cannot happen by chance. Many hospitals in Nigeria are private businesses, they pay staff wages and tax to the government. It will be unfair if the government fail to provide any financial support to cover the free treatment of gunshot patients.

The government should have a genuine policy in place to support the Police and Health professionals in their jobs. It is not enough to approve treatment of all gunshot patients, the government should provide a general policy to support all stakeholders (Police, Members of the public, Hospitals, Doctors, etc) in their duties.

A general policy will remove confusion and show who is responsible for what.

Nezan:

^^ . . . and what are your recipes for cleaning the mess?

Would you fund to utilise the recipes?

dappssee:

What does he mean by who will bear the cost? Every doctor is mandated by the ethics of the profession to administer first aid to any patient before referral to a more 'appropriate' health facility. This means that if an okada rider has an accident in front of a St Nicholas Hospital, he would and should be treated there and when stable, be transferred to the General Hospital or any other facility he can afford.

So many innocent people have died from gunshot injuries and I think priority should be on saving the life

@dappssee, you've not answered the question. you're quite right about what you've said above, however you fail to answer the question of who picks the bills. the doctor like it or not operates a business, and like someone mentioned pays staff, taxes, maintains equipment and more importantly uses materials. all these cost money, if he keeps treating for free as you're implying, there won't be a hospital tomorrow. so back to the question, who pays the bills?

No doctor should treat nybody gunshots or otherwise without them paying.
i plead with the jurors to ignore the above statement.it was made at the peak of annoyance.
nothing i believe gives a doctor more joy than to carry out his function of saving lives without worrying about the cost(i least i know).whoever is putting forward the law should address it completely.

Doctors talk as though they are not mere humans.

Asking who pays at the expense of saving lives is funny. Is it not when a person is alive he/she will pay bills?

Gunshots can happen to anyone(including the doctors who are asking who pays) because no one knows who armed bandits would attack;victims are many times chosen at random.

The govt never said the victims will not pay, the govt said they should be saved first; when they are saved,they will be asked to pay, putting money first depicts callousness because it can happen to anyone,including the persons asking for money first, that one is a doctor does not mean the person cannot be shot by armed robbers/ or any other group of trigger happy bandits.

I'm not surprised for doctors to ask who pays the bills, because everything in Nigeria is all about money. Right from government to Private Individuals.

"who pays" what can of question is that, does it mean that the payment of money is more important than the life of victims who died in this country on daily bases as a result of this carelessness and insensitivity on the part of Medical professionals.

they should ask the minister of health, he was the one that signed and announced it

Anyway, the Bill should be forwarded to the Govt! the should set up an Accident Support Fund
_{or anyone signed on to the NHIS should be treated wherever they are in the country!}

Nigerian doctors have every right to ask who foots the bill. The materials used will definitely cost money, the generators running will cost money and the government will not reduce the tax they collect from hospitals because they are treating patients free in emergencies. I know it sounds calous but Nigerians and Nigeria can make a saint calous.  I have personally witnessed on several occasions patients rushed into hospitals as emergencies and once treated, refusing to pay.
Most private hospitals actually do not have the facilities to manage  serious gun shot wounds that usually come in at odd hours of the night. The people on duty at night are usually  junior doctors and nursing staff too is usually skeletal. Very few will be able to do emergency Xrays in the middle of the nite.If someone  is shot in the chest or head,he will need a cardiothoracic or neurosurgeon. NO private hospital in Lagos has any of these on their full time staff lit cos they are less than 5of each  in Lagos and all are staff of teaching hospitals. So the most any private hospital can do is set up drip and dress some wounds before either sending you to a teaching hospital or calling for one of the few specialists who may not be available.
But even the little they can do costs money and someone has to pay.

allycat:

Nigerian doctors have every right to ask who foots the bill. The materials used will definitely cost money, the generators running will cost money and the government will not reduce the tax they collect from hospitals because they are treating patients free in emergencies. I know it sounds calous but Nigerians and Nigeria can make a saint calous.  I have personally witnessed on several occasions patients rushed into hospitals as emergencies a[b]nd once treated, refusing to pay. [/b]
Most private hospitals actually do not have the facilities to manage  serious gun shot wounds that usually come in at odd hours of the night. The people on duty at night are usually  junior doctors and nursing staff too is usually skeletal. Very few will be able to do emergency Xrays in the middle of the nite.If someone  is shot in the chest or head,he will need a cardiothoracic or neurosurgeon. NO private hospital in Lagos has any of these on their full time staff lit cos they are less than 5of each  in Lagos and all are staff of teaching hospitals. So the most any private hospital can do is set up drip and dress some wounds before either sending you to a teaching hospital or calling for one of the few specialists who may not be available.
But even the little they can do costs money and someone has to pay.

are they refusing to pay or unable to pay?
if someone travelling is involved in an accident i don't see how someone will be expecting me to pay easily knowing full well i lost every damn thing but my life- and that you want to take away because of your noisy smoky generators, most hospitals don't pay tax ask the Lagos tax office!!

First of all, i think whoever put this on the front page of Nairaland has malicious intentions. The headline says "Nigerian doctors don't want to treat gunshot wounds". I read through the article and i didn't see anything like that.

What i understood from it, and i support, is that if you want to make policies, make policies that will be able to work. No matter how much sentiments people may try to throw in, all private hospitals are running a business and that is why people prefer them to government hospitals.

The doctor's point of view is that, there is nothing wrong for a caring government to undertake payment of medical bills of patients brought in under emergency situations for the first 48hrs.

What is the issue here, is it that our doctors cannot administer first aid to patients before asking for who pays the bill? It's very disheartening, we are not talking about gunshot victims alone, victims of accidents and the likes are all inclusive. I lost a friend (who had a cut from a fight) once because of this and it was really hurting knowing he could have been saved if first aid had been administered onto him, but our doctors didn't attend to him due to no bill yet and it awsn't as if he can't pay when okay or that his family is not able to pay.

Anyway, our doctors should put themselves in the victims shoes and imagine them in that position one day.

"doctors should treat patients without worrying about who pays",doctors are callous ,they are this n that n what not, shakes head in disgust.
loads of you guys av got no clue as to what you r talking about.patients come to the hospital with one form of emergency or the other.they plead with you that they've got no money on dem that u should please treat them evoking all the prayer points known.the minute they r stable d tone changes.they either refuse to pay,run away or start debating your pricing with you.
when i was a junior doctor in one of the teaching hospital,myself and a lot of my colleagues dat i know of bore some medical bills we incured while on call because we acted first to treat patients who came in as emergencies with claims of no money on them.
experiencies change people.
i would say this again nothing will please a doctor more than to carry out his skill to the fullest without worrying about who pays the bill.
for completeness,the government should state clearly who covers the bill in such situations.

I thought it is only ladies that normally do CASH 4 HAND BACK 4 GROUND ?

They should stop faulting and start acting.

sleak:

"doctors should treat patients without worrying about who pays",doctors are callous ,they are this n that n what not, shakes head in disgust.
loads of you guys av got no clue as to what you r talking about.patients come to the hospital with one form of emergency or the other.they plead with you that they've got no money on dem that u should please treat them evoking all the prayer points known.the minute they r stable d tone changes.they either refuse to pay,run away or start debating your pricing with you.
when i was a junior doctor in one of the teaching hospital,myself and a lot of my colleagues dat i know of bore some medical bills we incured while on call because we acted first to treat patients who came in as emergencies with claims of no money on them.
experiencies change people.
i would say this again nothing will please a doctor more than to carry out his skill to the fullest without worrying about who pays the bill.
for completeness,the government should state clearly who covers the bill in such situations.

Asleak, you're right. i remember an incidence that happened in 2006 in a private hospital in egbeda. an emergency c-section had to be done for a patient. To save the woman's life my then boss the owner of the hospital, being a woman opted to carry out the c-section, this was done with the understanding that the payment will be made. after the delivery and with the patient recovering, no money was forthcoming. on the 7th day, the husband came with relatives asking for the patient to be discharged so they could go do the naming ceremony. of course my boss refused and he (the husband) decided to raise hell by bringing in some other people, he forcefully discharged his wife.
you would think the story ended there, the next week, he had the temerity to bring the wife for a checkup, when my boss refused, he left but came back with area boys who threatened to vandalize the hospital, at this point we called the police who promptly rounded them up. money still not paid. sometimes people just aren't grateful.

for such hospitals, experiences such as these makes them demand payment first.

Nigerian docs are inexperienced n fearful. Wonder wot they learn in college

Dats is a very nice question to the Doctors and the truth is dat they are afraid and fearful thinking the person will die. And most of them are inexperience and quake doctors.