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jideolubiyi: Judging from the doctors' contributions, it appears they feel threatened by other health professionals attaining consultant status in their different professions. Why exactly is that?
1) How would that endanger patient care? (verifiable facts, no "em-em-em, just doing feel good about it all!"
2) How would it make medical doctors less medical doctors? (facts, pls.)
3) Isn't there a chance, that such changes would ultimately benefit the patients?
4) If medical doctors specializing in different areas of medicine actually improves patient care, is there any ground to insist that similar specialization by other suitably trained health professionals would impair patient management?

Abi, won't a patient with diabetes, or hypertension receive better care when attended to by medical doctors, nurses, pharmacists (...etc) who have received further training that qualifies then as specialists in diabetes or hypertension, respectively?
Lastly, if specialist medical doctors can be appropriately referenced and remunerated as consultants, why should other health care professionals not be so treated when they possess the required qualifications?

Personally, I think it should be criminal for health care professionals to go on strike. But most of our doctors are so used to seeing human suffering and death that they have become incapable of valuing human life. But then, that is my own opinion and I think many Nigerians think the same way.

It is indeed absurd for people who are entrusted with the job of caring for the sick to embark on a strike action,in saner climes other labour unions embark on such strikes in the stead of doctors and it usually takes a lot for things to degenerate to that level.but hey this is nigeria where everybody thinks the doctor is the enemy on account of his presumed bloated ego and the only language the govt understands is strike. You do not seem to understand the dynamics of the public health sector of this country and so your submission smacks of naivete when you say doctors are "threatened". These arguments cannot be reduced to those 4 questions you posed. The fact is that in a HOSPITAL SETTING, there can only be one set of consultants or Attendings going by the US system,and these are people with a basic MBBS degree who have gone through many more years of training in a well structured and regulated scheme called residency training to make you the go-to guy in a particular field of medicine including but not limited to laboratory medicine,pharmacology, therapeutics and sports medicine.it takes years of hard work and resilience to go through this training and i promise you, starting it is not a guarantee that you will finish it when you will be awarded a fellowship of whatever college you trained under.this still doesnt make you a consultant.the govt has to have need for your specialization in any of its tertiary institutions, where you are then APPOINTED a consultant.your job description includes taking the FINAL decision as regards the management of any patient under your care, as well as training other residents under you. This is the standard worldwide. You can therefore imagine the bewilderment of nigerian doctors when their colleagues who in a HOSPITAL SETTING are at best technical cadre staff woke up one morning and sayed they are now consultants. They attained consultant status by no laid down rules, no procedure other than longevity of service.Doctors thought it was a joke until these people under their amorphous group of JOHESU secured a court order to that effect and the govt was forced to circularize this anomaly. Do not be deceived by the various definitions of who a consultant is. The truth is every body who works in a hospital knows that that term is beyond a rank as it encompasses that as well as the fact that you are the final authority as regards patient mgt.to buttress this further, a professor of chemical pathology who after his mbbs got an MSc and a PhD in chemical pathology and having been found worthy by his peers promoted to the rank of professor in an academic setting is still not a consultant chemical pathologist! This is because his theses at masters and PhD level narrows his area of specialty unlike the doctor who has a fellowship in any of the colleges who has been trained in a HOSPITAL, to not only write theses on any field of chemical pathology but to understand these studies as it affects living patients daily. This is what these JOHESU people want to get by political gerrymandering and unionism. It doesnt work anywhere and nigeria will not be the first.

Morotov1: You haven't made a point that has not been made by your defendant.
What we are ascertaining here is .......there are other intra hepatic conditions that occurs with jaundice and pruritus. Irrespective of the epidemiology, it might be rare but the fact remains that it can also be diagnosed with thorough examinations not half baked.... that is not based only on clinical findings.

And if a doctor recommended a lab test for every possible differential?how affordable would that be for the patient? Which brings me back to my point and that which i think phantom was trying to make, viz: more than 85% of the time, the fact that i recommend xyz investigations for a patient, i have already,by virtue of my training and ability to factor in those confounding variables i mentioned earlier, narrowed down my diagnosis to a working one and a few differentials and require the lab to confirm.

Morotov1: Who says jaundice is uncommon in obstetrics cholestasis and that it occurs only after 25 weeks of gestation,it can occur anytime during pregnancy. Please update your textbooks. And even if your patient is either male or female, you will have a list of differential diagnosis that you have to rule out.
Not all jaundice with itching is post hepatic. WHAT ABOUT BRIC- benign recurrent intrahepatic cholestasis.

this right here is what makes the difference between a doctor's training and yours. You see whereas you are thought to think in concrete terms as regards the pathologic basis of diseases due perhaps to the technical nature of your field, the doctors horizon is broadened by a rigorous training that has stood the test of time. Where you for instance are thinking of a particular disease because your textbooks say so,the doctors mind is trained to entertain variables which will be confounding to you. Variables such as epidemiology of that particular disease. You see it is easy to attempt to bamboozle,or should i say,hoodwink, the unsuspecting public with medical jargon but a closer look at your diagnosis of OBSTETRIC CHOLESTASIS will show that it usually does not occur with jaundice and even though it is the commonest liver-related dx of pregnancy occurs in only 1% of pregnant women which by my training makes it a very low differential diagnosis. I could go on and on but i hope i have attempted to make it clear to you that by the very[color=#006600][/color] nature of our training I am the natural leader of the health team and you my dear friend are what you are. 8