His name is Michael Afolabi Sylfad, a medical laboratory scientist, researcher and social change advocate. He finds it hard to believe how the Nigerian public has been deceived over the years by the medical doctors on the issues of leadership in the health sector, role of the medical laboratory scientist in effective patient care and why the laws regulating the medical laboratory profession in Nigeria should implemented.The letter published by the nation newspaper reveals among other things the imperative of laboratory tests generated by the medical laboratory scientists for patient management, which the medical doctor cannot do without since 1918.
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'Unsuspecting members of the Nigerian populace have often been fed diets of misinformation as regards the nature of healthcare delivery as well as the roles and responsibilities of the different professionals involved in the task of health restoration.
There is an entrenched custom among doctors to tenaciously hold on to the adjective “medical” to the deliberate exclusion of other health professionals; thus, they are often quick to describe other health professions as paramedical. However, this stance or conceptual misnomer fallaciously attributes the significant tasks of the empire of medicine largely to medical doctors and has over the years filtered into the fabric of the populace, usually informing their evaluation of the relative importance of non-physicians. This development may therefore partly explain why several Nigerian home videos constantly portray doctors as being responsible for diagnostic laboratory tests, the idea that the Nurse is the errand girl of the doctor, and may underlie the reluctance of university applicants to study other health courses besides clinical medicine.
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On the other hand, since doctors believe that they alone are medical, it follows (according to this self-serving logic) that all other professionals by virtue of being paramedical are and must be directly or indirectly subservient to the dictates of doctors. Those who share this view should however note that language and meaning constitute a public, social phenomenon, hence, cannot be unduly monopolized. According to eminent historians of medicine such as Geison, Porter, Siegerist, Sturdy and Warner; medicine makes up a systematized corpus of knowledge harmonised from anatomy, biochemistry, pathology and physiology. For several years, only students studying to become physicians had ample access to this epistemology. But the changing nature of healthcare and its delivery coupled with the stark realization that doctors could no longer solely adequately attend to the needs of the sick brought about increased professional responsibilities on the part of other professionals vis-à-vis patient care, and subsequently fraught curriculum changes such that the post-1970 era increasingly saw professionals such as Medical Laboratory Scientists, Nurses and Optometrists having unbridled access to the epistemic base of medicine. Today, students undergoing training in these aforementioned professions go through rigorous theoretical and practical exposure in anatomy, biochemistry, pathology and physiology, just like typical students of clinical medicine. To therefore describe medical laboratory scientists as a paramedical profession is either a blatant show of ignorance or a recalcitrant denial of reality.
On the issue of leadership in the healthcare system, most doctors believe that it is their exclusive preserve to lead/head healthcare-related affairs. The clarion call (prior to the appointment of the current Health minister) of some state chapters of the Nigerian Medical Association (NMA) amongst her members to insist that the federal government appoint a medical doctor as the Minister of Health attest to this fact. The logic of the doctor–must-lead (DML) syndrome seems to go thus: If a doctor, therefore most qualified to head health institutions/affairs. Even non-philosophers will have a hard time swallowing this. At a symposium organised by the Oyo State chapter of the NMA in September, Professor Ajayi (a respected doyen of medicine who has been Chief Medical Director of two teaching hospitals: the U.C.H, Ibadan and O.O.U.T.H, Sagamu) made some points pertinent to the matter at hand. According to him, knowledge of clinical medicine was irrelevant to the execution of his responsibilities and duties in the course and context of running the affairs of the teaching hospitals. Doctors should always keep in mind (or be reminded, as the case may be) that they are only licensed to treat patients and not to lead and become self-imposed masters of the healthcare system.
The public must also be informed that Medical Scientists also have the option of acquiring advanced professional diplomas such as FMLSCN (Fellow of the Medical Laboratory Science Council of Nigeria), FIBMS, (Fellow of the Institute of Biomedical Sciences, U.K), C.Sci (Chattered scientist, U.K) amongst others; in addition to obtaining a PhD after which they are eligible to become consultants.
It seems to me that a task that has not been vigorously pursued is the periodic enlightenment of the public on the part of other health professionals. For, if the public including non-doctor government officials/policy makers know that 60-70% of data used for the clinical management of patients come from the laboratory and is generated by medical laboratory scientists, if they are made to understand that far back as 1918 doctors could no longer accurately diagnose patients’ ailments without laboratory tests perhaps, a willingness to give what is specifically due to medical laboratory scientists on a truly un-biased template may evolve. Thus, helping to forestall such incidents as the work-to-rule strike action recently embarked upon by the Association of Medical Laboratory Scientists of Nigeria to demand the implementation of the federal scheme of medical laboratory services.
By Michael Afolabi
Ibadan.'
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