I heaved a huge sigh of relief when I heard Hon. Ken Ofori Attah, the finance minister mentioned the word ‘grapple’ during his presentation of the state’s budget for 2017. At last, someone has realised the grapple in the health sector and has decided to address it. I was disappointed when, instead of addressing the more havocking grapple in the sector, he decided to address the rather less inciting, frequently repeated struggle by the sector in bridging the gap between the health care provision in the rural and urban areas: a task which has been almost like a chase after mirage.
The struggle for superiority in the health sector isn’t a completely new one. Little of these struggle however existed in the old system of health care delivery, when all Ghanaians thought any one who works at the hospital was a ‘doctor’. Even though it is still common to find people who refer to the entire hospital as ‘doctor’, many others have come to the realisation that, not only doctors and nurses work at the hospital. Interestingly, this elucidation has come at a time when the demand for evidence based medicine, together with the need for laboratory diagnostics of diseases, has surged to its maximum. Probably, it is the demand for evidence based medicine which caused the increased public knowledge on other professions in the hospitals aside the doctor and ‘Maame Nurse’.
The biomedical scientist is essential in the new trend in the health sector. Biomedical research, and for that matter, the biomedical scientist, is indispensable in evidence based medicine. In addition to this, the public, which have become even more mindful of their health, have realised the need for laboratory investigations, and other adjuvant clinical investigations required in disease diagnosis, and not mere diagnosis based on clinical history and/or signs and symptoms. This is manifested by the increasing number of people demanding for laboratory investigations, even when their ailments require none, together with the startling increase in walk-in visits to various health centres for routine laboratory check ups. Today, the public trust a medical centre based on the competence of its laboratory. Hospitals are now ranked based on how well-developed, ultra modern their diagnostic centres are. For instance Aninwah Medical Centre in Emena, Kumasi, which has very ultra modern diagnostic centre, with the other departments not so well developed is considered one of the innovative health centres in Kumasi.
The modern day biomedical scientist, alias the medical laboratory scientist, realising the above mentioned facts, therefore, priding in their worth in the modern day health care delivery, has carved a niche for himself in the health care centre, such that no other professional can penetrate the walls of his nook in health care delivery.
The medical doctor, who prides himself as being the ‘hospital’, upon realising that this pride would be stripped off him, if not sooner, later, has tried to plant itself in the concretised niche of the biomedical scientist. This has brought about the grapple the minister should have addressed- the fight for superiority at the laboratory. This grapple has led to limited communications between these two professionals. The medical doctor does not see the reason to approach the laboratory scientist when he is not clear on anything, he knows it all. Neither does the laboratory scientist find any reason to consult the clinician when a request is not clear, because he’s fighting to wipe away the outlook that he knows nothing, and confronting the clinician when he is unclear would jeopardise what he’s fighting for. The end results? I cannot tell. I have vowed not to profess evil with my mouth ever.
I do not write to condemn or commend. I do not write to extol one professional, while censuring the other. I write to express my empathy for the green grass, which the people of Kikiyu in Kenya say, suffer whenever two elephants fight. The other day, I stood at a corner, as I watched a laboratory scientist address an old and languid woman with great asperity as if the two have been in bitter ends for years. In curiosity, I asked the old woman what was it that she did that angered the laboratory scientist so much. She told me the doctor who requested for the laboratory test only gave her the request form, with the request, without writing her name on it. This listless woman had done no wrong to be treated with such acridity. It is not her responsibility to write her name on request forms. She probably might not even know how to spell her name. At worst, the laboratory scientist could have just told the woman politely to go back to the doctor who requested the tests to write her name on it for her, or ideally he could have communicated with the clinician directly, to release the weak patient some stress. But he would not do that because he has welled up so much indignation rooting from the quest of the clinician to satisfy his selfish ambitions by finding his way to plant himself as the head of the laboratory. The laboratory scientist, does not recognise the woman as a poor, enervated patient, who requires all the care and patience, and not treatments that only add woes to her ailments, but rather, he sees a vessel which could act as courier of all his welled up ires.
The story isn’t any different at the other side. A week ago, I was with a clinician friend in his consulting room when the next patient came in. When she handed her laboratory report to him, the clinician lost a nerve because one of the requests he made had not been done. He sent the patient angrily to go for the other tests. I didn’t know why he was angry at the patient, like it was her duty to do perform the laboratory tests. If there was a need for any anger at all, it should be towards the laboratory scientist. In past times, he would have walked straight to the lab and unleashed torrents of obloquies at the less confident, low self-esteemed ‘labman’, for not doing a request he made, like human beings are not fallible. But in modern times, he cannot do that. The antediluvian labman’s self-actualisation was to get a job in the city, and therefore deemed a job at a hospital in the city, even more than fulfilment of his dreams-therefore he kowtowed to all instructions, vituperations, and invectives, frightened by a possible loss of his dream job, if he does otherwise. The more enlightened modern day laboratory scientist, would not easily give in to such invectives because he has been trained formally, built his self-confidence such that his confidence has turned into conceitedness, hence the clinician finds the vulnerable patient as the vehicle of his vitriols.
It’s even more saddening to realise that the struggles for superiority is happening at the big government hospitals, mainly the teaching hospitals, while the consequences are felt at the the district and other lesser hospitals where, unlike the the teaching hospitals, patients are mostly the couriers of laboratory requests and reports. Another instance of what has been happening over the years in Ghana: grassroots bearing the consequences of the actions of their leaders.
The raison d’être of the hospital is to treat patients and give them good health or at least improve their health status, and make them feel much better than how they came. Studies have shown that depression, stress and other psychosocial disorders contribute enormously to patient visits to the hospital, and thereby the least the hospital could do is not make them more depressed, or stressed. Additionally, a good health status is devoid of all forms of disorders including emotional upsets. Therefore any act, which adds up to the health burden, or which have no positive effect on the health outcome of a patient should be desisted.
The government needs to establish policies which are fair to all professionals because acerbities usually come about when one party thinks it is being treated unfairly. The laboratory scientist needs to put aside all bitterness originating from quest to serve his ambitions and adhere to his theme of ‘Service to Humanity’. The clinician, despite being the captain of the medical team, should desist from acts of trying to plant itself as the head of the laboratory, as this is detrimental to the quality of health care delivered to the patient, the hospital’s ultimate client.
KWAKYE ALEXANDER
BIOMEDICAL SCIENTIST
UNIVERSITY HOSPITAL, KNUST
KUMASI-GHANA
Kwakyealex900@yahoo.com/axverses1@gmail.com
+233266045858/+233501044246
