Why are doctors still practicing medicine in Nigeria?

With the plethora of opportunities available to health workers abroad, how many doctors will be left in Nigeria in the foreseeable future?

As a doctor, whenever I compare my working environment while in Nigeria to my current working environment outside the shores of the country, I ask myself why I did not leave Nigeria much earlier.

The Nigerian environment is extremely hostile towards its health workers. They ignore the bitter reality that the expected standard of care in Nigeria has crashed, and measuring it with a global barometer is unrealistic. The level of improvisation and rationing of resources and manpower done daily by the Nigerian health worker is so profound but unknown to most patients’.

Why are doctors still practicing in Nigeria despite the vast array of opportunities available to them in other climes?

There is undoubtedly a toxic relationship between the Nigerian social media and health workers. Social media has become an instrument to orchestrate vicious attacks on doctors. Recently, a colleague refunded payment for an IVF procedure which failed, simply because the patient threatened to malign his name on social media. “Their camera phones pointed at my face felt like a gun to my head,” he said.

The truth is that not all negative outcomes in medicine are caused by negligence. However, when patients bash doctors on social media, the doctors’ silence is mistaken for culpability, when in actual fact the doctor is ethically restrained from discussing patients’ treatment. Nigerian social media might very well be the catalyst that will encourage immigration of Nigerian doctors to more conducive climes because of the barrage of attacks and vilifications for some explainable negative outcomes.

Unfortunately, the Medical and Dental Council of Nigeria (MDCN) have been unhelpful. Petitions drag at the MDCN for many years and this in itself affects the doctor’s confident disposition to patients.

Furthermore, the lacklustre performance of the MDCN, which on record was not constituted for the last five years until recently, have left doctors traumatized by the lengthy duration of their investigations.

The harassment of Nigerian doctors has also escalated to clout chasers like the Federal Competition and Consumer Protection Commission (FCCPC) claiming to investigate customer care and competition, and not medicine, but end up analysing medical records, case notes, x-rays, lab results etc., thereby unlawfully regulating medical practice. Sadly, this overreach by FCCPC has not been challenged by MDCN, NMA and other stakeholders in the Nigerian health sector.

Nigerian doctors are amongst the easiest category of Nigerians to migrate, young doctors especially. There is desperation from the Western world for Nigerian doctors. This was particularly evident during the peak of the Covid 19 pandemic, where Nigerian doctors were not only offered permanent residence in a foreign country, but also transported there privately. The opportunity to relocate and get a great paying job with no periodic strikes is extremely tempting that it is almost impossible to overlook.

For the doctors left in Nigeria who choose to tolerate the social media barrages, poor regulatory presence, and interference by none-stakeholders, the only way for them to continue to thrive in Nigeria is to practice defensive medicine – the cost of which will ironically be borne by the patients themselves.

In conclusion, as available data shows that well over two thousand doctors leave Nigeria annually, it is important to conduct an independent audit of doctors in Nigeria to know how many have left, and how many doctors we have left. In the future, I hope Nigeria can create a friendly environment where doctors can practice medicine to the fullest of their potential.

Dr. Folarin Ajibola, a Consultant Pediatrician and writes from the United Kingdom.

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