‘People travel abroad, cos they don’t know we offer such medical services’
Why are you here?We are looking at the health sector holistically from a business side, not from a clinical side. We are a business development company, promoting the business of health care, particularly looking at the issues that make patients in Nigeria travel abroad for healthcare. We want to see how they can be reversed. […]
Why are you here?
We are looking at the health sector holistically from a business side, not from a clinical side. We are a business development company, promoting the business of health care, particularly looking at the issues that make patients in Nigeria travel abroad for healthcare. We want to see how they can be reversed.
What motivated you to go into this?
We see a lot of gaps in medical practice and business in Nigeria, and we want to fill those gaps to ensure medical outcomes in Nigeria will be to the benefit of virtually every other person who desires those services.
What exactly do you mean by the gaps?
We have a lot of good doctors, hospitals and pharmacists, but how many people are aware of what they do and where they can get those services. It is not about the core clinical services, but to be able to provide information to the average Nigerian. From our research, a lot of people travel abroad because they do not know where some services are located in Nigeria. Ordinarily, they jump onto a plane without looking at development services locally. Those are the gaps we want to bridge.
How do you intend to do that?
We intend to hold some exhibitions in the next couple of years, looking at doctors, their services and providing that information to the public.
When are you planning to do that?
We are looking at the month of August for the north central; sometime later in the year in the south west zone. And in 2015 and 2016, we distribute it to other zones of the country.
You have worked in Nigeria as a consultant for a while. What’s your perspective of the Nigerian health sector?
It is on the upward streak. But when you look at it from a narrow perspective, you think our doctors are not doing much. They are doing quite a lot and the demand for medical services in the country is increasing. If you look at the population in the 60s and the population today, you see a lot of demand for medical services. 20- 30 years ago, you had like a 100 million people, but now you have 160, 170 million. You find a lot of demand. The supply side is a little bit low and the way practice is structured in Nigeria needs to be re-examined: single practice from single individual is not the best way forward.
We are advocating for group services, a template for it, where a number of professionals can come together to set up a practice. It affects the quality of outcomes that they have, and those outcomes aren’t what we expect in the Nigeria of the 21st century.
Many people turn to medical tourism as a matter of lack of confidence. How will your exhibition rekindle their confidence?
The issue of confidence is very realistic. When things have not gone well in a number of years, you have to make consistent efforts to rebuild the reputation of medical practice in Nigeria. One of the ways we are doing that is to look at the issue of advertising. No matter how good you are, if you don’t say this is who we are and this is where we are, the chances are that people will not know. And if people don’t know, then the issue of reputation can’t even be handled.
A lot of Nigerian doctors who were resident abroad in the 70s, 80s and 90s are all migrating back to Nigeria. These people will bring their expertise, money and reputation to bear. Nigerian doctors are also very well trained. Some data in the UK talk about the competency of Nigerian doctors. More than 80% of doctors who graduate in Nigerian universities are all excelling abroad. Most of them who apply themselves end up fantastic doctors but we have to help them.
The issue to some extent is that some parts of the medical curriculum of our doctors does not include business or financial education. They are just clinicians. We advise government and regulators to also look at the issue of who heads a hospital. There are certain people who are trained especially as hospital managers and administrators, while the clinicians run the clinical services of the hospital, thereby concentrating effectively on clinical while administrators run the administrative side of the hospital.
How many hospitals are on this exhibition?
The maximum unfortunately is 140 booths . We can’t do more than that because of space at the International Conference Centre.
There is a lot of criticism about advertisement of medical services. If you are working with MDCN, to what capacity has it allowed you to do this?
MDCN are working with us through the Federal Ministry of Health. The registrar of the council and the medical and dental council Act actually permits guided advertising. It’s there in their laws, but people need to look at it and apply it. You don’t just come out and say, ‘I’m the best gynaecologist or physician.’ No, but as long as you follow laid-down rules, they will not contravene you.
But there’s a difference between a doctor advertising and a hospital advertising. A doctor cannot advertise but a hospital with limited liability can actually advertise but guided within the constraints of the law.
How do you think Nigeria’s health sector can improve so we can compete with other countries?
One issue is the right level of investment and the right incentives for investment in the sector. Hospital vendors from so many other parts of the world don’t need to sell hospital equipment. If you want to buy an MRI and the cost is $1m, how many people can afford to put that down for a single equipment? But if that hospital through the financial services establishment works with vendors, they can lease these equipment as long as the cash flow of the hospital can support that project.
And for practice, sometimes you can find 10 clinics on a single street, all competing for the same market. How can they feed from that market? Therefore they will cut the quality of the services they render. But if they come together, the cost of operation of those services will go down by more than 70%—buildings, generators, running will all be cut off.
When they come together, there will be internal referrals. You keep your patients within or refer them to places when they don’t have the competencies.
When you go to hospital, you hear the doctor say, ‘this is my patient.’ He is not your patient; he is a patient of the hospital. Doctors and other staff should be patient-centric so the outcome for the patient will be the best for the patient.
We encourage Nigerians to patronize our hospitals. We don’t need to go outside the country for hospital services. Although it is a personal decision; nobody is going to force anybody. But by the time you move from Maiduguri to Bayelsa, there is no service you can’t get here. If you can afford to go to India, the bills are high and the cost of treatment in those areas may not be comparable to the cost here.
The major issue is that when you do that and come back, who does the follow-up? It is a Nigerian doctor. If a Nigerian doctor is good enough to do the follow-up, then he is good enough to do the initial treatment. But if you have to travel, make sure you get a referral from a Nigerian doctor. Most people travel abroad without referrals or without the consent of their doctors and sometimes it ends badly for them.
What about quality?
It is key. It starts with self regulation by the practitioner. The professional groups have a role to play but most importantly, various governments who run or regulate hospitals need to have standards of care, protocols of care that must be strictly followed. Plus they must have an inspectorate unit that must go and ensure that things are being done right.