Bad
An orthopaedic
doctor referred a patient to consult with us recently. The patient had
significant neck pains and arm pains. He was weak and unable to hold objects,
his walking was also unsteady. The MRI showed evidence of pressure on the
nerves in his neck, a condition called cervical myelopathy. He needed the
services of a neurosurgeon to decompress the spinal cord. So, our consultation
is N30, 000. However, he refused to pay because it was a doctor who referred
him!
Seriously! How does
that compute? Just because you were referred does not mean we should provide a
free service. I mean you can be asked to take a flight on ARIK from Lagos to
Abuja, but you do not go to the airport and ask to be flown across free of
charge! And of course, if you think that N30, 000 is expensive, try N100, 000
for a similar consultation on Harley Street in London. Same neurosurgeon, same
Nigerian patients, every time you come to the clinic! Because, of course,
someone has to pay for the electricity, the air-conditioning, the reception
staff and all else in between!
So bad
A young woman with a
brain tumour came for clinic consultation. She required an emergency operation
to remove the tumour and protect her from injury. The operation was discussed
and she went off to think about it. A month later she called from India to say
that she has had three operations! She related her experiences and confirmed
that the Indian doctors did exactly all we had promised to do for her here in
Nigeria and more besides. Oh really!
So she now feels she
could trust us and wondered if we would be so kind to see her on her return
from India for follow up care; as she cannot afford to go back and forth to
India! Moreover, she had spent much more than the Indian hospital said the
operation would cost. Now, I don’t know about you but that left a sour taste in
my mouth. Pretty disrespectful to ask a qualified and highly trained
neurosurgeon to do your follow up clinic visits for an operation you did not
trust him to carry out in the first instance.
The said operation is
usually billed cheaply at N5, 000, 000 in Nigeria and as much as N40, 000, 000
in other countries. This is the real cost of brain and spine operations on the
open market. For example, a man was billed N40, 000, 000 for a brain operation
in the USA. Same operation is being done successfully here in Nigeria for N5,
000, 000.
Another, a patient
of mine had successful spine surgery for N2, 500, 000 right at the same time as
his brother paid N15, 000, 000 for the same surgery in Dubai. The sad fact of
course is that the foreign neurosurgeon earns almost half of the money for
doing the operation as we twiddle our thumbs here working for chickenfeed. So,
just because we keep the costs to the barest minimum does not mean we are
stupid. It does not mean we should be treated as fools.
Pretty bad
A patient with
severe back pains and leg pains came to the clinic for surgical intervention.
He required an operation to fix the back through removing pressure on his
nerves and then insertion of pedicle screws to hold the spine together. The
bill for the operation was N1, 500, 000. By the way, the same operation will
likely cost N5, 000, 000 in India and up to N20, 000, 000 in America. He agreed
to pay and deposited N600, 000 begging that the operation should commence as he
was in severe pains.
A retired civil
servant, 70 years of age with no current source of income, he said he was
friendly with the Governor who had promised to help him. We agreed and operated
on him successfully. In fact, he was so happy he spent an extra week in Abuja
enjoying the creature comforts of the hospital, till we insisted on his
discharge. It is now almost 6 months since discharge without any effort to
redeem the balance of the money owed. Apparently, the Governor has not had time
to listen to him!
Now, what are we to
do with such people who come in distress to a private facility expecting
succour and then fail to redeem their pledges once health has been restored?
Many doctors continue to help and offer emergency services and in this case
assistance to a crippled old man, day in day out, without any appreciation from
the same patient. Perhaps we need lawyers, the courts and bailiffs to help
chase these debtors all over town!
Conclusion
The private sector
in Nigeria is improving at a remarkable rate to deliver quality health care
hitherto unavailable in Nigeria. Many hospitals especially in Abuja and Lagos
are capable of performing safe brain and spine surgery. Yet, the costs are a
small fraction of the market price for the same outcomes. And YES, we are
delivering better outcomes today!
The sad fact is that
some patients do not value what they have. Some will complain about the
environment even though it is better than home! Some will complain about the
service though they have not pressurized the government to provide quality
services in public hospitals. They then appear in a private facility expecting
free or cheap treatment for the same quality of service they might hope to
enjoy at huge costs in India or Germany. And after a good outcome and recovery,
refuse to pay!
The travesty!
NB: Please feel free to discuss and share your
experiences.
Orthopedic specialists in Delhi are educated from recognized medical colleges in India or abroad and generally have a work experience of five to seven years and more.
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