A few years ago, it was usual for consultant dcotors to be paraded on the Nigerian Television Authority network news. A gynaecologist for forgetting forceps or a surgeon for sponge in a patient's abdomen or a psychiatrist for forgetting a beer bottle in a patient's mind. Every system failure in government hospital would be blamed on individual doctor.
It was the doctor who had to take the fall for the deplorable state of the health systems in the country, and also as the team lead, also take responsibility for failures of his trainees (Vicarious Liability).
Thanks to Dr Google our patients are also getting more sophisticated. It is now usual for the patient to present to his doctor after researching their symptoms in the internet. Linked to some of these sites are further links to news about doctors who were docked for malpractice. As if this was not enough, there are now lawyers who ”specialize” in medical negligence and some who actively parasitize on grieving relations who have just lost relatives and persuade them to get even with death by making the doctors pay.
Being a relatively proactive association, the MDCAN response to all these was deliberate. First, during the watch of President Audu (2009-2011) the Articles and Memorandum of the MDCAN was expanded to facilitate the setting up of a Medical Defence system. The next regime organized a Round Table with Insurance companies, Insurance Brokers and Lawyers to discuss the Modus Operandi and management structures for a Medical Defence Union. The Maiduguri BDM (2013) approved the setting up of an MDCAN owned Medical Defence Union and a creation and transfer of some money to a special “MDCAN PROJECT ACCOUNT” for to set up a Medical Defence Union.
The Maiduguri BDM approved management structure for the MDCAN MDU consisted of
- Chairman (Past MDCAN President)
- Representative of the Board of Trustees
- 2 Representative of NEC
- Representative of the President MDCAN
- MDU Legal adviser
- MDU Consultant
Members of the MDU is open to all MDCAN members and all medical practitioners in the country.
Activities of the MDU
- Will keep a web presence to disseminate information for members and other doctors
- The MDU will retain lawyers to represent members
- Members will have options of having MDU lawyers represent them
- Pre-emptively educate members of how to conduct themselves with difficult patients
- To assess their risks when they suspect they may have issues with specific patients
- Inform the MDU as early as they suspect problems
- The MDU will attempt a pre-trial settlement in select situations
- Seek liaison with other MDUs in other countries
Easing Clinical Practice Initiative (ECPI) was born as a compromise with the CAC who did not want to register another Union in the country because the existing ones were always on strike. Defence would easily be confused with the Niger Delta or Boko Haram Inc. This particular MDCAN initiative will free doctors to face their clinical practice with confident, assured their backs are covered.