Integrity in Private Medical Practice: The Modus Operandi

The Dictionary defines:

1.Adherence to moral and ethical principles, soundness of moral character; honesty.

2.The State of being whole, entire or undiminished

3.A sound, unimpaired or perfect condition

Any human being operating in the flesh cannot be a man or woman of integrity. This was re-echoed by Apostle Paul who said in Romans 7: 18- 19: ‘for I know that in me (that is, in my flesh) dwelleth no good thing. For to will is present with me; but how to perform that which is good I found not. 19. For the good that I would I do not; but the evil which I would not, that I do.’

But with God all things are possible. It is encouraging and reassuring when Integrity as;

The same Apostle Paul said in Philippians 4: 13 ‘I can do all things through Christ which strengthens me.’

My driving force in life, therefore, dwells in the power of the Holy Spirit. And also on the fact that one day I have to give an account of whatever I do. Col. 3: 23-24 says: ‘And whatever ye do, do it heartily, as to the Lord, and not unto men. 24 knowing that of the Lord ye shall receive the reward of the inheritance; for ye serve the Lord Christ.’

THE FOUNDATION

To maintain integrity in Private Medical Practice, the hospital set up must be based on transparency and registered by the Ministry of Health, Ministry of works and the Ministry of Environment, who will make sure that all the personnel are medically qualified and not quacks; the premises and the environment must meet up with the standards stipulated for setting up a Private Hospital. All these processes were duly followed before we set up our hospital.

EMPLOYMENT AND STAFFING

Competency, honesty and dedication to duty should be the criteria for the selection of staff. Integrity and not religiosity should be the priority in selecting workers. There are some Christian workers that are dedicated and hardworking, so also amongst Muslims. In our organisation, we have dedicated Christians as well as dedicated Muslims. However, before any Muslim picks up a job in our honesty. The premises must be duly hospital, he or she has to abide by our Christian principles of early morning devotions and prayer meetings.

We have adopted this way of selecting our workers based on the Warren Buffet principle: ‘that hiring people with integrity is a top priority when selecting a candidate; not race or solely their religious background.’

PROMPT PAYMENT OF SALARIES AND EMOLUMENTS

To maintain one’s integrity in private practice, the medical director should pay the workers’ salaries regularly and as at when due.

Leviticus 19: 13 b says, ‘The wages of him that is hired shall not abide with thee all night until the morning.’ It is inhuman to keep the workers’ wages in a private bank account in order to obtain interest and thereby making workers suffer. The love of money, the Bible says, is the root of all kinds of evils – 1 Tim 6:10a.

We maintain our integrity to our workers by making prompt payment of their wages. If you hire visiting consultants and anaesthetics, they should be paid as soon as the job is done- no delay for even a day.

INTEGRITY AND MORAL

The Medical Director must maintain a high moral standard among his workers and patients as a way of maintaining his integrity. 2 Tim 2: 19c says; “and let every one that nameth the name of Christ depart from iniquity.” A Christian Doctor should maintain his integrity by keeping away from sexual harassment of his workers. It is an act that brings shame to the name of the Lord. Such a Medical Doctor is a bad example of Christianity and cannot witness effectively to the people under him. I see it as a call to duty and reverence to God by maintaining a clean relationship to all my female workers.

I have heard and even seen female nurses seducing and even marrying their bosses thereby destroying homes. To maintain clean record and integrity in the workplace, I recommend that such a female member of staff, when recognised, be sacked immediately before she wreaks havoc.

INTEGRITY AND ETHICS OF THE PROFESSION

To maintain integrity in the Medical Profession, the ethics of the profession must be maintained. It is emphasised in our Medical Practice that no doctor should give false certificates-birth, maternity leave, sick leave, disability etc. It is ungodly and against the law of the land. When evil is discovered, it brings shame unto the Doctor and the Hospital.

Some years ago, a man who had worked abroad for many years connived with a Doctor in a government hospital in Nigeria who wrote for him a death certificate to enable his children to collect his death insurance claims while still alive. The bubble busted when experts came all the way from Europe to verify the claim. It cost the doctor his job and he lost his integrity.

MAINTAINING STANDARDS

To keep the integrity of the Doctor and his hospital, i. The premises must be clean always

ii. The laboratory reagents and theatre equipment must be adequate and of a good standard

iii. Qualified Doctors and Nurses must be hired

iv. The hospital must keep and dispense genuine drugs that are not expired.

v. The Medical Director must be careful not to fall into the traps of some pharmaceutical companies who may want to push out expired drugs at ridiculously low prices.

vi. Water and electricity must run 24/7

vii. Supporting staff, carpenters, electricians and rewires, medical laboratory technicians etc. who come from outside must be well remunerated and given incentives when called out at odd hours.

HONESTY IN MEDICAL PRACTICE

A medical Practice will become famous and known for integrity if the workers are dedicated and honest. It is difficult to imagine what some Nigerian Doctors do to their patients. Permit me to give two life stories.

A ten-year-old girl inadvertently swallowed a ten kobo coin. She was rushed to a private hospital in Ibadan. The Doctor, not an ear, nose and throat Surgeon, and definitely with no equipment and no surgical skill to remove the foreign object from the throat took the patient to the theatre, put the child to sleep with an intravenous Anaesthetic agent and after fifty minutes brought out the child and showed the parent a similar ten kobo coin which he apparently brought out of his pocket. The jubilant parents went home and the child tried to feed but each time had a choking sensation.

Subsequently, the child developed a cough and fever. She was taken to another Doctor after 3 days. There a chest x-ray was done and lo and behold a ten kobo coin still remained in the throat. The parents then brought the patient to us at Highland Specialist Hospital. We called in the Paediatrician to look after the chest infection before the child could be fit for surgery under general Anaesthesia. Unfortunately, the child died a day later because the chest infection was overwhelming. Meanwhile, the parents had paid us for surgery that was not yet done. The next day after the death of their child, we traced the home of the parents, commiserated with them and refunded the money. The parents were surprised that we made efforts to trace them and found it unbelievable that the money was refunded. Up until today, that family and their friends saw something special in our hospital and adopted our centre as their family Hospital. A physician has to be honest to earn his integrity. If there are cases you cannot handle in your centre, it is honourable, to be honest, and humble enough to invite a specialist who can handle the case or refer the patient to a centre where he can get help. After all, no single man is an island of knowledge.

Another case is that of a young dishonest medical doctor who nearly lost his practising license. He operated on a woman who had a lump in the breast. He collected money for both surgery and histology. In his own judgement at surgery, he saw all the features that the lump was not cancerous. He deliberately didn’t send the specimen for histology and lied to the patient that all was well. However, months later, the lump re- grew and the patient had to undergo a repeat surgery at another hospital following the detection of the cancer of the breast. The doctor landed in disgrace. To maintain one’s integrity, honesty should be the watchword in Private medical practice.

KEEPING PATIENT INFORMATION PRIVATE

As health workers -Doctors, Nurses and Record clerks- we have the privilege of knowing so much about our patients’ secrets. Our Hippocratic Oath requires us ‘to maintain confidentiality and never to gossip’. Hospital workers should be men and women of Integrity to keep the patients’ information secret. There were cases of friends and relations putting pressure on us to give information about our patients but we declined. The hospital workers will lose their integrity if secrets are not kept. I have had a course to sack a Doctor for loose talks and carelessness in handling patients records.

KEEPING APPOINTMENTS WITH PATIENTS

Keeping time and meeting up with appointments are parts of the virtues that determine the integrity of a man. If you are running late for an appointment, it is better you put a phone call across and reassure the patient. Carelessness in keeping appointments can make a private practitioner lose his integrity.

CONTINUOUS MEDICAL EDUCATION

It is a fact that you can only give what you have. Medical doctors and nurses and other paramedics in a private Medical Practice must go for update courses from time to time. This will give them more exposure to perform excellently well. It is when health workers perform their duties in an excellent manner that the patients get satisfaction with good results and this will earn the institution an excellent name.

CONCLUSION

With the power of the Holy Spirit, it is still possible for a Private Medical Practitioner or any health worker in any institution to be regarded as a man of integrity. Integrity in Medical Practice is all encompassing. It calls for the Doctor and other health workers to be honest, dedicated and work with the fear of God. This calls for discipline and commitment. With God, nothing is impossible.