We’ll punish doctors who divert patients to private hospitals – Onyebuchi, FMC Umuahia CMD

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Dr. Azubuike Onyebuchi

Dr. Azubuike Onyebuchi, the Chief Medical Director (CMD) of the Federal Medical Centre (FMC), Umuahia, has only been in office for 100 days. In this interview, Onyebuchi talks about plans to make the hospital a transplant centre among other issues.

This is a Federal Medical Centre and I came from a Teaching Hospital background. So, basically, that concept of training of medical students and other health professionals might not just be as it is in a Federal Teaching Hospital. However, the core functions of a tertiary hospital, which include service delivery, training and retraining of health manpower and research, are also in FMC Umuahia. What are the things lacking here and what have you done so far about them? What I’ve done first is to re-motivate the staff.

Before I came on board, most of the service delivery points lacked things they required to work. I understood from them that that was a major problem and they required me to change the narrative and make sure that logistics, consumables and other things they need to work with are provided and that I’ve tried to do. I also noticed that the environment was dilapidated and not conducive for the staff who did not have job satisfaction, that I’ve also tried to address.

I also noticed that morale was low because most of them had been denied promotion, sponsorship or things that motivate. To address that, I sponsored some health professionals to local and International conferences. What are the major challenges you’ve encountered so far? The place needs more modern medical equipment to function.

The CT-scan which you can use to diagnose almost anything is not working at the moment and we are working very hard to put it in order. The Intensive Care Unit where you take care of very sick people is not properly established and the equipment you require to monitor people who are critically ill is not there and we’ve decided to work on those things.

If you go to the Intensive Care Unit now, you’ll notice that we have new ventilators, new string pumps, new infusion pumps and new modern monitors to monitor patients who are critically ill. We’ve also tried to provide for the cardiology unit a state-of-the-art 2D echo machine that can look at you and tell you how your heart is functioning. For that, cardiologists came here as a group to thank me.

One had to tell a story of a patient who had massive pericarditis and was being treated as a case of cardiomyopathy, but with the aid of that 2D echo machine, they were able to look into the heart, pick the fluid and the patient got well. So, without that machine, they would have been treating the wrong ailment. So, we need more modern diagnostic machines to be able to make correct diagnosis and of course treat. We are also trying to renovate places that are bad. If you go to the maternity ward complex now, both the Obioma and Nkasiobi Ward where incidentally I was born and my mother told me that the place had been like that since I was born and it was still like that for some time, I renovated them within my first 100 days in office.

If you go there, you’ll be happy to send your wife there to get delivered of your child. We’ve also renovated the dental and ENT complex. It was about collapsing when I came. READ ALSO: FG approves renaming of FETHA to Alex Ekwueme University Teaching Hospital, Abakaliki We’re lobbying the necessary people at the National Assembly and the Federal Ministry of Health to get things done here. I’ve been able to attract in the budget, a building for a modern Accident and Emergency Unit and ICU.

If you go to our Accident and Emergency Unit, you feel sorry for the patients there because the place is overcrowded and overburdened by cases that ordinarily should have been managed at the primary and secondary health care facilities. But because those systems of health care have collapsed, pressure is coming on the tertiary hospital. Sometimes you see patients lying on the floor. We can’t reject patients because the space is small.

So, I’ve been able to attract a modern building in the 2019 budget and once they release fund, we’ll take off and, before the end of our first tenure, this place will have a modern Accident and Emergency Unit. The previous administration was applauded for organ transplant. What do you intend to do in that area? Yes, we are sustaining what was done by the previous administration. I’ve had a renal transplant done after taking over as Medical Director. And we did not use the American partners, we used our Nigerian partners and that reduced cost. So, we intend to consolidate on that and bring in more plants.

Part of my long term plans is to have a transplant centre here, and not just a renal transplant but also for other areas like cornea, liver. We are talking to our brothers and sisters who are transplant surgeons abroad and they said the best thing is to have a transplant centre. What do you want FMC Umuahia to be like at end of your tenure? I want FMC Umuahia to be transformed from a Federal Medical Centre to a Federal Teaching Hospital.

That’s what I’ll want to be remembered for and, by the grace of God, we’ll get it from this President who listens to genuine concerns. I want the narratives to change from when people say if you are going to FMC, you are going to die to a situation where people will now say, if you are going to FMC, you are going to get healing because the staff would have been motivated and the hospital becomes patient friendly.

That will be my overall aim. Are you comfortable with your staff strength, especially the health workers? I’m not comfortable. Basically we’re lacking resident doctors. And that’s one thing we’ve tried to change. I’ve made the case for a waiver to take more health professionals and that waiver is getting attention at the Head of Service Office and I’m very sure that soon that waiver will be granted and we’ll employ more health professionals.

The health workforce is obviously inadequate. How do you intend to handle the issue of nurses and patients relationship in terms of the way nurses take care of patients? It will be very unprofessional of me to single nurses out of health professionals on patients. We’ve already started retraining our health professionals, that is, nurses and doctors, and non-health professionals who are also working here to change their attitudes towards patients. Without patients, everyone of us medical professionals will be in the labour market. I’ve made this clear to them through my interactions.

So, whatever we have to do to make our patients comfortable, we have to do. We are collaborating with some institutions abroad, so that they come down here to do in-house training for our staff to enable them see international practices on how they should relate with patients. So, I don’t want nurses to be picked singularly on this issue because it’s a general thing that all health professionals must be retrained on their attitude to work and attitude to patients. What do you intend to do to improve the Internally Generated Revenue of the hospital? With money you can do almost everything you want to do.

And increasing the internally generated revenue of every organization is what every CEO must try to improve. The first thing is to improve services. Make sure that the clinical services you’re rendering are of high quality so that more people can access that. That’s why I said we have to get the CT-scan back to functionality, get our labs back to functionality which we have done.

In the radiology section, we’ve refurbished all the x-ray machines, provided back-up for the ultrasounds, resuscitated the mammograms. Secondly, we’ve tried to block all loopholes, automated our revenue collection system. With automation, I know that our IGR is going to go up. We also aim at creating more services for our people.

The things that we’re not doing regularly, like inter-fertilization, we intend to make it more regular and let the public know that these things are done in FMC and not only in private hospitals. We’re also trying to make sure that the environment is conducive so that people who visit here will tell others what they’ve seen here. What are going to do to checkmate the issue of diversion of patients by doctors? As we talk about automation of revenue collection, we are also trying to automate the electronic medical records. With that, you are going to reduce physical contact between health professionals and patients who walk into this hospital willingly. Because everything you’re doing is going to be through the computer. If I see a patient, he is entered into the computer. He wants to go and get his drugs, the doctor keys in his prescription in the computer and he goes to the pharmacy, so there will be no prescription slip to take away. That’s one diversion that will be reduced. If you’re supposed to be sent to the lab, it will be keyed into the system and you go to the lab and the lab will say the investigation you’re supposed to do, you go and pay, they’ll give you a computer-generated receipt; you come back to the lab and get your investigation done.

That will reduce lab forms being filled and taken away to labs in town. In terms of doctors diverting patients, once your name is keyed into the system, the doctor who is following you will also be keyed into the system. And we are also talking to doctors that anyone caught diverting patients who willingly walked into this hospital will be dealt with according to public service rules. Whether you’re the highest consultant or lowest doctor, you’ll be dealt with according to public service rules. We interact frequently. And with that, inter-professional rivalry will end.

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