The cold war between the pathologists and medical laboratory scientists on who is in charge of the laboratory seems to have no end in sight.
In this interview with HASSAN ZAGGI, renowned medical laboratory scientist, DR. GODSWIL OKARA, insists that medical laboratory scientists have been duly licenced by law, hence, take responsibility for what happen in the laboratory.
What is the connection between a pathologist and a medical laboratory scientist?
It is team work. A pathologist is a physician who has had specialist training in a branch of medicine called pathology. A pathologist, as a clinician or physician is trained to run specialist clinic to treat and manage patients that have health conditions related to their area of specialization. During our training in the University College Hospital, Ibadan in the 1970s, consultant pathologists in the various pathology specialties had their clinic days, as well as bed space in the wards for admitting patients that management.
In chemical pathology, there was Metabolic Clinic which the consultant chemical pathologists took turns to run with their resident doctors in training; in histopathology they had Oncology Clinic; in Haematology, there was Haematology Daycare Clinic; in Medical Microbiology, they had Special Treatment Clinic where patients were attended to by pathologists and their resident doctors.
A Medical laboratory scientist on the other hand is trained and licensed to run and manage diagnostic laboratories and analyse body fluids and tissues which aid the effective diagnosis, rational treatment and management of disease conditions by physicians and surgeons. At the specialist level, a medical laboratory scientist also renders services for the interpretation of laboratory test reports.
Modern healthcare practice is a team work involving a multiplicity professions and professionals including pathologists, medical laboratory scientists, physicians, surgeons, pharmacists, physiotherapists, radiographers and many others.
It is a team work. It is a question of respecting the skill set and knowledgebase of each other. That is what it is in the western world where orthodox healthcare practice originated.
When you go there, all these superiority contest does not arise, everybody is busy doing their thing the best they know how to. It is here that people carry title on their head. Nobody cares what you are and what your profession is, all that matters is what you can bring to the table, your skill and the knowledge you have upstairs. But when you come here, everybody is claiming I am this and that. That is the undoing of our system.
A pathologist is a physician. Physicians are trained to attend to patients. Pathologists are supposed to run their specialty clinic and attend to their patients that have abnormalities related to their specialty. But what you see in Nigeria is that they want to leave their job as physicians to be struggling with the medical laboratory scientists over sample testing in the laboratory. You don’t see this outside the borders of our country.
Who takes the responsibility when there is any wrong doing in the medical laboratory?
For somebody to be licensed, it means conferring on him or her original authority derived from law to perform a specified task. A medical laboratory scientist takes full responsibility under the law for any wrong doing in the course of his practice.
A medical laboratory scientist islicensed under the Medical Laboratory Science Council of Nigerialaw,to analyze body fluids and tissues of man and animals, run, administer and manage medical laboratories for the purposes of diagnosis, research and production of vaccines and other biological reagents.
Sections 15 and 16 of the Medical Laboratory Science Council law have made elaborate provisions for disciplinary mechanisms and penalties for unprofessional conduct by any medical laboratory scientist.
A pathologist does not take responsibility for what a medical laboratory scientist does. If that were so, there will be no need to license the medical laboratory scientists under the law. It is complete fallacy for anybody to say that a medical laboratory scientist cannot appear before the court or be liable for his work. That is complete fallacy.
I have been a member of the Medical Laboratory Science Council Board, there is a disciplinary committee as enshrined in the law. The disciplinary committee works on cases of either negligence or malpractice complaint by members of the public against a registered licensed medical laboratory scientist.
A panel is set up, the panel investigates the allegation and the report of the panel goes to the disciplinary panel and the disciplinary panel, by the law has the status of the Court of Appeal. Any decision taken by the disciplinary panel against any medical laboratory scientist can only be challenge at the Supreme Court of Nigeria. That is to show you what the law has put in place for the practice of the profession.
But unfortunately, some people arrogate to themselves the powers above the law of Nigeria. They talk and behave as if they live in the moon and not subject to the laws of Nigeria.
It is really unbecoming for somebody that calls himself an educated person to be making outlandish and bogus statements that amount to insulting and denigrating the laws of Nigeria.
I read in one of the publications where, to be specific, one Dr Kenneth Iregbu made very insulting statements against the Nigeria judiciary. It is really unbecoming of an educated person. The law is there to checkmate people’s conduct to avoid excesses. Nobody is above the law.
But what you see in Nigeria is that the court of law will give a judgement, an individual that calls himself a medical doctor will claim to know more than the judiciary and be insulting the legislature including the National Council on Establishment that is charge with the statutory function of bringing schemes of service for the orderly conduct of government business.
What he is advocating is complete anarchy in the system. A situation where a medical doctor will say that the judiciary knows nothing about healthcare practice, it is only what he said that should reign in the health sector, that is unleashing the rule of the jungle in the healthcare sector and environment.
Such excesses and irrationality must be checkmated. The law court should rise to the occasion and charge people for contempt and commit them to prison until they purge themselves. That is the way to ensure sanity in the system because every human being’s right ends where another person’s right begins.
The insinuation that internal fight over control in the medical laboratory is the cause for spurious results to the public, do you buy this idea? And what is the way forward?
Science is all about empirical proof and data. People can sit in their little corner, wake up with a dream and begin to make bogus, unsubstantiated and outlandish statements. Tell people as professional, present the data, the fact, the experiment you carried to arrive at the conclusion.
In science we talk about the method, the observation made, the inference and the conclusion drawn from the inference. Science is different from faith.
How do we get harmony in the medical laboratory sector?
Harmony comes by mutual respect. You respect me, I respect you. You respect the law that regulates my practice, I will respect the law that regulates your practice. That way, there will be harmony.
Medical practice did not originate from Nigeria. We should play according to the rule and practice it the way it is being practiced, if we want the type of result they are getting there.
If you go to the UK that colonised Nigeria, you will see that all this rivalry is not there. Our colleagues are in charge of the laboratory, they run lab, signed results from the laboratory and take responsibility under the law.
The same thing is what is envisaged by this Medical Laboratory Science Council Act. But what you see is that some pathologists will not want to restrict themselves to what they are supposed to be doing according to their training and legal regulation. Somebody is saying that the regulation made by his professional body should supersede a law made by the National Assembly of the Federal Republic of Nigeria or the judgment of the Nigerian judiciary. It is really unfortunate.