THE PECKING ORDER.
A newly qualified doctor is called an intern. After one year of internship, he / she are promoted to a medical officer. After three years, a medical officer is allowed to take his masters degree in a field of his choice. The most common fields are surgery, anesthesia, internal medicine, pediatrics, obstetrics and gynecology, radiology, psychiatry and psychology. A master’s holder in medicine is known as a registrar. After practicing for 10 years, and after specializing in a particular branch of medicine, one becomes a consultant in that specific field.
Most doctors stagnate at this level, and opt to make money. For a few who get involved in research and academics while attached to a recognized university, they are rewarded with a professorship.
The technical nature of a consultant’s qualifications necessitates that he takes an active managerial role. Kenyatta national hospital has entrusted the smooth running of the clinical departments to consultants, who formulate policies, and protocols to be used in treatment of patients, and supervision of training of doctors. It is consultants who recommends weather candidates have qualified or not. Their recommendation supersedes the actual score obtained by the candidates in both written and practical exams. Some consultants are corrupted with power, to an extent that they abuse it at will. It is very sad that the hospital has very little control over these bullies in lab coats. As a result, both patients and paramedics suffer without an avenue of recourse.
Consider. Dr. olunya, a consultant neurosurgeon who refused to see a patient with a brain tumor, who had presented in casualty at 7:00pm. He directed that the patient be kept waiting till 8:00 am of the following day. Then there is this Dr. Kambuni who has specialized in abusing junior doctors in front of patients to such extent that patients loose confidence in them. Dr. Musau, a neurosurgeon who sexually harassed a nurse, who happened to be a wife to one of his student registrar. When she refused to give in to his demands, he had the poor nurse transferred from his department. Dr. Okutoyi , an anesthetist who refused to attend to a 5 year old boy who had been involved in a road traffic accident, just because no senior surgeon had requested her to. The child ended dying in much pain. Dr Masinde, of ENT once removed a patient from the operating room, before surgery, when he learnt that the patient had not paid the hospital admission deposit. Dr. hamdun a pediatric surgeon once declined to perform an emergency operation on a 5 day old baby who could not pass stool due to twisted intestine. In spite the fact that consultants are paid non practicing allowance so as to concentrate on patients in public hospitals, many do not put in the required 40 hours per week like other civil servants. They have structured their work schedules in such a manner that junior doctors attend to 99% of the patients unsupervised. And when medical errors occur, blame is allocated to paramedical staff. In cases where this is not possible, the junior is fried while the senior goes scot free.
Here is an illustration: an anesthetist forgot to turn oxygen on when he was administering anesthesia during surgery. In his defense, he blamed an unnamed nurse for switching off the oxygen. The nurse refuted the claim, wondering why the anesthetist did not take corrective measure immediately, as the responsibility to monitor a patient under anesthesia falls squarely on the anesthetist.
A medical doctor forgot to prescribe pain relief medication for a patient. In his defense, he claimed that the nurses did not remind him.
A patient had an allergic reaction to some dressing materials put in her wound. She had previously informed the surgeon about her allergy. Unfortunately the doctor did not communicate the same to the rest of the surgical team. The doctor blamed the nurse who applied the dressing and demanded that she apologizes in writing.

@ murenj, you are obviously a surgery registrar at KNH. What you highlight happens in all hospitals around the country. It is unlikely this will change unless we have a change in attitude. The malaise of our doctors, our love for shortcuts and the handed down colonial disdain for training doctors which was laced with racism continue every single day. Unfortunately, if you speak to any registrar, he wishes to become the next Dr Musau, Prof magoha or any of our consultants with little knowledge and bloated egos. New doctors continue with this practice, sexually harrass nurses, avoid work and take bribes. I pity our patients...

Supervising your superiors:
The day Dr. kabetu was appointed as the deputy director clinical services, professor Mulimba of orthopedic surgery scoffed wondering ‘what this little boy will tell him.’ He had taught Dr. Kabetu way back in medical school, and also had more academic papers than him.
This is nothing if you consider the treatment Dr. Onguti got at the hands of his peers. A brilliant maxillofacial surgeon, deeply religious; Dr. Onguti took his duties seriously, to the point that he sacked one of his relatives from the employment of the hospital. He is credited as the only director who smoked out the consultants from their hiding places. For once, most of the absentee consultants clocked in for duty and were at hand to attend to the patients.
This, however did not last for long. One day Dr. onguti sent his client to be admitted in a private hospital, for surgery. At the admissions desk, the client was politely informed that Dr. Onguti had no admission rights with the hospital. The angry client called the good doctor, who in turn contacted the hospital administrator. Sorry sir, but the order came from the BOG…….yes, am aware that you have been admitting there………….. but approval from the BOG is a prerequisite. The scenario was repeated in several hospitals… the brilliant maxillofacial surgeon was Jobless! He had overlooked the fact that the senior consultants whom he was antagonizing in Kenyatta also served on various hospital management teams, while others actually were shareholders of the same. But these people were not through with him. Anonymous callers would demand his head, urging him to resign. Poor Dr. Onguti became paranoid, walking around with huge security detail. The last straw that broke the camel’s back came when the cartel incited some ministry official to slash down the worker’s allowances. Predictably, the hospital workers went on strike, chanting that ONGUTI MUST GO….. and he was sacked that very day.
Currently, Dr. Kabetu is finding it hard to practice privately. His peers have sidelined him from this lucrative circuit. Anesthiologists do not have private patients of their own, but rely on surgeons to give them that friendly call. In other words, the surgeon has to subcontract the anesthetist. And if that surgeon happens to be the one whom you threatened with a sack, he will opt to sack you first….

This is the kind of info I hate to know! What are we supposed to do when we fall sick...

The devil came in and disguised when medicine stopped being a calling into a business!

Nice knhleaks there @ Dr.murenj.I dont like that Musau guy.He once told a woman that her husband 'is as good as gone, there is no need of even thinking about him'