“Op finished,” announced the General Surgeon, signalling to the anaesthetic team that the surgery was over. The General Surgeon, Dr David has 35 years of surgical experience under his belt. Dr David, having been put out to pasture at 60, is now 67 and is engaged by government as a contract doctor. He was called in by the gynaecological team when they realized the patient would need a General Surgeon’s attention.
This trend where doctors who worked with government and retired come back to work under contract is not new.
In Nigeria, the compulsory retirement age is 60 years. Doctors too are meant to retire at that age. But there has been a steady decline in the number of Nigerian doctors willing to stay back in Nigeria, with fears of a looming doctor shortage crises.
According to a survey by Nigerian polling organization, NOIPolls, which has a technical partnership with Gallup (USA), 8 out of every 10 medical doctors in Nigeria are seeking job opportunities abroad, and this includes junior doctors, senior doctors and specialists.
Last year, doctors resigned in droves from Government Hospitals across Nigeria. A state in the North can’t fill doctor vacancies. The Cuban doctors that used to serve this purpose are either staying at home or going elsewhere. Just a few days ago a recruitment agency for hospitals in Saudi Arabia conducted a job interview in Lagos, and according to a colleague not less than 160 consultants in various specialties of medicine came, not counting medical officers. A junior colleague who just concluded his internship is not even thinking of National Youth Service Corps (NYSC) but the Professional and Linguistic Assessments Board (PLAB) test which he wants to write so that he can practise in the UK. He said almost everyone that graduated with him is either writing PLAB or thinking of writing it. And the UK awaits them with open arms as there are many vacancies as European Union doctors are leaving the UK because of BREXIT.
While this brain drain has continued the Nigerian government at both the federal and state levels have kept an awkward silence or seem not know what to do about the situation.
Nigeria has roughly 72,000 medical doctors registered with the Medical and Dental Council of Nigeria, but only about 35,000 are practising in Nigeria.
One way round the shortage of doctors is to increase the number of medical graduates. But that could also mean increasing the number of doctors that will be going abroad; our loss is their gain. The other way is to make available in Nigeria those things that make Nigerian doctors leave Nigeria. But that might take some time if at all there is the political will to even tinker it. And even if Nigeria’s healthcare system is an Eldorado for doctors, it won’t stop a few doctors who may have acquired “nomadic Fulani” instincts from leaving.
A more pragmatic thing to do is to keep longer in service those doctors who are willing to weather the storm as it were in their fatherland. India did this two years ago as a way round this problem.
There is nothing new about people retiring at above 60 years. Roman Catholic Priests and Bishops retire at 75, and the first doctors were priests. Supreme Court Justices and lower court Judges retire at 70.
Indeed, this is the time for government to review the 60 years retirement age of doctors. If Professors in Nigerian universities retire at 70, these include medical doctors who teach in the universities, this should also be extended to doctors in Government Hospitals. Not only this, some Government Hospitals run postgraduate training just like the Teaching Hospitals and these specialists who teach there and do research are doing the same thing as the Professors in the Teaching Hospitals but retire at 60. What is sauce for the goose is sauce for the gander.
The age of 60 was used as retirement age because it was thought of as the age when one begins to decline penultimate to death, with pension meaning “pending when death will come.”
But as can be seen people no longer retire to die. It’s even when they start a new life. They find new vocations and new hobbies and keep close family and friendship ties, secrets to what I call “aging younger.” Your Peter Pan is no other person than a former Nigerian President who just got his Doctor of Philosophy (PhD) at 80 and dances like a 50-year old. Indeed as they say age is just a number. All that matters then is how you feel about yourself.
All over the world good nutrition, better sanitation and improved healthcare service have continued to increase life expectancy, and old people of today are fitter than those of past generations. Added to this is information technology and the social media which keep people better informed and through sharing information on how to have a better control of their health.
Today, people who are 60 look 50, those who are 70 look 60, and those who are 80 look 70. That’s why in Japan two groups of ageing experts think labelling those at age 60 retirees is a waste of resources. According to them those aged 65-74 are “pre-old”, and that “Old” would be better defined as 75-89. They even proposed a special label of “super-old” for those 90 and above.
If we follow the doctor patient ratio one Nigerian doctor has 6,000 patients to himself, and he retires at 60, while the Nigerian President has 180 million Nigerians to himself and seems not ready to retire at his official age of 75!
But, older doctors need to stay longer in service so that their skill and experience can be fully harnessed by the younger doctors. It’s often said that a young doctor has one drug each for 10 ailments but an old doctor has one drug that can treat all 10 ailments.
A fellow told me how he had continually complained of a right foot pain. And any time he saw his doctor, a young chap, he would prescribe an analgesic for him. The medication would work. But after he has exhausted the drug the pain will recur. This continued for a while, until one day he sought a second opinion, this time with an old doctor. The doctor was not in a hurry, according to him, unlike the young doctor. He took a good history and examined his foot. The doctor did not prescribe any drug but only told him to avoid a certain type of shoes. Since then he never experienced the pain.
This is not to say young doctors don’t have their own advantage over the old ones. Young doctors tend to be “cool,” “smarter” and “more current.” Still some are ever so grateful learning from more experienced doctors. The young shall grow.
Many of the old doctors have their surgical skills and cognitive skills intact as can be attested to by those Government Hospitals where they are working on contract. Many of them are into active research, they remain relevant in the Postgraduate Medical Colleges, and are examiners. They can do well to still be working and then retire at 70.
This is a task for the Nigerian Medical Association (NMA), the National Association of Resident Doctors (NARD), and all other medical associations.
Sceptics might still argue that a doctor might not perform well at 70, but again, this is far from true. Like wine, cheese, and fruit your “good old” doctor matures with age.
Dr Odoemena is a medical practitioner in Lagos [email protected]
