Health-seeking behavior of medical directors in Nigeria

Abstract

Introduction: Medical doctors get poor quality healthcare because they do not accept the patient's role to enable them receive appropriate quality care from their colleagues. They indulge in self-medication with its attendant untoward effects to their health. Medical directors occupy the highest echelon in the policy making hierarchy in any healthcare facility. This study aims at determining health seeking behavior of medical directors. This group can easily influence the behavior of doctors working under them. Methodology: This is a cross sectional study of sixty medical directors that attended the National Executive Council meeting of Association of General and Private Medical Practitioners of Nigeria (AGPMPN) in Lagos, February 2018. Sample size was determined from previous prevalence study and sixty was adequate. Self-administered structured questionnaire was used to elicit answers from participants and analysis was done with the Statistical Package for Social Sciences (SPSS) version 20. Results: Most of the medical directors, 38 (63.5%), are specialist family physicians and 46, (76.7%) are general practitioners. Almost half of them 28 (46.7%), do not have personal physicians that they consult for regular healthcare while half of those that consult their colleagues do so informally. Reasons for not consulting their colleagues range from “illness not perceived as serious, 14 (46.7%)”, through “lack of time to consult another doctor, 10 (33.1%)” to “not believing that another doctor can give the sick doctor better treatment than he can give himself, 2 (7.7%)”. All the medical directors, 60 (100%) self-prescribe drugs while 46, (76.7%) self-prescribe and self-interpret investigations. Most of them, 54 (90%) know that self-medication is unethical while 58 (96.7%), know that it can delay making appropriate diagnosis and worsen morbidity. All the participants, 60 (100%), are aware of the modification in the physicians' oath that requires that the doctor has to be healthy to give good care to his patients. Conclusion: Medical directors in Nigeria practice self-medication. Almost half of them do not have personal primary physician. Half of the medical directors that consult their colleagues do so informally. This practice goes on despite their knowledge that it is unethical for a doctor to treat himself and that self-medication is injurious to health. Recommendation: Medical directors should include discussion of health-seeking behavior as part of their agenda during meetings. This will be able to make them internalize the culture of good health-seeking behavior and cascade it down to their junior colleagues in their establishments.