Rudiments of a medical check-up

A reasonably high sum of money is being taken out of our country for the all-important need of medical check-up for our privileged political and business leaders. This endeavour is not only important but very crucial since health is wealth and life activities are only possible when there is sound health.

While I do not have a problem with the serious attention our leaders give to their health issues, I have a serious doubt about the overall benefit of this medical tourism, compared to the magnitude of investments that goes into it.  This approach appears wastefully unnecessary, as it also suggests in a subtle way that medical check-up is only possible abroad and it is the exclusive preserve of the rich.

The fundamental focus of a medical check-up is the client who should take ownership of this programme. Everyone who is 40 and above should take this seriously because clinically noticeable degenerative changes begin to set in as from this milestone, although it could be earlier, depending on an individual’s clinical history.

The average person has not learnt to connect with the functioning of his body until it malfunctions and an emergency intervention is required. An experienced car owner easily detects an extra noise in the car and can locate the source either from the engine or the chassis. The body systems have elastic limits with inbuilt sensors that alert us when the limits are exceeded. In clinical parlance, we call this ‘alert’ ‘symptoms.’

It may be a pain, a disturbance in sleep pattern or a general vague sense of unwellness, among  others.

The attending doctor should, preferably, be a generalist who is not a political associate or a childhood friend to ensure frank professional assessment. Generalists are better as first-line physicians because of their broad-based clinical paradigm. Specialists may, unconsciously, interpret the complaints in the direction of their discipline, which can frustrate early detection and delay appropriate treatment.

The attending doctor must be skilful enough to harvest symptoms and elicit relevant signs that can lead to a possible diagnostic formulation, even before baseline investigations are requested.

The current medical paradigm is that of prevention rather than curative. Clinical advice can be therapeutic at this point, which may involve, among others, modification of dietary habits, work schedules and achievement of work-life balance. This exercise must be done frequently and early enough so that the attending doctor can have a consistent and comprehensive clinical profiling of the client.

When we travel for medical check-up, we land in the hand of an alien specialist who does not have comprehensive clinical information about us apart from his knowledge and sophisticated medical equipment. We actually become guinea pigs in the hands of these foreign doctors because of the unavailability of a longitudinal, systematic clinical history and baseline investigations.

When there is a genuine need for investigation or intervention, a trip abroad may be very important. Even in such situations, the attending doctor at home is indispensable because the clinical information available over time may be useful in the interpretation of the results of investigation and sustenance of the recovery achieved.

However, there are some possible reasons for a subtle disdain for the Nigerian doctors, especially by those who have an alternative means to seek medical advice elsewhere. Our medical practice is bedeviled by some quackery practice and avoidable heartless professional incompetence. Some hold on to patients that should be referred to other relevant doctors because of pecuniary gains and parade skills they don’t have.

Our professional fallacies cannot be exhaustively explained away on the unavailability of sophisticated equipment but sheer negligence and irresponsibility. Fake drugs and reagents can also impair reasonable intervention and investigation.

However, against the background of these minor setbacks, Nigerian doctors are still comparable to their counterparts elsewhere in the world in terms of competence. This is the reason for the clarion call to our political leaders to adequately equip our hospitals so that they can live long and give the ordinary citizens the same opportunity.

There are even emergency situations that require immediate intervention. There is definitely no need for wasting so much money for medical tourism because competent experts abound in this country and the major handicap is the non-availability of relevant equipment.

I think it will be reasonable for our leaders to plough back their investment from these futile consultations abroad. The National Health Insurance Scheme can actually plan a yearly standard medical check-up programme for those in their scheme and made mandatory for annual assessment.

Companies and other institutions can also organise medical check-ups at regular intervals, coordinated by the appropriate departments which  can invariably reduce the ultimate cost of care for our wellbeing.