Saturday, July 26, 2008

The game of numbers

Even the professional associations are a game of numbers

There is a new benchmark that the performance contracting is based on, and that is the numbers, or figures for those in the financial sector for which a target is set. A target is an objective towards which effort is directed, and it could be a certain number, which is a proportion of the total possible. Alternatively, it could be a figure we so desire to reach. 

Why are numbers (or figures) this critical even in the seemingly welfare groups that professional societies are?


Medical associations and societies have existed for as long as structured healthcare systems were developed. With time, private home visits by individual doctors reduced to give way to health institutions. This allowed lower costs of medical care per person and wider coverage of healthcare provision. The expanding system meant that there was need for more health workers as there was need for more specialized treatments for wide range of diseases that came with the higher number of patient visits. 

The governments got involved when the issues of healthcare became more important tool for those seeking political offices as politics is a game of numbers. At the same time, the increased attention on the welfare of the patient meant that the welfare of the pharmacists, doctors, nurses and other health workers took a back seat. The individual practitioners with little time and resources could do very little to change the situation. Like for everything in the modern beaureucracies, the only option was the trusted game of numbers. The most successful associations and societies were and still are those with the numbers.

A casual look at the medical associations and society’s websites will show how these professional associations take seriously the issues of the day. One association had a very catchy plea for more membership by reminding individual practitioners what they can do if they have the requisite numbers. It goes as follows: “If one doctor can find answers, heal wounds, bring hope... Just imagine… what we can do together. Together we are stronger.” 

Given, professional associations and societies are largely welfare groups and voluntary at start. This is the first selling point to its members before it can undertake roles that are more complex. The members are that their plight as individuals are addressed before they can agree to pay the subscription that will enable smooth running of the society. Some of the selling points are negotiation for improved remuneration for members, formation of cooperative societies, profession indemnity schemes and sometimes negotiated financial services for the members. 

However, it is always the desire and intention of each professional society to have as much say in the sector they are involved in as much as the law can allow, even if it going beyond boundaries and trampling on ‘competing’ professions. In such situations, the law must be restrictive and clearly separate matters of importance to the larger society from those of selfish and self-preserving traits among individuals under the guise of professional cause. This is the path that has been taken by the medical association in Kenya, as pathetic as it is primitive.
While I am not at liberty to go to details as the matter is in court, I can only laugh at the poor sense of priority for those schemers. Those ones who chose to fight pharmacists at the ministry of health boardrooms, and a poor attempt at that in the courts. I welcome anyone fighting us, but just make sure that you are ‘well oiled’, because it is going to be a long fight. 

In such dangerous situations, when professional associations are tempted to use their numbers for negative dominance over other related professional bodies rather than for the welfare of their individual members, then the law must be applied firmly. In addition, such associations must never be allowed have statutory powers, a status that must always come with responsibility. 

Any time spent by a professional body fighting other professional or professional bodies is opportunity lost, to improve the welfare of its members, the reason it exists. There are many reasons professional associations are founded, but advocating for lower remuneration, withdrawal of any privileges or propagating any kind of negative energy towards allied professions are not among them.

My final word of advice is this. The most immediate threat to a Kenyan doctor in terms of daily income, is the traditional practitioner ranting the very audible but incomprehensible words just outside his office on top of a rundown vehicle, and with the help of the best loudspeaker that his daily sales can buy. 
Who will not go to the person who promises to cure all the maladies that have existed before, the present and the ones to come? I will if I did not know better. 
But many are pre-occupied with the pharmacists to recognize this. Why didn’t they just choose to be pharmacists in the first place and solve this problem once and for all?