Crossfire! Response To The Press Release By The NMA Lagos State Chapter On The Implementation Of The Consultant Pharmacist Cadre- By David Owoidoho

In response to the press release issued by the Nigerian Medical Association (NMA) Lagos State Chapter, dated 18th April 2025, titled “Information on the Implementation of Consultant Pharmacist Cadre”, I would like to address a few critical points as follows:

1. “Let it be stated in no uncertain terms: This policy, if allowed to stand, poses grave threats to professional harmony, patient safety, and the sanctity of the healthcare delivery framework.”

This assertion misrepresents the objective and impact of the Consultant Pharmacist Cadre. Rather than posing a threat, Consultant Pharmacists enhance patient safety, improve therapeutic outcomes, and strengthen interdisciplinary, patient-centered care. Internationally, countries such as the United Kingdom, Australia, and the United States have long recognized the value of Consultant Pharmacists. For instance, in Australia, Consultant Pharmacists conduct medication reviews that significantly reduce hospital readmissions and adverse drug events. Similarly, in the United States, their involvement in collaborative drug therapy management has been associated with improved clinical outcomes and cost savings.

The real threat to professional harmony lies not in the policy itself, but in the resistance to acknowledging evolving professional roles in line with global best practices.

2. “It undermines the hierarchical structure of clinical decision-making and introduces a dangerously ambiguous overlap in roles within the health team.”

Healthcare delivery today does not operate on a rigid hierarchy but rather on a model of interprofessional collaboration. Each profession contributes uniquely and complementarily to patient care within clearly defined scopes of practice. Overlapping scopes are a natural and expected feature of modern healthcare systems. It is neither abnormal nor threatening when a professional performs functions that are also within the legal and ethical remit of another profession. In fact, the World Health Organization emphasizes that collaborative practice among health professionals leads to better health outcomes and more efficient health systems.

3. “This not only confuses patients but also disrupts the well-defined workflow essential to effective clinical outcomes.”

Patients are not confused by the presence of multiple professionals in their care. On the contrary, when each healthcare provider introduces themselves appropriately and communicates their role clearly—as is standard practice—patients benefit from the collective expertise of a coordinated team. Consultant Pharmacists do not claim to be physicians; they bring specialized pharmacotherapeutic knowledge to ensure safe, effective, and individualized medication use, particularly in complex cases.

4. “As the custodians of professional order within the healthcare sector, we cannot and will not sit idly by while the integrity of medical practice is threatened.”

We are all custodians of professional order within the healthcare sector. Upholding professional integrity means respecting one another’s roles, practicing within our respective scopes, and working collaboratively in the best interest of the patient. The healthcare system is not designed for siloed practice. It requires consultation, collaboration, and referral across disciplines. No single profession holds a monopoly on healthcare delivery.

The implementation of the Consultant Pharmacist Cadre is not a usurpation of medical roles—it is a forward-looking initiative aligned with global standards and aimed at strengthening Nigeria’s healthcare system. Let us embrace progressive, evidence-based reforms that promote collaboration and elevate the quality of care for all Nigerians.

As a registered nurse, I would like to clarify that while I am not speaking on behalf of the pharmacist community, my intention is to address this issue in the best interest of the members of this group and the overall healthcare system.

Nr David Owoidoho,an activist wrote this piece

NIGERIAN MEDICAL ASSOCIATION (NMA), LAGOS STATE

Information on the lmplementation of Consultant Pharmacist Cadre

Date: 18th April 2025.

Fellow Colleagues,

The State Officer Committee of the Nigerian Medical Association (NMA) Lagos State is aware of the covert implementation of the Consultant Pharmacist Cadre by the Medical Directors of Federal Medical Centre (FMC), Ebute Metta, Dr. Adedamola Dada, and the Federal Neuro-Psychiatric Hospital (FNPH), Yaba, Dr. Olugbenga Owoeye.

This action was carried out in direct contravention of the clear and unequivocal position of the NMA-a position communicated to all Medical Directors/Chief Medical Directors, Ministries, Departments, and Agencies—that the implementation of such a cadre, devoid of a patient-centred care model and proper legal framework, is not only ill-conceived but detrimental to the health system.

Let it be stated in no uncertain terms: This policy, if allowed to stand, poses grave threats to professional harmony, patient safety, and the sanctity of the healthcare delivery framework. It undermines the hierarchical structure of clinical decision-making and introduces a dangerously ambiguous overlap in roles within the health team. This not only confuses patients but also disrupts the well-defined workflow essential to effective clinical outcomes.

The Nigerian Medical Association, Lagos State, vehemently rejects the implementation of this crisis-prone policy. We consider it an affront to the dignity of the medical profession and a potential catalyst for avoidable industrial disharmony.

We hereby issue a stern warning to the 2 MDs that had implemented it and those MDs/CMDs that may want to follow their path as the association will leave no stone unturned in addressing the matter and ensure the sustainability of the integrity and dignity of the medical profession are maintained. The same goes to relevant government authorities who may be nurturing such.

The State Executive Council (SEC) of NMA Lagos State as a matter of urgency will deliberate on appropriate measures to address this breach and safeguard the health sector from imminent disruption. Our resolutions will be communicated soon.

In the meantime, we urge all our members across the state to remain alert, united, and prepared for decisive collective action.

As the custodians of professional order within the healthcare sector, we cannot and will not sit idly by while the integrity of medical practice is threatened.

Together, we will defend the medical profession and uphold the sanctity of patient care.

Thank you.

Dr. Saheed Babajide Kehinde

Chairman,

NMA Lagos State

18/04/2025