Not everyone in a white coat is a doctor!

When Mugo wa Wairimu was arrested on allegations of rape, the media was awash with stories of the ‘Fake Doctor’ and the horrible things he was accused of having done to unsuspecting women who sought gynaecological services from him.

It was a tough time for doctors across the country. They were angry that one more time, a white coat had been used to tarnish their title by the alleged perpetrator, the media and by the public at large.

Not every person who wears a white coat is a doctor! Every doctor in practice has had to use this phrase over and over. During the Mugo wa Wairimu saga, doctors repeatedly corrected the press to no avail. Mugo was not a doctor, period. The use of the terminology ‘fake doctor’ served to reinforce the stereotype that criminals purporting to be doctors were actual doctors gone rogue.

Cap 253 of the Medical Practitioners and Dentists’ Board Act categorically declares it an offence liable for prosecution, to use the title ‘doctor’ unless you have a degree in MBChB, BDS or their equivalent; or you are awarded the title by virtue of being a PhD holder.

But in Kenya, the title has been reduced to any person of the male gender wearing a white coat within a medical institution. The public does not seem to be aware that the white coat is a protective gear, worn by those who come into contact with patients or laboratory samples for purposes of infection prevention.

DOCTOR IN THE ROOM

This means that, within a hospital setting, doctors, pharmacists, clinical officers, male nurses, physiotherapists, occupational therapists, nutritionists, morticians, records officers and radiation technicians will all wear the white coats or hospital scrubs.

In private practice, doctors, clinical officers and nurses are eligible to open a consulting clinic or a healthcare facility of various levels, based on the expertise they possess and the services they are eligible to render. The facility owner may also not be a doctor/clinical officer/nurse but may engage their services on a contractual basis, to provide a given specialised service to their patients within the facility.

The biggest challenge is that patients are not aware of the differentiation of cadres and their scope of service, to the extent that they fail to even recognise the quacks when they come into contact with them.

Sometimes people are inclined to choose healthcare providers who are unqualified on the basis of cost. They do not realise that quality healthcare is very expensive and if one wants safe, quality care, then one must dig deep into their pockets. Otherwise, one may easily fall prey to criminals using ill health for monetary gain.

The lack of awareness is further instigated by traditionally held cultural beliefs that doctors are generally male. Every female doctor has had to grow accustomed to being called ‘Nurse’ even when she is the only doctor in the room! Hence it becomes easy to fall prey to unscrupulous male characters who will put on a white coat and confidently masquerade as doctors. Also, due to the long duration that doctors spend in training, most people expect them to look far more elderly than most are.

What they may not be aware of is that, after the basic degree training of six years, every other training that a doctor undergoes, is in-service training, hence they are eligible to provide care. This is from the mandatory one year internship training, through postgraduate specialist training and the super-specialisation fellowships.

Kenya has only seven thousands practising doctors currently, of which, a thousand are in internship and a further 800 in specialised training. Another 2,500 work in public hospitals and another 1,000 work in special programmes, research and health management.

There aren’t too many doctors sitting around in small clinics across the country in facilities where they are not able to use their skills for lack of equipment. So the next time someone claims to be a surgeon, it is common sense that they demonstrate which hospital they will be using to perform major surgery on you.

SPECIFIC SKILLSET

How do we mitigate this? For the last few months, the health regulatory authorities (the Kenya Medical Practitioners and Dentists’ Board, the Nursing Council of Kenya and the Clinical Officers Council) have come together, with the support of Intra Health, Funzo Kenya programme of USAID, to develop a professional identity card that identifies the professional, their cadre and their registration number.

The use of technology will curb fake cards and the quacks can be easily exposed.

However, for this technology to be successful, patients must step up and make it work. Call out quacks by asking to see their identity cards as soon as they are rolled out and where forgery is suspected, alert the authorities and refuse to accept the quack’s  services.

It also helps for the public to know the jurisdiction of each service provider according to their skill level and registration. For instance, a doctor may be a good orthopaedic surgeon, but however skilled she is in treating conditions of the bones, she is not qualified to open up your heart. That remains the jurisdiction of the cardiothoracic surgeon.

The law must also be enforced. It is alleged that Mugo wa Wairimu was arrested several times before the rape scandal but was always let free without due process being followed; until criminal charges were levied upon him. This is unacceptable. Any person purporting to be a doctor must be dealt with to the fullest extent of the law, otherwise, they will get on with their fraud and in the process, cost this country lives.

Together, let us make things right. Know your doctor!