Nairobi is full of cheap doctors, are treatment guidelines really necessary?

Most nairobians think buying a prescription from a doctor or seeing a private doctor is too expensive, actually, it is expensive especially when it is not a complicated case. This could be the reason why most people will see a doctor only when they think their case is complicated. Question is, how will you tell your case is complicated? Let’s say conditions well known as “silent killers” …diabetes and hypertension needs a regular check up both at patient level or physician. Will you wait until your pharmacist gets tired of refilling your old prescription and forces you to see your doctor?

There are those who’ll go for a lab test then show the results to a pharmacist to interpret, which is good, saves time and is evidence-based treatment other than relying on signs and symptoms alone. But are you sure most pharmacists are able to interpret that? Approximately more than 60% of Kenyans buy over the counter medicines (OTC) prescribed by a pharmacist to save time and money. Most of these pharmacists are quick to prescribe and dispense other than taking the history of the patient first. They may prescribe ignorantly poisons that may interact with what the patient is already taking.

Patient history is important, and this would be perfect if most of us were seeing the same doctor as from five or ten years ago. But doctors are becoming more and more expensive for most middle-class Kenyans. Some private doctors are forced to raise their consultation fee to reduce the number of patients seeing them in a day, but the patients still find money and the waiting queue still remains long so they’re forced to keep raising the consultation fee. This partially explains why patients keep switching between doctors for cheaper charges.

It may sound hilarious that a patient may walk to a pharmacy with two prescriptions from two different doctors, same condition but the drugs prescribed are totally different. This places a pharmacist in a very tricky position to decide which prescription is better.  This tells us something about our treatment guidelines, either we choose to ignore the guidelines available or we don’t have guidelines altogether. I wish doctors would prescribe the same medication for instance pneumonia if we were two of us and went to see different doctors.

The ministry of health has played a very important role in laying down treatment guidelines for most diseases. These guidelines keep changing because of lifestyle changes and the emergence of new superior drugs. Problem is, old doctors still stick to what they’ve been used to while emerging physician fresh from campus adopt new guidelines. There is a lot that has to be done to control this confusing trend.

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