Reports that doctors are opposed to the National Hospital Insurance Fund’s (NHIF) recent change of mind to pay for surgical procedures and imaging tests ordered by clinical officers are worrying.
The Kenya Medical Practitioners, Pharmacists and Dentists' Union (KMPDU) argues that allowing clinical officers to prescribe imaging tests could expose patients to unnecessary radiation and that the clinicians should be made to refer patients to doctors for such treatments. Yet the reality in Kenya is that doctors are few and are mostly concentrated in urban areas. The majority of the population, who live in rural areas, rely on the services of clinical officers and nurses for health services and it was completely unacceptable that NHIF, whose mandate is to drive universal health coverage would refuse to pay for their services.
While the doctors have every right to defend their own interests, it is important not to lose sight of the bigger picture, which is to expand the reach and access to medical services among the population.
Doctors have their place in the medical services chain, but they certainly cannot allow their pecuniary interests to override the public good. Though not specialists, most clinical officers are well-trained in general medical duties such as diagnosis, treatment of general diseases and injuries and must be allowed to apply those skills to serve the public.