Layi Adeoti, M.D., left, acting dean of the Lautech College of Medicine in Osogbo, Nigeria, discusses the differences in health care delivery between his country and the United States with VUSM Dean Steven Gabbe, M.D.
photo by Dana Johnson
Nigerian doctor offers perspective on medicine’s rapid technology advances
During his first visit to the United States and Vanderbilt University Medical Center, Layi Adeoti, M.D., said he enjoyed his introduction to Southern hospitality, American football, and most of all, “high-tech” medicine.
Adeoti, who is the acting dean at Lautech College of Medicine in Osogbo, Nigeria, returned home late last month after a seven-week visit. During his time at Vanderbilt, Adeoti observed various clinical procedures and practices at Vanderbilt and was amazed at the difference technology can make in medical care.
“Surgery has gone so high tech here in the U.S.,” he said. “There are a lot of machines for diagnosis, monitoring and assisting in surgery. They allow for minimally invasive procedures, which are unavailable in Nigeria. In Nigeria, we do everything manually. We depend on clinical acumen and we do what we can with what we have. There's certainly room for great improvement.”
Adeoti explained that while Nigeria is not a poor country, it does not have the infrastructure in place to support high technology.
“You cannot depend on machines that run on electricity, because by noon, it will have gone out several times,” Adeoti said. Other items American hospitals take for granted, such as continuous access to running water and a central supply of oxygen, also are unreliable in Nigeria.
Adeoti said he was surprised at the difference these amenities, and the technology that depends on them, can make in surgical practice.
“When I visited the Critical Care Unit, I saw cases survive there that are very fantastic,” Adeoti said. “Because we do not have the state-of-the-art procedures, most of these patients would have died in Nigeria.”
Along with technology, Adeoti noticed some other, more subtle differences, such as the amount of unused medical supplies that are discarded.
“Everything here is disposable. I'm afraid that soon there will be disposable surgeons,” Adeoti joked. “It was difficult to watch things being thrown away, but I'm told it is more expensive to actually sanitize them to be used again.”
Adeoti also noted a distinction in the work culture. “People here are more committed to their work. They work harder,” he said. “When I get back to Nigeria, I will advise my residents to work harder, because people work very hard in the U.S. There is no rose without its thorns, so if they are hoping to study in the U.S., they need to know how to work very hard.”
Although the way medicine is practiced is very different in the two countries, Adeoti found that medical schools operate in a similar manner. He sat down with Steven G. Gabbe, M.D., dean of the School of Medicine at the end of his visit. Adeoti said they found that many of their medical school practices were the same.
Adeoti did make one suggestion for Vanderbilt medical students.
“I think they should visit Nigerian hospitals. I think they would appreciate what they have more,” he said. “Many times we take things for granted — such as running water and stable electricity. If they had to practice medicine without it, it would be a good experience.”
Adeoti's visit was arranged by John Tarpley, M.D., professor of Surgery, who has spent many years teaching medicine in Nigeria. Adeoti was Tarpley's student at one time.
Adeoti departed with a laptop computer for his son, a pulse oximeter, an operative headlight, some books, and a vision of American medicine.
He said there was still one thing he wished he could stuff in his pocket to bring back — a surgical unit, filled with all the latest equipment.
Unfortunately, it wouldn't fit.