Look at them! Our grandmothers are dying on their poor dilapidated beds, but look, look at these privileged bastards! They are on strike, because they want more money. Abey!

In a front page story published in the 21st October, 2011 edition of the Daily Graphic, Ghana, the current salaries of Ghanaian Senior Medical Officers under the Single Spine Salary Structure (SSSS) is anywhere between GH¢ 3,469.53 ($1795.22) and GH¢ 3,970.44 (2054.41) a month. That is about $22,000 annually.

These figures represent between 84% – 105% increments over a period of 5 years. The rise in paychecks came at the back of repeated strikes by Ghanaian doctors at the expense of the “sick and dying taxpayer,” lamented a senior government official at the time.

But why?

Many medical practitioners in Ghana would liken their paychecks to co-professionals in countries like the United States where doctors seem to be paid a whole lot more, and truly their take home imbursements are much smaller.

Across the Atlantic, The Annual Compensation Survey administered by the Association of American Medical Colleges representing all the 134 accredited U.S. medical schools and 400 teaching hospitals and health systems, which cover 125,000 faculty members, 75,000 medical students and 106,000 resident physicians reveals that general practitioners in the United States earn up to $220,196 annually, and general surgeons get more than $383,333 per year.

Do Ghanaian doctors make enough money?

The answer lies in the pudding that is the United States. Lessons from the United States’ Health System which Ghanaian medical doctors like to covert is in fact a dishonest comparison of an inhumane health system to one that Nkrumah built to serve the country.

It takes on average $50,000 (tuition and board) a year to train a single physician in the United States. There are few financial aid programs for medical students and more than 94% of medical students in the United States foot the whole bill in loans with interest rates that range between 4 and 8 percent.

On the other hand, information by the New Statesman at the University of Ghana Medical School indicate that the cost of training a single doctor for a year in Ghana does not exceed GH¢5,000 ($2587), and that students would usually dish out the tuition and board fees of about GH¢1,000 ($517) a year.

Furthermore, as part of an age long program Ghana has with Cuba for training some of its physicians, the Ghana Ministry of Health disclosed that the cost of training a single Senior High School graduate in Cuba amounted to GH¢50,660.12 ($26,212.84) a year, translating into GH¢303,960 ($157,300.00) per head for a six-year period.

In general the taxpayer in Ghana pays over $15,000.00 to educate a medical doctor at home and about $160,000 in Cuba. While in the United States, the taxpayer pays zero dollars. The students are fully responsible for their $200,000 medical school loans, which they must repay with exorbitant interest.

In addition, students in the United States can only apply to medical school after an undergraduate education, which would usually cost another $200,000 in loans at a private university (the pre-med programs of choice amongst US high schoolers).

This brings the post medical school total debt of a United States physician to about $400,000, which they are required to repay with an average of 6% interest! This will require a medical doctor to pay $2,398 a month for a 30 year repayment plan (360 payments). In sum, a medical doctor owes the United States taxpayer and government $863,500 due in monthly payments.

Any further training needed to become a medical specialist is also an additional expense in loans that a medical doctor has to consider. A specialist trained in the United States is easily in a total debt of about one million dollars ($1,000,000) before the have performed their very first surgery!

The post medical school debt of a Ghanaian physician assuming they trained in Cuba is zero! That for a home trained physician is at most $3,000 for the entire six years. Then again that’s assuming they borrowed all the money to pay their part of their heavily subsidized education!

What do these numbers mean and why does a Ghanaian trained physician feel short changed in an economy that pays him $20,000 a year?

The Purchasing Power Parity (PPP) of Ghana’s 2,479.5 PPP Dollars based on GDP versus the United States’ 41,889.57 PPP Dollars means that a Ghanaian medical doctor’s $20,000 a year salary translates into a whooping average of $337,000 annually in the United States.

PPP GDP is gross domestic product converted to international dollars using purchasing power parity rates. An international dollar has the same purchasing power over GDP as the U.S. dollar has in the United States. GDP at purchaser’s prices is the sum of gross value added by all resident producers in the economy plus any product taxes and minus any subsidies not included in the value of the products. It is calculated without making deductions for depreciation of fabricated assets or for depletion and degradation of natural resources.

Compared to the United Sates Association of American Medical Colleges numbers on physician salaries, $220,196 per year, Ghanaian doctors are making quite simply a titan sum especially at the back of paying close to nothing for their education.

Essentially they are fat cows walking around with every trimming of the taxpayer at their behest. They are educated and paid by the taxpayer.

But, these Ghanaian doctors cannot seem to understand their responsibility to society – the social responsibility needed in this equation is missing. Some run away with the expensive education to the United States in the name of better working conditions at the sheer cost and detriment of the Ghanaian taxpayer!

Is that not unfair?

If there was any sense of morality left in these greedy medical doctors, they would apologize to the average Ghanaian for causing so much pain with their ungodly random strikes and disrespect for the hand that made them and continues to feed them.

Perhaps it is time for medical students to pay in full for their education. The taxpayer will be happy to loan them the money with 6% interest. Only then can they ask the government for higher and higher salaries.

Only then! But as it stands, they are greedy, inglorious and ungrateful.

12 COMMENTS

  1. This is a very well thought out, researched article. Just that I thought the last paragraph kind of reduces the overall quality greatly.

    • You have a point there.

      However, when it comes to the issue of life and death, when poor Ghanaian mothers, who are really the most important part of our society and mostly are the taxpayers, are left on hospital beds unattended to without care, and they die together with their newborns or unborn kids, I harbor very little respect for these twenty-eight year olds who feel blindly entitled to a ‘glamorous’ life, similar to America’s doctors!

      The writer may have been carried away there and perhaps I am equally gripped to monstrous proportions of why these doctors go on strike. But Ken, you could agree that it’s immoral for a doctor who has for all his/her life tagged at the apron strings of these women would refuse them care in the name of ‘better working conditions.’

      I will not respect wickedness in any shape or form. Nevertheless I see eye to eye with you that emotions, sometimes carried to excess do blur the overarching import of our arguments.

      Thanks for contributing!

  2. This article is so good that I’d be happy if I could disagree with it. But, wherever I sway my disagreement, I find myself in a stupefying dilemma. You make good arguments.

  3. There’s a whole other part of this discussion that hasn’t yet been touched. Our hospitals are grave yards in essence.

    What kind of education are we giving our medical students if they are only capable of killing us one at a time. i have to admit, 100 years ago, our traditional herbalists had better survival rates in their cults!

    For me this is simple. The education we give these doctors is probably not a quality one. We are wasting our money on them and we waste even more money paying under-trained professionals.

    The solution is simple. Let’s go back to the traditional system and let’s use our taxes rather to organize it and perfect it.

    • I completely agree with Nana. Traditional medicine works much better. But why have people lost trust in that system and rather moved to giving patients capsules and slicing them open with a knife?

      • I agree with you and disagree at the same time. I love herbal medicine, but that alone will fall short of our health needs especially when other people, like the drug giants of the world continue to bring new diseases to Africa.

  4. I completely disagree with this article because not all doctors working in Ghana are trained in Ghana or government sponsored students in Cuba,Russia,China and others. Some of us had to pay a whole lot of money for 6-7 years, qualify and come back to our motherland to work and what do we receive in return? Your assumptions are incorrect.Ghanaian fee paying students in medical school pay as much as $6000 so tell me why some of us shouldn’t feel short changed .

    • MIS J, I get your story. No matter how much some of our students spend elsewhere to become medical doctors it is still inconsequential since in our analyses at Patapaa, they make enough money in Ghanaian terms.

      One cannot expect a medical doctor in Ghana to be paid $200,000 as if they live in the US. A doctor in Ghana may take home a $20,000 a year paycheck, but in Purchasing Power Parity terms that average medical practitioner’s income translates into a hooping $300,000 year.

      The question is, is that not enough? If not, then why?

      I am sure many Ghanaians would be proud of your sacrifices, I do, but MIS J, medical doctors cannot expect to be paid like doctors in the USA when our GDP staggers at a stupefying fraction of theirs! Our African mothers and children also continue to make great sacrifices as well.

      Besides, let’s not forget where we come from. Let’s not forget why we are here. Our African herbalists who were intricate elements in our societies cured illnesses for free or took a chicken in for fees. Back then those herbalists were also trained for close to nothing by our communities. Our African societies have made great sacrifices as well!

      The same is true now, except for those few who got their education from abroad. Even then, though laudable, these sacrifices cannot morph into exorbitant demands. There’s a broader moral issue at stake here and I feel our medical doctors are heavy handed in the way they have demanded pay raises.

      Leaving our mothers and children to die on hospital beds especially in our rural communities is evil, MIS J. It is a sign of a collapsing society. It breeds animosity. It breeds hatred. It breeds greed and gluttony. And it is in a general moral context, very ungrateful. This destroys society! And for what? All that glitters, MIS J, is not gold.

      We have a duty to heal our society first. Otherwise there wouldn’t be any left to support us.

  5. First of all, education all over the world is expensive. While the capitalist society of US has it that most students who go into medicine in the US, barring their raw intelligence, is for heavy after-school remuneration, plus, the US being largely capitalist, thus engendering the heavy financial turnover. Again the there is every legitimate reason for doctors to bargain for more chips. The crux will lie only on how much are they bargaining for. To the extent that medical profession is putatively a largely altruistic one, more than anything else, ethically codified by te Hippocratic Oath, the compromise would have to be made viz a viz remuneration and selflessness and humanness, with with respect to rendering of care. That is why I have stipulated always that students entering medical school be vetted on categories that will be data analyzed to bring out the right mixture. Surely these students are bright and intelligent, but medicine is not just a scientific endeavor it is also an art and presently a bit of sociology and psychology! The payers know all the economics and PPPs.

  6. Interesting article and analysis. I am a physician trained in Ghana and I don’t think it is realistic that Ghanaian physicians should expect to earn the exact same amount as their counterparts in the US or other Western societies. That’s simply unrealistic for many reasons a major one being that doctors are paid according to the ability to pay of their patients or third party payers. From a productivity stand point American doctors are paid as much as they are, not because of how much it costs for them to be trained or how much they owe but how much they produce. Like it or not medicine is a business and the more revenue doctors are able to generate the more they can expect to be paid.

    Having said that most Ghanaian doctors are several time more overworked than their American counterparts. The doctor patient ration is much higher in America and so each doctor is required to see more patients in Ghana with fewer resources and support staff to help them. The quality of care a patient receives from a given doctor is dependent on many factors besides the doctors training. In fact the cost of the doctors training is the smallest part of the cost involved in quality health care. A forgotten part of that cost is the time and effort and strain the doctor endures in the process of providing the care they do. What is the value of that? People complain about the quality of care they get and get upset when doctors go on strike. But what does it cost to provide the kind of care that will match international standards? Will patients and their families be willing or able to afford these costs?

    Let’s talk about productivity. If the output of a doctors work is saved lives and better health for their patients, what should the input be? I would say among other things, a well functioning system, well trained support staff, modern equipment and good pay. What constitutes good pay has to be open to discussion between the parties involved because like it or not each doctor makes a personal commitment to the job they do and that commitment is a lifelong one. They have a right to say what that commitment is worth in monetary terms. Those who pay for health care, the patients and the government also need to look honestly at the product they are trying to obtain from the doctors and decide if they can afford what they call for. A unique feature of our economy in Ghana is our desire to negotiate the price for everything. This are should not be any different. There should be open discussion between doctors and those they serve without one group calling the other names. If the people want world class doctors and health care then it should be willing to pay something that matches that kind of quality.

  7. Wow, looks like you don’t know much about the doctors you are insulting in your article. Do you have any doctor friends? If you don’t, make some and learn about the things we go through as medical students. It is unfair and wrong to insult people in the first place.

    Medical school is expensive. Talk to the parent of any doctor or medical student you know and they will tell you how they paid through their teeth to see their child become a doctor. The taxpayers money pays for only a handful of all medical students education and training. For example, medical students of the University of Ghana School of Medicine and Dentistry (Korle Bu) can be divided into the following groups: undergraduate (6 years) and post-graduate (Graduate entry: 4 years). The undergraduates can be divided into the regular, fee paying and international students. I don’t know if it is the same for the other medical schools. The undergraduate students are SHS graduates and so they tend not to be employed. This means their parents or guardians pay their fees for them. The fees of the regular students are subsidized by the government (which is where the taxpayers money comes in) and the student pays the rest as his/her school fees. The 1000-cedi-a-year school fees almost likely applies only to the regular students since their education is partly funded by the taxpayers money. The rest of the groups near the full cost of their fees. The fees of a regular student cost about 1000 to 2000 cedis a year and that of a regular student cost about 5000 to 7000 cedis a year. The international and post graduate students pay in dollars. I don’t remember the cost of the international student’s fees, but that of the post-graduate student students averages 20,000 to 22,000 dollars per year. As a regular student, I paid over 13,000 cedis for the entire Programme. The school fees paid increases yearly. The number of regular students is rapidly decreasing by the year. My class started out with 100 regular, 50 fee paying and 50 international students. This was about 5 years ago, in 2012. A few years down the line, one of the later classes had only 43 regular students. This means less and less of the taxpayers money is going into training medical students at home, and either the students or their families have to risk going into debt as you wanted. You can rejoice over that. I don’t knlw anything about the Cuban doctors, so I cannot speak for them.

    Doctors are not the only ones who seek greener pastures abroad. When the engineers, IT specialists and lawyers graduate, where do they go? Don’t a lot of them leave the country? Do they ever get insulted? Quite a number of people go into engineering and computer science, but look at Ghana now. Where are they? People of other professions leave Ghana for greener pastures too. Insult them as well. Without them, Ghana is developing at a slow pace.

    The government doesn’t look after it doctors properly. Did you know that the previous government wanted junior doctors (house officers) to work for no pay? That’s working for two years of no pay. Would you do it if that were you? Doctors don’t receive any allowances like our MPs do. When have to pay for everything like the ordinary Ghanaian, and yet people always want free services from us. How do you expect us to survive in this our hard country? A lot of our health facilities are sub standard. They are understaffed, poorly equipped, and are sometimes inaccessible to patients. Some doctors (especially in the rural areas) are not paid for months on end. Some of these doctors are housed in deplorable conditions and are expected not to complain. Other things worth noting are the overwhelming number of patients and the healthcare systems (such as the NHIS) in crisis. These are just a few of the many challenges doctors in Ghana face on a daily basis. Is it any wonder why doctors would seek greener pastures abroad? Would you not do the same?

    Doctors in Ghana DO understand their social responsibilities. We understand that society needs us and that we must do our best. Society, however, doesn’t seem to care about the welfare of its doctors. All society is interested in is what they can get free from doctors. They expect doctors to work like machines with no need to take a break, eat or spend time with family and friends. They Don’t expect doctors to have a life. They expect doctors to be compassionate, but will not show compassion towards each other (and the doctor). How many times have you been extorted by a trader during Christmastime because he wants extra money for Christmas? What if a doctor did the same thing: increasing his comsultantiom fees because it’s Christmastime? How many times have repairmen destroyed something of yours while supposedly fixing it, and added the cost of fixing it to our bill which you have no choice but to pay? What if a surgeon did a similar thing: accidentally cut something during an operation and added the cost of fixing it and extra treatment to your overall bill? Would you be happy with that?

    You obviously need to do some thinking and get your facts right. Talk to doctors and medical students and get their sides of the story. You will be pleasantly surprised. Go on the medical school websites and check out the fees each group of students pay, the number of students whose fees are subsidized, and the changes in this number. This is an unimpressive article filled with insults and slander. I hope that since you think so poorly of doctors, you will not go to one when you are ill. You should probably go to the traditional leader, herbalist or religious leader for treatment since they apparently seem to be doing a better job than we are.

  8. Thank you Rachel Osei MD for your comment. It seems the writer speaks purely based on envy and hatred for doctors. He is very ill informed and his facts are totally skewed. I hope he does not get sick. And if he does he seeks help from his most beloved and trusted traditional herbalist… Lol…

LEAVE A REPLY

Please enter your comment!
Please enter your name here