18/10/2023
The Physiological Era: Exploring the role of Physiologists in advancing the Nigerian Healthcare Sector
- Ubaydullah Abdulmalik
The Healthcare Sector is a vast industry with the primary responsibility of maintaining and improving the health and overall well-being of the human population. From medical treatment and preventive care to research and public health programs, services of the healthcare sector are aimed at promoting healthier lives and addressing illnesses and diseases.
The role and function of healthcare professionals are primarily aimed at restoring normalcy in the functionality of the body after being distorted by a disease condition or abnormality. With their in-depth understanding of body function, physiologists play an essential role in all aspects of healthcare delivery and monitoring.
Physiology as a medical science is not limited to abstract and theoretical knowledge. The relevance of Physiology extends to all aspects of healthcare including disease prevention, diagnosis, and treatment. Understanding these scientific applications is key to disease prevention and restoration of health.
The theme of discourse is rather a three-dimensional subject matter that spans across the three zones of time; the past, the present, and the future.
Ever since the evolution of healthcare knowledge and practice in Nigeria and beyond, Physiologists have been known to play a vital role in promoting the healthcare industry and securing the health and well-being of the population.
In today's world as well, the role physiologists play is second to none. From medical and health education, research, and advocacy to diagnostic medicine and patient care, Physiologists have always been at the forefront.
However, the roles of physiologists become even more pronounced and essential with the current landscape and future trends of the healthcare system in Nigeria and around the world.
But before we explore these roles, let's shed some light on the concept of Physiology as a medical science. In simple terms, physiology can be defined as the study of biological functions of living organisms; from molecular mechanisms within cells to the functions of tissues, organs, and systems, and how the organism as a whole, accomplishes particular tasks which are essential for life.
Human Physiology is concerned with the in-depth exploration of the processes and activities essential for the maintenance of life, from the cellular level to the level of the organism and even entire species. Physiology is therefore studied, at the cellular, organ, systemic, and organismic levels.
The beauty of physiology lies in its profound ability to describe the processes and functional mechanisms that occur within our body, ranging from cellular activities to organ and organ system functions like respiration and metabolism, growth and reproduction, sensation and learning, etc. The knowledge of physiology comprises detailed information on normal body function and provides a fundamental framework for understanding the function of the body in disease conditions and suggesting therapeutic approaches to disease and illnesses.
Physiology, also known as the ‘Science of life,’ explores the intricacies of how the human body works and how we are able to thrive as living organisms. Physiology is thus a fascinating subject with diverse applications and fundamental essence in healthcare and other aspects of human endeavor. In a popular physiology text, tagged "Sembulingam," the authors state:
“Physiology is the most fascinating and ancient branch of science. It is fascinating because it unfolds the mystery of the complicated functional aspects of the individual organs in the body. It is ancient because it has existed ever since the origin of life. Even before knowing the language, culture, and society, man knew about hunger, thirst, pain, and fear, which are the basics of Physiology.
Physiology is defined as the study of functions of various systems and different organs of the body.” - Essentials of Medical Physiology, K and Prema Sembulingam.
Some of the branches of Physiology include:
Cellular and Molecular physiology
- The cell is the most basic unit of life. Cellular physiology studies body function at the cellular and subcellular levels, investigating how individual cells of the body carry out life processes and how they interact with other cells in the body.
Organ Physiology
- This is the study of the function of a single body organ and the processes that occur within. Physiologists might study the function of the heart, lungs, kidneys, or brain by utilizing various techniques and deducting valuable information.
Systemic Physiology
- Systemic Physiology is the study of the functions of organ systems within the body. It explores how different body organs work together to perform specific functions and how the various systems in the body contribute to the maintenance of homeostasis.
Physiology is mostly studied at the systemic level and examples include neurophysiology, cardiovascular physiology, respiratory physiology, endocrine physiology, etc.
Microbiome Physiology
- Microbiome physiology deals with the complex interplay between intestinal microorganisms and the body. This branch of physiology emphasizes the roles of gastrointestinal microbes in health and well-being exploring the relationship between the gut microbiota and body function.
Exercise Physiology
- Exercise physiology deals with the study of body function during exercise. It explores the effects of exercise on body organs and systems and the role of exercise in prevention and treatment of diseases and in improving overall health and quality of life.
Sleep Physiology
- Sleep physiology is the study of the functional processes that occur in the body during sleep. It explores the role of sleep in body function and overall health and the underlying mechanisms behind sleep disorders and abnormalities.
Environmental/Ecological Physiology
- Environmental physiology is the study of the complex interplay between the body and the environment. It explores the effects of environmental conditions on physiological parameters and body function and ways to mitigate the effects of adverse environmental conditions on body health.
The knowledge of environmental physiology is essential in addressing environmental crises like climate change, environmental pollution, adverse temperatures, etc.
Pathophysiology
- Pathophysiology is the study of body function in disease conditions. Disease occurs when the normal organic function of the body is disrupted and homeostasis is unable to be maintained.
Pathophysiologists investigate the underlying mechanisms behind diseases and illnesses providing insights into diagnostic methods and suggesting therapeutic approaches to disease conditions.
Clinical physiology
- Clinical Physiology is a branch of physiology that deals with the diagnosis, treatment, and prevention of diseases. Clinical physiologists may work in hospitals, laboratories, or other clinical settings and they constitute a vital component of an integrated healthcare system.
Clinical physiologists employ diagnostic procedures and techniques to investigate various disease conditions. They may also participate in surgical procedures, monitor and evaluate patient health, and provide insights into therapeutic approaches and best treatment methods for various diseases.
The Roles of Physiologists in Healthcare
Physiology is a diverse scientific field with wide application in all aspects of therapy and healthcare. From preventive medicine to disease diagnosis, treatment, and rehabilitation, the application of Physiological concepts remains manifest.
Clinical Physiology and Diagnostic Medicine
Whether in clinics, laboratories, research institutes, or hospitals, Physiologists play a vital role in the effective diagnosis and treatment of various ailments. Here are some of the roles of clinical Physiologists in medical diagnosis and healthcare improvement:
1. Audiologists: Audiologists are experts in diagnosing and managing hearing and balance disorders. They use various tests, including audiometry and tympanometry, to assess hearing levels and ear function. Audiologists provide treatment options such as hearing aids, cochlear implants, and therapy to improve communication and quality of life for individuals with hearing impairments.
2. Cardiac Physiologists: Cardiac physiologists work as diagnostic scientists in cardiology departments and laboratories. They perform diagnostic tests like electrocardiograms (ECGs) to record the electrical activity of the heart, echocardiograms to assess the integrity of heart structure and function, and stress tests to evaluate cardiovascular health. Cardiac Physiologists play a crucial role in diagnosing heart conditions and supporting patient care.
3. Perfusion Physiologists: Perfusionists are an integral part of cardiac surgery teams. They play a critical role in operating heart-lung machines that take over heart and lung function during open-heart surgeries. This ensures the patient's blood remains oxygenated and circulating allowing surgeons to work on the heart.
4. Critical Care Scientists: These professionals work in intensive care units (ICUs) and critical care settings. They monitor patients continuously collecting data on vital signs, oxygen levels, and other critical parameters. They assist in making real-time decisions about patient care and are instrumental in managing critically ill individuals.
5. Gastrointestinal Physiologists: Gastrointestinal physiologists study the functioning of the digestive system. They perform tests like esophageal manometry to assess esophageal function or pH monitoring to diagnose acid reflux. This information helps in diagnosing and managing conditions like gastroesophageal reflux disease (GERD) and irritable bowel syndrome.
6. Clinical Neurophysiologists: Clinical neurophysiologists are concerned with diseases of the nervous system. They conduct tests like electroencephalograms (EEGs) to assess brain electrical activity, nerve conduction studies to evaluate nerve function, and electromyography (EMG) to diagnose muscle and nerve disorders. They play a key role in diagnosing conditions such as epilepsy, neuropathy, and muscular dystrophy.
7. Ophthalmic and Vision Science: Professionals in this field diagnose and manage eye conditions. They perform vision tests, evaluate eye health, and assist in surgeries, such as cataract removal or laser vision correction. Their expertise is vital in preserving and improving visual health.
8. Respiratory Physiologists / Sleep Physiologists: Respiratory physiologists assess lung function and diagnose respiratory conditions like asthma and chronic obstructive pulmonary disease (COPD). They perform procedures such as spirometry, vitalography and measurement of peak expiratory flow rate (PEFR) to assess lung function parameters indicative of respiratory disorders.
Sleep physiologists specialize in sleep medicine and conduct polysomnography to diagnose sleep disorders such as sleep apnea. They help patients breathe easier and achieve better sleep quality.
9. Urodynamic Scientists: Urodynamic scientists specialize in evaluating the urinary system. They perform urodynamic tests to diagnose conditions like urinary incontinence, voiding dysfunction, and neurogenic bladder. This information guides treatment plans and interventions to improve bladder function.
10. Vascular Scientists: Vascular scientists focus on the circulatory system, particularly blood vessels. They use techniques like Doppler ultrasound to assess blood flow and detect conditions such as peripheral vascular disease, deep vein thrombosis, and arterial blockages. Their work aids in the diagnosis and management of vascular disorders.
Clinical Physiologists play a vital role in curative medicine which is centered on diagnosis and treatment of disease conditions, injuries, or health issues. Each of these clinical physiologists plays a critical role in diagnosing, monitoring, and managing specific health conditions within their respective fields of expertise, contributing to patient care and improved health outcomes.
Medical Education and Training
The role of Physiologists in training healthcare professionals including medical doctors, nurses, pharmacists, laboratory scientists, etc has been prominent over several decades. Essential knowledge of body function in health and disease as presented in numerous Physiology texts like Guyton and Ganong is paramount for prospective healthcare professionals.
In universities, health and research institutes spread all over the world, Physiologists have been at the forefront of teaching and training generations of medical doctors, researchers, and other healthcare professionals.
The several techniques and procedures employed in the diagnosis, management, and treatment of health conditions are based on the understanding of the functional processes that occur in the human body.
It is pertinent to state here that a strong knowledge of physiology is therefore a sine qua non for all healthcare professionals, and thus the role physiologists play in medical training and education.
Preventive and Rehabilitative Medicine
Preventive Medicine is the branch of medicine that deals with the protection of healthy individuals from illnesses and diseases.
The popular adage, "prevention is better than cure," underpins the importance of preventive medicine in securing the health and well-being of the population. This branch of medicine employs various strategies to prevent diseases and promote health and well-being, ranging from vaccinations, lifestyle modifications (e.g., healthy diet and exercise), regular health check-ups, and public health initiatives.
Physiologists play a vital and indispensable role in promoting healthcare education and protecting the population from disease and adverse health conditions. Nutrition and Exercise physiologists educate individuals on healthy lifestyle choices to avoid chronic conditions like diabetes, obesity, hypertension, and nutritional defects. Exercise Physiologists prescribe exercise regimens for healthy individuals to improve cardiorespiratory health, fitness, and general well-being.
Physiologists also partake in routine measurement and evaluation of vital signs of individuals identifying risk factors underlying several disease conditions like high blood sugar, high salt intake, dehydration, chronic stress, poor sleep habits, etc and making necessary recommendations.
Physiologists possess in-depth knowledge and understanding of the homeostatic mechanisms necessary for normal body function. Therefore, they are in the best place to monitor and evaluate the health and wellness of individuals and educate the population on healthy lifestyle choices and the best ways to avoid disease and illness.
Rehabilitative medicine, in contrast, is concerned with restoring and improving the functional abilities of individuals who have experienced injuries, illnesses, or disabilities. Exercise physiologists play a crucial role in rehabilitation.
Exercise physiologists are experts in studying the body's response to exercise and can design and implement exercise programs tailored to a patient's specific needs. They can work in collaboration with other rehabilitation specialists, such as physical therapists, to help patients regain strength, endurance, and overall physical fitness. Exercise physiologists can also guide lifestyle changes and exercise routines that support long-term recovery and well-being.
Biomedical Research
Physiologists are medical scientists who play a key role in the advancement of healthcare knowledge and practice through research. Through centuries of research and investigations, physiologists have been able to unfold the several mysteries behind the way we live and thrive as living organisms.
The results and outcomes of research activities over several years have led to cutting-edge developments and breakthroughs in healthcare education and practice, therapeutic methods, and improving the overall quality of life.
Physiologists engage in basic research to expand the boundaries of knowledge and improve understanding of various phenomena underlying health and disease conditions in humans and animals. In addition, Physiologists carry out applied and translational research to influence policy change, explore alternative methods of therapy, formulate medical equipment, and develop new drug and treatment methods for patients.
Physiologists carry out basic and applied research in hospitals, research laboratories, pharmaceutical and biotechnology companies, non-governmental organizations, etc.
In Pharmacology and drug development research, physiologists also play a vital role by drawing on their knowledge of body function to develop drugs and optimize their functions in treating diseases and illnesses.
A few examples of research breakthroughs made by Physiologists over the years include:
1. The discovery of Insulin in 1921 by Physiologists Frederick Banting, Charles Best, and other colleagues. Their research led to the discovery of insulin, a hormone crucial in regulating blood sugar levels. The discovery and isolation of Insulin was a breakthrough in endocrine physiology that transformed therapeutic approaches to diabetes.
2. Development of the Electrocardiogram (ECG) (early 20th century) by Physiologists Willem Einthoven and Thomas Lewis. Their research made significant contributions to the development of the ECG, a vital tool for the diagnosis of heart conditions.
3. Uncovering the Circadian Rhythm Research by physiologists like Franz Halberg and others in the 20th century, led to the discovery of the body's internal clock and its impact on sleep-wake cycles and other physiological processes.
4. Research on Muscle Contraction
Research by several Physiologists, including Andrew Huxley and Hugh Huxley in the 20th century made substantial contributions to understanding the molecular mechanisms responsible for muscle contraction.
These breakthroughs are a few of the significant contributions made by physiologists in advancing our understanding of the human body and its functions. Research on body functions has aided the understanding of disease mechanisms and the development of diagnostic and treatment procedures.
Future Trends in the Healthcare Industry
Physiologists play crucial roles in the future trends of the healthcare industry in several ways:
1. Personalized Medicine: Physiologists contribute to the development of personalized treatment plans by understanding individual variations in physiological functions. This can lead to more effective and tailored healthcare interventions.
2. Preventive Medicine: Physiologists can help identify early signs of disease by monitoring physiological parameters, enabling preventive measures and lifestyle modifications to reduce the risk of health issues.
3. Wearable Technology: Wearable technologies are electronic devices placed on top of the skin and used for various purposes. They can be used to monitor vital signs e.g. heart rate, blood pressure, and temperature. Physiologists can collaborate in the development of wearable devices and apps that track and interpret physiological data, enhancing patient engagement in self-care and wellness management.
4. Data Analysis and Artificial Intelligence: Physiologists can contribute to the interpretation of vast datasets through AI, assisting in the early diagnosis of diseases and optimizing treatment regimens.
Physiologists have great expertise in data analysis and evaluating health and disease conditions, they can play a crucial role in training AI algorithms and educating AI developers and health professionals on the implications of integrating AI into health management.
5. Rehabilitation and Physical Therapy: Physiologists help design personalized rehabilitation programs and physical therapy for patients recovering from various medical conditions, injuries, or surgeries.
6. Environmental Health: Environmental physiologists study the critical interaction between our bodies and the environment. Their expertise is crucial in highlighting the effects of adverse environmental conditions on Human health and suggesting ways to mitigate such effects.
7. Research and Drug Development: Physiologists are essential in conducting pre-clinical and clinical trials in drug studies. Their expertise is necessary in evaluating the safety and efficacy of new drugs and therapies on the population.
8. Aging Population: By studying age-related physiological changes and addressing age-associated diseases, physiologists contribute to the development of interventions and lifestyle strategies that promote healthy aging and help older individuals lead fulfilling lives with greater independence and well-being.
9. Health Education: Physiologists also contribute to health education and public awareness by explaining the importance of maintaining a healthy lifestyle and understanding the role of physiological health factors. Physiologists conduct applied research to effect policy change and educate relevant stakeholders and the general public on contemporary health challenges within society.
Physiologists are an integral part of the future trends within the health industry. Their contributions will be essential in enhancing healthcare outcomes, promoting wellness, and advancing medical research and technology.
Challenges and Way Forward
The above sections have elaborated on the essence and roles of Physiologists in the healthcare sector within Nigeria and beyond. Notwithstanding, the physiology discipline in Nigeria and the healthcare system as a whole is faced with a plethora of challenges that have undermined the roles of Physiologists in advancing the healthcare sector.
Some of these challenges are:
I. Absence of a professional body/bodies regulating Physiology training and practice in Nigeria.
II. Poor Curriculum and Lack of Specialized training.
III. Inadequate research facilities and lack of research funding.
IV. Lack of Awareness of the relevance of Physiologists in the healthcare sector.
The way forward for integrating Physiologists, fully, into the Nigerian Healthcare Sector is a strategic responsibility that needs multi-stakeholder collaboration and efforts on the part of many. This can be achieved by a number of approaches, including but not limited to:
1. Prioritization of Research and Funding
One of the most glaring challenges crippling the development of the healthcare sector in Nigeria is the lack of research funding. There are inadequate research institutions both in the public and private sectors of the country. Moreover, the few available ones are grossly under-sponsored.
Governmental and Non-governmental organizations should prioritize research as a major way to foster the healthcare sector in Nigeria. Prioritization of research and provision of the necessary resources including infrastructure, research funding, and expertise training would contribute hugely to solving the crisis of the healthcare sector in Nigeria. Physiologists as biomedical scientists would cause research-driven innovations for the development of the Nigerian Healthcare Industry.
2. Adoption of Physiology as a Recognized Profession
It remains a huge dilemma that the Nigerian populace and the political elites do not fully understand the significance of the Physiologists within them.
Physiologists are under-recognized in the Healthcare Industry and this leaves the healthcare sector to a great loss, reducing the effectiveness of healthcare delivery and affecting the general population.
It is the collective responsibility of the government, private sectors, Physiological associations, and other stakeholders to promote awareness amongst the different levels of society on the relevance of Physiology to the healthcare sector and in safeguarding the health of society.
These stakeholders must also work towards promoting the Physiology discipline and establishing a strong regulatory council for the Physiology profession.
The Physiological Society of Nigeria (PSN) has played a major role in this regard over the years. It is noteworthy that the communique from the 35th Annual Scientific Conference of the PSN hosted by the Department of Human Physiology, College of Medicine, University of Nigeria, Nsukka, Enugu State had recommended the establishment of a regulatory body to be known as the Physiology Council of Nigeria (PCN).
The proposed purpose of such a council is to further strengthen professionalization, specialization, and functionalization, to improve physiology teaching and practice in Nigeria. Additionally, the communique recommended a holistic review of the current B.Sc Physiology curriculum in Nigerian universities.
In a similar development, the former president of the Physiological Society of Nigeria (PSN), Prof. Arthur Chuemere stated that a bill for an Act to provide for the establishment of the Physiology Council of Nigeria (PCN) is currently before the National Assembly.
This was reported in the communique of the 38th Scientific Conference and Annual General Meeting of the Society held at Ahmadu Bello University, Zaria in 2019.
Establishing a professional body for the Physiology discipline would go a long way in advancing the healthcare sector through the invaluable services physiologists provide in research, training, diagnosis, and treatment of diseases. As the PSN engages the legislation on this vital task, physiologists must continue to pursue their education and career development with great passion, motivation, and optimism for a more fruitful future for the profession in Nigeria.
3. Personnel Training
A huge percentage of Nigerian physiologists lack the necessary expertise and technical know-how to effectively discharge their roles and duties in the healthcare sector. This is due to a lack of specialized training on advanced physiological techniques and procedures employed in research, diagnosis, and teaching all over the world. Compounding this problem in synergy is the lack of modern medical equipment, infrastructure, and state-of-the-art facilities needed for effective research and training in the field of Physiology.
Physiological equipment used in teaching and research laboratories within our universities are usually few and outdated.
The Nigerian government needs to scale up its investment in the healthcare sector through the provision of necessary human and material resources that would boost the health industry's productivity and guarantee health security for the Nigerian populace. The government through the Physiology Council of Nigeria (PCN) after its establishment should recruit a sufficient number of Physiology Graduates and professionals to get specialized training on the latest medical techniques and procedures used in physiology training and research all over the world.
4. Optimization of the Physiology Curriculum
Together with the establishment of a council for the profession, an intensive review of the current curriculum for training physiologists in Nigerian universities is needed. A holistic and careful review of the curriculum would ensure strict adherence to the standard and best practices in physiology training and research all over the world.
Introducing a compulsory internship at the end of the Physiology program would ensure more practice-based physiology training. Students may choose to have their internships in clinical settings, research laboratories, fitness centers pharmaceutical or biotechnology companies, and many more depending on their interests and preferred career paths.
This will equip upcoming generations of physiologists with the adequate knowledge, skills, and expertise required to pursue different healthcare roles of their choice in the future.
6. Advancing the Clinical Physiology Profession
While clinical physiology remains a distinct and well-recognized profession in other parts of the world, the status quo is entirely different in Nigeria. Nigerian Physiologists lack the professional recognition and legislative permission required to exercise their roles in advancing the healthcare sector in the country.
Moreover, their rightful places and positions in hospitals and other clinical settings are being occupied by members of other professions.
It is pertinent to state here that the knowledge and expertise of physiologists are of immense importance in clinical settings for the effective diagnosis and treatment of diseases and the prescription of medications.
As elaborated in the above sections, the roles of physiologists are diverse and physiologists constitute an integral and vital component of a functional healthcare system anywhere in the world. Advancing the Clinical Physiology Profession would be a major landmark in revolutionizing the Nigerian Healthcare Sector, aiding composite diagnosis and underpinning the importance of evidence-based medicine.
7. Spreading Awareness on the role of Physiologists in Healthcare
The salient efforts on the part of many in educating the Nigerian populace on the roles of Physiologists in the healthcare sector and their utter relevance to society have never gone unnoticed.
Worthy of mention are the efforts of the PSN (Physiological Society of Nigeria) which remains the mother body of all Nigerian Physiologists. For several decades, the PSN has organized annual national conferences for propagating research, collaboration, and development in the field of physiology. The PSN has also established partnerships with other professional bodies of physiology within Africa and beyond.
The SPAN (Students' Physiological Association of Nigeria) at both the local and national levels has also played a major role in this regard. The SPAN, through its annual national conferences for the past 15 years has been able to foster unity and collaboration among Physiology students all over the country, breeding meaningful engagements, insightful discussions, and job and networking opportunities.
The SPAN is an umbrella association uniting all B.Sc Human Physiology students in Nigeria, and over the years, it has made tremendous efforts in promoting awareness about the roles of Physiologists within society.
Other passionate students, alumni, and lecturers of physiology have made a lot of efforts in this regard too. A countless number of conferences, seminars, and symposia have been organized, however, a lot still has to be done.
It is appalling to realize that even some physiology students and graduates are ignorant of the roles they in the healthcare sector, and talkless of the general public.
Deliberate, strategic, and collaborative efforts need to be made to increase awareness, especially amongst students and enthusiasts of physiology, the government and political elites, and stakeholders of the healthcare industry including the private sector and the general public. An increase in awareness will further strengthen the discipline, according it greater recognition and speeding up the process of legislative covering for the profession.
In conclusion, the roles physiologists play in the advancing healthcare sector within Nigeria and other countries are diverse and numerous. They have always played a golden role in securing the health and well-being of our population from the past through the present and likewise, in the future.
This piece was written in celebration of SPAN National Day 2023 and is aimed at enlightening physiology students and enthusiasts, relevant stakeholders in the healthcare sector, and the general community on the significance of Human Physiology as a scientific and medical discipline and as a driving force in shaping the future of our healthcare industry.
Even with the plethora of challenges ahead, great hope lies in a brighter future for the Nigerian Healthcare Sector and for the Physiology discipline in Nigeria. However, efforts must be made on the part of many to bring these dreams to reality and to foster a society where physiologists can thrive in their profession and contribute their quota to the development of the healthcare sector in Nigeria.
As stated by Ernest Nwoke, a Physiology lecturer from the Department of Human Physiology, Ambrose Alli University, Ekpoma, Edo State;
“Nigerians will not wake up one day and ask, "Where are our Physiologists?" It is the Physiologists that will wake up one day and say "Here are your Physiologists, Give us our place to move the Nation to the next level in Health Care." - Ernest Nwoke, 2012.
With Physiologists fully integrated, the healthcare sector in Nigeria will be great. But until then, it's our collective responsibility to make it happen.
- Ubaydullah Abdulmalik is an undergraduate physiology student from Bayero University Kano, Kano State. He currently serves as the Secretary General of SPAN BUK-CHAPTER and as Secretary to the National SPAN President.
He can be contacted at: [email protected]
