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‘More access to capital will enable women scale their businesses’- Njideka Udochi

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Njideka Udochi is the CEO/Board President of Summit Medical Group, a multidisciplinary practice leveraging technology and research to provide evidence-based culturally sensitive medical care to patients in family medicine, pediatrics, internal medicine, nutritional medicine, psychotherapy and occupational medicine. Named Maryland’s Family Physician of the Year 2021 by the Maryland Academy of Family Physicians in the United States, she obtained her medical degree from the College of Medicine, University of Nigeria, Nsukka in 1988. Certified by the American Board of Family Practice and the American Academy of HIV Medicine, Udochi completed her internship and residency at the George Washington University/Holy Cross Family Practice Residency Programme in Rockville, MD. She also completed a fellowship in Geriatrics at the George Washington University Medical Center in Washington D.C. Before opening SMG, she worked with Mercy Medical Center and served as the Medical Director of HCH in Baltimore City. A Fellow of the American Academy of Family Physicians with a degree in Public Health from the Bloomberg School of Public Health at Johns Hopkins University, she tells TOBI AWODIPE how her background influenced her career; founding her own medical practice; overcoming racism and sexism; why healthcare professionals would keep leaving the countries and ways to improve the country’s healthcare sector.

Tell us a bit about your growing up years, how did that influence your journey so far?
I grew up in university campuses; both parents were academicians. My dad, a Professor of Economics and Statistics and my mum a Professor of Sociology; first at the University of Nigeria, Nsukka and then at the University of Ghana, where my dad was the Director of the United Nations Regional Institute for Population Studies. So, this had a major impact in my life’s journey.

Surrounded by academicians and children of academicians, the emphasis was on academic excellence and hard work. This expectation has been the major guide as I navigate my life and career. In Ghana, I also learnt the importance of tolerance and respect of all people. Since my father was working in the UN, I was fortunate to meet and interact with his colleagues’ children who were from different parts of the world and learned quickly that we are all the same and want the best for each other. The love shown to me by my friends in Ghana helped mould me into who I am today.

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Tell us a bit about your career journey, how has it been?
My career has been very interesting. After graduating from Nsukka at the age of 22, I proceeded to the United States to study Public Health at Johns Hopkins. My classmates remind me that I always wanted to be a public health physician working for WHO. I then spent a few years in Public Health first as a Research Assistant at Johns Hopkins and then at the Department of Health and Mental Hygiene, rising to the position of Director of Clinical Methods for the Center for Health Programme Development and Management.

In that position, I was a key player in getting the High Cost User Initiative developed to target and identify high cost patients in the states Medicaid programme and develop an initiative targeting these patients to help reduce cost. I then left public health to begin a residency at the George Washington University Hospital in Family Practice and completed a Fellowship in Geriatrics at the same hospital. After my residency and fellowship and with young children in tow, I decided to choose a job that combined both public health and clinical medicine and went to work for Mercy Hospital in Baltimore as the Medical Director of Healthcare for the Homeless in Baltimore City.

After that, I pivoted into private practice and worked as a solo practitioner for 16 years and more recently with the disruption in the health space, merged my practice with others to become a multispecialty practice to deliver care to patients in the DMV (Washington DC, Maryland and Virginia) area.

You come from a family of global achievers, did that put a bit of pressure on you in any way?
My parents taught my siblings and I to focus on ourselves and our talents and socialised us to celebrate one another’s achievement. My extended family has always had a high expectation for everyone, so it came naturally to want to excel and do the best you can, especially in service to others.

What does opening your own medical practice mean to you and for black women there?
It feels awesome. For many years working in the primary space which is very fractured, I have yearned for a more holistic and comprehensive approach to achieving better health outcomes by taking a team-based approach to care like we had at Health Care for the Homeless, caring for a very vulnerable population. So, it feels wonderful to be able to finally implement this model of care with a very experienced and talented group of physicians many of whom are women.

What impact do you intend to make in the health sector, what are your bringing to the table?
Summit Medical is what we call a patient-centered medical home model. Our patients should expect us to use evidence-based medicine and a multiciliary team approach to address their health issues. Working with other partners in the community, we will also focus on other social determinants of health that impact health and address this for our patients. Bridging the inequities in the health space is very dear to us as physicians of color and women in particular.

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What would you say has been the most challenging moment of your career till date?
The business of medicine has been the most challenging part of my career. As a physician, you’re trained to provide and care for patients and most physicians are good at this. But there is very little training given on how the business of medicine – billing, coding and so on, and so many physicians like myself outsource these aspects to billing companies to provide expertise and bill for the services we provide.

The problem comes when the company/companies provide you with a code, which is not appropriate and then that code is used to bill for services on your behalf. This is what happened to me and many others; we outsourced our billing to companies that provided us with wrong codes for payment. As a result, we were shocked to discover that although services were provided, the codes were wrong. There is a class action lawsuit in my state by physicians who are in a similar position. Unfortunately, we learnt that it is the physician or practice that gets blamed when the billing companies don’t do what is expected of them.

In my own case, I decided to resolve the case without admitting any liability and we are pursuing legal action against the marketing company, the billing company and manufacturer of the device. Most physicians that go through a traumatic experience like mine will just give up. It’s highly unfair when you know you’ve done nothing wrong and it is very important to pursue legal action against entities that wrong you.

In life, what doesn’t kill you makes you stronger. I am now a better ‘business physician’ and have decided to improve my business knowledge by obtaining an MBA at Cornell University. I hope to use my knowledge to guide other physicians in the health space and improve the business of medicine.

As someone with experience both home and abroad, what would you say are some major differences between practicing medicine here and over there?
A big gap exists in terms of resources (medical personnel) and tools needed to manage and properly care for patients in Nigeria. You have to really admire the ingenuity of physicians in Nigeria who despite the limited resources and the practice environment, have figured out a way to continue to provide the best possible care to patients.

Patients in Nigeria are very dependent on their physicians and leave all decision making to the doctors, whereas in the US, patients feel more empowered and its more of a collaboration. Most patients pay out of pocket for all their care, whereas in the US, employers, government and patients pay for different portions of care.

As a black woman doctor, have you faced any form of profiling or discrimination?
Yes, definitely and still continue to. It’s subtle in some situations and in others, totally blatant. I am not unique and other female physicians of color have and continue to experience racism. But nothing succeeds like success so I have learnt to live with it and not let it bother me. It motivates me to do the best I can to create the best possible life for my people and myself.

How would you rate Nigeria’s health sector, do you think we are moving in the right direction?
The health sector in Nigeria is definitely below average. Nigeria has a long way to go to ensure equitable and good care is provided for citizens. A healthy society can help propel technological advances and improve all sectors of the economy. This has become more evident with COVID-19.

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A lot of doctors and other healthcare professionals are leaving Nigeria in droves, what is responsible for this trend?
Physicians invest a lot of years and effort to train to become doctors and deserve a living and comfortable wage to support their families and themselves. As Nigerians, we are go-getters and optimists, so if the wage gap is not bridged for this sector of the economy and an enabling environment provided for doctors to flourish, they will continue to leave to seek work in other countries who value their expertise.

Many see medicine as a calling, is that how it feels for you?
Definitely, I love my job, my patients and colleagues. You cannot imagine the sacrifices physicians face every day to do their work and save lives. COVID-19 has really underscored the importance of medicine and physicians. My love for this profession led me to encourage my son to also go into medicine. Today, he is finishing up his residency in the same hospital, George Washington University where I trained and will be starting a fellowship in Gastroenterology.

If you weren’t a doctor, what else would you have been?
An architect. I love building and art and would have moved into that space.

In what ways can we improve Nigeria’s healthcare and access to it?
Nigeria’s healthcare system needs special attention and an overhaul. The infant and maternal mortality rate in Nigeria remains very high. We should focus on providing better training to health extenders, especially in rural areas of the country and basic primary care services for all Nigerians. This will help improve the health status of many Nigerians. We should also improve the supply chain for pharmaceuticals and also improve the practice environment by developing and providing basic infrastructure. This will enable the use of telemedicine to help provide expertise in areas where we lack manpower.

With your busy career, how do you strike a perfect work-life balance?
There is no perfect work-life balance; I just try to ensure that I do the best I can as a mum and wife. Having a supportive spouse or partner is really important and family support is also key. My husband provides the backbone from where I have been able to pivot; he encourages me to excel at my work.

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How best can we improve the number of young girls and women in STEM in Nigeria?
Nigerians are perhaps some of the smartest and most ingenious people on this planet. The government should provide and improve basic infrastructure in the technology space and in our schools. A push to embrace technology in schools from primary to university level will help encourage STEM.

If you could change something for Nigerian women, what would you do?
This year has been absolutely ground-breaking for Nigerian women; they are heading many organisations and in many sectors. It is absolutely wonderful. So, I would say – more access to capital to enable them scale their businesses where possible. So proud to be a Nigerian woman.

Do you have any plans of establishing a facility back home anytime in the future?
I am from Ogwashi Uku in Delta State and my family is very committed to my people, community and state. The future of health care is in systems of care. I am thinking of building a medical centre and leveraging technology to provide primary care.

What do you do to relax/disengage from life’s stress?
I love to travel, socialise with friends and family and watch movies.

What advice do you have for women that admire and look up to you?
Work hard, work hard and work hard! Do not be afraid to fail because it is only when you make mistakes that you learn and propel yourself to success. In these uncertain times, it is those who are willing to look at their sector and think out of the box and be disruptive that will make big gains. Absolutely pursue a career you love and make no apologies. Always remember that Rome was not built in one day and that a journey of 1000 miles starts with one step.

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