By: Bushuben Kanneh, M.Sc. Candidate, Public Health Epidemiology I E-mail: bushubenkanneh@gmail.com
The Fundamental Problem: Clinicians as Administrators
Liberia’s health system faces a critical, self-inflicted wound that undermines patient care, drives donor fatigue, and perpetuates poor health outcomes: the misplacement of clinically trained medical doctors into administrative and public health roles.
A medical doctor is trained to diagnose, treat, and provide care to individual patients. Their license and their years of study are dedicated to the direct clinical work of saving lives. Yet, across our counties, many of these vital professionals are found in offices, serving as County Health Officers (CHOs) or in other administrative positions, thereby neglecting their primary, life-saving duties.
Misalignment of Skills and Consequences
The issue is not one of motivation, but of gross misallocation of scarce resources.
Impaired Patient Care
Hospitals and clinics, which desperately need physicians at the bedside, are instead left shorthanded. The direct treatment of citizens afflicted with diseases suffers when the doctor assigned to a facility is instead focused on managing paperwork and attending meetings.
Weakening Public Health Data
The role of a public health scientist is to interpret population data, plan programs, and oversee system logistics. This demands specialized knowledge in epidemiology, health economics, and data systems—fields not covered in general medical training. By placing general practitioners in these roles, we should expect—and we are currently experiencing—the perpetually poor planning and messy data systems that have historically plagued our health system. This technical inadequacy is the very reason donors express frustration and fatigue.
Financial Discrepancy
The problem is compounded by reports of doctors drawing salaries based on their clinical license while simultaneously earning pay for an administrative position. This dual compensation scheme, particularly in a country where the state invests heavily in their free education and provides stipends, raises serious questions about the ethical use of public funds and social equity.
Moving Forward
A Call for Rational Deployment
To build a truly resilient health system, we must commit to rational human resource deployment.
Doctors must be rigorously assigned and held accountable for their primary clinical functions—treating people.
Administrative and public health roles, such as the CHO position, must be filled by qualified Public Health Scientists and professional managers who have the specialized expertise to interpret health data, forecast needs, and effectively manage complex programs.
We must stop using our precious medical doctors as temporary administrators. Their skills are too vital, and the needs of our sick population are too great, to tolerate this persistent misapplication of talent. The health of the nation depends on ensuring that every professional is performing the duty for which they were trained.
