Monday, September 25, 2006

Pinoy MD

Bago kayo umalis ng Pinas basahin nyo muna itong salaysay mula saisang manggagamot. An article from PINOY.MD...Here's hoping that things change for us all.

By now, everybody knows of Elmer Jacinto--the February medical boards topnotcher who publicly announced his plans to work in the US as anurse. I was inZamboanga City visiting my parents when that news broke out. A topnotcher from Lamitan, Basilan hit close to home and I showed the article to mybrother. His only question was, "Why? Doesn't he have any offers?"I could only laugh and muster a short, "No, I don't think so."Elmer Jacinto's situation and the reactions from various sectors areboth funnyand sad. I can only think of my brother's question and wonder: What can thecountry offer its best and brightest in the medical profession? The short answer is none.

Unlike the legal profession, of which the medical profession is often compared to, there are no offers made to topnotchers. We've read news of bar topnotchers invited to join prestigious law firms. Top law graduates are employed even before the bar results are released, while some receive hefty signing bonuses from happy employers. Medical board topnotchers are not that lucky. After a day or two inthe light of fame, most fall back to the shadows of anonymity--their achievements a mere footnote in their sum. We hardly remember the board topnotchers of the previous years. How many of them are practicing in the provinces,much less in the country? Can you just imagine the public outcry if we found out that onlya few have stayed?

Therein lies the problem--the public outcry. Why is the public so pent up about doctors going abroad as doctors or nurses or caregivers or whatever? Because mys hort answer is not exactly correct. The country does have somethingto offer the graduates of the most noble profession: the poor and sick of thePhilippines. Physicians, especially new ones, are expected to grab the opportunity to serve--for a pittance of a fee, or even for free.

I tried my hand in volunteerism once when I was "in between jobs"--or, in short,unemployed. Living a few blocks from the Malate Parish, I volunteered my services to their social services division for one day a week. I scoured the streets of Manila for jobs on Mondays to Thursdays, while I devoted Fridays tothe urban poor of Malate. They gave me an old desk in the small office at the back of the church. The social worker announced my presence to community leaders, and, in no time, I was seeing 10-15 patients a session,which isn't exactly heavy.

It was a fun experience. A patient wanted me to give him a medical certificate stating that he should sleep on cement benches because it was good for his back. He was supposed to show this document to police officers of Luneta where he spent his nights. Another patient, a jolly 80/M, went to see me not for a checkup but to show off that he was in perfect physical health. He would do jumping jacks and push ups in front of me.It was also a time of desperation. A stroke patient, with half her body paralyzed, persistently showed up every Friday, limping her way through Manila traffic. She continued to have a BP of 200/140. Another patient had a resting systolic BP of 220-240. The list goes on. And I could do nothing but prescribe the cheapest anti-hypertensive. But they all had the same excuse: they didn't have the money to buy the drugs.

Not willing to lose a battle, I wrote the Parish for some support, financial or otherwise, I was asking for some drugs, about P800 worth, and a P500 money pool,in cases of emergency. And they replied that they can't contribute at the moment since they'e finishing the wing for the missionaries, putting in a library and airconditioning. I kid you not! I wrote a short letter to the city government, but they said all health support should go to the local healthcenter.

One Sunday after mass, the parish social worker informed me that the Rotary Club of Manila was conducting an outreach program. I went with her and talked with the President of the club. They agreed with the whole package, insisting onlythat I submit proper accounting reports every month for their newsletter. I can't say it was smooth sailing from then on. It definitely helped me with some of my patients, monitoring for drug response rather than just looking on helplessly.My experience is not unique.

Volunteerism doesn't have to be so obvious. Surgeons forego professional fees after operations, internists accept P20 forconsultation fees, pediatricians charge break-even for immunizations, and general practitioners accept eggs and chickens in exchange of services. These may be small acts, but they are by no means less heroic. There are, of course, doctors who work with the poorest of the poor. Volunteer doctors to the war-torn parts of Mindanao would have different stories: their experience, more colorful, their desperation, more intense, their helplessness, more personal. Their dedication is a strong testament to their character. These doctors who work with the poor often become poor themselves, and I have nothing but the utmost respect and admiration for them. In all these cases, doctors are found in the frontlines of poverty. They work with almost no logistic and financial support. They carry the burden of salvation for their countrymen, with little or no compensation, with little or no thought of self. But the fact remains that mere presence can onlydo so much.What can a doctor give if he has none. aside from compassion and care? Is that really enough?

It's ludicrous how the public expects too much of a sacrifice from Filipino doctors, when it expects too little from its government officials. The fight forbetter health is a fight against poverty. It is not won by doctors becoming poor themselves, but by government officials becoming the leaders they need to be. Doctors do not make laws, allocate resources, handle budgets, public officials do. Doctors do not get kickbacks, destroy public trust, and plunder taxpayer's money, government scalawags do. So, when did doctors become sacrificial lambs for the ineptitudes of Philippine government?

The public flogs physicians, living on P10,000 a month, who pack upand go tothe US as nurses, when they pay no mind to regional directors, earning P22,000 a month, who go abroad as tourists for weeks at a time. People looksuspiciously at doctors driving a brand new Toyota Corolla after 5 years of practice, when they find nothing wrong with mayors sporting shiny Ford Expeditions after 6 months in office. If we should mourn for doctors who leave, let us grieve more for corrupt officials who stay. If we should complain of doctors who dream of decent living, let us object more of unscrupulous government employees who lead obscene lives. Wounded souls search for healing in other countries, but there is no cure for callous hearts.

A mayor once asked me to join a free medical mission he sponsored. I humblyasked if there was any payment involved for my services. "Ah, eh,wala. Pero libre naman ang pagkain. Tapos ipapahiram ko naman yung Pajero ko at isa kong Starex para libre na rin yung transpo."I wanted to bitch-slap him until his lips bled.

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this article made me want to cry... it didnt made me want to think twice of the profession im about to have or is having right now. its true, i have consultants, residents who go into nursing and most of them are in hiding. afraid that they might be judged. as a junior intern i can feel the disparagement that people make our from doctors. i work in a public hospital, and i have seen how doctors are treated. Its in OM that i saw a nurse screaming at a doctor, a nurse who disrespects a doctor... his superior. even i as a junior intern is lucky enough to be called doctor by nurses. tuwang tuwa na ko nun. because i get used to be called as "clerk" and as much as you want to correct them i'd rather not coz i know how i stand in the hospital and i respect myself to even argue with them.

as a soon to be doctor, i envy those who study medschool in universities like UST, St. Lukes and the likes, because they have economics subjects. They're the ones who become rich through medicine since they are being taught the economics of the business, while we, students from a public medical school are being taught the hardest way. my family didnt become well-off with a flick of a finger, my father brought us all the things we now are experiencing. and just like anybody else, he will retire and i would assume his post. all those times he worked hard for me was for a dream that i would be doctor... a rich doctor for that matter. but im afraid that it would take years for me to achieve that.... even more i might not be able to. its sad to know that even in this early point in my career, i am saddened by the idea on how doctors are being treated. Nurses would impose their superiority towards the medical profession since they know that the monthly pay they recieve is just but a week's salary for doctors here.

after all those years of hard work and pure sacrifice, a public doctor is paid a humble P15,000 a month and a private doctor with P8,000 max. i remember in my medical ethics class, they told us that its not a sin to charge money for one's service, doctors like anybody else are human with needs and aspiration, with goals of putting up food for his family's dinner table, but doctors charge equally. Its funny how we let go of undying charges in the city hall just to get some piece of paper saying that we are cleared of any misconduct but when doctors charge P200 for your life, people would complain how high the fee was. funny but true.

last night i was watching TV patrol and i saw how people merry and support bar examinees as they finish their last sunday of exams. There were bands, banners, everybody was there. medical board examinees dont have that. the media dont even care that we have just taken the exam. when the august medical liscensure results was released, the media didnt made a fuzz out of it... we medical students, interns and doctors, celebrated in the silence of our hearts the achievements of our fellow alumni... that the PLM College of Medicine placed 2nd among the nationals. we could only rejoice with ourselves.

i wish things are much more different... a little hope goes a long way

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