Cast & Curious

Category: Professional Capabilities

  • Three Questions Filipino Physicians Must Answer in the Age of AI

    Three Questions Filipino Physicians Must Answer in the Age of AI

    An AI Generated Anchor Post for #HealthXph Twitter/Bluesky Chat

    As artificial intelligence rapidly reshapes healthcare around the world, Filipino physicians—especially those in the 30–60 age group—are standing at a crossroads. We’re experienced enough to know the realities of clinical work in the Philippines, yet young enough to adapt to the changing digital landscape. But with this transition come real challenges, anxieties, and opportunities.

    Based on conversations across clinics, training programs, and professional circles, three issues consistently rise to the top. I’m turning these into three key questions we will tackle together in our upcoming #healthXPh Twitter/Bluesky chat. Your insights matter—our collective answers can help shape how Filipino medicine evolves in the next decade.

    1. The Skill Gap: Are We Equipped to Integrate AI Into Daily Practice?

    For many physicians, AI still feels abstract. Some worry about falling behind emerging tools, while others struggle to identify which technologies actually improve patient care versus those that add to the workload. With uneven access to training and digital infrastructure, the skill gap between clinicians is becoming more pronounced.

    Chat Question T1:

    How confident are you in using AI tools in your practice today, and what specific skills or training do you feel Filipino physicians urgently need to stay relevant?

    2. The Trust Dilemma: Can We Rely on AI While Protecting Patient Safety?

    AI promises faster diagnostics, decision support, and workflow efficiency—but many physicians remain cautious. How do we validate accuracy? What do we do when AI recommendations conflict with clinical judgment? And in a country with varied standards and regulatory gaps, how do we ensure patient safety while adopting new tools?

    Chat Question T2:

    What would make you trust—or distrust—an AI tool in the clinical setting, especially when managing Filipino patients with diverse and complex health needs?

    3. The Identity Shift: What Happens to the Physician–Patient Relationship?

    As AI takes on more cognitive tasks, physicians are asking: Where does that leave us? Does AI free us to be more human, more relational? Or does it threaten to reduce our role in the clinical encounter? Many mid-career physicians feel tension between efficiency and empathy, especially as patients increasingly arrive with AI-generated opinions about their health.

    Chat Question T3:

    How do you see AI changing the physician–patient relationship in the Philippines, and what should our role evolve into over the next 5–10 years?

    Join the Discussion

    These three questions are only the beginning. AI isn’t just a technological shift—it’s a cultural, ethical, and professional one. Filipino physicians have a unique vantage point shaped by our healthcare system, our patient population, and our resource realities. Your voice will help clarify where we stand—and more importantly, where we want to go.

    Let’s talk.
    Let’s question.
    Let’s shape the future of Filipino medicine, together.

    Join the #HealthXPh chat on Bluesky this Saturday Nov 22, 2025 9PM manila time as we tackle yet again- AI in the clinics!

  • How should healthcare professionals act on social media, nowadays ?

    How should healthcare professionals act on social media, nowadays ?

    Revisiting the ethical social media principles then and applying it now.

    The recent social media controversy that irked many in the Philippine medical community is this- a student nurse posting a video of a healthcare worker doing a medical procedure, on tiktok. While this, arguably constitute a breach of privacy and confidentiality and the ethical ramifications are quite disturbing, I wonder why the student nurse failed to grasps an established social media and medical etiquette? Did we somehow missed something when crafted the social media guidelines before for future generations? Maybe it’s time to revisit this.

    The #Healthxph was founded as a community of healthcare social media practitioners, laying down the foundations of the ethical use of social media to achieve common good in healthcare. We even have our signed manifesto accepted by the different medical associations in the country. I and many of #healthxph team talked about ethical and good use of social media in healthcare and even came up with actual conferences about it. That was ten years ago. Now, we are seeing a resurgence in privacy and confidentiality breaches in healthcare with the use of social media. Again, did we miss something here? Implementation? Commitments? This will be the topic of our chat today.

    T1. Do you see a resurgence in healthcare privacy and confidentiality breaches with the use of social media?

    T2. Is the healthcare community effective in preventing privacy and confidentiality breaches on social media?

    T3. Recommend three ways of preventing preventing privacy and confidentiality breaches on social media.

    I’d like to share my previous talk on How should nurses act on social media platforms. This was part of my speech during the Annual Convention of the Philippine Nurses Association in Davao City. I knew this student is not yet a full fledged nurse, but it may be good to start early. What do you think?

    Join #healthXPh chat on this topic this Saturday Aug 10 9PM Manila time. See you all!

  • Leading Change When “Change” Isn’t the Norm

    Leading Change When “Change” Isn’t the Norm

    “If there is one thing that will definitely change about our complex healthcare system, practices and behaviors aren’t one of these”

    One comment I get whenever I talk about “learning organization” as a way for healthcare institutions to adapt to the new normal is this- “I really like the change concepts your saying, but what else can I do if many in my organization doesn’t embrace that change philosophy?”

    Rina is a new resident physician assisting more senior residents attending and treating fractures at one healthcare institution. Yet to learn the finer details of cast application and monitoring, her team leader instructed her to apply cast on a young patient who had recently incurred a forearm fracture after a fall from a height. The senior resident added that she “read about techniques of applying and monitoring cast” from the recommended textbook. When an emergent call from ER summoned her senior to attend to another patient, Rina eagerly went on applying the cast to the patient’s forearm alone and unsupervised, with only her recently “acquired” cast application techniques, and a single experience of seeing one senior resident applying a cast in their last team duty. She sent home the patient after advising the parent about cast monitoring she learned from the book she read.

    Less than two hours after, the patient was brought back to the ER in pain and crying. “My arm hurts! like it is being squeezed and twisted! ” complained the patient. Suspecting that the cast its too tight, Rina instinctively cut the cast in half (bivalved) using a cast cutter. Patient immediately reported relief, but Rina was shaken by the experience. She felt she did what is the right for the patient and still ended up with a potential complication.

    Rina brought her experience in one group mentoring discussion with an attending consultant. “Is there a certain level of competency which a resident possess to be able to apply cast and prevent this complication from happening?” she asked. “If you are referring to how many times did the resident applied cast to the same extremity in a number of patients in the past, there’s no ballpark figure” said the consultant. “The incidence of that complication is less than a percent. What we know is that you have to have some high index of suspicion to catch the prelude to a complication” the consultant added.

    Rina then talked to several ward nurses and patient companions about their knowledge of cast monitoring and what they actually do in the wards and at home. “We write on the monitoring sheet what our clinical inspection would tell us, but I’m not quite sure about what’s the exact results do we refer to the residents on duty” said one nurse. One parent told her that although pain and tightness in the casted extremity is a danger sign, “we’re leaving”we live far away from the hospital it is usually too late when we arrive back in the hospital.

    Rina is currently doing a research on a better protocol for cast monitoring and preventing such devastating complication before it happens. Since the incidence of such devastating complication is low (as we all believe it to be based on foreign literature) and local literature about this complication is scarce, she lamented that her experience and research will just be buried in anecdotes again. I smiled. “Just keep on doing what you are doing” I said to Rina . “Maybe your research results will change behaviors, practices. Maybe it won’t, but at least you will have made things better for you, your patients, and then some”.

    “Do what Rina did” is my reply to the comment -“I really like the change concepts your saying, but what else can I do if many in my organization doesn’t embrace that change philosophy?” Start small, talk to like minded people, research, recommend a change policy, do it, even if others won’t. Maybe your new policy will change behaviors, practices. Maybe it won’t, but at least you will have made things better for you, your patients, and then some”.

    So what would a healthcare professional do when you want to change behaviors and practices in your organization yet many doesn’t espouse the change philosophy? This will be the topic of our #HealthXPh chat this Saturday May 27, 2023 9PM Manila time. Here are some guide questions:

    [su_box title=”change behaviors and practices in healthcare industry”]
    [su_list icon=”icon: hand-o-right”]

    • T1. Do you have any experience in the past urging you to change practices and behaviors in your healthcare organization?
    • T2. What healthcare change initiative did you do and what were the results?
    • T3. What advice would you give a colleague or health advocate when it comes to changing behaviors and practices in healthcare? [/su_list] [/su_box]

      Please join #HealthXPh chat Saturday May 27, 2023 9-10 PM manila time. Reply to the guide question above via twitter and append #HealthXPh to all your tweets! See you there!

      (Image by wavebreakmedia_micro on Freepik)

  • Digital Divide in the Healthcare Industry | The haves and have nots of a healthcare professional in the digital age

    Castells broadly defined digital divide as “the inequality of access to the internet”. Scholman defined digital divide as “the gulf between those who have ready access to current digital technology and those who do not”. This definition included the consequential “social or educational inequality” that comes with this gap.

    An approximate measure of determining the extent of “digital divide” in a country is the NRI ranking.

    “The NRI is part of the World Economic Forum’s Global Information Technology Report 2015: ICTs for Inclusive Growth. The NRI identifies the capacity of countries to leverage Information and Communication Technologies (ICTs), by assessing the overall political and business environment, the level of ICT readiness and usage among the population, businesses and government, as well as the overall impacts of ICTs on the economy and society at large.”

    The Philippines ranked 77th, in the most recent, 2016 Global Information Technology Report by World Economic Forum.   That’s a notch down from our previous 76th ranking. Detailed results and subcategory analysis of this NRI ranking can be found in this site. We scored worst in infrastructure but other indices are no better. This, despite the country being tagged as the sms and social media capital of the world. Around 87% of our adult population spends average of six hours on the internet per day. Our internet and mobile population penetration is increasing also. So while, infrastructure (physical access, internet speed and portals) seem to be the biggest obstacle up front, it cannot account for the digital divide occurring in sectors where physical access is not the biggest concern.

    Health implications:
    While the greater portion of our general population is consequently denied physical access to internet because of poor hardware and network infrastructure, this is may not be true for the healthcare industry’s professionals such as doctors or nurses. Many healthcare professionals already have material and physical access to the internet. The recent Digital Asia report also showed many patients are are going to the internet for information regarding their health issues. Health information is increasingly made available over the internet . Healthcare professionals need more and more sophisticated skills to use electronic resources in improving healthcare services. This, despite the rising cost of accessing copyrighted, medical journals. This complicates the issue and resolution of digital divide. It places tension on patient- doctor relationships or collegial collaborations when either of the party belong to the opposing fences in this digital divide.

    T1. Is there a digital divide within the healthcare sector? Please elaborate on your answer.

    Scholman further subdivided digital divide in to mini gaps namely technological, content, gender and commercial divide. These mini gaps form many of the basis for surveys of the occurrence of digital divide among population. While this gives us an idea of how we fare in terms of our digital literacy with that of other countries, it does not account many other factors that contribute to digital divide other than infrastructure or physical access, like in healthcare.

    Scholman’s mini digital divides are often good when identifying or characterising gaps. I find Jan van Djik’s relational views of digital divide relevant when looking for strategic solutions. Jan van Djik’s proposes a relational framework for understanding digital divide and coined a cumulative, recursive model and successive kinds of access to digital technologies. (See figure 1) .

    Source: van Dijk (2005, p. 22) Figure 1: A Cumulative and Recursive Model of Successive Kinds of Access to Digital Technologies

    When a sector of society went pass the motivational and material access problem, they are still faced with another level of obstacle to hurdle the “digital divide” -namely skills and then usage access.

    T2. What’s most salient reason or contributor to this digital divide in the healthcare industry?

    In my opinion, this is what the health sector (the academe to be specific) should deal with to narrow that gap or digital divide in healthcare.

    T3. What do you think is the best solution to this type of digital gap in the health sector?

    This is the main topic for our discussion this Saturday July 7, 2018 9:00PM Manila time. Here are our guide questions:

    In your experience as a healthcare professional:

    • T1. Is there a digital divide within the healthcare sector? Please elaborate on your answer.
    • T2. What’s most salient reason to this digital divide in the healthcare sector?
    • T3. What do you think is the best solution to this type of digital gap in the health sector?

    Closing Thoughts:
    Digital literacy and digital scholarship has been put forward by many strategist as a way to narrow this gap in medicine. As a healthcare professional, what do you think could be your biggest contribution to advocating or promoting digital literacy or scholarship in the field of medicine?

    References:

    Castells, Manuel 2001 The Internet Galaxy: Reflections on the Internet, Business, and Society. New York: Oxford Univesity Press.

    Schloman, B. (May 7, 2004). Information Resources Column: “The Digital Divide: How Wide and How Deep?” Online Journal of Issues in Nursing. Available: http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/Columns/InformationResources/TheDigitalDivideHowWideandHowDeep.html

    van Dijk, J. A. (2005). A framework for understanding the digital divide. In The deepening divide: Inequality in the information society (pp. 9-26). Thousand Oaks, CA: SAGE Publications, Inc. doi: 10.4135/9781452229812.n2

    World Economic Forum (2016). Global Information Technology Report 2016. Retrieved from http://reports.weforum.org/global-information-technology-report-2015/economies/#economy=PHL

    Department of information and communications Technology (June 6, 2016).Department of ICT Law takes effect today. Retrieved from http://dict.gov.ph/department-of-ict-law-takes-effect-today/

  • Healthcare Professionals’ Guide to Establishing a Professional, Social Media Presence

    Majority of healthcare professionals have personal social media account(s) nowadays.  None of them, use their personal accounts to engage patients online. These I learned after asking workshop participants’ if they use social media to engage patients online.

    Here are the important points I learned from the participants and workshop I gave on Establishing Social Media Presence at the 1st SKMS Post Graduate Course in St. Louis Hospital last February 17, 2018 :

    1. There’s an increasing number of patients going to the internet and social media to seek health information, join support groups and share their healthcare experiences. 
    2. Majority of healthcare professionals are on social media to update on medical healthcare news, share information or join colleagues in support groups.
    3. Healthcare professionals don’t use their personal social media accounts to engage patients online.
    4. There is confusion as to the benefits of using social media in healthcare.
    5. There is some degree of confusion on how should healthcare professionals (or healthcare institutions) respond when they are tagged in a social media posts.

    I cited several, global and ASEAN studies to support points number 1 and 2. None of the workshop participants (around 300+ of them) raised their hands when I asked if any of them is using social media to engage patients online.  I have no current local study to validate or refute this, so I’ll take point number 3 until proven otherwise.   I discussed the benefits of using a professional social media account to protect one’s reputation online and leave a positive digital footprint to impact healthcare.

    For those interested,  I will be posting my slides at my Slideshare/ LinkedIn account soon. Please visit my profile there.

    References:

    1. Patdu, Ivy. Recommendations for Social Media Use in Hospitals and Health Care Facilities. Philippine Journal of Otolaryngology Head and Neck Surgery, North America, 31, jun. 2016
    2. Marie Ennis-O’Connor (2017). Social Media: A New Dimension In Health Research [PowerPoint slides]. Retrieved from https://www.slideshare.net/ennoconn/social-media-a-new-dimension-in-health-research
    3. Pei-Li Teh & Marc Yates. 2013. Digital Health in Asia. Issue no. 4. Research Partnership. Available at https://www.researchpartnership.com/media/1182/free-thinking-digital-research-in-asia.pd
    4. Warden, Christopher. 2017 Referral MD. www.getreferralmd.com. Accessed at https://getreferralmd.com/2017/01/30-facts-statistics-on-social-media-and-healthcare/
    5. The Healthcare Social Media Shakeup. CDW Healthcare. Accessed http://www.cdwcommunit.com/resources/infographic/social-media/Massachusetts Medical Society Social Media Guide. 2015
      http://www.massmed.org/Governance-and-Leadership/Committees,-Task-Forces-and-Sections/MMS-Physicians–Guide-to-Social-Media-(pdf)/
    6. Gholami-Kordkheili F, Wild V, Strech D: The Impact of Social Media on Medical Professionalism: A Systematic Qualitative Review of Challenges and Opportunities J Med Internet Res 2013;15(8):e184
    7. Chua, ER , Calderon, PE . Ethico-Moral Responsibilities of Health Care Practitioners on Social Media. Proceedings of the DLSU Research Congress Vol 4 2016. March 7-9, 2016
    8. Isip-Tan, Iris Thiele (2014). Establishing a Professional Social Media Presence [PowerPoint slides]. Retrieved from https://www.slideshare.net/isiptan/establishing-a-professional-social-media-presence-86320762