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  • Some horrendous claims of herbal supplements may kill you…

    It’s not only irritating to hear horrendous “cure all” claims of some food supplements manufacturers and advertisers about their “drug” but the lack of advertisement control also nauseates me to no end. The sickening charade of food supplements jumping out of nowhere and claiming to heal all kinds of human afflictions thinkable (just so they can corner the poor man’s pocket) is staggering to say at least. Taking these supplements at advertisement value is already one big step to your sick bed. Deceiving someone with false hopes and killing the patient in the process is another “crime” worthy of harakiri.
    (Photo taken from Science Blogs.)

    In almost everyday that I listen to the radio, some airtime (at times lasting a full 15 minute!) is spent on miracle cure throttled by exaggerated personal testaments of complete strangers.

    What happened to “PANA: Truth in advertising?” or the KBP’s commitment to “Nothing but the truth, so help us GOD?”

    Here’s BFAD guides on how to spot false claims by these unscrupulous supplement manufacturers.

    1. The product is advertised as a quick and effective cure-all for a wide range of illness.
    2. Certain key words like “scientific breakthrough, miracle cure, all natural without side-effects or ancient remedy” are used.
    3. The promote claims that medical professionals and scientists have conspired to suppress the product.
    4. Adverts contain undocumented, anecdotal cases, but with amazing results. No science involved.
    5. These products sell falls hope for extreme physical attractiveness and shortcuts to weight loss. They will never emphasize the value of healthy lifestyles, like avoiding smoking, excess drinking of alcohol, eating appropriately, adequate rest and sleep, and regular exercise.
    6. Remember that legitimate health supplement products will never carry claims for quick cures; claims such as cancer prevention, good for arthritis, good for diabetes or good for hypertension, should be high suspect.
    7. The product is advertised as available from only one source.
    8. There is a money-back guarantee promise.

    The usual excuse laid for such drug supplements goes along the lines of herbal medicine being natural and hence, is the best form treatment. Another sad excuse propagated by these unscrupulous manufacturers and advertisers is the soaring prices of BFAD certified drugs. Both of these excuse “prompts” the ignorant listener to buy the cheaper, food supplements that claims healing every imaginable human disease yet lacking in rigorous scientific testing! It’s like jumping on a plane hoping your jacket will save you (it may even get tangled in the plane’s props) instead of your chutes. Stupidity does have its additive effect remember. It might not only rob you of your hard earned money but it may sometimes kill you or your patient!

    To argue that some drugs or supplements need not pass rigid testing to be effective is an outright lie. Often, these are Russian Rolette type solution to a worsening health economics. Licensing and BFAD approval of any drug aims at at least two basic goals. Rigid and scientific testing makes sure the quality and quantity of any drug is not only safe for human consumption but should also be effective against the illness(es) it claims to combat.

    At the very least, any drug must be tested for its safety profile and efficacy. Remove the first and your taking in a poison. Any dubious drug efficacy even in rigorous scientifically studied drugs, is nothing but pure waste of money. Take out both, and you make yourself poor on your way to your deathbed.

    One (or two) person’s testimony, no matter how famous that person, is not tantamount to a safe and effective medicine.Some physicians or physician’s name is even attached to these claims. In the current recommended evidence based approach to treatment and procedures, anecdotal testimonies ranks the lowest in the strength of evidence.

    Now would you want any food supplement giving you all these complications? Would you even dare to give food supplement to someone you love and risk losing his life base on false claims?

    Think again…

  • The First Ever TBR Bloggers EB at Serendra The Fort!

    I’ve been to The Fort (Taguig) some years back for a class mini reunion and party. I still remember walking along a dimly lit, but paved road flanked by mostly vacant, half finished buildings. Taxi ride is nearly non existent then, especially at night. I have to wait for almost an hour just to get a taxi!


    That was five years ago. The Fort, now less spacious and “taunting” a well manicured park (was it really a park I saw?) of some sort,  is reminiscent of the booming  Greenbelt of the late nineties ! Tagging along Joy, another “foreigner” to this place, we feel lost in a somewhat distantly familiar place.

    “Where on earth is Serendra?!”

    Uh, by the way, me and Joy is about to join other medical bloggers for The Blog Rounds Mini EB. Megamom has volunteered to arrange this EB and was practically cajoling everyone to come,  meet, dine,and have fun with fellow TBR bloggers.

    “If only we can find Brazil restaurant…or Serendra”…

    “Let’s go that way!” I excited nudged Joy towards a crowded portion of this spacious, stacks of buildings. “Just ask the guard, dude!” quipped Joy.

    Just about 30 steps east we found Brazil Restaurant– a fine looking restaurant known for its mouth watering buffet and endless barbecue slices!. Megamom and Louell are already “warming up” their muscles of mastication. After introducing ourselves, we settled down the table, got busy with our plates and went on with the sumptuous meal..

    Doc Harry and Doc Gigi came in halfway our meals and endless “joking around”.

    Exchange of blogger stories, ideas, news and almost everything else started pouring in.  So is the never ending barbecue slices of Serendra.

    “You have to turn that yoyo upside down so the waiters and waitresses will stop feeding us with barbecue cholesterol.” Ugh!

    The one thing I liked most about bloggers is their endless “pond” of ideas. “Pond” that never “dry” up!

    Doc Joey and her  hubby came in when we were on our second meal serving. Yup, no dessert yet. The hilarious parking mix up by Doc Joey‘s hubby (near market market) made us all laugh. Obviously, Doc Joey and hubby got lost too, in the Fort‘s maze, looking for Serendra.

     The Blog Rounds EB at Brazil Restaurant, The Fort
    (Clockwise, R-L: Doc Joey’s hubby, Joey MD, Bone Doc, Harry, Louell, Megamom, Gigi. Not in this photo is Joy, who volunteered to take this picture)

    Doc Tess Hey texted she’s coming to this EB too. Somehow, she never showed up and  we all wondered why. “Bakit nga ba?”

    Not around also were Docs Manggy (who had to fetch someone at the airport)  Doc Prudence, (suddenly called for duty) , Doc Mel and Che  (who are not around Manila during those times).

    The EB went on with ideas for the upcoming TBR Summit! Here are some of the resolutions we agreed upon during the EB. Pinay Megamom  promised a full account of the meeting and tasks assignment for this summit.

    1. There will be a TBR summit summertime (April-June) next year (2008). The date, place, and full summit topics will be decided on by the Org Comm, Bloggers next meetings.
    2. The organizing committee will be composed of those who attended the EB plus any other volunteers form the TBR bloggers’ pool.
    3. Those who weren’t around EB will be given special assignments. (TBA by Megamom)
    4. Part of the TBR summit resolution will be some sort of medical blogging ethical guidelines (akin to hippocratic oath in medical blogosphere?).
    5. TBR bloggers will be encourage to contribute topics for the summit and suggestions will be great appreciated. In fact, some TBR editions will be devoted to this.

    I’m still waiting for Megamom to post details of the EB meeting…

    “Kain pa tayo!” Indeed we (me actually) ate to (over)indulgence. We had great time and fun, meeting other sane minded medical bloggers. Thanks to Aileen and her anonymous EB sponsor!!!!.

    And to those who weren’t there at the EB, watch out for your summit assignments and better be there next meeting. Doc Manggy promised to cook for that meeting! Our chef, will no less than the Best Food Lovers/Blogger awardee of Phil. Blog Awards!

  • Closing the Pandora’s Box: Mandatory Return of Service, A better solution?

    According to ancient Greek mythology, Pandora opened the “box” (actually a jar which Zeus entrusted but forebode her to open) because of one uncontrollable urge-curiosity. The opening of Pandora’s box released all “human evils” kept inside the jar by Zeus, except one human trait.

    (Pandora’s Box Painting by JW Waterhouse)

    In one striking parallelism, the current brain drain of professionals is rooted in one analogous reason. Better financial and professional opportunities abroad fueled the curiosity of homegrown professionals to go on an exodus and opened the lid of our Pandora’s box.

    No other profession suffered more scrutinizing eyes than what physicians received in this brain drain phenomenon . Believing that this mandatory return of service will close the exodus of professionals from the country, a congressman filed HB 4580 requiring all professionals to a mandatory return of service after training here in the Philippines. Ironically, while the government is drum rolling OFWs as the nation’s new heroes (cultivating the exodus of skilled workers in exchange for dollar remittances) it is quick to criticize physicians who thread the same path of seeking better opportunities abroad. Worse, labeling these physicians as unpatriotic offers the most hideous method of enticing them to come back, and appeal to their nationalistic pride. Why is the government capitalizing on the OFW phenomenon but openly shun doctors planning going out?

    Some medical training institutions have tried to close this Pandora’s box with a “lid” of their own. The UP College of Medicine, a government subsidized university, has approved a three year mandatory return of service for its medical graduates. Other government funded medical training institutions have their own return of service program in place as part of a medical training contract for years already. The penultimate questions still remain.

    Was it successful in preventing the brain drain of physicians?

    Was it able to solve the worsening physician -patient service ratio?

    Is this a a wise move to close our Pandora’s box?

    Doc Mel ( Philippine Daily Idiot) didn’t think so. Here’s his egg laying bird nest appraisal of this move:

    Straight to the point: forcing our dear motherland’s brightest med future (naks, UP med students) after graduation to serve three years in the country smacks of a short-term Band Aid in one thickening subplot of the Philippine Zombie Healthcare System.

    and some more egg laying truth..

    A short-term Band Aid is maybe ok NOT because it is cheap and high-impact. It is ok if only because it is one prong in an all-out multi-pronged approach to a problem. To be charitable about it, give it to the government that it is tinkering with every way possible to do it.

    Most of us in the industry feel this move is a good start, but should be part of wider and broader long term solution to the brain drain and dwindling patient to physician ratio in the health care system.

    Prudence MD lauds this UPCM move (Is Hb4580 the solution to Philippine’s brain drain?):

    I find it fair enough that medical students whose education have been subsidized using taxpayer’s money should be required to render a certain amount of time for medical service to the country. Also, I believe this should be applied to graduates of any other courses in all state universities.

    So does Pinay Megamom here (Starting somewhere):

    I laud UP for making this move. However, its effectiveness to try and address the bigger issues remain to be seen. If other measures are taken to address the other contributing factors to brain-drain (compensation, professional satisfaction, work conditions, etc…), in conjunction with this move, we may actually see some changes for the better. It’s a start.

    and Joey MD here (Solution to healthcare?)

    I do not think that this will ultimately result in better health care, but it’s a good start. At least, this program will try to ensure that there will be enough MDs, hopefully, to serve the people’s health care needs, assuming that the enrollment in UP Medicine is about the same every year.

    But weather it will end up in a better health care system on its own, we all sing a united “I doubt it this is a long term solution on its own.”

    Several issues and potential caveats where raised by blogger MDs themselves that needs to be addressed if this mandatory return of service will make its impact on our zombie health care industry. Cautioning the government that even HB4580 is not the only solution to this current brain drain, it also has to make appropriations and just compensation for those who choose to work here.

    • Prudence MD cautions that it is unjust to impose this rule on privately trained professionals.
    • Mel B warned that this band aid approach is a single pronged approached to a otherwise multi pronged problem. And he espoused a “global” caffeine injected solution to a zombie, global capitalist health care system.
    • Joey MD echoed the same sentiments of strengthening other aspects of the health care industry (e.g. budget, facilities, health care education)
    • Pinay Megamom insists that provisions for adequately compensating those who are forced to work here.

    Unaddressed, these issues are the same reason why most professionals leave the country. This is what JA (Ripples from the river of my thought) put forth in her blog (Here, there or Anywhere)

    I don’t think that creating laws to keep people from leaving are going to be helpful in the long run though. What is necessary is for young doctors to feel that they are justly compensated during training and actual clinical practice in our country. That way, they will have more reasons to stay than a feeling of ob
    ligation to serve the country.

    And if we are threading in to the realm of cutting liberties and human rights of physicians in the name of public service, them we might have missed the root cause of this problem. Just like what Anakat ( The Saga Continues) in “Exodus part 2” is saying.

    I am not an expert on human rights or related laws but there has to be a breach of this in the government’s decision to pass this house bill. UP used to be a staunch protector of these rights and freedom. My alma mater has let me down by devising this return service mechanism.

    In a democratic institution, where does the freedom of a professional ( to choose where to practice) ends and that of public service starts??Or does it end at all? These lines simply put a good thinking salvo on this issue.

    In an attempt to close this Pandora box, the various stakeholders tried but failed to understand why the lid was opened in the first place. And while starting a band aid solution to the brain drain problem seem laudable, it has yet to prove its impact on the health care system fraught with vulnerabilities.

    Sadly, we fail to discern the reason(s) why our box was opened in the first place. Knowing these reasons and addressing them primarily, maybe we will have a better shot in closing this Pandora’s box. Hope is only what’s left inside this box.

    (To the MD bloggers who contributed to this edition of TBR, thank you all! Prudence MD will be hosting TBR 18, for another interestingly relevant topic of our times, The State of Reproductive Health Care in the Philippines)

  • Mandatory Return of Service for Professionals: Closing the Pandora’s Box?

    In an unprecedented and controversial move, the UP College of Medicine (the state’s subsidized premier medical school) through its UPCM College Council,  approved overwhelmingly the proposed Return Service Mechanism for its UPCM graduates during the council’s March 11, 2008 meeting. (See the details of this new UP Medicine Admission Policy here).

     UP College of Medicine main entrance. Legacies that lived beyond hundred years..

    Simply put, starting academic year 2009-2010, all freshman medical students who enter the halls of this premier medical institution, will be required a three (3) year return of service after they graduate before they will be allowed to go out of the country for training, further studies or employment. This is way ahead of that House Bill 4580 authored by Rep. Ignacio T. Arroyo (5th District, Negros Occidental)  that if approved into law, will require all Filipino professionals to render service for at least 2 years before they can go abroad.

    In my previous post here, I was trying to determine if there was indeed a shortage of physicians here in the Philippines. The scary answer is yes we have communities who have not seen any physician at all. The average density estimates of 1.2 physicians per 1000 Filipinos (WHO 2002) or 1.2 physicians per 10,000 Filipinos (ADB 1998) is still among the lowest in Asia and globally.

    The debate on MD brain drain and MD-RNs going abroad goes protracted and ironically, is still unresolved or acted upon by major stakeholders. Majority of the Filipinos still suffer from the lack of physicians especially in the provinces. This fact still hounds us all and especially the physicians.

    Is the this move by UP College of Medicine, the government’s premier medical school and that of HB 4580 of trying to stop this “exodus” and lack of physicians by requiring doctors and professionals to render service to the countrymen a valid one?

    Will the provisions of these policies offer solutions to this half a century of professionals leaving our country?

    If you think so, maybe you can elucidate some more. If you think not, please say so and elaborate on your answers. In fact, you can give recommendations and suggestion to these policies and laws so your opinion(s) will be read!

    That will be the topic for the 17th edition of The Blog Rounds– Mandatory Return of Service for Professionals: Closing the Pandora’s Box?

    Submit your link and title to my email kokegulper(at)yahoo(dot)com or leave a link by commenting to this post!Deadline for blog articles will be on Tuesday August 26, 2008.

  • Is there a shortage of physicians in the Philippines?

    The World Health Organization (WHO) use these core health indicators to determine the status of health and healthcare delivery systems in a particular country. One of these indicators directly concern me as a Filipino physician. It actually scares me the most.

    Is there a shortage of physicians in the Philippines?

    To answer this question, I tried searching available statistics in the net, evaluated the credibility of these sources and studied the parameters in understanding these statistics. The results surprised me more than being confused some more.

    Take a look at this graphical presentations and their sources.

    A graph representing the estimated number of physician(s)per 1,000 Filipinos from 1960 to 2002 (Source the WHO and reproduced here)

    The same data noted the following trends:
    For the whole of the period 1960-2002, an annual mean of 0.4 is recorded for this country. 1997 shows the highest level (1.2),1992 records the lowest (0.1). In this case, the registered change equals 695%. These numbers are based on the results for 14 years of the period 1960-2002.

    Take note, 695% increase, in 42 years. According to this data, there is approximately 1.2 physician per 1,000 Filipinos. Roughly, the same estimates as that of WHO listed here.

    Compare this statistic with that published in Philippines Special Report: The Health Care System in the Philippines December 2001 produced by MCA Ltd. Virtual-Asia.com


    According to Asian Development Bank there is approximately one doctor per 9,869 Filipinos…

    Whichever statistics you’re believing compare that with the regional and worldwide statistics in this graph.

    Physician density per 10000 population per region (2008)

    One thing is for sure. We lag behind our Asian neighbors and globally!

    How big is the impact of this indicator in the over all health care delivery system of the country?

    That I hope I can answer in my future post!