I’m publishing this blog post a bit late. I can’t stand not writing about a blogger friend and defy her preference for “slipping away” silently.
Goodbye blogger friend. We will miss your blog posts, your writing and your knack for demystifying music to us, cold souls.
Goodbye fellow bone doc. Even if we rarely had a chance of actually doing bone surgeries together, we shared the same tenacity for fishing out the medical absurdities of our work.
I hope you did take the “wave and smile” I made during your induction to the fellows fold a warm welcome and congratulations.
Once in a while I get a break from purely orthopedic stuff and wield a stethoscope as a “general practitioner”. I used to like the general medicine as a student but when clerkship bombarded me at least fifty patients a day giving nothing but prescriptions and prayers as “medicines”, I resigned myself to cutting it out in the surgical field. In my place of practice though, there are times when you’re the only doctor within 1 kilometer of a medical emergency and every other medical practitioner is busy handling other medical emergencies somewhere else. God knows what happens if the patient’s relatives find out you don’t know what atrial fibrillation looks on ECG. So when push comes to shove, I welcome instances where I can re-learn my rustic general medical skills. Or at least mount an attempt to re-learn.
Two days ago I started seeing patients for routine medical physical examination. The sheer volume of patients made me think I’d get bored or get tired sooner. Surprisingly, I found myself enjoying the “routine” job simply because its something not routine for orthopods like me. “A break in the monotony of bone breaking, hammering and screwing..” perhaps. The same fun feeling and excitement when you had your first few patients as a medical student. This routine physical examination also gives me the opportunity to look at the depth and effectiveness of my patient communication skills, especially in medical topics way beyond the orthopedic cram space.
The sheer volume of patients also brought in funny experiences and encounters you’d probably die of laughing out loud in the washroom.
Here are some of my (funny) encounters;
Patients chart says: Chief complaint: “occasional headaches”.
Me: “Masakit po ba ulo ninyo ngayun?” (Do you have a headache now?)
Patient: “Wala po”. (None)
Me to self: (Right, this encounter must not be an occasion for his headache to come out)
Here’s another:
Me: “May “cough” po ba kayo ngayon??” (Do you have coughs right now?)
Patient: “Wala po. Ubo meron” (None, but coughs I have.)
and another:
Me:” Sino po ba nag bigay reseta ng “salbutamol” sa inyo?”(Who gave the prescription for your medicine, Salbutamol?)
Patient: “Tatay ko po” (My dad.)
Me: “Doctor po ba cya?”(Is he a doctor?)
Patient: “Opo, doctor po apilyedo nya!” (Yes, this patient’s last name is “Doctor”)
You couldn’t hide snickers whenever a patient answered like this:
Me: “Kelan po ba sumasakit ulo nyo?” (When does your headache usually occur?)
Patient: “Tuwing nag tatanggal kami ng damo sa school” (Everytime we’re tasked to weed out grass in the school grounds!)
Believe me I couldn’t contain my heart laughing out loud during these light moments. I don’t know if its because of the many misunderstood and trivial complaints you get whenever its an ambulatory clinic you’re conducting (or that I was just too confined with more serious, trauma patients). One thing though, we all needed the laugh just so we can finish some two hundred plus patients each day.
Who said my specialist life is too constricted and boring? If there are instances like this where you can find time to re learn your medical skills as a general practitioner, why not? Especially, when there are plentiful of laughs you can make out of the “routine-ss” of the situation. I can surely wield some stethoscope.
Yesterday I started a survey asking healthcare professionals (physicians, nurses and allied medical professionals) if their healthcare institutions have a social media usage policy. (If you’re a healthcare professional you can still vote and comment in that post. ) Now its time to ask our clients, the Filipino patients:
Do you want your healthcare professionals (physicians, nurses allied medical personnel) and /or healthcare institutions (hospitals, clinics) to have a social media policy?
Philippines, the social media capital of the world!
This question is important and highly relevant. Why? Philippines is the social media capital of the world and there’s a surge of content sharing in these social networks. That is according to this report by the Global Web Index. Sharing health related patient information on these social networks threads dangerously on an already greyed (if there is/was) privacy and health information laws here in the Philippines. Without enforced laws or governing policies, a breach of patient’s privacy and confidential information have consequences that pose a threat to the mutual trust between patients and his/her physician or that of his/her healthcare institution.
The other reason is about enhancing patient communication. Social media is an alternative, revolutionary way in which healthcare professionals or institutions communicate or interact with their patients. Social media (though research data is lacking on this) could be a venue for positive reinforcement of actual clinical consults and follow ups. A recent survey also shows that social media is now gaining ground as source of health information in first world countries. The absence of policies regarding its use defaults the interaction to a “free for all” and often negatively affect the overall outcome of these patient-physician or patient-healthcare institution interactions.
So again, I’m asking you, Filipino patients, or anyone since obviously you are the ones will be ultimately affected by this policy.
Do you want your healthcare professional or healthcare institution to have a social media policy use?
Please vote below and comment (in the comments section) if you wanted to explain your answer. Should you want to maintain anonymous, just email me privately thru this contact page and I will assure you of your confidentiality)
Philippines ranks first in the global social media penetration according to a February 2011 market survey by Global Web Index. In this survey, it was also pointed out that asian countries do more ‘content sharing‘ than sharing messages as in other countries (UK, Canada). What is the implication of this survey results to Philippines’ healthcare system?
Philippines tops social media usage globally! (Infograph from Mashable by Global Web Index)
For Filipino patients, the surge of content sharing and social media usage puts a huge stress on prevailing (or lack of) Philippine laws that govern patientinformation confidentiality. The lackluster enforcement of such laws, if there is/was, is/are sporadic. One does not need to look further. The gruesome photos (trauma, surgical, etc) that somehow lands on your Facebook wall is a testament to this breach. It’s also not uncommon to read patient blogs, tweets and comments on Facebook that cast doubts on healthcare professionals or or institution’s credibility. Some even lead to sensational malpractice suits.
To healthcare professionals (physicians, nurses, allied medical professionals) the responsibility is even greater. In first world countries, there are stringent rules of engagement for healthcare professionals on how they relate to their patients and to healthcare institutions on social media. Such policy govern healthcare professionals employed in healthcare institutions and who’s social media usage directly or indirectly affects that of his or her employer. In the Philippines , while majority of healthcare professional and institutions does not seem bothered yet, catastrophic consequences still hangs in the future . How many times have you encountered photos on Facebook that are in one way or another health patient or institution related? Too often?
For healthcare institutions, this surge is promisingly positive should they take advantage of social media usage. This study by the Global Web Index for example is a market survey for business entrepreneurs. This could be an area for healthcare institution to reach out, communicate to their clients and improve the institutions online visibility. This is what the Mayo Clinic, Mount Sinaihospital for example is doing crafting their own social media policy to enhance patient – institution communication.
Filipinos spend one fourth of a day on social media network.(Thanks to Dr. Iris Isip Tan for posting this infograph)
But without a policy to govern such social media practices by their employees (internal) or their patients (external), the healthcare institution risks running into so many potential negative social media issues aside from economic ones (employees using social media at the workplace).
As an afterthought, let me share another info graphic about use of health related IT technologies in US (source). Take a look at the social media usage. To think, Philippines is ‘ahead” of US in terms of per population social media usage. I don’t know if Philippines has have similar figures in terms of health related social IT. This should be an interesting research for healthcare markets.
Health related IT technologies usage in US (source)
So to answer this post title-question, I’m making an informal, non scientific survey here. This is open to all medical and allied medical professionals. Please answer the poll and please comment below if you need to explain your answer.
Central to correcting medical errors is accepting one first, if it did happen. Improvement in healthcare delivery will only happen if we learn from our mistakes and make concrete, active steps to rectify it. This is what we actually do during mortality and morbidity conference- analyze medical events and cases to help improve delivery of healthcare services.
The health care industry accepted the occurrence of medical errors decades ago. But disclosing medical errors publicly is unpopular even in countries where litigation is relatively not so common. Why? No one really knows. In our society however, publicly apologizing for one’s true medical mistakes is akin to killing your medical career. I guess it’s a bit easier to admit moral turpitude publicly than let’s say admitting you misdiagnosed a patient. The acceptance is just too low.
But what can we do? First, we should create an environment of open-mindedness among medical peers and enact laws that will protect disclosures of medical errors publicly. That way, we can freely examine medical errors to institute appropriate corrective actions based on acceptable and evidenced based medical practice.
This is what John Hopkins University Hospital is doing since 2001. Their Disclosure Policy protects and actually encourages employees to confess or report medical errors. This is partly the reason why JHUH litigations have continually decreased ever since the policy has been implemented. John Hopkins is the top ranked hospital in the US for 20 years already.
Medical errors simply don’t surface over time. For us, providing a “medical whistle blower” law might just be the first step in improving delivery of healthcare services. Don’t you think so?
I’m publishing this blog post a bit late. I can’t stand not writing about a blogger friend and defy her preference for “slipping away” silently.
