Tag: Medicine

  • Top Five Health Care Priorities Needing Immediate Positive Action

    What are our healthcare priorities?

    Health care issues that have been there before he ascended into office. Pres. Benigno Aquino III, my president, if health is one of your top two (other is education) thrust for governance, these are the issues that needed your immediate attention and resolution.

    1. Realistic, workable and universal health care reform policy that covers ALL the stakeholders in it.
    2. Control population growth explosion vis a vis the reproductive health care law implementation.
    3. An national health insurance system that is expanded and will benefit not just patients but to health care providers as well.
    4. Implementation of Magna carta’s for patients, magna carta for health workers, including the freedom of the “Morong 43”.
    5. Restructuring of the medical education act and the policies governing education of our health care workers.

    Too much?Impossible? Hard definitely. But not impossible. Six years enough?I took Ninoy his life to give us our freedom. Whether you like it or not, that will be our standards for your performance.

  • Why I am for a government funded universal health care system in the Philippines

    Yes. I am for a “universal” health care in the Philippines.

    I cannot think of anyone not wanting a “secured” (meaning easily accessible, convenient, and efficient) health care coverage especially at the point of need. Majority (except US until, recently) of developed nations have some sort of universal health care system that protects its citizens.Look at their health indicators as a result of this. All points to a ‘healthier’ population. Simplistic, yes, but then personally I think health care should be that way. Everyone, every citizen should have access to an affordable, efficient and effective health care system (more…)

  • Relaunching a Rejuvinated Season Two Blog Rounds! Join us once again!

    Six months ago we were poised to rejuvenate season two of TBR. Some of us actually did submit articles for inclusion but it never went beyond my draft. Sorry, my mistake actually.  I thank all those who gave an article for that bungled season two. My apologies, to all of you.

    To make amends and to revive our thirst for more blogging action, I, together with some blogging MDs are re-launching Season Two of TBR. No fanfare, just pure blogging indulgence on stuff that affects our lives, our patients and the world we live in as physicians. I’m sure we all miss the fun!

    I’m encouraging my fellow blogger MDs to comment below if you wanted to again join TBR. It will also be our guide in choosing our host blogs for the carnival. For those who are new to TBR feel free to read our previous round ups and guides here so you will know how and when can you join.

    Here are a  few new guidelines for the Season Two of The Blog Rounds:

    1. The Blog Rounds edition host each week shall be chosen at least 3 days prior  to posting of the call of articles. Adherence to hosting schedule is very much encouraged.
    2. Call for articles for the upcoming TBR edition should be posted on the host blog by  6:00PM PST of Sunday
    3. Blog articles for carnival are due by 11:59 PM PST Friday the same week.
    4. The Blog Rounds round up of posts will posted on the host’s blog, 12NN Saturday the same week after the call for article post.
    5. Send the host- blogger for that edition (schedules are listed here) an email containing the title and url link to your post.
    6. One entry per blogger.
    7. Short, recent posts between 200 and 300 words are preferred, but we’re not banning dissertations should you insist.
    8. Posts are to be written for a general audience and may be medical or non medical, depending on the category or topic chosen by the host blogger.
    9. The host blogger has the sole authority and responsibility of choosing the topic, announcing them, receiving the contributions, proof reading it, and posting them as he/she deemed fit for his/her topic of choice.

    In short, we’re reverting back to the old weekly blog rounds format, but with a shorter more concise posts. Also, the scheduling is designed with the work week and leisurely weekend in mind that approximates a busy MD schedule. Of course there is always a leeway for the schedule especially during emergencies, but I highly encourage contributors and host to stick  our schedules which I will be posting soon.

    One more thing, I’m changing our TBR logo to a simpler one for easy pasting on all our blogs. Lets enjoy blogging again!

    I miss the blog rounds. Everyone else I talked to seem to miss our blog rounds. Even some of my non medical friends miss it too.  Heck they were actually reading our blogs!

  • Some peculiar Filipino health habits and physician consultation behaviours

    Filipinos in general,  have some peculiar, health and physician consulting habits  It’s an observation many of us (physicians) noticed even before my generation of medical professionals. Surprisingly, we somehow developed  an adaptive, physician-patient working environment that is “attuned” to such behavioral peculiarities. Even if sometimes, they are as annoying as fascinating as they can be!

    Some words of caution though and a bit of a “disclaimer”. I’m pretty sure these are not unique to my set of patients nor to my field of specialty. Also, I am not saying these habits are trademarks or are unique to every Filipino patient out there. There are plentiful of exceptions and there are probably a hundred more similarities with another nationality. Certainly, I don’t want to stigmatize Filipinos but I’m sharing across a set of unique habits that sometimes hinder delivery of health care.I am not passing any judgment on these also, since I believe, talking and working these out with your personal physician is best in curbing some of these peculiar habits.  Let’s do away with those and read on my observations. Feel free to agree or disagree by commenting afterward.

    1. A lot of patients seek consult about their health problems late in the stages of their disease. Pag malala na saka pa lang ipakonsulta.
    2. Many seek physician consult as a last resort. They go through the rigodon of first seeking the opinions of these people : neighbors, friends, albularyos and then finally a physician. I still get patients who have their x-rays taken because a bone setter told them to do so. Rarely, I get referrals from them, with x-rays already!
    3. Some patients really like to switch the urgency of their diseases on their own- an emergent problem needing immediate physician attention to a non emergent problem and vice versa. Pag emergency ang kaso, palipasin muna ang ilang araw bago dalhin sa hospital. Pag di emergency naman sa Emergency Room agad ang punta at nag aapurang makita ng duktor.
    4. Most patients love watches but hated time. They’re in the habit of seeking consult outside the physician’s clinic schedule. A plethora of excuses may come your way, ranging from the death of some relative, to the death of someone elses’ dogs.
    5. A lot of patients do listen, but rarely ask questions or clarify their health problems. They leave your clinic nodding and then call their docs when they get home. The usual question? Anu nga ba yung gamot na iinumin ko doc?
    6. Some patients do not want to wait in line for consultation. So they employ all sorts of maneuvers to go inside the clinic first only to remember they haven’t got their lab exam results yet!
    7. “Kaw na bahala doc, kung anu yung pinaka maganda na gagawin sa akin-Is the most common response  I get whenever I ask patients what’s their decision on the options of treatment I just lengthily explained to them.
    8. Most patients do not know what medications they’re taking or for how long they’re taking it already. Others skip medications and drink only on as per liking basis. Despite, take note, despite their docs telling them about it and giving them prescriptions.
    9. It’s not unusual to see a patient taking an antibiotic for a month thinking it was some sort of vitamins. And they think antibiotics are as harmless as candies.
    10. Some patients ask for medical advice that they rarely follow or worst, do the exact opposite. There’s always the physician to blame for unclear instructions.
    11. Frugality aside, most pinoys give less priority to their health than things like a new dress, eating in a restaurant, malling, alcohol, loaded diet and all other things except the word health.
    12. Vitamins is the most sought after “drug”. Second is an albularyo. They are not drugs and many don’t need any of them anyway.
    13. The macho guy patient is the cry baby. Ask the nurses who give skin testing for drug medications in the ER.
    14. So far, the best and effective form of advice I gave is, surgery. If you tell a patient you would operate on him if he won’t follow the medical treatment you give, 90% of a time, he’ll do the medical advice. Works wonders for me.
    15. Many still think that unhealthy diet, obesity and lack of exercise can only kill patients other than themselves. So party living in the meantime is necessary, until it gets worse.
    16. Those who swear in front of their physicians,  are most likely the first to break them.
    17. Most have this habit of comparing their disease to other diseases of another person, even if the two entities are kilometers in difference. Then they worry about someone else sickness and not theirs.
    18. Some patients do pop out like mushrooms on rainy days, and disappear suddenly like thin air on good days. Nobody follows up when they feel good up front despite the careful advice of a close follow up.
    19. Many prefer to have their children seen at the slightest fever, rather than themselves when they are spitting out blood.
    20. The last but certainly not the least annoying is, patients believe and only follow the medical advice that they like. This selective understanding is often used to support an unfounded belief and realigned to suit a particular socio-cultural belief and tradition.
    21. (Updated) The bantay (guardian) system. On the positive side, we rely on bantays to assist us in providing personal care of the patient. But sometimes, some Pinoy bantays are really just mirons (kibitzers) and just meddle on issues for the sake of gossiping. Whew!

    So, these are all I can think of for now. I’m sure there’s a lot more to tell but well, I’ll leave the others to my colleagues! So which among these traits or habits do you have as a patient? Leave a comment to reply!
    (Update: After I wrote this article, I stumbled upon Doc Emer’s posts some 2 years ago about the same topic. We have strikingly similar observations in not a few instances! Here , have a good read on his post)
    Photo credits: Photo taken from here

  • Unceremonious unseating of UP-PGH Director

    Here is one concise analysis of the UP-PGH Directorship issue from the former dean of the UP College of Law, Raul Pangalangan. Original article can be read here in his column in the inquirer.net.

    Unceremonious unseating of UP PGH director
    By Raul Pangalangan
    Philippine Daily Inquirer
    First Posted 22:39:00 03/04/2010
    I AVOID writing about faculty intramurals in the University of the Philippines, preferring to talk instead about the more benign politics of murders, massacres and wars. However, the recent unceremonious ouster of a sitting hospital director smacks too much of Malacañang-style politics that writing about it, come to think of it, is just like writing about President Macapagal-Arroyo.
    On Dec. 18, 2009, the university’s Board of Regents appointed Dr. Jose Gonzalez as the new director of the UP Philippine General Hospital. I do not know Gonzalez, have never met him, have never spoken to him. I also do not claim to evaluate his qualifications or platform. I write solely about the sheer brazenness of his ouster.
    The university is governed by the 11-member BOR, consisting of two co-chairs (the Commission on Higher Education chair and the UP president), two seats for Congress (one each from the House and Senate), four organic members each chosen respectively by the faculty, students, staff and alumni (“organic” in the Gramscian sense), and three non-organic members or as the Philippine Collegian loves to call them, “the Malacañang appointees” (a four-letter word in Diliman’s lexicon, as you can imagine). Gonzalez won by a 5-4 vote. He got the vote of all the four organic regents plus the tie-breaker by the CHEd chair.
    On Jan. 4, 2010, the first working day after the long Christmas holidays, the BOR officially announced Gonzalez’s appointment. This is where the story starts to get exciting. The next day, at around noon, UP president Emerlinda Roman announced that one of the non-organic regents, former Supreme Court Justice Abraham Sarmiento, had filed a protest letter to strike out the vote of the student regent, Charisse Bañez, on the ground that she did not enroll for the second semester. On that basis, Roman appointed an officer-in-charge for PGH, which provoked opposition. On Jan. 7, the long-delayed formal appointment of Gonzalez as PGH director was finally released and on that same day, he took his oath.
    In its January meeting, the BOR upheld Sarmiento’s motion to declare the seat of the student regent vacant and to nullify her vote in the earlier decisions. The organic regents walked out: faculty regent professor Judy Taguiwalo, staff regent Clodualdo Cabrera, and Charisse. Alumni regent Alfredo Pascual, president of the UP Alumni Association, did not participate in the vote.
    In its February meeting, the BOR nullified the appointment of Gonzalez and elected Dr. Rolando Domingo as the new PGH director.
    To start with, why the tangled legal attempts to block Gonzalez? Why try to appoint an OIC when there was no vacancy? How can the vote of a collegial body be set aside without a collegial decision, and on the basis of a letter by one regent? Is there such a thing as a super-regent whose solitary vote overrides those of his colleagues?
    Gonzalez is entitled to hold office for the duration of his term. In the archaic language of the law of public officers, the “termination of official relations” occurs only upon death or disability, retirement, resignation, expiry of term of office, abandonment, abolition of office, recall or removal for cause. Not a single ground is present in this case.
    The entire ouster of Gonzalez was actually carried out by first ousting yet another person, Charisse Bañez. Indeed Charisse wasn’t enrolled, but there are two important issues here. One, when her vote was counted in favor of Gonzalez on Dec. 18, the BOR fully debated her enrollment issue (even asked her to step out then) and decided that she could vote. I recall the joke during martial law. Marcos was complaining: Filipinos are so demanding—I already let them vote, now they want their votes to be counted! The BOR must respect its own decisions, and not reverse it only after they discovered that Charisse voted for Gonzalez.
    Two, Charisse has a pending application for residency as a student, which is routinely approved for others but which has been kept hanging for Charisse who, not surprisingly, has been harassed by a series of disciplinary cases filed for her activist work. Again, I do not know where she stands ideologically—and I have my own criticisms of the dogmatic and doctrinaire—but the students have chosen her as their regent and the school administration cannot frustrate the students’ choice by harassing her with disciplinary cases.
    Irony of ironies, it now turns out that the three Malacañang appointees all have expired appointments. President Arroyo appointed them merely as “Acting Member, Board of Regents.” However, the Administrative Code, Executive Order 292, provides that “in no case shall a temporary designation exceed one year.” All three had exceeded one year. Sarmiento himself was appointed on Sept. 29, 2008. They were all essentially impostors on Dec. 18, trying to oust the student regent who enjoyed an authentic mandate.
    The BOR has pooh-poohed that argument, saying that “acting” is different from “temporary.” In what way, I ask? That is a cockamamie legal distinction. I ask the BOR: What is the difference between an “acting” regent and a “temporary” regent? The “acting” designation is as temporary as it gets.
    What I have chronicled here is familiar to us by now: the Machiavellian manipulation of technicalities to justify just about anything and to maneuver events to get precisely the desired result. It is a mindset, a way of life, that I identify with the Arroyo administration, and I am saddened when I see it practiced in a university that has become a part of my life since I entered as a freshman 36 years ago.
    Originally published here: http://opinion.inquirer.net/inquireropinion/columns/view/20100304-256678/Unceremonious-unseating-of-UP-PGH-director

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