Cast & Curious

Tag: Medicine

  • Cheaper Medicine Bill Part II: Not cheap at all!

    The dizzying melee over the Lower House version of the Cheaper Medicine bill has brought out some disconcerting and ironically “costly” issues to the medical community and the current Philippine healthcare industry. And these almost intangible yet paralyzing and costly “side effects” are beginning to wreck havoc and are not cheap at all!

    Even before the passage of the bill by the congress and senate bicameral committee, the Quality and Affordable Medicine Bill (which is supposed to lower the high cost of medicines in the Philippines) already took its toll on the very parties it primarily aimed to help- the Filipino patients and their MDs. Imagine these:

    1. The discussions and bickering had succeeded, in some way, of polarizing two of the primary parties to the bill. The doctors has been “demonized” ( to use Prudence’ term) as anti-poor and greedy because of their alleged ” incentive” driven practice of prescribing “branded” drugs . The PMA loudly declares “MDs are for the patient’s welfare” not some drug companies! The patients on the other hand, thought to be less informed and knowledgeable about their sickness, is deluded by unscrupulous politicians of the promise that a cheaper generic drug will heal all their illness. Imagine the mistrust (between these two parties) that emanates from this polarization! I am totally scared to even think of a doctor patient-relationship that is based on mistrust.
    2. A landmark study about the therapeutic equivalence and safety profile of generic drugs in the Philippines (compared to its branded counterpart) has yet to be heralded by someone. This is perhaps the gist of The Physicians’ arguments against some (generics only prescriptions) provisions of the cheaper medicine bill, and remains a major stumbling block towards MD’s accepting some generics drugs as a good alternative. But such studies is costly, and not even BFAD (who wallows in its funding mediocrity) nor some low cost generics drug company, will willingly spare any cent at all.
    3. That the general perception of doctors receiving “incentives” from the pharmaceutical companies (in any form) and that these incentives influences his prescribing objectivity, is a costly blow to the medical profession. Even the PMA President acknowledges that a few MDs practice such “incentive driven drug prescribing habits”, but this form of “bribery” is not unique to the medical profession. Nevertheless, such practice is totally unacceptable and is a shame to medical community. The noblest profession on earth couldn’t afford such stain to its integrity.
    4. BFAD accepted its inadequacies in implementing stringent rules on the testing, approval, monitoring and policing all (not just the generic but also branded) drugs in the market. This confession made us wonder how on the earth did the current drugs went into market after all? Are we having less or subpar medicines in the market?If BFAD is inutile, then the doctors were left with their expertise and preferences in prescribing their drugs after all! BFAD therefore needs some sort of “medicine” to take care of its ailing “status” of de facto licensing and drug regulatory agency. And in this government, where health is of lesser priority, surely it has a long way to go.
    5. The “BFAD inadequacy” thus lead to another costly move for some of exhibitionist politicians to jump gun on the MDs directly. “Screw the BFAD rehab for now (we need more of our pork barrels instead), lets police the doctors and coerce them to give only the cheapest generic drugs! More ever, lets allow the hapless pharmacist (if your lucky to face one in the drug stores) to guide the patient in choosing one of the 3 or so generics in the drug store“! Anyway, it is the doctor who will be held liable if this drug wouldn’t get its desired effects. Tell me I am all wrong but this is another costly pursuit for any parties involved, the patient or the doctor-litigation for a malpractice suit!

    Nobody wants an expensive medicine, not even the doctors. In fact, everyone is for lowering the cost of medicines here in the Philippines. Even the pharmaceutical companies themselves wants their medicines be affordable to the masses. If nobody can afford their medicines, how can they reap their profits?And if the doctors prescribe exorbitant drugs and the patients didn’t get well because he/she can afford it, will the doctors make a living?

    As Prudence has said, “lets not loose our guard in this discussion”. Because after all the hullabaloos in the race for “enacting the Cheaper Medicine Bill”, we might have been deceived at seeing the real cost of our incessant political exhibitionism.

  • The passage of the cheaper medicines act: Who’s got the better scalpel?

    I certainly laud the intentions of some politicians working hard “passing” a bill to improve our health care system. But when politicians begin to bicker with each other, I’m getting hell of goosebumps.


    The deliberations on Cheaper Medicines Act has been a flawless exhibition of our congress’ circus like “treatment algorithm” for an ailing Philippine health care system. It’s a deja vu of the Generics Act passed in the congress before- the mud (nay, shit) slinging and ass kissing, it is all governed by who’s got the numbers and the money, and not by the merits of the bill itself. Luckily for both bills, it survive the dirty tactics despite boulders of blabbering and rhetorics.

    I don’t want to go nitty gritty into the merits (or demerits) of the bill. I certainly believe it is the duty of every Filipino to read and understand congress bills affecting us, the cheaper medicines act included. No excuses whatsoever.

    I am not just comfortable with the fact that when I get sick and will undergo surgery, my surgeons would fight it out who’s got better scalpel to cut my skin. It’s darn scary!

  • Desirable traits of a good (or excellent) surgeon

    What makes a good surgeon?This is a common question that comes into the mind of patients whenever they choose their surgeons or physicians to entrust their life. There are probably a hundred of these “desirable” traits but they generally fall into “categories” of surgeon attitudes and are definitely interrelated. Medical school (and residency training) attempted to make us all adept at new skills and the science behind the art of medicine, yet there are some who excel in the hearts of their patients and colleagues. Here is why .

    • According to Dr. Thomas Russell, Executive Director of the American College of Surgeons“surgeons have to be technically adept…”, able to change when needed “…and have new ways of doing things” . This means that surgeons should have wide array of technical skills and be able to adapt or tailor his expertise to the patients he’s handling or his community of practice. This is remarkably important among us Filipino surgeons, that though we lag behind in technological advances in medicine (notice the disparity between what is taught in med school and what you have in the real life practice), we should be able to innovate from what we have with our solid foundation of scientific knowledge.
    • Compassionate and love for humanity. Filipinos are known for their superior compassion and love for their patients. Our patients expects us to be compassionate every time we deal with them. Being a Filipino, its a terrible offense not to.
    • Surgeons should be approachable and not difficult to deal with. Patients and colleagues hate any surgeon who treats them like they are inferior species of human beings. It will also save you from litigations and malpractice suits.
    • I would love a surgeon who is truthful and is open minded to any questions. He should be ready to answer any question from his patients and explain to them in a manner they can understand and relate. In this age of technological advances, not one patient wanted to be treated without having to know why and how his treated and what is his chances of recovering from the surgery.

    I can enumerate some more but this I think are the most important ones. A peculiar trait that Filipino patients wanted from their doctor or surgeons is their ability of a doctor or physician to “waive” partially or in whole the surgeons fee for rendering his professional service. While this trait is anchored probably on patient’s frugality, it can make or break your practice.

  • Skills every doctor should possess

    Perhaps, these skills apply also to Filipino MDs. Or not.

  • Trauma care facilities for bombing victims

    One bombing attempt foiled, another one killed many people and injured hundreds. Seems like a normal day for me. But I am not in Iraq or Afghanistan. I live in the Philippines.

    The news of another foiled bombing attempt in the busy marketplace of Tacurong City just went on the news because of a hero’s brave attempt at saving lives. Without such bravery and gore, I bet it would just be another addition to the so many attempts on the bomb scarred Tacurong City.

    I wonder whats with Tacurong City that terrorists seem to use it as a bomb exercise target more often! Money?Power?Politics? The place is bleeding! It had barely recovered yet from the previous bombing injuries it incurred! And here we go again…

    Manila has been rocked lately by a bomb that killed and injured hundreds of innocent victims. It is a nightmare to everyone.

    But unlike Metro Manila, Tacurong City don’t have the Level I Trauma Care center and the facilities to support medical staff tending to bombing victims. In the last powerful blast that wrecked havoc in Tacurong City, the medical support personnel were practically scampering for help and logistics and the city bled with its finances just to help the injured victims.

    Needless to say, prevention is still the best way to prevent this acts of terrorism. But when such disaster occur despite efforts to prevent it, it may be wise to just coordinate such medical interventions with the alert medical trauma response team and a Trauma Center.