Cast & Curious

Tag: Uncategorized

  • Why Talking about Money is Taboo among Physicians

    [dropcap1]D[/dropcap1]octors talk about medical stuff many ordinary people will cringe and consider foul. Stuff like STD’s or bloody eviscerations get discussed lengthily without them missing a bite of their breakfast. When discussion shifts to money matters however,  you’d hardly get discussions beyond few sentences. Here are the top  reasons why:[check_list]

    • Doctors don’t want to be heard as “bragging” their ‘high” income. Physicians generally earn more than the average worker. When doctors discuss money, it is often seen as “bragging” about their income. “Why would physicians talk about money when they’re earning more than anyone else?That’s just bragging!”
    • Doctors are rich people and rich people don’t talk about money.  While doctors earn higher than most workers, it’s nonsense to automatically consider doctors as rich people. Despite that flawed conclusion, even the truly wealthy people discuss financial matters carefully.
    • Doctors find it hard to accept they have money issues. Not a very nice thing to say about people with big suffixes after their names. The long years in med school and training gave us a sense of entitlement to spend our income wantonly. Coupled with higher than most income, this sense of entitlement often bar us from facing head on, money issues.
    • Doctors feel that money issues only affects them, alone. “The other doctors, they probably don’t have any money issues at all.” But there are telltale signs that doctors have money issues even if they don’t discuss it in public.  Complains of not enough compensation,  HMOs and claims underpayments, etc,  are all telltale signs that money for us too are issues that needed to be sorted out.  Since doctors rarely discuss money issues with their colleagues, that feeling of money issues isolation is propagated unknowingly.
    • Doctors don’t like to ask “stupid” questions.  “Who would, when I belong to an intelligent profession?” Intelligent and paid well, why would I ask such questions, hah?  When you ask someone, even colleagues for example, about money matters, the throwback question would most likely be ” Didn’t they teach you that in med school?“. There’s practically zero money learning in med school. Our professors would tell us “Ah, you’ll learn those when you go into practice. Learn from who? From experience? Thus we take this stance of “yeah I know it” when we actually do know nothing. I don’t know, but I’d look very stupid pretending to know something about money matters when in fact I don’t know anything.
    • “It’s taboo discussing financial lifestyles, it’s not us, doctors.” The dilemma most doctors have today is that as role models, we’re just here to deal with the health of our patients and communities. Nothing else. We’re not supposed to deal with finances as it confabulates our practice of the profession. Most people think we’re super humans,  that all we do for eternity is heal, care and work without having to feed our family. It’s really a good thing to render  charity service but it’s not immoral and illegal to earn from services you rendered. How can you possibly continue to care for patients when you’re wallowing in debt or without housing?  Please tell me.
    • “I’m busy saving lives, I have other more important task to finish than talking about money.” Correct. But until when? Should you wait being thrown of your mortgage house or default in your new car because you were busy and didn’t care to check on your financing? How can you save lives then when you can’t even save a part of you thats sustaining your service or profession? Again,  lets not succumbed to the idea that we’re super humans and that financial woes exempt physicians. I’m sure nobody thinks he or she can still go on hospital duty 24 hours when they’re already 60 simply because he/she didn’t plan out a retirement for him/herself. Busy you said?
    • We really have not learn money sense from our parents. Again, the more we should strive to have some sort of financial literacy or we’ll just pass that legacy to our children. For many Filipinos, financial maturity is being equated to frugality or thriftiness on everything. “It is the only trait I wanted to learn“. Well, being frugal and thrifty will surely save you money and expense but how will you plan out your retirement, your children’s education etc etc?
    • We’re afraid the internal revenue agency is eavesdropping and will hunt us down and tax us to the max. I’m not sure whether eavesdropping or maxing out on taxes is the mantra of that agency, but there’s only one reason I can think of if you’re afraid of that agency- You don’t pay the right taxes. It doesn’t matter if your excuse is ignorance about taxation laws and hence you  don’t have any idea how much you should pay. It is still not paying the right taxes and in the legal parlance, that’s still cheating. Again, If you’re at least financially literate, you would know the right taxes you should pay and which one will legally exempt you.

    [/check_list]

    Why am I enumerating these? These are the same stumbling blocks I encountered when I started learning personal finance as a physician. The taboo like treatment of money issues inside the conservative hippocratic institution is painfully hindering me from gaining financial freedom.  It is only by learning personal finance that I finally come to terms with these undeniable facts:  Even doctors aren’t exempted from financial woes and that financial freedom is not the same as getting rich. So, for as long as I needed to learn something for me to achieve that goal of having financial freedom as a physician, I’d willingly talk, discuss and listen to money issues within my profession. Taboo or no taboo for others.

  • This is an opionion

    Mavik Banner: physician; scientist. Searching for a way to tap into the hidden strengths that all humans have… then an accidental overdose of gamma radiation alters his body chemistry. And now when David Banner grows angry or outraged, a startling metamorphosis occurs. The creature is driven by rage and pursued by an investigative reporter. The creature is wanted for a murder he didn’t commit. David Banner is believed to be dead, and he must let the world think that he is dead, until he can find a way to control the raging spirit that dwells within him.

    What would we do baby, without us?

    I bet we been together for a million years, And I bet we’ll be together for a million more. Oh, It’s like I started breathing on the night we kissed, and I can’t remember what I ever did before. What would we do baby, without us? What would we do baby, without us? And there ain’t no nothing we can’t love each other through. What would we do baby, without us? Sha la la la.

    Here’s the story of a lovely lady

    Here’s the story of a lovely lady, who was bringing up three very lovely girls. All of them had hair of gold, like their mother, the youngest one in curls. Here’s the store, of a man named Brady, who was busy with three boys of his own. They were four men, living all together, yet they were all alone. ‘Til the one day when the lady met this fellow. And they knew it was much more than a hunch, that this group would somehow form a family. That’s the way we all became the Brady Bunch, the Brady Bunch. That’s the way we all became the Brady Bunch. The Brady Bunch!

    Who can turn the world on with her smile? Who can take a nothing day, and suddenly make it all seem worthwhile? Well it’s you girl, and you should know it. With each glance and every little movement you show it. Love is all around, no need to waste it. You can have a town, why don’t you take it. You’re gonna make it after all. You’re gonna make it after all.

    In time of ancient gods, warlords and kings, a land in turmoil cried out for a hero. She was Xena, a mighty princess forged in the heat of battle. The power. The passion. The danger. Her courage will change the world.

    Being evil has a price. I hear a lot of little secrets. Tell me yours, and I’ll keep it. You oughta know my name by now, better think twice. Being evil has a price. I’ve got a nasty reputation. Not a bit of hesitation, you better think twice. ‘Cause being evil has a price.

    Chosen from among all others by the Immortal Elders – Solomon, Hercules, Atlas, Zeus, Achilles

    The time to play the music, it’s time to light the lights. It’s time to meet the Muppets on the Muppet Show tonight! It’s time to put on makeup, it’s time to dress up right. It’s time to raise the curtain on the Muppet Show tonight. Why do we always come here? I guess we’ll never know. It’s like a kind of torture to have to watch the show! And now let’s get things started – why don’t you get things started? It’s time to get things started on the most sensational inspirational celebrational Muppetational… This is what we call the Muppet Show!

    Chosen from among all others by the Immortal Elders – Solomon, Hercules, Atlas, Zeus, Achilles, Mercury – Billy Batson and his mentor travel the highways and byways of the land on a never-ending mission: to right wrongs, to develop understanding, and to seek justice for all! In time of dire need, young Billy has been granted the power by the Immortals to summon awesome forces at the utterance of a single word – SHAZAM – a word which transforms him in a flash into the mightiest of mortal beings, Captain Marvel!

  • Taming a Firecracker Craze Nation

    Filipinos should get rid of another culture we imbibed from colonizers – the love for the new year, firecracker bang. It is said that new years eve revelries isn’t “happy new year” without a loud, ka-boom in our backyard.

    The firecracker lighting habit, will supposedly ward off  bad “spirits” and bad luck in the coming year.  An entirely huge  business market (legit or otherwise) emerged from this  habit. This , together with our superstition,  fuel a culture of indifference that is dangerously playing with life threatening injuries.

    Legit firecrackers makers says it’s a problem with implementation of regulations, the illegal ones say they’re just “earning a living”. Department of Health noted there is a yearly reduction of firecracker injuries (17% this year) and proposes a selective ban of firecrackers. The national overnment on the other hand  let the local government impose its own “rules” on their constituents. What does the ordinary Juan dela Cruz say? 

    No (credible) survey has been made on this yet. If ever there will be, will you be for a total ban on firecrackers or selective ban? Please comment below for your answers.

    As a physician, I had my stand on this since 2009- a total ban, and I’ve said my reasons years ago in the same post. In a country where imposition of ‘selective” laws is wanting (selective logging ban, remember?), another selective law is a joke. (Ironically, some of our esteemed authorities was caught on camera squabbling to get their hands on firecrackers confiscated after their photo-ops!).

    Loss of fingers and hand functions from a firecracker (Photo by Phillip Ko)
    Loss of fingers and hand functions from a firecracker (Photo by Phillip Ko)

    From a physician and surgeon who deals with firecracker injuries every new year, even a single firecracker injury is unacceptable. It is one totally avoidable surgical condition and expense. Be realistic? Look at Davao City, who had a total firecracker ban for many years already and have zero firecracker injury case for 4 straight years. How much did the local government saved on the medical expense of treating firecracker injuries? of fires brought about by firecrackers? Of cleaning up trash? Treating bronchitis from smog of firecrackers?

    Firecracker reduction and statistics are for bureaucrats who deal with laws.  I deal with extremities, with functions and quality of life. That is obviously a minus for those who were victims of firecrackers! Thus I repeat, a single firecracker injury is unacceptable. Total ban on firecrackers should be imposed.

     

  • Prison break

    Today, one of the longest overstaying patient I had finally went out of the hospital.

    Everyone gonna miss this jolly, friendly guy for sure.

    But he seem not happy.

    He’s being escorted out of the hospital and into a jail, for a crime he committed before he was admitted.

    Guess, he liked the ambiance of this hospital than the place he’s going to live in for some time.

    If I was in his place, I’d be sad too.

     

  • Should new technologies in medicine threaten one’s (old) practice?

    In one community where I practice, no hospitals offered diagnostic procedures like CT Scans or MRI (Magnetic Resonance Imaging). Thus the current practice is to immediately transfer the patient to a nearby hospital with such capabilities. This, in spite of the fact that medical professionals here can actually perform the needed medical procedure after the CT was done. This practice went on for so long as I can remember and physicians bothered less and less about honing their skills managing ill patients diagnosed with the help of  a CT Scan.

    Until one day, one hospital invested in a cat scan. Many physicians suddenly find themselves in a dilemma. That despite, the availability of a ct scan now, many physicians lacked or simply forgot to learn or re-learn how to manage patients that was diagnosed with the help of a CT scan.

    Many physicians view new medical technologies as a threat, simply because they lose patients in the process.  Somehow though, there’s this lukewarm acceptance for re-learning of skills. The quandary is not about what you don’t know, but about how confident are you in managing those that you now knew because there’s a CT. Should they still refer the patient to another city for treatment despite the fact that the diagnostic technology is available here already? Would you see this as an opportunity for re-learning or would you simply refer the patient and free yourself the hassle of it?

    This is just an example of technologies that threaten conventional practice. Many physicians view it as a threat, simply because they lose patients in the process but somehow, there’s this lukewarm acceptance for re-learning of skills. For some, this an opportune moment for seizing the timing for creating value added services (like ICUs and neurosurgery) in the hospital. For patients, this is totally a welcome development and improvement. Lower costs and convenience for both the diagnostic procedure and the value added service cannot be simply ignored. New technology, if indeed necessary, is here to stay.

    So are you going to just ignore it and go on with your old practice or re-learn skills to adequately manage the influx of patients as a result of new technologies? Put your comment below.