Filipino Doctors

Filipino Doctors, Sacrificial Lambs
> by: Michael Hussin B. Muin, M.D.
>
>
> By now, everybody knows of Elmer Jacinto--the
> February medical boards topnotcher who publicly
> announced his plans to work in the US as a nurse. I
> was in Zamboanga City visiting my parents when that
> news broke out. A topnotcher from Lamitan, Basilan
> hit close to home and I showed the article to my
> brother. His only question was, "Why? Doesn't he
> have any offers?"
>
> I could only laugh and muster a short, "No, I don't
> think so."
>
> Elmer Jacinto's situation and the reactions from
> various sectors are both funny and sad. I can only
> think of my brother's question and wonder: What can
> the country offer its best and brightest in the
> medical profession?
>
> The short answer is none.
>
> Unlike the legal profession, of which the medical
> profession is often compared to, there are no offers
> made to topnotchers. We've read news of bar
> topnotchers invited to join prestigious law firms.
> Top law graduates are employed even before the bar
> results are released, while some receive hefty
> signing bonuses from happy employers.
>
> Medical board topnotchers are not that lucky. After
> a day or two in the light of fame, most fall back to
> the shadows of anonymity--their achievements a mere
> footnote in their résumé. We hardly remember the
> board topnotchers of the previous years. How many of
> them are practicing in the provinces, much less in
> the country? Can you just imagine the public outcry
> if we found out that only a few have stayed?
>
> Therein lies the problem--the public outcry. Why is
> the public so pent up about doctors going abroad as
> doctors or nurses or caregivers or whatever? Because
> my short answer is not exactly correct. The country
> does have something to offer the graduates of the
> most noble profession: the poor and sick of the
> Philippines. Physicians, especially new ones, are
> expected to grab the opportunity to serve--for a
> pittance of a fee, or even for free.
>
> I tried my hand in volunteerism once when I was "in
> between jobs"--or, in short, unemployed. Living a
> few blocks from the Malate Parish, I volunteered my
> services to their social services division for one
> day a week. I scoured the streets of Manila for jobs
> on Mondays to Thursdays, while I devoted Fridays to
> the urban poor of Malate. They gave me an old desk
> in the small office at the back of the church. The
> social worker announced my presence to community
> leaders, and, in no time, I was seeing 10-15
> patients a session, which isn't exactly heavy.
>
> It was a fun experience. A patient wanted me to give
> him a medical certificate stating that he should
> sleep on cement benches because it was good for his
> back. He was supposed to show this document to
> police officers of Luneta where he spent his nights.
> Another patient, a jolly 80/M, went to see me not
> for a check up but to show off that he was in
> perfect physical health. He would do jumping jacks
> and push ups in front of me.
>
> It was also a time of desperation. A stroke patient,
> with half her body paralyzed, persistently showed up
> every Friday, limping her way through Manila
> traffic. She continued to have a BP of 200/140.
> Another patient had a resting systolic BP of
> 220-240. The list goes on. And I could do nothing
> but prescribe the cheapest anti-hypertensive. But
> they all had the same excuse: they didn't have the
> money to buy the drugs.
>
> Not willing to lose a battle, I wrote the Parish for
> some support, financial or otherwise. I was asking
> for some drugs, about P800 worth, and a P500 money
> pool, in cases of emergency. And they replied that
> they can't contribute at the moment since they're
> finishing the wing for the missionaries, putting in
> a library and air-conditioning. I kid you not! I
> wrote a short letter to the city government, but
> they said all health support should go to the local
> health center.
>
> One Sunday after mass, the parish social worker
> informed me that the Rotary Club of Manila was
> conducting an outreach program. I went with her and
> talked with the President of the club. They agreed
> with the whole package, insisting only that I submit
> proper accounting reports every month for their
> newsletter. I can't say it was smooth sailing from
> then on. It definitely helped me with some of my
> patients, monitoring for drug response rather than
> just looking on helplessly.
>
> My experience is not unique. Volunteerism doesn't
> have to be so obvious. Surgeons forego professional
> fees after operations, internists accept P20 for
> consultation fees, pediatricians charge break-even
> for immunizations, and general practitioners accept
> eggs and chickens in exchange for services. These
> may be small acts, but they are by no means less
> heroic.
>
> There are, of course, doctors who work with the
> poorest of the poor. Volunteer doctors to the
> war-torn parts of Mindanao would have different
> stories: their experience more colorful, their
> desperation more intense, their helplessness more
> personal. Their dedication is a strong testament to
> their character. These doctors who work with the
> poor often become poor themselves, and I have
> nothing but the utmost respect and admiration for
> them.
>
> In all these cases, doctors are found in the
> frontlines of poverty. They work with almost no
> logistic and financial support. They carry the
> burden of salvation for their countrymen, with
> little or no compensation, with little or no thought
> of self. But the fact remains that mere presence can
> only do so much. What can a doctor give if he has
> nothing more than compassion and care? Is that
> really enough?
>
> It's ludicrous how the public expects too much of a
> sacrifice from Filipino doctors, when it expects too
> little from its government officials. The fight for
> better health is a fight against poverty. It is not
> won by doctors becoming poor themselves, but by
> government officials becoming the leaders they need
> to be. Doctors do not make laws, allocate resources,
> handle budgets, public officials do. Doctors do not
> get kickbacks, destroy public trust, and plunder
> taxpayer's money, government scalawags do. So, when
> did doctors become sacrificial lambs for the
> ineptitudes of Philippine government?
>
> The public flogs physicians, living on P10,000 a
> month, who pack up and go to the US as nurses, when
> they pay no mind to regional directors, earning
> P22,000 a month, who go abroad as tourists for weeks
> at a time. People look suspiciously at doctors
> driving a brand new Toyota Corolla after 5 years of
> practice, when they find nothing wrong with mayors
> sporting shiny Ford Expeditions after 6 months in
> office. If we should mourn for doctors who leave,
> let us grieve more for corrupt officials who stay.
> If we should complain of doctors who dream of decent
> living, let us condemn more those unscrupulous
> government employees who lead obscene lives. Wounded
> souls search for healing in other countries, but
> there is no cure for callous hearts.
>
> A mayor once asked me to join a free medical mission
> he sponsored. I humbly asked if there was any
> payment involved for my services. "Ah, eh, wala.
> Pero libre naman ang pagkain. Tapos ipapahiram ko
> naman yung Pajero ko at isa kong Starex para libre
> na rin yung transpo."
>
> I wanted to bitch-slap him until his lips bled.
>
>
> ---------------------
> Michael Hussin B. Muin, M.D. is the Founder and
> Editor-in-Chief of Pinoy.MD - The Website for
> Filipino Doctors. He is a professor of Clinical
> Anatomy and Medical Informatics in Pangasinan.