Doctors Vs Social Media and Philippine Health Care System

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Doctors and Social media.  MyFinanceMD was put up to educate doctors on how the world of finances works. But now, I am writing this post not to educate the doctors, but to educate the people and society on the entire health care system.

There has been a recent viral post regarding an incident where a child died due to an “alleged neglect of an OBGYNE in a Private Hospital.” Maybe many of you have seen it and cried with it, because I did too, it was so sad it even happened. First and foremost, I would like to sympathize with the death of the child, nothing is more painful in the world for a parent than losing a child, I am a mother too.

But before pointing a finger to a single person in this incident, please have an open mind and heart about what I am going to say.

  1. The OB that was singled out was a resident physician, she is working in the hospital 24-36 hours duty every other day, with 15-18K allowance every month.   A minimum wage worker earns even more than her since they only work for 8 hours a day, 5 days a week (40 hours a week). For resident doctors, they work 100+hours per week (note: we only have 168 hours per week), no holidays and oftentimes no weekends off. If she only wants money, there are more profitable professions out there.

 

If the hospital has pre-deposit policy, she will never gain anything from it. In USTH, (clinical division), the doctor’s fee and room/service are free. But all procedures and medications are paid for. She is following a rule. No matter how much she would want to operate, her hands are tied to the hospital policies, she cannot just accept the patient and operate. She cannot use the facility even if she wants to.

 

  1. Even if they have a pre-deposit policy, the hospital will not chase away patients if they are still unstable. They always make sure that before making a patient transfer, it is in a “stable condition.” Yes, maybe painful and bleeding, but stable condition. “Stable means” there is still enough time to get to another nearest hospital. As mentioned in the post, they were examined before they were advised to transfer.

 

True story: There was an incident in the same hospital, that a woman was about to give birth. Seen and examined, and triaged as emergency. No deposit, not even a check-up done in the hospital (which is a requirement usually in any birthing facility), yet, they still admitted and delivered the baby. Happens many times even in many hospitals in the country but not tweeted nor posted in social media.

 

  1. They reached another hospital, and where turned away, because there was no incubator. The post did not mentioned if they were examined again in that hospital before they were turned away. It is a protocol. To make sure to examine the patients (mother and baby) before advising them to transfer. Yet, the post did not mentioned if they were examined there or no.

 

Why return to UST if, there is another government hospital nearby. Why not Fabella, few distance away from JRMMC. Why go to East Avenue, in Quezon City?

 

These are questions we need to ask. Questions need to be answered before passing judgement to a single person responsible.

 

I repeat, I am not defending the doctor, nor the institution but before pointing a finger to one person and destroying her entire life, consider blaming the entire health care system of our country too:

 

Few points you have to consider:

  1. The health care system in our country is SICK. Do you know that in other countries, if  they pay taxes, HEALTH CARE is their RIGHT? If they get sick, the government takes care of them until either they die or gets completely healed?

During my visit in Canada last 2014, and I got to visit a family of a friend I am with (a Filipino-Canadian Citizen). She is in the hospital for about 2 years then. She was diagnosed with Breast Cancer. I was amazed not because she is still alive, I was amazed because she has been in the hospital for the last 2 years with not even a single dollar to pay. When I ask why, they said, there are only 2 reasons where she can go out. One is she is healed completely, another is if she dies. And this happens not only in Canada but even some Asian countries besides us.

In our country, Health Care is a privileged for only those who can afford. PhilHealth is an attempt to help us but realistically speaking, it only helps you a little then you are on your own.

  1. In our country, we are paying up to 32% income tax, 12% VAT every time we buy anything, and yet, our country cannot even afford to make health care a right for every Filipinos. Our taxes are not even enough to buy an incubator? Why?

 

Government hospitals, bakit walang “incubator” up to now? This has been a problem since time immemorial.   When I was still a student in a government hospital, there were not enough facilities. If there was a time that we were very lucky there was an incubator, it is either only one or two, and the other is non-functioning. That was 6 years ago, up to now, wala pa ring incubator? I don’t blame the hospitals, I blame the support system from the government for not providing those essential life-saving apparatus. Why are there not enough funds that are allocated for health?

 

  1. To the patients, giving birth is not an emergency that happens anytime like stroke or heart attack. It has a 9-month-developing-period. For those who wanted to start a family and for those who are planning to have a family, there is such thing as “saving” before giving birth. Strategic plans should have been well thought off.

 

Saan manganganak?

Saan pinakamalapit na kayang Hospital?

If magka-premature delivery, saan pinakamalapit?

Magkano dapat itinatabi ko every month bago manganak ang misis ko? Paano if premature?

Saan mag-prenatal check-up? If they had this, this case is preventable.

 

 

That is also called “responsible parenthood.”

 

I had a fair share of delivering babies in a government hospital. It’s sad that, many are giving birth there with not even a 500 pesos in their pocket. “Pangtahi man lang sa kanila. Bakit?” For doctors there, it becomes out-of-the-pocket expense for us. What can we do? “kaysa magbleed sila to death, we buy the sutures for them.” And yet, have you heard of any doctor, going to social media to tell the world of our experiences like that every day? If we do it, you will get tired of hearing that from us every day.

 

Have you heard anything from us, that people around us gets free consult every time they see us. Be it in Facebook chat, in messenger, in text, in calls. It is our source of income, yet, we give it for free because you need it. Have you heard a doctor rant about that in social media? No.

 

I am not here to defend anyone. I am not saying that what the doctor and hospital did was right nor wrong. Yes, obviously something went wrong, but, it is not right to point finger to one (1) person as responsible.

 

This is clear case of trial by publicity. We did not even heard what the concerned doctor has to say. Do you think it’s fair? “Killers and rapist nga tinatanong bakit ginawa ang crime nya.” Pero ito, people are posting the picture of the doctor anywhere and labelling her as “mukhang perang doctor”, “killer doctor” and etc. People are invading her privacy for this, without asking her side of the story. Put yourself in her shoes. What if, she has a version of her own and yet unheard?

 

Social media has been very cruel to her and some even generalized the entire profession and all the doctors. Many judge the doctors that we only want money. Well, I say, yes, there are few who may be like that. But most doctors will never turn its back to patients in need. That, I am sure of.

 

I do not know personally the resident physician involved. But I know some of the student doctors who knew her personally. They described her as kind and very passionate doctor who really loves what she does. What if, there is a  story behind all of these that is unheard of?

 

We already heard the one side of the story but not the other side. And maybe some of you are one of those who judged quickly and shared the viral post. What if it’s you that is being bullied now?

Lessons to be learned in this incident:

 

Social media has already destroyed a reputation and a whole life of a person here. For all of us, at least learn something from this.

“An Unexamined Life is Not Worth Living.” – Socrates

 

Patients (In General):

  • Before blaming others, look at yourself first. Pregnancy is long. Plans and contingencies should have been put into place before the 7th month of pregnancy or even before even planning to start a family.
  • We know the government is not so capable now, but we also have to do our share. Are you even contributing to your PhilHealth? “Sabi nga nila, if may pang load sa cellphone, dapat may pangbayad ng PhilHealth.” The contribution is only 6 pesos a day, mas mahal pa ang 30 pesos cellphone load mo every day.
  • If you have legitimate concerns, go the authorities. Report them, get them arrested if you want. Don’t post them in social media and make the people judge them. It’s not fair. Give them a fair trial where they can defend themselves. This is being human.

 

Netizens:

  • This is a basic GMRC lesson that people in social media should start going back to basics. Be courteous to everyone. Don’t judge quickly. Before destroying one person’s life, she is also a human being like you and me. Think before you click. Blame the entire health care system to begin with.
  • What if this ever happens to you and you can’t defend yourself?
  • Use the power of social media to bring positive relationship between doctors/health professionals and patients and not sever the ties. We are all victims of a defective health care system.

 

Fellow Doctors

  • Make sure that you stabilized patients first before transferring them. I know you all know this. Just make sure and have everything documented.
  • Remember “No incubator” should not be a wastebasket reason for not admitting patients. Emergency situations are always prioritized.

 

To Hospitals:

  • Evaluate things. If there is something wrong with the system or protocols, change it if you must.

 

To Government:

  • Please allocate more budget for health. Your people are dying and all you can give is PhilHealth and PCSO. Are there any more radical solutions for this?
  • Please evaluate the duties of Physicians. We are the only country that still practices 24 to 36+ hours of duties per shift. If you come to think of it, it is not PHYSIOLOGICAL, or even possible to be on your top shape saving people when you are so tired. It is not because there is not enough Physicians, but the system is inadequate and positions are very few even in government hospitals. Why? No budget?

 

To Everyone:

  • This post has been made not to side anyone, but to lay down facts.  What has happened is just the tip of the iceberg.  There is a bigger picture here.
  • This coming election, think before you vote! Who can promise and really deliver?
  • Doctors are only there to heal you, but you, as a responsible voter, you can help heal our sick Health Care System by voting wisely.

To the family of the baby, I am extending my deep condolences. I believe, nobody ever wanted this to happen. We are all victims of an inadequate health care system.

Thank you for reading this very very long post. Keep an open mind, there are always two sides of a story.

 

Dr. Pinky Intal

 

 

 

 

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Doc Pinky is a licensed Medical Physician, Internationally Registered Financial Consultant, Certified Investment Solicitor and Associate Wealth Planner and Estate Planner of the Philippines. She loves to educate and spread financial literacy. She is a Lactation Consultant. She loves to travel. She is a devoted wife and mother.

17 thoughts on “Doctors Vs Social Media and Philippine Health Care System

  1. bimbo

    Actually, my point of contention in that very sad story is the second time that the couple were turned away… Admittedly, yes, the couple should have planned for it. Yes, they should’ve gone to a government hospital in the first place knowing their financial capability. I support what the doctors did and when they advised them to go a cheaper hospital because there was still time for a transfer. I have doctor friends and I heard their side, and I must admit that they have a point. BUT the second time that the couple were there, they shouldn’t have been sent away anymore because the situation was already critical.

    I was not there at the hospital and I am not a doctor so I cannot say for sure–but the second time that the couple was there, the resident should’ve known that the situation was already critical at that point because they examined the mother the first time and would somehow know what the situation was. Perhaps what the resident should’ve done THAT SECOND TIME was to do what exactly you said, “There was an incident in the same hospital, that a woman was about to give birth. Seen and examined, and triaged as emergency. No deposit, not even a check-up done in the hospital (which is a requirement usually in any birthing facility), yet, they still admitted and delivered the baby.”

    The couple had their faults, yeah. But the doctor was the one faced with the decision AT THAT PRECISE MOMENT–whether to save the life of the mother and child or not. The thing is, she chose not to because of the protocol. We gotta admit that she was partly to blame in that situation.

    • jaypee

      I just have to comment that we have, by any means, no proof what was the situation on the second visit. Given the regular protocol, the resident would have still evaluated the patient prior to transfer. If the situation is indeed emergent at that time, the patient wouldn’t be able to go out of the ER (unless they waived it and decided to go to another hospital themselves).

      • bimbo

        If they did evaluate the mother during the second visit prior to transfer as per the protocol, all the more telling that something was sincerely wrong with what she did. Because she would know that the child and mother is already in distress because the baby died inside the womb en route to East Ave–give or take that would be 45 minutes to an hour taking into account the time of the situation (very late at night or very early in the morning). Again, this is just hypothetical considering the givens, but I don’t think a second evaluation at the ER was given anymore; the couple might just have been advised to go to East Ave.

        • Caloy

          @Bimbo, I agree with you here. We call them “comebackers”. If the patients insisted to be admitted, they will have to be advised about their financial obligations. If they opt to go to another hospital after understanding well enough of their responsibilities, a waiver must be signed upon full explanation of what is going on, the risks and complications they might encounter after signing the waiver. Otherwise, I believe they should have been admitted for further management.

  2. bimbo

    “For resident doctors, they work 100+hours per week (note: we only have 168 hours per week), no holidays and oftentimes no weekends off. If she only wants money, there are more profitable professions out there.” I know this to be true… But the thing is, we know that residency is a requirement so that a general practitioner can specialize in a particular field in medicine. There’s also something in there for that “sacrifice.” Residents made that informed decision to apply for the job because of the promise of a bigger ROI once s/he has finished his/her sub/specialization. That’s my another point of contention with all the defense going on around, which makes it look like the resident doctor was there for pure altruism’s sake (because of the low pay grade, etc. etc.)

    I’m just expressing my thoughts and disagreeing on some points. I’m not here to troll or to make any derogatory remarks. I hope this won’t be merited as offensive.

    • Caloy

      @Bimbo Actually, no one is denying about the fact that after residency, and after about 10 years or so more in establishing one’s profession as a specialist (do the math, after residency, they still have to take diplomate exams which are divided into several parts: written, oral and practical exams, PLUS establishing their profession through time as no one really has the magic to have abundant patients after passing the diplomate exams), the ROI is indeed big. The contention here is actually the issue at hand: what can the resident gain by not admitting the patient? Or vice versa, will she gain and earn much more if the patient has money? The answer is a clear NO, because residents can only get monthly stipends which are fixed in amount, and so regardless of whether they see more or less patients, the stipend they receive remains the same. And so whether you like it or not, the fact that Filipino doctors go through yearS of schooling, training, and establishing their profession (do the math again, 4-5 years of premed, 5 years of medschool, 3-6 years of residency, 1-3 years of fellowship training, 10 years of establishing profession) and not getting compensated well financially, is a reflection of the kind of altruism that lay people find difficult to comprehend.

      • bimbo

        Point taken in that angle… But I do angry that what the netizens are unnecessarily villifying the resident doctor… As one of my doctor friends said, “Sira na kaagad ang reputasyon, hindi pa nagsisimula ang practice.”

      • bimbo

        *agree

  3. I hope, after Pres Pnoy, our health care system would be improved..remember, we have "sin tax",.the govt could get something big from this to improve our govt hosptls..

  4. xian

    pero dapat kasi mas better na trabaho ng admin (admission dept or finance or etc.) na mag explain sa patient about financial consequence.

    hindi dapat problema ng doctor kung makabayad or hindi.

    ang alam ko ethics yun. kaya nga ung mga doctors na nagkiclinic may secretary para maninigil eh. so dapat ganun din.

    • Which begs the question: why was the resident left with the task of advising regarding financial concerns? I also see patients at the ER, in my capacity as an internist. I also see it as an obligation to inform patients and the family what their expectations should be. But as I have repeatedly explained in many threads about this issue, the decision to admit in the hospital is not solely the doctor’s decision. She can only give her assessment whether the patient is admissible or not. The HOSPITAL ADMIN and the admitting staff are tasked with that. So the other questions are: was the case referred to the social service since, obviously, the patient is admissible but has some problems financially? Was the hospital’s senior house officer informed of the problem and the need for transfer? Did the senior house officer agree with the decision to transfer?

  5. This is true. It is one of the reasons kaya madalang ako magfacebook. Meron at meron kang makikita posts ng paninira sa iba. Dinadaan nilang lahat sa social media yung problema nila sa ibang tao, without thinking kung anong epekto nun sa taong sisiraan nila.
    Can I share this din po? Para naman po mainform din po yung iba. Thanks. 🙂

  6. Pa share po. lamang talaga ang may financial literacy, dapat sa kahit ano mang propesyon financial educated is an advantage.

  7. True. Its unfortunate that we have to wait till someone dies before we realize this.

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