That adjective that we demand of all people yet so hard to achieve. This came from a lecture in Physiology by the Physiology Sensei; you'll see why if you see him in person. Anyway, he has this habit of inserting guest speakers into his lectures talking about principles that future physicians should have. However, the downside is he is a bit religious; so during those talks I feel like a minority. Oh don't get me wrong; I agree with his intentions: strike them while they're still in 1st year Medicine and that's partly what the intention of SLCM - WHQM to begin with. We're not just taught Medicine but also values. Let's just say I tune out when the speaker mentions a god but the rest of the substance of the talks; I agree.
Anyway, what brought about this talk from Physiology Sensei is he was slightly disturbed when a very unethical practice was brought to his attention: the request of procedures that are not even needed so that PhilHealth has no choice but to reimburse the requesting physician. Did I scare you off from our Filipino physicians? Oh, this practice is not just limited in the Philippines; some physicians in the U.S. do the same principle. So yes, some physicians are a bit unethical that they value money over the patient.
So I better react to his talk while endorphins are pumping through my body. Sure, its unethical but let's take a look at the journey a physician-wannabe takes. After an undergraduate course in a college, he/she enrolls in a medical school (in the Philippines, medical education is for 5 years). And then, residency training so that he/she becomes a specialist. That takes an additional 3-6 years. And if he/she wants to sub-specialize, that is to add another segment of knowledge to specialization just attained, then it takes another 3 years at the most. So let's add them all up: 5+3+3 = 11 years or 5+6+3 = 14 years. So take note, the average age of a medical student is 21; for the rest of his/her 20s are spent in books and studying. These are the prime years of a human's life. So if for some they have already earned their first million in their 20's; for us, we earn that in our 40's.
I haven't mentioned the cost and the effort and the stress that it entails in getting that MD and other initials after one's surname. And here's somewhat of a downside; we are expected to provide cheap service. Our attorney-brethren, on the other hand, have very high legal fees. Not that I have any problem with the legal profession but there is something inherently wrong if a person who saves lives is valued less over a person who exists to give honeyed-words. Sure, I agree with the cheap service provision. We exist to serve human life.
But I have to disagree if it is all the time. Excuse me, how much did we study, how much years of our lives did we give up and not to mention the stress? And in fact, I posited this question to 2 of my friends.
Me: So are you willing to provide the best of your abilities if in exchange it's only a "salamat doc"?
Them: Heck no!
Well to be fair, I asked them an extreme case. No physician in his/her sane mind would ever say yes to that. A "salamat doc" doesn't feed me, doesn't pay my rent and doesn't clothe me. So I posed this follow-up question:
Me: So are you willing to provide pro-bono work for some cases?
Them: Yes.
However, the downside is that it was based on the assumption they would be having a decent practice. That is one of the problems facing Philippine Healthcare: our physicians do not want to go to the provinces. Believe it or not, there are some people in this country who have not even seen a medical doctor. Our doctors are concentrated in the urban areas. Because face it; we have to eat, we might want to start a family and we have wants too.
Look at UPCM. Almost all of their graduates are abroad; so, part of your money goes into funding physicians for other countries especially the USA. But, don't get mad just yet. Have you been to UP-PGH? Are you aware of the burden on those dear 160 students, how much they have to study and what is expected of them? So, if you ask me; I don't really blame them for going out of the country. Sure, they got a cheap medical education but the UPCM environment is a very stressful one. Their clerks and interns face a different level of hell in PGH compared to private hospitals (not that its easier in private hospitals; it's more of the equipment is lacking and the increased patient load).
Oh you might think I'm going to be a money-grabbing physician; I assure you I won't be. It's just that I'm offering a pragmatic analysis. In fact, I'm a bit angry with then-Senator Noynoy's speech to the graduating class of UPCM (forgot which year, just go to pinoy.md and search for it there). It was the same "please, please serve our country!". No mention of health reforms, salary increases and manageable workload. So are we expected to just take it? Are we just going to easily sacrifice? So easy to say for those outside the medical field but for us in this field; it's a different proposition. Remember, our parents paid like a million pesos for our medical education; so are we just to sublimate our desires and their sacrifices? And not to mention, residency doesn't have a formal salary. Really, really being pragmatic over here.
To future medical doctors: yes, this is the dilemma you will have to face. If you want to walk away from your dream then better do it before your entry to a medical school rather than after graduation. If still you want to continue with our profession; you're like me, insane but committed and I commend you and I welcome you with open arms.
I really don't have the answers but I hope that at least some people will value our Filipino physicians instead of looking at us as automatons of diagnosis. Remember, we are human beings like you. We eat, breathe and get tired also. Get out of that self-entitled mentality Filipinos seem to have!
Reforms would be nice; getting paid the best salary eases our burden a bit because let's face it, we also need money. I'm not averse to providing free services but I have to limit it to "depends on the situation".
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