Sunday, July 8, 2007


I attended the Medical School homecoming for the first time because I wanted to start meeting people. After all, it will never hurt to know a few more doctors. There was an incumbent Senator, all the way from Manila who wangled an invitation and was seen vigorously schmoozing.

Every meeting has a Continuing Medical Education portion that allows participants to claim part of the trip as a tax deduction. One topic dealt with telemedicine, technology that I am very familiar with considering I practiced in a rural corner. At 1 in the morning and you would be called to see a trauma patient, you would invariably “send” the x-ray studies to Amarillo, TX for the radiologist to give a provisional reading. We would physically send the films the next day for a final diagnosis. That was 10 years ago. Today, it would be cheaper to “send” studies to India because we don’t use film any longer. Radiological studies are digitized into compact discs. For other specialties, it has become vastly easier to send the entire medical record of a patient to any specialist anywhere in the world for another opinion.

An older physician asked the doctor from the Philippines who was presenting the topic why we couldn’t hire more physician assistants and nurse practitioners to staff the thousands of unmanned Barangay health centers. Those of us in the audience who knew the reality in our country were flabbergasted. Was this guy from another planet? We don’t have PA’s and NP’s because anyone with these skills would have left the country a long time ago. We don’t have a problem with diagnosis in the Philippines. We don’t have the resources to treat diseases.

The UP Class of 1989 had a reunion one evening. After 17 years, I saw my group-mate in anatomy. He was now a Jesuit priest. He was peppered with questions regarding ethics and morality the entire evening. I also met an ophthalmologist classmate who had practiced in the hinterlands of Mindanao for 13 years until she decided for reasons of personal safety to migrate to the US as a registered nurse. Nothing dishonorable whatsoever in her decision. She had freely given her time and talent but was regularly showing up in the list of potential kidnap victims.

How to harness this large group of doctors most of whom earnestly want to give back to their country? How to effectively utilize the combined resources at their disposal? We all want to help.


r.g. lacsamana said...

Across the years, here's a partial list of what these U.S.-based medical groups have been able to do:

(1) Organize medical missions to needy areas back home, several times a year, where thousands of patients are seen, treated (including operations), and referred for follow-up to local doctors.

(2) Donate money, through foundations, to medical schools to update their resources, sponsor professorships, and provide scholarships to deserving students. The idea is to maintain consistent high standards of medical education.

(3) As a corollary to above, donate drugs, equipment, and books
to respective medical schools. Many schools maintain charity clinics and need these infusions of help.

(4) Participate in charity drives at home in times of disaster like earthquakes or typhoons.

My experience tells me that doctors who go to the U.S. for post-graduate training usually stay there for good, with but a few returning home. Those who go home later do so to retire, or to stay there part of the time.

This was not the case before 1965, when doctors came here thru an exchange visitors program, but the
new immigration law that took effect in 1965 allowed those who came here to stay permanently.

Rare, indeed, is the doctor (or nurse, or engineer, or anybody) who comes here and makes the sacrifice of going back to serve there. It borders on the heroic to do so, as the Good Doc did with his family.

ano nino said...

be selfish... take care of yourself.

That is a very good rule.

rey said...

The comment of the old doctor is indeed funny. Even if we have an oversupply of RN's, some would rather work in other fields as healthcare workers are ALL underpaid. The only ones left in some rural areas are baranggay health workers or midwives (as their training and education is not recognized in many developed countries). Even the few that are left are unappreciated and underpaid, so expect them to leave too.