25 April 2005

Medical Apocalypse

How do you react when the current president of the Philippine Medical Association (PMA) says that the Philippines is now in the middle of a "medical apocalypse" and that the "end of medical practice" is either coming soon or probably upon us now?

RP Running Out of Doctors

SOMETIME in the near future, the Philippines will run out of anesthesiologists. Obstetricians are also a dwindling breed, and pediatricians may not be far behind.

They are among eight million Filipinos -- nearly a 10th of the population -- working abroad, abandoning their poor homeland for better paid, but lesser skilled jobs overseas.

The brain drain is so huge it is threatening the very fabric of the nation.

Medical school enrollment plunged 20 percent last year and one school has already been forced to close. Ten medical schools and two provincial hospitals are threatening to close.

The local medical association says that thousands of doctors are going back to school --- nursing school --- so they can get nursing jobs in Europe, the United States or even the Middle East, to work in "dirty" or dangerous jobs like helping doctors deliver babies, inject sedatives and treat ailing tots.

"I call it medical apocalypse, the end of medical practice in the Philippines," says Dr. Bu Castro, president of the Philippine Medical Association.

He estimates that 2,000 doctors leave the country each year, while about 1,000 graduate from medical schools.

Even though they cannot practice medicine abroad, the specialists do not mind the downgrade as they still earn around $8,000 a month, 16 times the pay of doctors at government hospitals in the Philippines.

[PJI Journal Group, 23 Apr 2005]

A reflex follow-up question might be to ask if there is anybody here doing something about it.

If you read Health Secretary Manuel Dayrit's famous and lengthy "herculean speech," you will note that at the bottom of that speech, when you reach his "9th labor," the part where he discussed about "Developing Human Resources and Initial Steps to Deal with the Migration of Health Workers," he mentioned:

"... the DOH is working with UP National Institute of Health, the Department of Labor and Employment, the Department of Foreign Affairs, Commission for Higher Education, the nursing schools and the nursing associations to find strategic short and long-term solutions to this phenomenon.

"The problem is complex considering that the economy cannot absorb the number of graduates for the various health professions. Also radical adjustments need to be made in the compensation of health professionals here who are generally underpaid."

[Dayrit's Herculean Speech, 3rd UP Public Lecture Series]

Up to the time that speech was delivered until today, I do not know if the DOH is still baffled at this "complex" problem and still needs more time to figure out "strategic short and long-term solutions" to this problem.

My former mentor and now president of the Philippine College of Physicians (PCP), Dr. Adrian Peña along with idealist cardiologist Dr. Willy Ong, had already pushed forth a covenant last year which sought to ask Filipino doctors "to stay in the Philippines for the next three years and serve our less fortunate countrymen for free."

I do not know how many doctors signed the covenant and how many were committed enough to follow its ideals.

In my opinion, I agree with the PMA president. There is really cause for alarm. For a long time already, most Filipino doctors have been overworked and underpaid. I have written about this many times already last year. Read my posts here and here and here. This post is my fourth on this problem. And I have no doubts that there will be a fifth, a sixth, and even more.

We cannot blame the doctors for leaving the country or for shifting into nursing. They cannot be called traitors for they will always be heroes in the eyes of their families.

Once in a blue moon, there are good doctors like Dr. Willy Ong and Dr. Jesus Canto who come along and make us smile. But they are rare and are never enough to put even a dent on the problem.

Truth is, our ship is sinking. The captain is either doing nothing or so little to save the ship's passengers. Take your pick what the real reason is. The reality is that doctors are leaving in droves each year. Our sick countrymen especially those in the rural and far-flung areas are getting less and less of the much-needed medical care they so rightly deserve.

I do not know how long before anyone considers this problem a true emergency.

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