Nepalese MD’s to train and render service in Bicol Medical Center

As a result of the drop in the number of medical school graduates and the exodus of local doctors to foreign countries, the Bicol Medical Center (BMC) in Naga City has resorted to bringing in 40 doctors from Nepal. From the remote country close to Mount Everest, Nepalese foreign medical graduates will be in the city to train and render service.

“The Bicol Medical Center (BMC) in Concepcion Pequeña, Naga City is a 500-bed government tertiary hospital under the direct supervision of Department of Health Center for Health Development – Bicol, Legazpi City. It is a non-profit institution and one of the 13 medical centers under the National Government.” http://doh.gov.ph/bmc (Photo Credit: bmc)

The presence of imported healers in Naga is expected to beef up the medical personnel of the government hospital which has suffered the lack of MDs for the last 5 years. There have been fewer applicants to fill in the 28 doctor-vacancies in BMC. Therefore, the coming of the international physicians appears to be a boon to the hospital service in the city. But is it?

Without inciting any nativist sentiment against the foreign professionals, I think it is justified to ask if the Nepalese doctors’ schooling is comparable to those of the local physicians. The adherence to standard medical training (i.e. in the tradition of Western allopathic medicine) is important before they are allowed to handle patients. Their medical background must be adequate to meet the peculiar health needs of the community. To ascertain competency and avoid compromising the health of patients, they must be tested for basic communication and clinical skills.

Though the Department of Health (DOH) approves of these foreign doctors, does the government have guidelines that define the scope of medical duties and accountability? Are the professional regulations in place to protect the doctors, their patients and the hospitals where they work? Will the presence of these trainee-MDs not interfere with the training and oversight of local doctors, nurses, and other paramedical professionals? Are there enough senior MDs to supervise and teach them? Are they not in violation with the rules of the Professional Regulations Commission (PRC) which regulates physician licensure and practice? Has there been discussions on the effects of foreign doctors on the healthcare of the nation? Their presence may distract the government from pursuing the programs which will make local doctors stay and serve the community instead of going abroad.

In a blog I posted on August 27, 2008, I wrote:

According to Philippine Medical Association (PMA) president Reynaldo Santos, M.D. the arrival of these foreign medical trainees attests to the high quality of education in the country. But this is doubted in the wake of a sharp decline of the number of hospitals, a marked rise in patient load for doctors and nurses, a low passing rate of Filipinos in the United States Medical Licensure Examination (USMLE,) an over-crowding of patients and trainees, lack of budget, equipment upgrade, and medical facilities in many hospitals.

I hope Bicol Medical Center has ironed out the important issues cited above. Otherwise, sending in the Nepalese doctors will solve some of the current healthcare problems of Naga City, but it can also spawn fresh and bigger challenges that haven’t been given enough attention and consideration.=0=

RELATED BLOG: “RP’s 40% drop in med school enrollment & the foreign doctors” Posted by mesiamd at 8/27/2008

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More primary care MD’s needed for Obama’s promised healthcare reform

After a survey came out disclosing the frustration of primary care doctors who suffer in their job, the American College of Physicians (ACP) followed with a paper culled from more than 100 studies from the last 2 decades.

The report details the need for more primary care physicians whose number is dwindling. They are needed to improve healthcare and lower the cost of treatment.

If primary care physicians in a metropolitan area are increased by 15 %, researchers on health care utilization believe there will be beneficial cuts in the following services: emergency room 10.9%, surgeries 7.2%, inpatient admission 5.5% and out patient visits 5%.

In the last 10 years, US medical graduates entering family medicine and internal medicine have decreased to half its number. Many young doctors prefer high-paying specialties with less demand for time to see patients.

The developing doctor shortage crisis is a result of extended hours, low pay for primary care, and paperwork hassles associated with medicare, Medicaid, and private insurers. Sixty percent (60%) of surveyed MDs won’t recommend their profession. —American Medical News (12/08/08, O’ Reilly, Hedger, B)

The situation is best characterized by Ted Epperly, MD, president of the American Academy of Family Physicians (AAFP) when he said, “What remains unclear is how politicians’ promises to rescue primary care will play out in a likely fierce battle over health system reform. But raising awareness of the crisis is the start of finding a solution…. This won’t be turned around overnight. It will take a decade to get out from under this.“

A decade! That’s 10 years. 3,650 days!

A decade to correct the problem is incredibility long in the face of increasing health needs of Americans and rising cost of medical care. Obama has been served the notice. =0=

MDs plan to quit & its potential impact when 46 million uninsured Americans get their medical coverage

Before Pres. Barack Obama can assume office and work on his promised universal health care for Americans, primary care physicians in the United States are saying they are overworked.

Almost half of them plan to cut back on their practices or quit seeing patients. They are lobbying for rational reimbursements in their insurance claims particularly on Medicare and Medicaid patients.

In the survey by the Physician’s Foundation, 90% percent of doctors complain they devote too much time in paper work rather than take care of patients. Frustrated by the work environment, 60% of those surveyed is not recommending medicine as a career. Reuters (11/17/08, Fox, M; Wilson, C)

Experts say that there’ll be an increase in number of those who’ll need health care services. A rise of work load required for the aging Americans and the newly insured plus the upward climb in cost of treatment and medicines are likely to lead to a rationed medical care that Americans haven’t been used to.

Under the plan of Obama, 46 million uninsured will gain access to medical services. If not handled correctly, these may mean more triage of patients in the emergency rooms, longer lines in the doctor’s offices, greater cuts on tests, denials on procedures, and slowing of getting consultation appointments and treatments. The current health care isn’t ready to absorb the volume of work, much worse, if doctors scale down their practices or retire early from their jobs. (Photo Credits: by Julie70; Allsus)=0=

Paying Homage to Community Service

The Diamond in the Rough Awards of a fraternity at UP-PGH caught my attention. I thought UP Ibalon Bicol had an excellent candidate-M,D. for the nomination. But there had been obstacles to hurdle. So I wrote a letter to the secretariat which oversees the contest for service-oriented doctors to share my thoughts. Read and you decide.

“To the Diamond in the Rough Awards Committee:

I’m elated to know about the Diamond in the Rough Awards. I thought I have a fine candidate in mind, but I was a bit disheartened that it has age and location restrictions. Here’s why.

I have difficulty reconciling that age matters in giving honor to a lofty and admirable endeavor such as community service. In the US, there are a few bases of discrimination that I know. One of them is age. I believe it is also true in the Philippines.

Come to think about it. Isn’t there a shade of injustice if we give a shelf-life (expiration date) to recognize exemplary deeds? I always think honorable work must be for all and for eternity. I believe many of us in the profession feel young way beyond 40 years old. Besides, we’re not thinking here of an award that can prop-up careers, but awards that careers have made.

Also I notice that the contest is for rural doctors. But aren’t there blighted and underserved areas too in the big city which have worse conditions than in the countryside? I believe doing grassroots work in the city can be no less daunting.

I don’t have control over the rules. I humbly respect your age limit of 40 and other restrictions. But in my opinion, in considering a person’s recognition, longevity of work and service gives more bone and credence to a person’s motivation. It will give prestige to your contest. The location of the exemplary work isn’t very relevant as I explained above.

An award such as what you offer is better not restricted for prodigies or upstarts who dazzle us like evanescent dewdrops that may vanish in the cold. How many outstanding young men have gone astray? Who has left the rural areas after receiving honor? How many of them abandoned their cause or tarnished their recognition?

I’m sure there are unsung people out there who in their middle age or in their twilight years got the holy grail of their life passion. They are among the people worth honoring in the contest. I’m pretty sure they’ll inspire us more, just like the young ones to pursue causes greater than their own.

I hope this observation may help your fraternity reconsider the criteria of your award. If there is any change, please tell me and I’ll be happy to try and make a nomination. Thank you so much for your attention.” =0=