It was a Friday night and we had an informal huddle to think of ways to provide solutions to overcrowding in the emergency room of a government institution. Being part of the workforce, we get to witness, on a daily basis, the impact of the cost of health care most especially on the financially challenged. If it was bad before, it is on the uptrend of becoming a graver concern. Everyone feels the pinch, even for those who previously had the capacity to pay. The financial aspect when discussing treatment is always woven into the conversation and at times becomes a center point for deciding whether to continue or withhold management after considering all angles, including ethical concerns. After asking about prognosis, what inevitably follows is, how much?
During pediatric residency in a private facility in the late 1990s, there was minimal exposure to the look and scent of poverty. It was not until my fellowship training that I was able to fully understand the depth of the connection between health-seeking behavior and being marginalized. Back then, I had a difficult time understanding why people chose to self-medicate or let an illness linger until it was too late to reverse the condition. Without being dismissive of the past and current efforts to try to improve the health situation, nothing much has changed for the problem runs deep. The government hospitals are still more than filled to capacity and with inflation and the higher cost of living, we are seeing more patients presenting with severe diseases and chronic conditions, and more people lining up for financial assistance for out-of-pocket expenses needed for additional diagnostics or therapeutics. This surge is never more felt than in the emergency room department where people wait for days to be admitted to the wards from the lack of hospital beds.
“We have to firefight once again.” This came from the more systematic thinker and objective one in the group who had played a central role during the pandemic. This announcement was quickly followed by another colleague, who, to our surprise, had already come up with a plan of doable solutions to improve services, utilize available resources, and hopefully improve quality of care. Taking a deep breath, we all looked at each other and were in agreement that we had to stem the flow of people needing care. How? By quickly triaging those needing outpatient versus immediate care, exploring the possibility of initiating outpatient parenteral therapy through partnerships with hospitals who frequently refer their patients to our institution because of a lack of facilities or expertise but capable of providing primary care.
On the way home, I dissected this problem and decided to share my thoughts for this Monday’s column not only to apprise those who are unaware or unexposed, but more to get everyone involved as health is a concern for all. Much has been said about universal health care and though it is laudable, one is grounded in the reality that it would take a considerable amount of time before it comes to fruition. So in the meantime, taking inspiration from lawyer Alex Lacson who had come up with a list of things that everyone is capable of doing to help the country out, I decided to make my own on the topic which to most of you might be more like a wishlist.
To-do list. Reserve privileges, most especially discounts, for free medical services or medicines to those without any iota of support. Next, avoid visiting the emergency hospital rooms and competing for needed beds for those needing urgent care. Third, for those in positions of influence working in local government units, push to prioritize strengthening primary and secondary facilities to avoid congesting tertiary hospitals. Referrals are possible via teleconsult which nowadays is an accepted practice. Fourth, prioritize preventive care and self-care. Take advantage of annual checkups if available and keep up to date on needed immunizations. Last but not least, for those with enough time and financial resources in their hands or looking for a purpose, think of ways you can volunteer, whether it be in an individual capacity or as part of an organization. The benefits are immeasurable.
Please feel free to add to the list.
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READ: Overcrowding and COVID-19