Medical practitioners were recently shocked to learn from media reports that the Bureau of Internal Revenue was considering compelling physicians to post on the doors of their offices tables listing the services available together with the corresponding costs. The immediate response was disbelief. Doctors’ offices are humanitarian venues to relieve pain and suffering, not commercial establishments akin to carinderias, restaurants, or beauty parlors! Civility requires that the difference be noted.
The rationalization of the proposed BIR policy was to direct the attention of government agents to the items they should include in their search for bases to impose taxes on physicians. Some doctors are reported to be tax cheats. But should the sins of a few be invoked to penalize all doctors, including those who pay their taxes religiously?
It appears that some sectors of the government and the public are not aware of the role of physicians in the community.
Medical practitioners are highly trained professionals in the art of healthcare; they cater to the comfort, well-being and the very lives of people. Hence, they are entrusted with highly confidential secrets and the state of the most private of body parts. To safeguard a patient’s security and well-being, physicians are taught disciplined behavior in medical school.
This is why learning the art of medicine is a long process. It takes 25 years to be a medical specialist, as compared to 18 years for a lawyer and 18 years for a priest. “We grow a beard before we finish our studies,” it’s been said. Medical practice is guided by a strict Code of Ethics that is provided for in the Medical Act of 1959, or the Law on Medical Education and Practice of Medicine.
All over the civilized world, this is the role of physicians. Correspondingly, society accords them the high esteem and respect they deserve.
In the Philippines, physicians are overworked, compensated less, and often maligned. Lately the media have been vocal about physicians not paying the right taxes based on the observational review of tax collectors that does not take into account that the lifestyle of some physicians is not subsidized by income from private practice but by family assignments.
In support of the government’s drive for increased revenues on one hand and fairness toward physicians on the other, officials of the BIR and the Philippine Medical Association have signed a memorandum of agreement stating that in the event that physicians are suspected of tax evasion, a meeting between PMA and tax officials be scheduled before they are accused publicly, to enable the association to support its members and assist in the investigation.
Physicians at Makati Medical Center have pleasant relations with tax officials. We hold and attend seminars on taxation. When the agents want to visit us, they call our secretaries and schedule their visits. They are considerate enough not to disrupt the appointments of patients, and permissive as well to enable us physicians to inform our tax consultants/accountants to prepare a documentary trail for an amiable evaluation of tax responsibilities.
Some doctors relate incidents in the past where tax investigators made unannounced visits. The agents supposedly did so in order to catch the doctors unprepared and to make first-hand observations on how the latter charged for their services and whether they issued the proper receipts. The patients were asked if their physicians had issued correct receipts that were printed by shops registered with the BIR. Such practices are only done in countries with totalitarian governments. Filipino doctors fumble because they are not used to sneaky investigations uncommon in civilized democracies. But they neither report these incidents to authorities nor complain for fear of repercussions and retaliatory behavior, like the transfer of a decimal point to a more precarious position in their tax figures.
Entering a physician’s office, one will notice a conspicuous sign by the BIR written in three-inch red letters: “Ask for receipts.” An embarrassing sign like this is not found anywhere else in the world. This degrades our world slogan “It’s more fun in the Philippines.”
Because medical services and healthcare in the Philippines are internationally acceptable, foreign patients are patronizing our health institutions and practitioners. Physicians are appealing to those concerned to save them from embarrassment and give due respect to professionals who have chosen to stay and serve our countrymen instead of succumbing to attractive lures overseas.
There has to be a way for the government and the private sector to work together in peace and harmony. It is the better prescription for effective and productive performance.
Santiago A. del Rosario, MD, is a former president of the Philippine Medical Association and chair of the Department of OB-GYN at Makati Medical Center.