Healthcare not a government priority
May I thank the Inquirer for publishing my letter (“ER fee charged just for waiting for ‘Dr. No-Show’”) last Oct. 8.
May I share an issue related to it.
The sister I mentioned in the letter is actually a resident doctor at the Philippine General Hospital (PGH), so I get to learn more about the hospital which has more patients than it can cater to. With the number of patients going to PGH, the doctors there can only do so much.
Aside from being a doctor, my sister plays social worker (attends to patient queries) and case manager (makes discharge summaries and other paperwork) as she goes from patient to patient. Yes, she has experienced the 36-hour call time which is widely accepted in medical training all over the world. However, I won’t go into that issue now: whether fewer hours are better for the doctors (since they get to rest) or whether more hours are actually beneficial for them (since they learn more in the process).
Although I feel that duty hours need to be regulated, a more glaring issue is the spreading of work load among physicians-in-training. There was a period when PGH experimented on schedules and had the residents go on 12-hour shifts (either in the morning or in the evening). My sister, as well as her fellow residents, more often than not, would go over the prescribed number of hours not to attend to a critical patient, but simply to finish work that needed to be finished before going home. Like endorsements or communicating to the next resident-on-duty the case of a patient. Or more paperwork that’s beyond patient-care activities.
If PGH had additional personnel to help with the workload (like paperwork, insurance issues, etc.), the doctors would have more time to spend caring for patients. True, tired doctors don’t make for efficient doctors, and overworked and pressured (trying to finish everything within the duty period) doctors also make for very inefficient ones. And sometimes, this could lead to something more negative—doctors getting sick themselves and not being able to take care of the patients.
My sister precisely got sick one time. She really wanted to work as she had patients to attend to, but she was in no state to treat other people. I asked her what her department does if a doctor calls in sick for a few days, given that the workload never decreases. She looked at me and said, “Pull out doctors from other rotations.”
There are constraints we do not have control of. Like the progress of a patient. But there are constraints that are well within the boundaries of controllable factors. Like budget constraints. Especially for a government hospital. There would be no need to pull out doctors from other rotations if only a department had sufficient personnel to handle the given workload. The hiring of additional personnel is largely dictated by the salary allotment.
I thought the Philippines was, well, poor. But with the pork barrel scam, I am surprised that we actually have a lot of money to spend. Maybe our government could look again at how our yearly budget is allotted.
—KATHERINE TANYU,
