Without the White Coat
By Dr. Florentino Alerta II

"Medical apocalypse". the death of medical practice

If we don't see the real numbers it is hard to believe that this is happening in our own backyard, "an exodus of medical doctors" in the Philippines for the unending search of greener pastures in other developed countries like the US of A. The facts: 30% of the country's registered doctors have chosen to migrate and settle in North America. With some medical schools closing down with a dwindling number of entering first year medical students and with an estimate that if 1,000 will graduate from medical school, the 2,000 will just leave the country each year (as immigrant doctors), isn't that number scaring enough, so who's gonna stay behind to take care of the sick and dying "Filipino people"? An income of $8,000 per month will greatly appeal to the young and adventurous physician and his beloved family. It will gave him enough dough to mortgage and buy a comfortable and a humungous mansion by the sea and lastly a brand new race car which he can change every year. (That's life in the old US of A, good opportunities in which you cannot blame them, isn't it time that the national government address this catastrophe?)

Time will come that there will be massive exodus of practicing physicians out of this country, the ratio of a doctor to patient is getting bigger everyday, thus comes a time that there will be one doctor for every municipality then we will see an overworked physician who is not well compensated by the local government unit.

The medical practice will thus be reverted back to the days that you have one physician for the entire family, a physician that will see all patients irregardless of their sex and age. You may call it a General Practitioner, nowadays he/she is known as a Family Medicine Specialist, whose practice had been curtailed by some specialist groups like Pediatrics, OBGYNE and Surgery. Gone were the days that these specialties smelled too well to us, in the training situation the specialty of Family Medicine is their first line of defense. When they were short of residents in the medical institution it was the Family Medicine residents that were given the task to augment their ranks, now that they don't need the Family Physicians anymore they all place sanctions in the practice of Family Medicine.(Pediatrics-according to PPS-Philippine Pediatric Society, the graduates of a Family Medicine residency training are not allowed anymore to accept admissions in the nursery, in short do baby care, in Surgery this is what you see in the bulletin board of the operating room " Attn: OR staff , Family Medical doctors no operating room privileges", posted by the surgical resident who gets his orders from one of his threatened superiors or trainors, we know who they are, they are thinking that the Family Physician had become a threat to their medical practice, so what else do we have to do in the operating room since it is only "some" minor surgical procedures like circumcision or an ingrown toenail, isn't this another added income to the medical institution since the patient will pay for the OR fee and supplies to the hospital) In spite of a dwelling number of doctors practicing around why does some specialties have to curtail the practice of a Family Physician?(Instead of doing an ingrown toenail, the only procedures that we can do in our offices are " PEDICURE and MANICURE ") Isn't it a shame that during this time of need of practicing doctors there are still "doctors" out there who have the greediness and envy to solely practice Medicine just for themselves ( SOLO Practice)?

As long as the Family Physician practices Medicine within his bounds, then there is nothing wrong with him/her to embark on the competencies that were set aside by these specialties. As a Family Physician, we know what our capabilities in practicing Medicine are and on what to do and what not to do. The national directorate of PCS have seen 2 resource persons Dr. Nestor E. de la Cruz and Dr. Gabriel L. Martinez to set aside the definitive competencies in Surgery for Family Physicians.

With a shortage of Physicians and with some physicians experiencing the "El Niño Phenomenon"-TIG-GULOTOM , expect patient snatching from your fellow physician, professional jealousy , envy , greed and the Filipino Crab Mentality existing in one basket. (Why don't they just maintain a good relationship with their Family Medical doctors so that they will have a lot of referrals, so they could feed and clothe their children and give their wives a lot of room to go about an endless shopping spree).