Without the Whitecoat
HMO can never replace the Company Physician
Every start of the year Department of Labor and Employment (DOLE) is receiving the AMR (annual medical report) of establishments and companies. This report shows the worker's profile of employees and the illnesses that they have for the past year. This is the same report utilized by the Bureau of Working Conditions to come out with the annual report on the illnesses occurring in the industries.
As a member of a community of occupational health practitioners, my interest will always be on the health of the workers. Is there a physician or nurse who takes care of the health of the workers? Is there an existence of an occupational health care program for the workers? Is there an implementable program for the company or establishment?
Going across some reports some or most of the companies or establishments had placed that the health provider that they have is an HMO (Health Maintenance Organization, ie. Fortune Care, HMI, ). The establishment or companies have the wrong notion or belief that when a physician or doctor signs that AMR everything is finished. They usually forget that when the physician signs that document they are, by standards, the retainer physician of that company or establishments. We should correct the practice of paying or extending financial or monetary compensation to the physician that signs the form, we should remember that once the physician signs that AMR he is now the retainer doctor of your company or establishment and he/she performs all the responsibilities listed on Rule 1965.02 of the "standards" of the Occupational Safety and Health Standards of the Labor Code of the Philippines (Presidential Decree # 442). In this connection an HMO cannot or never take the place or duties of the company physician even if their physicians have the basic training course in Occupational Safety and Health considering that their doctors do not know or never have any idea on what is happening inside the plant or establishments.
The HMO may have rendered services to the companies they serve, but they should also set that line when they examine or do assessment of workers in the industries and return these workers back to work. They should follow the guidelines in properly returning this workers back by having the classifications and recommendations for workers when it comes to his self being and his job description. (If you have a worker presenting with a pulmonary or an upper respiratory tract infection and have probable exposures to some fumes or chemicals in the plant, the physician that examined the worker should also address this problem which is an essence of the practice of Occupational Medicine, so if you don't have the necessary training and qualifications and you think the kitchen is getting hot you might as well leave the kitchen and just practice the specialty on where you were trained... Shame on you, if you are an internist or a pediatrician then you practice as one and not as a trained and qualified occupational health physician and practitioner.)
Others are of the belief that any doctor, physician or specialist can practice occupational medicine. I tend to disagree with them though. In the practice of medicine we have to set boundaries on what we can do. An internist practicing Pediatrics is a big no-no, but that physician will argue that as regulated by PRC he can practice any medicine from Internal, Surgery, OBGYNE, Pediatrics, by definition general medicine, so why in the first place undergo training in a specialty and subspecialty.
I think it is a matter of "delicadeza" on the part of the doctor or physician, you know in the first place that you don't posses the necessary qualifications the same goes for the new graduate in training may it be his post graduate internship and passing the board or who just have graduated from a residency program, they should not make the job of a company physician or retainer as a fall back. (The rule is, if you are not qualified to practice then you should give way to somebody who is much more qualified and knows what he is doing... I rest my case, cuz "MAHUYA KAMO, sobra na ang kapalmuks nyo".)
With this day and time there is no way a Health Maintenance Organization can take the job or the obligations of a company or retainer physician, if they want to do so, their qualified physicians should do plant rounds, conduct walk-through surveys and implement a work environment monitoring system, then we can call that the "practice" of Industrial and Occupational Medicine.