Without the White Coat
Down payment needed before medical treatment
The statement will always hold true for those that have taken there patients and love ones to a nearby emergency room , "pay first before treatment".(commonly seen in private institutions, surprisingly true in a " religious institution")In economic hard times it may be difficult to collect, especially in emergency situations, the common Filipino was never taught or never learn to save for the "rainy days", in times of emergency or in an emergency situation he/she will either take out a loan or pawn something to cover some obligations in the hospital. It may be convenience for those have medical insurances or belong to HMO at least this companies have set aside a bond in the medical institution, but how about the rest which composed more half the population since it is only a mere 10% or less will have an HMO or medical insurance that will take of them.
As an SOP the medical institution may be much obliged "just" to apply first aid measures in the emergency room and assess the whole situation and transfer the patient to a government facility if need be.(mostly due to financial reasons, it is like a bing bang bong, the faster you can transfer to a government medical facility the better, since you won't get stock with the patient, but there will be instances and situations that "john does and janes" will occupy the ER in which a big headache will be in your hands).This may have separated the health system that we have in the Philippines, from the one in the US, irregardless of what you are in society you will always get needed emergency medical care in the US, the percentage that you will be turn down is nil. Working in the emergency room of Mother Cabrini all the "bums" from Bowery were all taken care of, even they are infested by lice or maggots. Maybe we couldn't blame the medical institution since they have to "survive" too. The question of medical care is always based on the on your capacity to pay, but it shouldn't be viewed that way, like most physicians are doing in entry of patients to his/her clinic offices he/she is viewed as a peso sign or simply an earning for the day.( so were is the humanity in medical treatment?, since most of us view it as a business transaction) The peso sign should not separate the patient from the physician nor the medical institution from the patient, the dictum may hold true that we also have to "survive", but not to the expense of our dear patients.
I don't know how our patients will view us as there physicians or how the general public will view us as practicing doctors in the community. Some patients are already well aware of the ban on a Filipino pharmaceutical company by a certain "college", like asking questions " Doc, why change my medications since they work for me?", for some of our patients the stickers on the wall or have seen it outright that "selected" medical representatives from this Filipino pharmaceutical company are not allowed to detail on the medical offices that are members of this "college". I won't talk about "professionalism" anymore since all we have to do is view ourselves in the mirror then we could see our "real" selves. Maybe one pitfall that we see is how we deal with the dying patient or a colleague in the practice of medicine, never in medical school or in the medical training residency we were taught by our mentors or "professors" to be empathic or sympathetic and most important to be a compassionate physician to a dying colleague and his family. We could have avoided any altercations and shouting matches if we were just trained to deal with cancer patients, even we have been fellows in our colleges or have attained the highest status of a "specialist" in our fields of medical endeavors, we were never taught to deal with dying and becoming a compassionate physician to all our patients, which is not seen in a "compleat" physician.
Let us look back to the training programs that we all came from and as early as medical school and correct those inequities and practices that we teach them. We should encourage, teach, show and gave all medical students and training residents and interns examples in being a "compassionate and caring" doctor and physician.