Without the White Coat
Patient-centered medical practice
A person once asked me, "What is your specialty, doctor?"
Well, medical practice nowadays had become "Mafia-style", the referral and the management in all. We have young medical practitioners that are in a hurry to earn that "buck", but entirely forgetting that they are dealing with a breathing human being.
There are fewer students who enroll in medical schools, thus, the shortage of doctors soon.
The general public had been too cynical and critical of our practicing medical doctors, looking or viewing at them as hawking vultures in the dry wilderness. Gone are the days of house calls and an intimate patient care wherein a physician is viewed highly by their patients and family. Maybe we have already come to a point that loving and caring are secondary to monetary gains.
We have physicians and doctors who were trained in different specialties, but they overlap. A fully trained pulmonologist (a lung specialist) who practices occupational and industrial medicine (but has not undergone training in the basic occupational and safety course as mandated by Presidential Decree # 442 or popularly known as the Labor Code of the Philippines, article 160), or a fully trained pediatrician (specialist of children's disease) doing pre-employment and annual medical examination of workers which should fall under the practice of occupational and industrial medicine. So, where has the practice of medical ethics gone? Does this reflect the society where we belong, or they just don't have any idea at all?
As family physicians, we are trained to do minor surgery like excision biopsy, circumcision or removal of an ingrown toenail --- competencies that have been sanctioned by the Philippine Academy of Family Physicians and the Philippine College of Surgeons in the manuals that they published.
I could not understand that despite the guidelines of these two academies, family physicians are still not allowed to do minor surgery in the medical institution's operating room or even in a minor operating room.
We have never taught our medical students since the time they entered medical school. Some mentors say that problem-based teaching is better than the traditional form. Then, the traditional teachers declare that the old and traditional way of teaching is still the best. These two schools of thought may have created a system of medical teaching, whose outcome we have seen. We have produced a lot of physicians who don't know how to care for the patient.
Our medical schools have never made the patient as the center of care of their medical practice. A lot of us had been indulging in our specialties that we forgot about our patients, have viewed them as disease organs, an illness or a symptom in order for supportive care can be given.
So, at present, is the patient-centered medical practice attainable? With the help of Dr. Alma Frondoza of the Central Philippine University, College of Medicine who churned out graduates in Medical Ethics and Values, there is hope.
If a medical student becomes "monetary centered", "Mafia-centered", "luxury centered", or "patient-centered," it's up to the medical schools to produce.