Desperate how's and why's

Early Monday morning, I got an email coursed through our med school class e-group, from a classmate currently undergoing residency training in the United States- at Johns Hopkins no less!- detailing what is now the infamous dialogue from an American tv series:

In the episode entitled. "Now You Know", Susan's character was questioning the credibility of a gynecologist and said, "Ok before we go any further, can I check those diplomas? Cause I would just like to make sure that they're not from some med school in the Philippines."

And the rest, as the cliché goes, is history.

Truth be told, I haven’t had the chance to really mull over this piece of “news”. Honest to goodness, my first instinct after reading the email was- “Uhmm… Ok.” I proceeded to read subsequent emails, prepare the questions for the end-of-rotation examination of the third year medical students in our section, etc. The issue did not creep back into my consciousness until tv newscasts, and radio talk shows began taking to task health sector professionals and leaders on what the appropriate response was to the perceived slur. The issue was slowly dissected in the media, if you will.

All the while I still haven’t formed an opinion. I was even somehow put on the hotseat last night when a handful of us high school friends got together for dinner- a lawyer, a financial analyst, myself, and a pediatric resident doctor.

Our pediatric resident MD friend still haven’t formed an opinion about the matter; she was too busy saving lives at the emergency room of the university hospital the past few days.

Our financial analyst friend was very upset but still level-headed. She narrowed down the choice of reactions to just two: be mature about the issue so let it slide OR be mature about the issue so stand up for your rights and dignity. She is very much for the latter.

Our lawyer friend, well, she was for the first option, that we Filipinos ought to bear it and grin. The fact of the matter is, it’s a tough world and it’s not in our best interest to be onion-skinned. C’est la vie.

And as for me… I… still don’t know.

I know I am expected to express irritation, dismay, anger, displeasure over this entire brouhaha. As part of the Filipino medical profession, I should resent being disparaged in one fell swoop by that 29-word dialogue. As part of the premiere medical education institution in the Philippines, I ought to be outraged by that remark insinuating that doctors who graduate from Philippine medical schools are “substandard” and unworthy of a patient’s trust.

And to a large extent I do resent being at the butt of that disparaging tongue-in-cheek line. I am outraged about the statement that looks down on the quality of instruction in medical schools in the Philippines.

I laud the immediate, thunderous retort of the Filipino-American community: pickets and petitions at a moment’s notice.

I am in awe of the Philippine government’s fast-paced action and tough talk: protests from various U.S.-based consular offices, statements of displeasure unleashed through various forms of media, the House of Representatives’ posturing that may lead to the banning of showing the Show-That-Should-Not-Be-Shown in- egad!- Asia.

I am amazed at the speedy crafting of protest letters and statements of the Philippine Medical Association decrying the demeaning dialogue disparaging doctors. And as luck would have it- the president of the PMA is in the World Medical Association meeting in Copenhagen, a very opportune time to raise this matter of how a Sunday night tv series can precipitate the crumbling of the Philippine medical community.

Everybody, altogether now, wake up and smell the rotten condition of Philippine medical training.

(For those not in the best of moods, ranting is about to commence. Since misery loves company- feel free to swim in my random thoughts of disgust at the hypocrisy of the people in this brewing controversy. Else, feel free to browse my other feel-good entries. You have been warned... Do read on.)


Haay... Fussing over this darn tv show! When one Filipino dies of TB every 20 minutes- is ANYONE writing a petition for government to act more swiftly on this issue?! Or the fact that 100 municipalities in the Philippines are DOCTOR-LESS, including areas as close to Manila as Batangas- is ANYONE frantically picketing government institutions for this problem's prompt resolution? Or the fact that more than half of all deaths in the country have not been attended to by a health professional, meaning you have NO WAY of knowing if the disease that brought about the patient's demise is familial, infectious, genetic, or environment-related- have you seen this occupy the frontpage of dailies or the top news item among tv news programs?!

For the life of me, I cannot understand how this furor can benefit the Philippine physician and the Filipino patient living as an informal settler (read: SQUATTER) in a piece of land abandoned by its owners who have now migrated to the United States and give nary a care to that inherited piece of property.

I wonder where is the expression of OUTRAGE AND DISGUST when we talk about the state of Philippine medical education? When students and residents still have to undergo 24-hour duties in almost all training hospitals in the Philippines even in the light of various international studies already showing that working long hours in high-stress environments like the hospital can lead to reduced quality of care for patients as evidenced by an increase in errors committed? Why is the Philippine Medical Association not actively advocating for better working conditions in hospitals and training centers?

I wonder where is the government’s FAST-PACED ACTION with regard to really combating the real enemies of the state: infectious diseases like tuberculosis and diarrhea plus emerging lifestyle-related illnesses like cancer, diabetes, and heart disease?

I wonder where the government’s DECISIVE MOVES are with regard to the allotment of MORE HUMANE AND REALISTIC HEALTH BUDGET to fund its health initiatives? HONESTLY, DOES GOVERNMENT REALLY THINK THAT BY COMING TO THE DEFENSE OF THE MALIGNED MEDICAL COMMUNITY WE WILL BE GRATEFUL AND TURN A BLIND EYE TO THE 16-BILLION PESO BUDGET IT ALLOCATED FOR HEALTH, A MERE 1.328% OF THE 1.277-TRILLION BUDGET IT IS PUSHING FOR IN 2008? 1.328% IS SOOOO FAR AWAY FROM THE 5% BEING ADVOCATED BY THE W.H.O.!

I still wonder where government is when medical education in some schools is arguably so poor that a very low percentage- if any one at all- among their graduates pass the PRC licensure examination. I still wonder where government is when a certain medical school is allowed to trumpet the fact that one of its medical graduates would top the medical board exams every so often- while deceptively leaving out the fact that less than a third of its graduates would pass the medical board exams each time the licensure examination is given.

Not that the PRC examination IS a worthy gauge of a Philippine medical graduate’s know-how. Kindly enlighten me please of the relevance of this question from our own physician licensure examination in my practice of medicine:

Who is the first person in history to be recorded to have had small pox (or was it measles)?:
A. Catherine the Great
B. Rameses
C. Moses
D. somebody I already forgot

SO WHAT IS MY POINT?!

All of the ruckus created by

"Ok before we go any further, can I check those diplomas? Cause I would just like to make sure that they're not from some med school in the Philippines."

is GOOD. It brings back to the limelight the state of Philippine medical education and training.

BUT IF WE WANT TO RESTORE THE BESMIRCHED NAME OF THE PHILIPPINE MEDICAL ESTABLISHMENT, LET US TURN INDIGNATION INTO ACTION. Please consider-

To our dear Filipino-Americans:

If you can gather 30,000 signatures for an online petition with regard to a malevolent television show and if some of you feel SO strongly for Philippine pride and Filipino doctors that you would skip work to picket in front of ABC offices, I am sure there is no problem in mustering enough support and dollars to fund scholarships for Filipino medical students AND support non-government institutions that field doctors to far-flung underserved communities IN THE PHILIPPINES. Quality training can be implemented AND quality service can be rendered by these quality graduates who will likewise receive quality remuneration enough for them not to give in to the enticement of working abroad.

IF YOU REALLY WANT TO RESTORE AND MAINTAIN THE DIGNITY OF THE FILIPINO PHYSICIAN, please, kindly put your money where your mouth is. I am sure Filipino doctors appreciate your current display of support- but, really, what we need IN THE PHILIPPINES are more than petitions. We need your resources: subscription to medical journals; medical equipment and reference materials for hospitals; basic hospital supplies and medicines for our patients; doctors abroad- come home to train doctors HERE, serve patients HERE.

To the Philippine Medical Association:

PLEASE FIGHT FOR THE FILIPINO PHYSICIAN! FIGHT FOR BETTER PAY, BETTER BENEFITS, BETTER WORKING CONDITIONS FOR DOCTORS! Lest we doctors begin to think that the PMA is one big useless confraternity of practitioners who do nothing but compare practice toxicity, golf handicaps, and number of luxury vehicles in you garages.

To the government:

IF YOU REALLY FEEL THAT MEDICAL PROFESSIONALS AND FILIPINOS IN GENERAL WERE SLIGHTED BY THAT LINE IN THE TV SERIES, I SUGGEST THAT YOU STOP BEING AN ACCOMPLICE TO THE DEGRADATION OF THE DIGNITY OF THE FILIPINO DOCTOR.

Implement the Magna Carta for Health Professionals NOW! Make the pay of health professionals from Batanes to Bicol to Bukidnon equal and just! DIPLOMATIC MANEUVERS like a note verbale or consular protests WILL NOT RESTORE THE DIGNITY OF THE FILIPINO HEALTH PROFESSIONAL that government has already so callously allowed to degenerate; IMPROVED PAY, BENEFITS, AND WORKING CONDITIONS WILL!

INCREASE THE BUDGET FOR HEALTH! Medicines not machine guns!

IMPROVE THE PRC and it conduct of the Physician Licensure Examination!

To Filipinos in general but particularly Filipino physicians:

We can always demand for RESPECT, but the reality is, WE MUST EARN IT. And I believe that what will make FILIPINOS RESPECT THEMSELVES and make the world turn towards us with the utmost respect is if we can pluck our country out of the muck we are in- the quagmire of poverty, corruption, disease, and hopelessness. By getting our act together, contributing to the welfare of our country wherever we maybe, remaining always on the lookout for our country’s best interest, placing the nation’s welfare before our own and converting all our good intentions into concrete action, we will move the nation forward and upward.

No snide remark from any personality- real or imaginary- can erode our dignity then.