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The Patient-Physician Mismatch

22 Apr


At present, the doctor-patient ratio in the Philippines is one doctor to 20,000 or 30,000 patients while the ideal ratio prescribed by the World Health Organization (WHO) is one to 10,000. — Pia Lee-Brago (http://www.newsflash.org/2004/02/hl/hl103248.htm Manila, November 27, 2005)

The disturbing fact is, most of the skilled physicians (specialists and subspecialists) are clumped in urban areas where ratio may be lesser than 1:10,000; while only few specialists/subspecialists and mostly generalists are catering to the rural area, and where the ratio may be greater than 1:30,000. This is mainly due to absence of facilities and equipment in the rural community that will allow these specialists and subspecialists practice their craft. During my med school days, I had the chance to rotate at a government hospital. Then, the hospital didnt seem a building for you to seek treatment. Water is scarce, comfort room is very un-hospital-like. Beds are rusting. Supplies are lacking if not incomplete. Would you imagine, povidone iodine for dressing wounds is very limited; lucky if the last patient would have a drop of iodine for his wound. Antibiotics prescribed for a patient kept on changing depending on what’s available in the pharmacy. (Thus just when the proper blood level of one antibiotic is established to start killing microbes, it gets shifted to another kind as the former isn’t available. This is highly dangerous to favor microbial resistance to these antibiotics, rendering them inutile afterwards). 

A lot were asking me why I have not trained, and perhaps practice, abroad? I always tell them what use would it be to be exposed to high technology and sophisticated equipment when they will not be available just the same in my locality, and yes, I always wanted to serve in my own community. Of course, one’s credentials would sound flattering with all those foreign degrees and institutions clipped to his resume but it isn’t always a gauge and guarantee you will provide better and quality care than those who trained locally. I, myself, have confined my practice at an urban community. Why so? I cant compromise my skills and training with non-availability of resources in the rural areas. It will cripple me just the same and render me ineffective and inefficient. Yet again, in some hospitals I am affiliated with, some equipment are lacking too invoking resourcefulness (eg, turning a phototherapy box unit into makeshift incubator). 

Will we see a reversal of the physician-patient ratio in the rural community? Even if some patriots want to, we cant do it by ourselves. We need the government to do its part… Just look at this instance: For 2012, WHO recommended that the government should allot 440B for health care. The DOH asked for a 90B (just 20% of WHO’s recommendation), but only 40B was rewarded at the annual budget, a meager tenth fraction of the WHO’s recommendation… frustrating. But I’m not losing hope. Maybe not in my lifetime.

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Posted by on April 22, 2012 in Personal

 

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