Davao Blogspace

a href=”http://www.ciccparenting.org/newsimages/istock_000000357240small_child_crying_1.jpg” onblur=”try {parent.deselectBloggerImageGracefully();} catch(e) {}” style=”clear: left; float: left; margin-bottom: 1em; margin-right: 1em;”img alt=”" border=”0″ height=”200″ src=”http://www.ciccparenting.org/newsimages/istock_000000357240small_child_crying_1.jpg” style=”float: right; margin: 0pt 0pt 10px 10px;” width=”181″ //ab(Disclaimer: All names and characters in this story were deliberately changed to protect the privacy of the patient concerned. If you felt the story was referring to you or someone you know, you are wrong.)/bbr /
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“Hepe, you might want to go the ward now.” The nurse on duty ’s voice on the phone, sound a little bit gloomy. I just came down from assisting a junior for an OR that extended to almost 12 midnight and I barely touched “the bean bag” to rest. My team wasn’t on duty that night.br /
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“Bakit hepe?” (Hepe, is our pet calls for male residents and male nurses in the wards, sort of brotherly respect). “Nag icode/i si bNanay Delia/b..iIkaw yung hinanap nya/i…” For a moment, I don’t know what to think of or how to react to this news. I immediately ran to the wards and joined the code team doing bACLS/b on Nanay Delia.br /
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Just 5 hours ago bNanay Delia/b and I are happily exchanging goodbyes and hugs in what supposedly a very heartwarming patient-doctor relationship punctuated by a successful OR procedure. To thank me, she insisted I’ll take a gift wrapped iPierri Cardin/i hankies and neckties fresh from underneath her pillows. To bNanay Delia/b, I was her savior-son. To me, she was a motherly patient I can never forget. iI am her surgeon/i.br /
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“She what???!!!”br /
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I first met bNanay Delia/b in the outpatient clinic two weeks before this incident. She was this jolly faced 56 years old ilola/i with a very happy disposition and a charming talker. Without make up but only the ever infectious smiles you see in your grandma’s face, her wrinkles in the forehead looked like lines of happiness. Needles to say, resisting her motherly charms is totally futile. Unable to walk because of nagging pain in her right hip, she was totally unfazed by her predicament and was in fact very much hopeful she can walk again.br /
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“Sa tulong at galing nyo doctor!” Nanay Delia was proudly chatting with some patients at the end of the clinic room. She was already infecting the whole OPD team with her crazy punchlines and contagious laughter. We can’t help but be swooned by her charm.br /
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After examining Nanay Delia and her xrays, a decision was made to have her right hip replaced (a procedure known as bTotal Hip Arthroplasty/b) to ease out pain and make her ambulate again. I asked her and her son who was assisting her to come back next week for admission and OR.”Tialaga duktor? Makaka pamalengke pa ulit ako??!/i” Everyone in the clinic saw the face of bNanay Delia/b lit up. She is over flowing with joy giving hugs to all the members of my service. A gesture that touched everyone in my service. Nothing extra ordinary, but a gesture in the right timing and execution, will melt the hearts of stone cold surgeons that we are. “iNany Delia just smooched us all!/i” Said one of my juniors.br /
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Our arthroplasty service see quite a number of outpatients everyday . Believe me, bNanay Delia/b seem to be an epitome of hope among these poverty stricken and ill patients. In this institution, residents spend hours and days haggling for funds and implants among sponsors, philanthropist and politicians(with their CDF),so that these patients can have their OR, free.We were able to get funds for her implants, and since the surgeon, anesthesiologist and procedure itself is free,b Nanay Delia/b will be operated with minimum of expenses.”Hay, salamat talaga duktor!”br /
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bNanay Delia/b passed the cardio-pulmunary clearance and labs easily. The internist classified her “low risk” for this surgery. So the next week, I saw bNanay Delia/b happily sitting in one of our ward beds. A number of bantays and ambulatory patients were already crowding near her bed. I can even here the laughter and giggles these people made because of bNanay Delia/bs funny stories and punchlines. She was the center of attention in our wards because of her friendliness, jolly type personality and talkativeness. She even talk loudly with patients on the other end of the ward, at least 10 meters far from her bed! i”Kung tayo nga na infect ni nanay, mas maganda tong mga patient natin masaya din!/i” I jokingly told my service.br /
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When bNanay Delia /bsaw me and my team coming for the ward rounds, she shouted: “iShhhhhhh! Tahimik na tayo, nandyan na ang mga gwapong doctor natin/i!” She was gesturing her companions to keep quite but I still could here giggles from the other beds. “iNanay, napasaya mo ata ang buong ward ah!!!/i”br /
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I talked with the cardio fellow and seek out another CP clearance, this time asking for repeat ECG and echo cardiogram. This premonition somewhat baffled me also. She was already cleared for OR twice and I was still asking another one. Obviously the fellow hated me for that, but I got what I wanted. bNanay Delia/b was cleared for OR. Nothing in the repeat labs picked up anything suspicious. Getting the final pointers and go signal from my consultants, I scheduled the OR in two days.br /
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Talking to bNanay Delia/b about the procedure, the risks, the benefits and preparations, we were all set for the OR. If there was one happiest person involve in this procedure, she wasb Nanay Delia/b herself. She was so happy and proud that at some point, we heared her overtly exaggerating our scalpel wielding prowess that I can only sigh in disbelief and smile.br /
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It was not my first bTHA/b as a resident and I have planned for this procedure several times In all of my previous surgeries, I have been chided for being too detailed on preparation and precautions to the point of obsession. bNanay Delia/b’s case was no special procedure and she too did not escape my obsession to preparation. Ironically she was a symbol of hope for most of our patients admitted to the wards. Her happy disposition is so infectious that my service actually felt the outcome of her surgery will be the barometer of how good our delivery of service was. “If this procedure will have a glitch, we will be devastated. So lets make this again, our best!” I pleaded my team.br /
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It was an uneventful OR indeed and the most satisfying one, finishing faster than we expected. bNanay Delia /btolerated the OR well and we were so admiring of the outcome of the procedure. The planning paid off and more. Everyone in the OR team had a pat on the back and even bNanay Delia,/b who was mumbling my name under anesthesia.br /
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The next day when I made my rounds, bNanay Delia/b was already sitting at her bed, her eyes glowing in joy. “iDok!, salamat po sa inyo. Maraming salamat talaga!”/i Coupled with a hundred more praises and exaggerations, I can’t help but gave her our “iakbay barkada/i”, a gesture we made to our nicest friends. She was already inviting me to her upcoming birthday and the christening of her grand son, to which I would be a godfather. i /ibr /
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i”Nanay, you still have to start your hip range of motion exercise so that by tom, I can teach you how to walk with quad crutches./i”I deliberately changed our topic of conversation.”iYes doc/i” was her smiling reply. I just shrugged my head. But deep inside, I was extremely please at the sight of one very happy and satisfied patient.br /
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The next rounds she was motioning my team again to her bed. “iKain tau dok!/i” “iMamaya na po Nanay after ma dress natin yang sugat nyo and maturuan namin kayo ng quad crutch ambulation/i.” Teaching bNanay Delia/b ROM exercise was no sweat at all. She was even proudly showing off to us that her hip pain is gone. I was just smiling at her antics. “iHinay-hinay lang nanay!/i” I told her, she will be discharged tomorrow, once I inspected her wound and assessed her fit for home ambulatory rehab program.br /
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bThat discharged never happened./bbr /
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“iAnother epi please!”/i I was shouting while doing chest compression(CC). I am perspiring heavily since nearly doing CC for almost 10 minutes already. I’m still dazed as to what has happened but I’m racking my brains at reviving bNanay Delia/b. “iWhy was I not informed immediately about this?!/i” I was shouting already. “iHepe, ginigising lang si nanay nung bantay nya for meds nung napansin di na pala humihinga. Before natulog yan nakipag kwentuhan pa sa mga katabi at tawa ng tawa/i. She was asking for you and looking for you at may sasabihin daw.”br /
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It was a massive MI according to the IM in the code team. “iHow can that be?”/i I said, bNanay Delia/b was cleared two times before this OR! Even the 2D echo did not pick up anything! It is frustrating to look for impossible answers. The obvious reason was, I, my service became attached so much to bNanay Delia/b. Nobody was expecting this event to happen because everything went well and she was one hundred percent happy just before sleeping. She never woke up to walk again.br /
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When the IM declared bNanay Delia/b dead, I was still shocked and dazed. I was literally angry and frustrated at the same time. “Why did this happen? Was there anything we could have done that might have save her life???” I can see bNanay Delia/b’s smiling face in my mind.br /
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I mustered enough courage to talk to the family gathered around her bed. I offered my best consoling words. I almost cried when each of the family member hugged me. “iShe was asking to see you before she slept, doc. She was very fond of you/i.” I was in the ORbr /
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I excused myself and hurriedly left for the call room. I sat in one corner staring at the blank wall. I am looking at nothing. I still couldn’t believe what has happened. bNanay Delia/b and that this whole procedure meant nothing. I wanted to cry, but I couldn’t. I don’t know where to get my tears..I just sat there and wanted to cry but couldn’t…I was crying dry…br /
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In my most isolated and stoned cold medical life, . I am hardened by pain and several deaths to our patients. I have trained myself to get detached and not be affected by emotions. I was trained to empathize, not sympathize.Yet, every time something like this happened, I felt it is easier to just cry and make ease the burden of guilt. It feels lot lighter and starting again, becomes easier.br /
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bBut tears never came./bbr /
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Perhaps, it was because bNanay Delia/b’s jovial face smiled on us every time. That for a short time, we were able to make another patient happy and satisfied with what we can do with our god given knowledge. That we learned from this mistake and that she gave hope for our other patients. More importantly, Nanay Delia taught us all that happiness is a constant state of mind. And you need no superfluous things or event to enjoy it. No excuse.br /
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I cried dry…/span/spandiv class=”blogger-post-footer”Bone MD is a board certified orthopedic surgeon and a Fellow of Philippine Orthopedic Association practicing in the hinterlands of Southern Mindanao, Philippines. He took up medicine at the UP College of Medicine and finish his Orthopedic Training at UP-PGH Department of Orthopedics. He is a visiting consultant in the Department of Orthopedics, Davao Medical Center and several other hospitals in South Mindanao area./div
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I’ve been to bThe Fort (Taguig)/b some years back for a class mini reunion and party. I still remember walking along a dimly lit, but paved road flanked by mostly vacant, half finished buildings. Taxi ride is nearly non existent then, especially at night. I have to wait for almost an hour just to get a taxi!br /
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/a/divThat was five years ago. bThe Fort/b, now less spacious and “taunting” a well manicured park (was it really a park I saw?) of some sort,nbsp; is reminiscent of the boomingnbsp; bGreenbelt of the late nineties /b! Tagging along bJoy/b, another “foreigner” to this place, we feel lost in a somewhat distantly familiar place.br /
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“Where on earth is bSerendra?/b!”br /
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Uh, by the way, me and bJoy/b is about to join other medical bloggers for bThe Blog Rounds Mini EB/b. bMegamom/b has volunteered to arrange this EB and was practically cajoling everyone to come,nbsp; meet, dine,and have fun with fellow bTBR bloggers/b.br /
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“If only we can find bBrazil restaurant/b…or Serendra”… br /
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“Let’s go that way!” I excited nudged bJoy/b towards a crowded portion of this spacious, stacks of buildings. “Just ask the guard, dude!” quipped Joy.br /
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Just about 30 steps east we found bBrazil Restaurant/b- a fine looking restaurant known for its mouth watering buffet and endless barbecue slices!.b Megamom /bandb Louell/b are already “warming up” their muscles of mastication. After introducing ourselves, we settled down the table, got busy with our plates and went on with the sumptuous meal..br /
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bDoc Harry/b and bDoc Gigi/b came in halfway our meals and endless “joking around”.br /
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Exchange of blogger stories, ideas, news and almost everything else started pouring in.nbsp; So is the never ending barbecue slices of Serendra.br /
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“You have to turn that iyoyo/i upside down so the waiters and waitresses will stop feeding us with barbecue cholesterol.” Ugh!br /
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The one thing I liked most about bloggers is their endless “pond” of ideas. “Pond” that never “dry” up!br /
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bDoc Joey /bandb /bherbnbsp; hubby/b came in when we were on our second meal serving. Yup, no dessert yet. The hilarious parking mix up by bDoc Joey/b’s hubby (neari market market/i) made us all laugh. Obviously, bDoc Joey/b and hubby got lost too, in the bFort/b’s maze, looking for Serendra.br /
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div class=”separator” style=”clear: both; text-align: center;”span id=”fullpost”a href=”http://1.bp.blogspot.com/_3J-pISBmOI8/SOTzZr6Iv9I/AAAAAAAABTw/k6DRHoR_JkQ/s1600-h/TBR+EB200802.jpg” imageanchor=”1″ style=”margin-left: 1em; margin-right: 1em;”img border=”0″ src=”http://1.bp.blogspot.com/_3J-pISBmOI8/SOTzZr6Iv9I/AAAAAAAABTw/dL2VrOubUew/s320-R/TBR+EB200802.jpg” //a/span/divdiv style=”text-align: center;”span id=”fullpost”span style=”font-size: x-small;”inbsp;The Blog Rounds EB at Brazil Restaurant, The Fort/i/span/span/divdiv style=”text-align: center;”span id=”fullpost”span style=”font-size: x-small;”i(Clockwise, R-L: Doc Joey’s hubby, Joey MD, Bone Doc, Harry, Louell, Megamom, Gigi. Not in this photo is Joy, who volunteered to take this picture)/i/spanb/b/span/divdiv style=”text-align: center;”span id=”fullpost”bbr /
/b/span/divspan id=”fullpost”bDoc Tess Hey /btexted she’s coming to this EB too. Somehow, she never showed up andnbsp; we all wondered why. “Bakit nga ba?”br /
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Not around also were bDocs Manggy/b (who had to fetch someone at the airport)nbsp;b Doc Prudence/b, (suddenly called for duty) , bDoc Mel /band bChenbsp;/b (who are not around Manila during those times).br /
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The EB went on with ideas for the upcoming bTBR Summit/b! Here are some of the bresolutions we agreed upon during the EB./b bPinay Megamom/bnbsp; promised a full account of the meeting and tasks assignment for this summit.br /
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liThere will be a TBR summit summertime (April-June) next year (2008). The date, place, and full summit topics will be decided on by the Org Comm, Bloggers next meetings.br /
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liThe organizing committee will be composed of those who attended the EB plus any other volunteers form the TBR bloggers’ pool. /li
liThose who weren’t around EB will be given special assignments. (TBA by Megamom)/li
liPart of the TBR summit resolution will be some sort of medical blogging ethical guidelines (akin to hippocratic oath in medical blogosphere?)./li
liTBR bloggers will be encourage to contribute topics for the summit and suggestions will be great appreciated. In fact, some TBR editions will be devoted to this./li
/span/olspan id=”fullpost”I’m still waiting forb Megamom/b to post details of the EB meeting… br /
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“Kain pa tayo!” Indeed we (me actually) ate to (over)indulgence. We had great time and fun, meeting other isane/i minded medical bloggers. Thanks to bAileen/b and her anonymous EB sponsor!!!!.br /
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And to those who weren’t there at the EB, watch out for your summit assignments and better be there next meeting. bDoc Manggy/b promised to cook for that meeting! Our chef, will no less than theb Best Food Lovers/Blogger/b awardee of bPhil. Blog Awards!/bbr /
/span/spandiv class=”blogger-post-footer”Bone MD is a board certified orthopedic surgeon and a Fellow of Philippine Orthopedic Association practicing in the hinterlands of Southern Mindanao, Philippines. He took up medicine at the UP College of Medicine and finish his Orthopedic Training at UP-PGH Department of Orthopedics. He is a visiting consultant in the Department of Orthopedics, Davao Medical Center and several other hospitals in South Mindanao area./div
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a href=”http://www.greek-gods-and-goddesses.com/images/pandoras-box.jpg” onblur=”try {parent.deselectBloggerImageGracefully();} catch(e) {}” style=”clear: left; float: left; margin-bottom: 1em; margin-right: 1em;”img alt=”" border=”0″ height=”215″ src=”http://www.greek-gods-and-goddesses.com/images/pandoras-box.jpg” width=”188″ //aAccording to ancient Greek mythology, Pandora opened the “box” (actually a jar which Zeus entrusted but forebode her to open) because of one uncontrollable urge-span style=”font-style: italic;”curiosity/span. The opening of Pandora’s box released all “human evils” kept inside the jar by Zeus, except one human trait.br /
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div style=”text-align: center;”span style=”font-size: 85%;”span style=”font-style: italic;”(Pandora’s Box Painting by JW Waterhouse)/span/span/divbr /
In one striking parallelism, the current brain drain of professionals is rooted in one analogous reason. Better financial and professional opportunities abroad fueled the curiosity of homegrown professionals to go on an exodus and opened the lid of our Pandora’s box.br /
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No other profession suffered more scrutinizing eyes than what physicians received in this brain drain phenomenon . Believing that this mandatory return of service will close the exodus of professionals from the country, a congressman filed span style=”font-weight: bold;”HB 4580/span requiring all professionals to a mandatory return of service after training here in the Philippines. Ironically, while the government is drum rolling OFWs as the nation’s new heroes (cultivating the exodus of skilled workers in exchange for dollar remittances) it is quick to criticize physicians who thread the same path of seeking better opportunities abroad. Worse, labeling these physicians as unpatriotic offers the most hideous method of enticing them to come back, and appeal to their nationalistic pride. Why is the government capitalizing on the OFW phenomenon but openly shun doctors planning going out?br /
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Some medical training institutions have tried to close this Pandora’s box with a “lid” of their own. The span style=”font-weight: bold;”UP College of Medicine/span, a government subsidized university, has approved a three year mandatory return of service for its medical graduates. Other government funded medical training institutions have their own return of service program in place as part of a medical training contract for years already. The penultimate questions still remain.br /
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Was it successful in preventing the brain drain of physicians?br /
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Was it able to solve the worsening physician -patient service ratio?br /
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Is this a a wise move to close our Pandora’s box?br /
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span style=”font-weight: bold;”Doc Mel/span ( a href=”http://thephilippinedailyidiot.blogspot.com/”span style=”font-weight: bold;”Philippine Daily Idiot/span/aspan style=”text-decoration: underline;”span style=”font-weight: bold;”) /span/spana href=”http://thephilippinedailyidiot.blogspot.com/2008/08/tbr17-last-week-sobrang-nakakatawa-ang.html”span style=”font-weight: bold;”didn’t think so/span/a. Here’s his egg laying bird nest appraisal of this move:br /
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blockquoteStraight to the point: forcing our dear motherland’s brightest med future (naks, UP med students) after graduation to serve three years in the country smacks of a short-term Band Aid in one thickening subplot of the Philippine Zombie Healthcare System./blockquoteand some more egg laying truth..br /
blockquoteA short-term Band Aid is maybe ok NOT because it is cheap and high-impact. It is ok if only because it is one prong in an all-out multi-pronged approach to a problem. To be charitable about it, give it to the government that it is tinkering with every way possible to do it./blockquoteMost of us in the industry feel this move is a good start, but should be part of wider and broader long term solution to the brain drain and dwindling patient to physician ratio in the health care system.br /
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a href=”http://health.tesstermulo.com/”span style=”font-weight: bold;”Prudence MD/span/a a href=”http://health.tesstermulo.com/?p=477″lauds/a this span style=”font-weight: bold;”UPCM/span move a href=”http://health.tesstermulo.com/?p=477″span style=”font-weight: bold;”(Is Hb4580 the solution to Philippine’s brain drain?)/span/a:br /
blockquoteI find it fair enough that medical students whose education have been subsidized using taxpayer’s money should be required to render a certain amount of time for medical service to the country. Also, I believe this should be applied to graduates of any other courses in all state universities./blockquoteSo doesspan style=”font-weight: bold;” a href=”http://megamomph.wordpress.com/2008/08/26/starting-somewhere/”Pinay Megamom/a/span here (a href=”http://megamomph.wordpress.com/2008/08/26/starting-somewhere/”Starting somewhere/a):br /
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blockquoteI laud UP for making this move. However, its effectiveness to try and address the bigger issues remain to be seen. If other measures are taken to address the other contributing factors to brain-drain (compensation, professional satisfaction, work conditions, etc…), in conjunction with this move, we may actually see some changes for the better. It’s a start./span/blockquotespan id=”fullpost”and span style=”font-weight: bold;”Joey MD/span here (a href=”http://www.joeymd.com/2008/08/26/return-service-mechanism/”span style=”font-weight: bold;”Solution to healthcare?/span/a)br /
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blockquoteI do not think that this will ultimately result in better health care, but it’s a good start. At least, this program will try to ensure that there will be enough MDs, hopefully, to serve the people’s health care needs, assuming that the enrollment in UP Medicine is about the same every year./blockquoteBut weather it will end up in a better health care system on its own, we all sing a united “I doubt it this is a long term solution on its own.”br /
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Several issues and potential caveats where raised by blogger MDs themselves that needs to be addressed if this mandatory return of service will make its impact on our zombie health care industry. Cautioning the government that even HB4580 is not the only solution to this current brain drain, it also has to make appropriations and just compensation for those who choose to work here.br /
ullia href=”http://health.tesstermulo.com/”span style=”font-weight: bold;”Prudence MD/span /acautions that it is unjust to impose this rule on privately trained professionals./li
lispan style=”font-weight: bold;”Mel B/span warned that this band aid approach is a single pronged approached to a otherwise multi pronged problem. And he espoused a “global” caffeine injected solution to a zombie, global capitalist health care system./li
lispan style=”font-weight: bold;”a href=”http://www.joeymd.com/”Joey MD/a /spanechoed the same sentiments of strengthening other aspects of the health care industry (e.g. budget, facilities, health care education)/li
lispan style=”font-weight: bold;”Pinay Megamom/span insists that provisions for adequately compensating those who are forced to work here.br /
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/ulUnaddressed, these issues are the same reason why most professionals leave the country. This is what span style=”font-weight: bold;”JA/span (a href=”http://jaaraf.blogspot.com/” style=”font-weight: bold;”Ripples from the river of my though/aspan style=”font-weight: bold;”t/span) put forth in her blog (a href=”http://jaaraf.blogspot.com/2008/08/here-there-or-anywhere.html”span style=”font-weight: bold;”Here, there or Anywhere/span/a)br /
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blockquoteI don’t think that creating laws to keep people from leaving are going to be helpful in the long run though. What is necessary is for young doctors to feel that they are justly compensated during training and actual clinical practice in our country. That way, they will have more reasons to stay than a feeling of obligation to serve the country./blockquoteAnd if we are threading in to the realm of cutting liberties and human rights of physicians in the name of public service, them we might have missed the root cause of this problem. Just like what span style=”font-weight: bold;”Anakat/span ( a href=”http://anakat-thesagacontinues.blogspot.com/” style=”font-weight: bold;”The Saga Continues/a) in “a href=”http://anakat-thesagacontinues.blogspot.com/2008/08/its-never-been-secret-among-my.html”span style=”font-weight: bold;”Exodus part 2/span/a” is saying.br /
blockquoteI am not an expert on human rights or related laws but there has to be a breach of this in the government’s decision to pass this house bill. UP used to be a staunch protector of these rights and freedom. My alma mater has let me down by devising this return service mechanism./blockquoteIn a democratic institution, where does the freedom of a professional ( to choose where to practice) ends and that of public service starts??Or does it end at all? These lines simply put a good thinking salvo on this issue.br /
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In an attempt to close this Pandora box, the various stakeholders tried but failed to understand why the lid was opened in the first place. And while starting a band aid solution to the brain drain problem seem laudable, it has yet to prove its impact on the health care system fraught with vulnerabilities.br /
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Sadly, we fail to discern the reason(s) why our box was opened in the first place. Knowing these reasons and addressing them primarily, maybe we will have a better shot in closing this Pandora’s box. Hope is only what’s left inside this box.br /
br /
(To the MD bloggers who contributed to this edition of TBR, thank you all! span style=”font-weight: bold;”Prudence MD/span will be hosting TBR 18, for another interestingly relevant topic of our times, ibThe State of Reproductive Health Care in the Philippines/b/i)/span/spandiv class=”blogger-post-footer”Bone MD is a board certified orthopedic surgeon and a Fellow of Philippine Orthopedic Association practicing in the hinterlands of Southern Mindanao, Philippines. He took up medicine at the UP College of Medicine and finish his Orthopedic Training at UP-PGH Department of Orthopedics. He is a visiting consultant in the Department of Orthopedics, Davao Medical Center and several other hospitals in South Mindanao area./div
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a href=”http://3.bp.blogspot.com/_3J-pISBmOI8/SK0RuQrG6NI/AAAAAAAABOQ/tEtSDnmOfcc/s1600-h/cmmain.jpg” imageanchor=”1″ style=”clear: left; float: left; margin-bottom: 1em; margin-right: 1em;”img border=”0″ src=”http://3.bp.blogspot.com/_3J-pISBmOI8/SK0RuQrG6NI/AAAAAAAABOQ/nRe_Jhn4FBs/s200-R/cmmain.jpg” //aIn an unprecedented and controversial move, the a href=”http://www.upcm.ph/2007/index.html”bUP College of Medicine/b/a (the state’s subsidized premier medical school) through its bUPCM College Council/b,nbsp; approved ioverwhelmingly/i the proposed a href=”http://www.upcm.ph/2007/upcmnews_jan_march08_1.html”bReturn Service Mechanism/b for its UPCM graduates/a during the council’s March 11, 2008 meeting. (See the details of this new bUP Medicine Admission Policy a href=”http://www.upcm.ph/2007/upcmnews_jan_march08_1.html”here/a/b).br /
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div style=”text-align: center;”nbsp;span style=”font-size: x-small;”UP College of Medicine main entrance. Legacies that lived beyond hundred years..br /
/span/divbr /
Simply put, starting academic year 2009-2010, all freshman medical students who enter the halls of this premier medical institution, will be brequired a three (3) year return of service after they graduate before they will be allowed to go out of the country for training, further studies or employment/b. This is way ahead of that a href=”http://www.congress.gov.ph/press/details.php?pressid=2509″bHouse Bill 4580/b/a authored by bRep. Ignacio T. Arroyo/b (5th District, Negros Occidental)nbsp; that if approved into law, iwill require all Filipino professionals to render service for at least 2 years/i before they can go abroad.br /
span class=”fullpost”br /
In my a href=”http://orthologbook.blogspot.com/2008/08/is-there-shortage-of-physicians-in.html”previous post here/a, I was trying to determine a href=”http://orthologbook.blogspot.com/2008/08/is-there-shortage-of-physicians-in.html”if there was indeed a shortage of physicians here in the Philippines/a. The scary answer is yes we have communities who have not seen any physician at all. The average density estimates of b1.2 physicians per 1000 Filipinos /b(WHO 2002) or 1.2 physicians per 10,000 Filipinos (ADB 1998) is still among the blowest/b in Asia and globally.br /
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The debate on MD brain drain and MD-RNs going abroad goes protracted and ironically, is still unresolved or acted upon by major stakeholders. Majority of the Filipinos still suffer from the lack of physicians especially in the provinces. This fact still hounds us all and especially the physicians.br /
br /
bIs the this move by /bbUP College of Medicine, the government’s premier medical school and that of HB 4580 of trying to stop this “exodus” and lack of physicians by requiring doctors and professionals to render service to the countrymen/bb a valid one?/bbr /
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bWill the provisions of these policies offer solutions to this half a century of professionals leaving our country?/bbr /
br /
If you think so, maybe you can elucidate some more. If you think not, please say so and elaborate on your answers. In fact, you can give recommendations and suggestion to these policies and laws so your opinion(s) will be read!br /
br /
That will be the topic for the b17th/b edition of bThe Blog Rounds/b- bMandatory Return of Service for Professionals: Closing the Pandora’s Box/b?br /
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Submit your link and title to my email ikokegulper(at)yahoo(dot)com/i or leave a link by commenting to this post!Deadline for blog articles will be on bTuesday August 26, 2008. /b/spandiv class=”blogger-post-footer”Bone MD is a board certified orthopedic surgeon and a Fellow of Philippine Orthopedic Association practicing in the hinterlands of Southern Mindanao, Philippines. He took up medicine at the UP College of Medicine and finish his Orthopedic Training at UP-PGH Department of Orthopedics. He is a visiting consultant in the Department of Orthopedics, Davao Medical Center and several other hospitals in South Mindanao area./div
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Boredom, is one thing I hate from being “incapacitated” by span style=”font-style: italic;”-a href=”http://orthologbook.blogspot.com/2008/08/oh-well-it-hurts.html”itises/a/spana href=”http://orthologbook.blogspot.com/2008/08/oh-well-it-hurts.html” of some sort/a. During these times, watching reruns on DVD and teevee is hatefully irritating!br /br /I am a person span style=”font-style: italic;”who can’t/span settle down longer than one minute without doing something. And if there is something that would kill me, it’s span style=”font-style: italic;”boredom/span rather than the disease!br /br /But, enough for that whining and ranting. Lets get back to blogging.br /br /First, I missed a href=”http://orthologbook.blogspot.com/2008/03/blog-rounds-blogging-our-way-through.html”span style=”font-weight: bold;”TBR/span/a. This twice monthly grand rounds in the medical blogosphere went into hibernation for two weeks. I lost track of assigning a host blogger.No host, ergo no rounds. My apologies to all a href=”http://orthologbook.blogspot.com/2008/03/tbr-list-of-blogger-contributors.html”span style=”font-weight: bold;”TBR/span bloggers/a and readers.br /br /Starting this week, TBR hosting will go on it’s second round, with a href=”http://health.tesstermulo.com/”span style=”font-weight: bold;”Prudence MD/span/a volunteering to host the coming week’s TBR rounds. The succeeding hosting schedule will follow the cascading schedules as of before. I will post the schedule ina href=”http://orthologbook.blogspot.com/2008/03/blog-rounds-archives-and-schedule.html”TBR archives sections/a soon. Hopefully, this will all be a relaxed schedule since TBR is published online every two weeks now rather than weekly.br /br /I’m still pushing through with thea href=”http://orthologbook.blogspot.com/2008/07/medical-blogging-summit-anyone.html” span style=”font-weight: bold;”Medical Blogging Summit/span/a and the span style=”font-style: italic;”organizing committee/span that will brainstorm on it.span style=”font-weight: bold;” I need volunteers for the org comm/span and I have approached some TBR bloggers actually via emails and comments. As Ive said before, we can have a mini i-ball in span style=”font-style: italic;”Manila/span this late span style=”font-style: italic;”August/span or early span style=”font-style: italic;”September/span (around a href=”http://kokegulper.wordpress.com/2008/07/24/so-whos-going-to-the-word-camp-philippines-2008/”span style=”font-weight: bold;”WordCamp/span/a time) to lay the ground work for the medical blogging summit. For those who wanted to join the org comm please email me or leave comments on my post so I can get your details and phone number.br /br /I think that’s all what my left hand can type for now!div class=”blogger-post-footer”Bone MD is a board certified orthopedic surgeon and a Fellow of Philippine Orthopedic Association practicing in the hinterlands of Southern Mindanao, Philippines. He took up medicine at the UP College of Medicine and finish his Orthopedic Training at UP-PGH Department of Orthopedics. He is a visiting consultant in the Department of Orthopedics, Davao Medical Center and several other hospitals in South Mindanao area./div
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div style=”text-align: justify;”I’ve been mulling with this idea for quite sometime now and perhaps its high time I’d bring up this here, so I’ll get more hundreds of ideas.br /br /div style=”text-align: center;”span style=”font-weight: bold;”Why not a Pinoy Medical Bloggers’ or Medical Blogging Summit?/spanbr //divbr /a onblur=”try {parent.deselectBloggerImageGracefully();} catch(e) {}” href=”http://bp0.blogger.com/_3J-pISBmOI8/SIlJelBrRdI/AAAAAAAABLg/MnAUSPDna04/s1600-h/blogsummit.png”img style=”margin: 0pt 0pt 10px 10px; float: right; cursor: pointer; width: 234px; height: 161px;” src=”http://bp0.blogger.com/_3J-pISBmOI8/SIlJelBrRdI/AAAAAAAABLg/MnAUSPDna04/s400/blogsummit.png” alt=”" id=”BLOGGER_PHOTO_ID_5226789632224216530″ border=”0″ //aIt would be the first ever here, and will be the pet project of MDs behind span style=”font-weight: bold;”The Blog Rounds/span. I admit it, that whatever up coming social media that’s going to transform the way physicians deliver the best of healthcare, we have to take advantage of it. The huge potential is astounding. And we’re not even talking yet of Web 2.0. If we are going to do it for us physicians, someone else will jump on it soon. I’ve seen the other more techie friendly professionals grabbed the opportunities of blogging and Web 2.0 and I’m really awed by the progress their taking. Not just hype.br /br /The healthcare industry in the Philippines is seen as a late bloomer in terms of taking opportunities like this. But perhaps it is one way of bringing in closer the archipelagic distances we have to give out the best in healthcare we can offer to our countryman.br /br /Do you have any ideas on this? Please leave a comment!br //divdiv class=”blogger-post-footer”Bone MD is a board certified orthopedic surgeon and a Fellow of Philippine Orthopedic Association practicing in the hinterlands of Southern Mindanao, Philippines. He took up medicine at the UP College of Medicine and finish his Orthopedic Training at UP-PGH Department of Orthopedics. He is a visiting consultant in the Department of Orthopedics, Davao Medical Center and several other hospitals in South Mindanao area./div
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span style=”font-weight: bold;”Prologue:/spanbr /
In the last few days I was finalizing my entry to thisa href=”http://vgsamson.multiply.com/journal/item/89/The_Blog_Rounds_16_Call_For_Articles_Unsung_Heroes” edition of span style=”font-weight: bold;”The Blog Rounds/span/a (span style=”font-weight: bold;”Unsung Heroes/span, hosted byspan style=”font-weight: bold;” Doc Gigi/span of a href=”http://vgsamson.multiply.com/journal/”span style=”font-weight: bold;”Beyond Borders: The Lei Si Chronicles/span/a), I had a hard time choosing which one of my “unsung heroes” will grace this blog post. Not that I ran out of people to write about. In fact there are too many of them this blog couldn’t possibly feature them all. After finally deciding who shall I brag about, I Google-d for pictures to “carry” my post. Suddenly, a loud call hit my ears.br /
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span style=”font-style: italic;”"Kain na!!!!!!!”/spanbr /
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I smiled while “shelving” the post I previously wrote. I found my unsung hero right in our own dinner table.br /
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span style=”font-weight: bold;”Disliking politics for a good laugh/spanbr /
I woke up in this world hating the kind of politics our politicians is brandishing. So the whole time that I grew up and went to school, I span style=”font-style: italic;”stayed away/span from politics as far as I possibly can. I became one of those passive silent lurkers that hated politicians trampling at anybody to forward their own interests. Ironically, within my family, there exists a sphere of politics that made me gasps in complacency. My mom and sis are both staunch (read: right hand) allies of politicians belonging to two opposing fences. Like having a republican and a democrat one same party, only this time they both live interdependently within a family. Whatever circumstances that brought them into two opposing fences, be it values or principles, it is not my cut to remake. The fact that two seem to be the strongest allies in any major decision- making in the family made me think their political affiliations is just one for the good, educated laugh. I tersely smile in the kind of annoying democracy our family lives in. We only laugh about it during family dinners and night outs whenever talk hit politics!br /
span id=”fullpost”br /
span style=”font-weight: bold;”The early years of helping others/spanbr /
My unsung hero’s story goes as far as my high school years. It all started with her aspiration of helping her fellow span style=”font-style: italic;”kabaranggays/span in what seems to be a common community span style=”font-style: italic;”bayanihan/span endeavor- leveling dirt roads and canal dredging. Her exhilarating feeling of span style=”font-style: italic;”"sarap pala ng makatulong sa kapwa no?/span” brought out a longing to help others help themselves. Catching up with the volunteer fever, she was so contagious and pervasive she never stopped since then. That “dirt road shoveling” started a barrage of so many other volunteer work she could get her hands into. She immersed herself into so many community work and training. Despite not having a college degree herself, she learned community health work, cooperative concepts and community organizing.br /
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span style=”font-weight: bold;”Community work and voluntarism continues, politics or no politics/spanbr /
There isn’t enough space to count her good deeds for the volunteer community work she gave in. While my Isko political education and sensitization probably has thought me about politics and service to humanity, this person is living service, on a daily basis, to her community. When I asked her what she knows about politics. She answered me this, in the bisaya vernacular.blockquote”What is politics? I do not even know what it means. I just know I wanted to help others. When our people will show any signs they don’t like me as a public servant, then I’ll stop with what you call politics but I will not stop helping others. Yan na siguro ang bokasyon ko sa buhay.”/blockquoteThe day her name propped up in one meeting as a nominee for span style=”font-style: italic;”purok/span president, our family gathered to talk about the upcoming political litmus test. I was first to oppose aggressively about her running any public office at all. Politics, no matter how “small time”, is such an annoying field. In fact we had reservations because we knew politics is so darn dirty she might just get frustrated and that desire to help others will die a monumental death. We were wrong. She said she wanted to serve our community in any way she can, politics or no politics. Winning or losing this race will not hinder her to continue community work. So our family decided to let her have her way just this time. That was two and a half decades ago.br /
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The uterine CA survivor and diabetic patient, is aspan style=”font-style: italic;” baranggay/span health worker first class, an on call span style=”font-style: italic;”baranggay tanod/span, charismatic women’s federation president, a tricycle driver and operator’s president, multipurpose coop board of director, a span style=”font-style: italic;”kapunungan/span president, a citizen’s watch officer and so many other things voluntary I couldn’t imagine she all could possibly take. Her track record will speak for itself. You can find her in any community information drive, health consciousness missions, women’s concerns, coop education drive or just in any shoveling on road widening projects, lipat bahay, injecting immunizations to dogs, etc . She graduated 4 community high school scholars, while sending 2 others now with her own personal savings.br /
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span style=”font-weight: bold;”The politics of service/spanbr /
She won a landslide that first time she “walked into” politics. Her opponents courteously bowing out of the race after her name would up as a nominee. That night was so memorable because it marked the day when she officially started as a public servant. The same person elected to office two and a half decades ago can be found in her “office” from 7Am till 5PM six days a week, on call at night and on Sundays and holidays for anything unimaginable for sane human beings. span style=”font-style: italic;”Her honorarium couldn’t even pay for her electricity bill/span. Four presidents, 4 top notch professionals and 8 grandchildren after, she is still is a public servant losing not any political race she joined. span style=”font-style: italic;”br /
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Not one./spanbr /
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And those retirement signals seem to be nowhere in sight. In the last election, despite living in a community where we don’t have any single relative to boast of, not a political clan to rely, nor fame to put forth, and not even the money to run a well oiled campaign, she won a whooping third consecutive term, in second place, the highest and her biggest margin in all her run for public office.br /
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span style=”font-weight: bold;”A mom, after all./spanbr /
I can only sigh in disbelief. Here was I, who can put a thousand words to malign “politics”. She was busy living one with public service unbesmirched for two and a half decade, My family is praying she retires next election. Her glucose swings is getting nastier. Her back, hips and knees showing signs of too much shoveling and cooking for the community. My unsung hero is span style=”font-style: italic;”human/span after all.br /
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div style=”text-align: center;”a onblur=”try {parent.deselectBloggerImageGracefully();} catch(e) {}” href=”http://bp3.blogger.com/_3J-pISBmOI8/SIS1Huqb5BI/AAAAAAAABLA/XC-o09L9new/s1600-h/me+and+my+hero.jpg”img style=”margin: 0px auto 10px; display: block; text-align: center; cursor: pointer;” src=”http://bp3.blogger.com/_3J-pISBmOI8/SIS1Huqb5BI/AAAAAAAABLA/XC-o09L9new/s320/me+and+my+hero.jpg” alt=”" id=”BLOGGER_PHOTO_ID_5225500612046349330″ border=”0″ //aspan style=”font-style: italic;”One of my unsung heroes, going through all the difficulties of wearing a formal dress (outside her jeans and tennis shoes casuals), just so she can see her son earning a board certification!/spanbr /
/divbr /
“span style=”font-style: italic;”To, kain na!/span!!!” Shouted our hero.br /
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span style=”font-weight: bold;”Epilogue/spanbr /
span style=”font-style: italic;”Nga pala, kakain na kami. Nagluto si mamang ng tinolang manok./span I was smiling going to our dinner table. I need not look outside for my unsung hero. She is actually amidst us cooking tinola and dining every night with us when she wasn’t on call. span style=”font-style: italic;”Politics or no politics/span.br /
/span/spandiv class=”blogger-post-footer”Bone MD is a board certified orthopedic surgeon and a Fellow of Philippine Orthopedic Association practicing in the hinterlands of Southern Mindanao, Philippines. He took up medicine at the UP College of Medicine and finish his Orthopedic Training at UP-PGH Department of Orthopedics. He is a visiting consultant in the Department of Orthopedics, Davao Medical Center and several other hospitals in South Mindanao area./div
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span class=”fullpost”a href=”http://orthologbook.blogspot.com/2008/03/blog-rounds-blogging-our-way-through.html”The span style=”font-weight: bold;”Blog Rounds/span/a/span span style=”font-weight: bold;”15th ed/span is up at span style=”font-weight: bold;”Doc Manngy/span’s blog span style=”font-weight: bold;”a href=”http://manggy.blogspot.com/”No Special Effects/a./span Head on to span style=”font-weight: bold;”Manggy/span’s blog and read an “a href=”http://manggy.blogspot.com/2008/07/blog-rounds-15th-edition-round-up-i.html”span style=”font-weight: bold;”I Wanna Sex It Up/span/a!” style of blogs’ round up that dissected gender issues in the clinics under scrutinizing eyes.br /br /span style=”font-weight: bold;”Doc Ian/span’s span style=”font-weight: bold;”TBR 7/spanspan entitled/spana href=”http://elsalvadordelmundo.blogspot.com/2008/07/blog-rounds-tbr-7-mission-i-heart.html” span style=”font-weight: bold;”Mission: I heart the Philippines/span/a, is up too, in his blog a href=”http://elsalvadordelmundo.blogspot.com/”span style=”font-weight: bold;”So far So God/span/a. This much awaited edition of TBR is a compilation heart warming stories and essays of MDs who love Philippines in so many special ways.br /br /The upcoming TBR 16 will be hosted by span style=”font-weight: bold;”Doc Gigi/span in her blog, span style=”font-weight: bold;”a href=”http://vgsamson.multiply.com/journal”Beyond Borders: The Lei Si Chronicles/a./span a href=”http://vgsamson.multiply.com/journal/item/89/The_Blog_Rounds_16_Call_For_Articles_Unsung_Heroes”Call for articles/a is up in her blog!br /span class=”fullpost”a href=”http://orthologbook.blogspot.com/2008/03/blog-rounds-blogging-our-way-through.html”/ablockquotea href=”http://orthologbook.blogspot.com/2008/03/blog-rounds-blogging-our-way-through.html”The span style=”font-weight: bold;”Blog Rounds/span/a is a biweekly compilation of thespan style=”font-weight: bold;” best in Philippine’s medical blogosphere/span, written by a href=”http://orthologbook.blogspot.com/2008/03/tbr-list-of-blogger-contributors.html”physician bloggers (or the medically inclined bloggers) /aand hosted on a participating blogger’s weblog. spanArchives and edition/spanspan style=”font-weight: bold;” schedules/span ( plus the host blogger) are listed a href=”http://orthologbook.blogspot.com/2008/03/blog-rounds-archives-and-schedule.html”here/a. The next edition of TBR will be up this span style=”font-weight: bold;”Tuesday, July 22 ,2008 7am PST.br /br //spanPhysicians and medically inclined bloggers interested in joining this blog carnival, please contact me through my emailspan style=”font-weight: bold;” kokegulper[at]yahoo[dot]com/span or any of the participating TBR bloggers. Guidelines and updates are a href=”http://orthologbook.blogspot.com/2008/03/blog-rounds-submission-updates-and.html”span style=”font-weight: bold;”posted here/span/a in my website, span style=”font-weight: bold;”a href=”http://orthologbook.blogspot.com/”The Orthopedic Logbook/a./span/blockquotespan style=”font-weight: bold;”/span/spanbr /span style=”font-weight: bold;”/spandiv class=”blogger-post-footer”Bone MD is a board certified orthopedic surgeon and a Fellow of Philippine Orthopedic Association practicing in the hinterlands of Southern Mindanao, Philippines. He took up medicine at the UP College of Medicine and finish his Orthopedic Training at UP-PGH Department of Orthopedics. He is a visiting consultant in the Department of Orthopedics, Davao Medical Center and several other hospitals in South Mindanao area./div
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div style=”text-align: justify;”Quite a number of studies showed that span style=”font-weight: bold;”differences in gender awareness exist in the health care industry/span. However, this is span style=”font-weight: bold;”not limited to professionals on the opposite side/span of the arguing fences,span style=”font-weight: bold;” but also within professionals of the same gender/span. Consider this;br /blockquote”Ms. applicant A, considering this is a very “masculine” dominated training program and specialty, do you have any other training program in mind, that you applied for also and which is more “feminine” that would fit your built?”- Female Interviewer B /blockquoteI don’t know if the interviewer was just “sensitive” enough to “enlighten” the applicant further by giving her options, but its pretty obvious such question is span style=”font-weight: bold;”consequential to the bias created by a less gender sensitive workplace/span.br /br /But what is gender awareness in the first place? Here is one conceptual definition like most.br /blockquoteWhen comparing men and women it is important to clarify the concepts of sex and gender and describe the gender perspective applied. Sex is a biological categorization based on reproductive organs and chromosomes while gender views women and men from a psychosocial and cultural perspective. When studying differences in health, behavior or attitudes it is generally not possible to know what is biological and what is social in origin. A constructivist perspective a name=”IDASYKPM”/a[a href="http://www.biomedcentral.com/1472-6920/3/8#B1"1/a] of gender is then suitable since it underlines that sex and gender, biology and culture are related and inter-reliant. In this perspective gender refers to the constantly ongoing social construction of what is considered “feminine” and “masculine”, based on sociocultural norms and power. Gender is not a fixed or ‘natural’ category, but subject to change and negotiation. We all “do gender” in all kinds of social interactions a name=”IDAKYKPM”/aa name=”IDAXYKPM”/aa name=”IDA0YKPM”/a[a onclick="LoadInParent('#B2'); return false;" href="http://www.biomedcentral.com/1472-6920/3/8#B2"2/a-a href="http://www.biomedcentral.com/1472-6920/3/8#B4"4/a]. span style=”font-style: italic; font-weight: bold;”Risberg et al/span.a href=”http://www.biomedcentral.com/1472-6920/3/8″span style=”font-weight: bold;”Gender awareness among physicians – the effect of specialty and gender. A study of teachers at a Swedish medical school/span/a span style=”font-weight: bold;”BMC Medical Education 2003/span/blockquoteThis same study showed that in popularly male “dominated” specialties like surgery,a href=”http://www.biomedcentral.com/1472-6920/3/8″span style=”font-weight: bold;” gender awareness is notably low/span/a. It is not limited and unique to these specialties however. Similar patterns of an overall lack of gender awareness exist even in “female” dominated specialties and not surprisingly, in our patients’ lounge. The segregation is arbitrary, the debate continuing to no end. But what is glaring is the span style=”font-weight: bold;”consequential biases that results from the on going gender tug of war/span and are whether manifested in the workplace, at home and in our clinics. These consequential biases always implies a dysfunction in the level of gender awareness going far deep amongst ourselves.br /br /That is the bad news.br /br /a onblur=”try {parent.deselectBloggerImageGracefully();} catch(e) {}” href=”http://bp2.blogger.com/_3J-pISBmOI8/SHBkdJVgBjI/AAAAAAAABHU/7JxxaWa1Yts/s1600-h/img07113152810.jpg”img style=”margin: 0pt 0pt 10px 10px; float: right; cursor: pointer; width: 306px; height: 212px;” src=”http://bp2.blogger.com/_3J-pISBmOI8/SHBkdJVgBjI/AAAAAAAABHU/7JxxaWa1Yts/s200/img07113152810.jpg” alt=”" id=”BLOGGER_PHOTO_ID_5219782420007487026″ border=”0″ //aThe good news is- span style=”font-weight: bold;”there is hope for change/span. While the ongoing gender debates may at best be educational to all parties involved, the span style=”font-weight: bold;”call for action needs ideas that work/span. Our society in general, and our profession in particular, should put in place a mechanism to sustain a growing “gender sensitive” policies in the work place. Some training programs I know actually had these policies on paper. But if these mechanisms are just there to attract applicants from the “marginalized gender”, then the span style=”font-style: italic;”stop gap/span mechanism might just be boosting the pervading culture of the “gender insensitives” .br /br /As a physician- educator I believe something can be (or should be) done to correct gender issues. Need a better and a more gender friendly physician workplace? Here are my few advices that goes deeper than the rabbit hole:br //divol style=”text-align: justify;”li span style=”font-weight: bold;”Start young, start at home/span. How young? Nobody knows. But ss soon as the kid discover that phenotypic sex have different biological needs, parents can introduce gender friendly concepts. Remember that most gender biases apparent in the adult life can be traced to the person’s childhood.Most of them proved to be very difficult to change.The formative years has the greatest “stick on” knowledge than any of the stages in a child’s life. It is important that the child understand the difference between sexes and gender and how one is related or how to be “sensitive” about it.br //lilispan style=”font-weight: bold;”Start in school/span. Education perhaps has the single most effective way of combating future threats of gender issues aside from the family.This is more important to a child person who’ s family dysfunctional . This is probably the best area to introduce gender awareness concepts. Sex segregation in this stage is often a result of a misguided awareness by some educators themselves. This is passed on to their students. Parental reinforcement then becomes an essential tool.br //lilispan style=”font-weight: bold;”Quality and productivity driven medical school and specialty programs/span. This is a very controversial issue and often the most debated upon. Thee issue is not about depending one’s gender from another, or gaining points for that matter. Qualifications and productive outputs measures who is best suited for a job description. No giving in or pluses to the gender. If the program do cultivate a culture of “gender insensitive workforce”, it is the taint of the program and not the trainees themselves. If the training gets more sex a than b, the only reason verifiable is because their evaluation and qualification process allows (or disallows) them to and thus cultivate such culture. Change the policies to implement more gender sensitive workplace. No excuses.br //lilispan style=”font-weight: bold;”More role models./span Perhaps one of the more effective “enticing methods” by the few who braved to the opposite sex dominated specialties. Most of the applicants interviewed for a particular gender dominated job alludes there persistence to role models entrenched in the workplace itself. The domino effect of such roles models often determines the number of gender wanting to gain access to that workplace.br //lilispan style=”font-weight: bold;”Educate the patients lounge/span. If you can’t do it for yourself, get someone else more comfortable to do it for you. We get patients we deserve, in one way or another. The quality physicians do not stop at treating their patients only. They educate too. As a physician, we are in a powerful position to create an impact, just like we do when we harbor negative issues on it!br //liliThe last but the most important of course, is to span style=”font-weight: bold;”educate ourselves/span. You can never teach someone else gender awareness without you being “aware” of it in the first place. We all knew what is gender sensitive and what is not. Sometimes we just do what is easy and our patients take cues on our actions. And there’s no denying actions speak louder than words!br //li/oldiv class=”blogger-post-footer”Bone MD is a board certified orthopedic surgeon and a Fellow of Philippine Orthopedic Association practicing in the hinterlands of Southern Mindanao, Philippines. He took up medicine at the UP College of Medicine and finish his Orthopedic Training at UP-PGH Department of Orthopedics. He is a visiting consultant in the Department of Orthopedics, Davao Medical Center and several other hospitals in South Mindanao area./div
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div style=”text-align: center;”a onblur=”try {parent.deselectBloggerImageGracefully();} catch(e) {}” href=”http://dartmed.dartmouth.edu/winter06/images/disc_gender_01.jpg”img style=”cursor: pointer; width: 354px; height: 239px;” src=”http://dartmed.dartmouth.edu/winter06/images/disc_gender_01.jpg” alt=”" border=”0″ //abr //divbr /Nope, it’s not what you think! But span style=”font-weight: bold;”The Blog Rounds/span span style=”font-style: italic;”Fifteen Edition/span will tackle gender sensitive issues in medicine, on being a physician and on one’s specialty!br /br /Head on to span style=”font-weight: bold;”Manggy/span’s spanblog/spanspan style=”font-weight: bold;”, a href=”http://manggy.blogspot.com/”No Special Effects/a/span, host to this interesting round of blog posts, to get a clear idea of what I’m talking about. His call for articles is already up a href=”http://manggy.blogspot.com/2008/06/blog-rounds-15th-edition-call-for.html”span style=”font-weight: bold;”here/span/a.br /br /span style=”font-style: italic;”For those unaware yet, /spana href=”http://orthologbook.blogspot.com/2008/03/blog-rounds-blogging-our-way-through.html”The span style=”font-weight: bold;”Blog Rounds/span/a is a biweekly compilation of thespan style=”font-weight: bold;” best in Philippine’s medical blogosphere/span, written by a href=”http://orthologbook.blogspot.com/2008/03/tbr-list-of-blogger-contributors.html”physician bloggers (or medically inclined bloggers) /aand hosted on a participating blogger’s weblog. spanArchives and edition/spanspan style=”font-weight: bold;” schedules/span ( plus the host blogger) are listed a href=”http://orthologbook.blogspot.com/2008/03/blog-rounds-archives-and-schedule.html”here/a. The next edition of TBR will be up this span style=”font-weight: bold;”Tuesday, July 8, 2008 7am PST.br /br //spanPhysicians and medically inclined bloggers interested in joining this blog carnival, please contact me through my emailspan style=”font-weight: bold;” kokegulper[at]yahoo[dot]com/span or any of the participating TBR bloggers. Guidelines and updates are a href=”http://orthologbook.blogspot.com/2008/03/blog-rounds-submission-updates-and.html”span style=”font-weight: bold;”posted here/span/a in my website, span style=”font-weight: bold;”a href=”http://orthologbook.blogspot.com/”The Orthopedic Logbook/a./spandiv class=”blogger-post-footer”Bone MD is a board certified orthopedic surgeon and a Fellow of Philippine Orthopedic Association practicing in the hinterlands of Southern Mindanao, Philippines. He took up medicine at the UP College of Medicine and finish his Orthopedic Training at UP-PGH Department of Orthopedics. He is a visiting consultant in the Department of Orthopedics, Davao Medical Center and several other hospitals in South Mindanao area./div
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a style=”font-weight: bold;” onblur=”try {parent.deselectBloggerImageGracefully();} catch(e) {}” href=”http://bp1.blogger.com/_3J-pISBmOI8/SF5wuK_5ahI/AAAAAAAABFE/n8MaHp30VL0/s1600-h/THe+Blog+Rounds448.jpg”img style=”cursor: pointer; width: 140px; height: 37px;” src=”http://kokegulper.googlepages.com/tbrgray.PNG” alt=”" border=”0″ //abr /div style=”text-align: left;”(I guess everyone in the TBR bloggers list has received an email from me regarding major changes to the carnival . If you haven’t gone one, email me back so I can include you to the TBR mailing list.)br //divbr /a onblur=”try {parent.deselectBloggerImageGracefully();} catch(e) {}” href=”http://bp0.blogger.com/_3J-pISBmOI8/SF52kRN_OKI/AAAAAAAABFM/1D6kvkQLvYE/s1600-h/THe+Blog+Rounds448.jpg”img style=”margin: 0pt 0pt 10px 10px; float: right; cursor: pointer; width: 156px; height: 195px;” src=”http://bp0.blogger.com/_3J-pISBmOI8/SF52kRN_OKI/AAAAAAAABFM/1D6kvkQLvYE/s320/THe+Blog+Rounds448.jpg” alt=”" id=”BLOGGER_PHOTO_ID_5214735784011053218″ border=”0″ //aThe Blog Rounds is indeed expanding! This MD blog explosion vis a vis TBR has been so rapid, I’m actually overwhelmed by the response. However, with the overwhelming response, comes the problem of having to put some “organization” on it to run “smoothly”.br /I like TBR as it is today- free flowing ideas, beautiful write ups, interesting topics and a relaxed atmosphere of friendliness online. And like everyone else at TBR , I am so amazed by the diverse interests and ideas of the blogger contributors!br /br /(Okay, enough Bone! Say what you want….)br /span class=”fullpost”br /I have set up an a href=”http://www.blogger.com/theblogrounds@yahoogroups.com”emailing list/a for span style=”text-decoration: underline;”span style=”font-weight: bold;”TBR/span/span bloggers-contributors, named a style=”font-weight: bold;” onblur=”try {parent.deselectBloggerImageGracefully();} catch(e) {}” href=”http://bp1.blogger.com/_3J-pISBmOI8/SF5wuK_5ahI/AAAAAAAABFE/n8MaHp30VL0/s1600-h/THe+Blog+Rounds448.jpg”img style=”cursor: pointer; width: 140px; height: 22px;” src=”http://kokegulper.googlepages.com/tbrgray.PNG” alt=”" border=”0″ //a at span style=”font-weight: bold;”Yahoo Groups/span for the following reasons:br /ollispan style=”font-weight: bold;”Announcements/span, major changes to the guidelines, dates of submission and hosting schedules./lili style=”font-weight: bold;”Newbie member introductionsbr //lilispan style=”font-weight: bold;”Birthday greetings /spanand other important life events of a style=”font-weight: bold;” onblur=”try {parent.deselectBloggerImageGracefully();} catch(e) {}” href=”http://bp1.blogger.com/_3J-pISBmOI8/SF5wuK_5ahI/AAAAAAAABFE/n8MaHp30VL0/s1600-h/THe+Blog+Rounds448.jpg”TBR/a blogger contributors!/lilispan style=”font-weight: bold;”Comments and suggestions/span for a style=”font-weight: bold;” onblur=”try {parent.deselectBloggerImageGracefully();} catch(e) {}” href=”http://bp1.blogger.com/_3J-pISBmOI8/SF5wuK_5ahI/AAAAAAAABFE/n8MaHp30VL0/s1600-h/THe+Blog+Rounds448.jpg”TBR/a itself./lilispan style=”font-weight: bold;”No Spam.No Spam. NO Spam./span Believe me I have been barraged by a style=”font-weight: bold;” onblur=”try {parent.deselectBloggerImageGracefully();} catch(e) {}” href=”http://bp1.blogger.com/_3J-pISBmOI8/SF5wuK_5ahI/AAAAAAAABFE/n8MaHp30VL0/s1600-h/THe+Blog+Rounds448.jpg”TBR/a wannabe bloggers cum poseur who are actually porn site owners, spammers, and viagra sellers! So lets spare our mailing list with such!br //li/ol I knew everyone else is very particular with their online identity, their emails and spam. I am too. I have set up my email filters for this (I’ll post a how-to on this soon) but some still land in my inbox while other true a style=”font-weight: bold;” onblur=”try {parent.deselectBloggerImageGracefully();} catch(e) {}” href=”http://bp1.blogger.com/_3J-pISBmOI8/SF5wuK_5ahI/AAAAAAAABFE/n8MaHp30VL0/s1600-h/THe+Blog+Rounds448.jpg”TBR/a contributions land on my spam folder. Hence, some of them got deleted.br /br /One thing though, the mailing list will not be the venue for posting your articles and submissions full text! Post should remain in the bloggers blog so readers will have to read and comment there. The mailing list will not be an aggregator site of posts and or some sort of RSS reader.br /br /So if you guys are amenable to this or you have any suggestions, please email me at span style=”font-weight: bold;”kokegulper[at]yahoo[dot]com/span with the words “span style=”font-weight: bold;”The Blog Rounds”/span included in the subject./spana href=”http://tinyurl.com/4mjg3s”img src=”http://tinyurl.com/3bl3bj” //adiv class=”blogger-post-footer”Bone MD is a board certified orthopedic surgeon and a Fellow of Philippine Orthopedic Association practicing in the hinterlands of Southern Mindanao, Philippines. He took up medicine at the UP College of Medicine and finish his Orthopedic Training at UP-PGH Department of Orthopedics. He is a visiting consultant in the Department of Orthopedics, Davao Medical Center and several other hospitals in South Mindanao area./div
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(This is an old post from my other blog, The Daily Habit, which I thought should be somewhat “related” to the theme of Em Dy’s 14th ed TBR, Paging Doc Hollywood). My well meaning compatriot physicians, please don’t kill me. I’m just reposting a study!)

The much controversial and perpetually challenged hypotheses that male surgeons are better looking and taller than their male physician counterpart has just reached another level. Now, this hypotheses is confirmed and supported by research and published in a very reputable and peer reviewed journal- The British Medical Journal. Here is an excerpt of the whole abstract:

Phenotypic differences between male physicians, surgeons, and film stars: A comparative study

Antoni Trilla, director of preventive medicine and epidemiology unit, Marta Aymerich, consultant, haemopathology unit, Antonio M Lacy, consultant, general and digestive tract surgery unit, Maria J Bertran, specialist, preventive medicine and epidemiology unit

1 Hospital Clinic, University of Barcelona, 08036 Barcelona, Spain

Objectives To test the hypothesis that, on average, male surgeons are taller and better looking than male physicians, and to compare both sets of doctors with film stars who play doctors on screen.

Design Comparative study.

Setting Typical university hospital in Spain, located in Barcelona and not in a sleepy backwater.

Participants Random sample of 12 surgeons and 12 physicians plus 4 external controls (film stars who play doctors), matched by age (50s) and sex (all male).

Interventions An independent committee (all female) evaluated the “good looking score” (range 1-7).

Main outcome measures Height (cm) and points on the good looking score.

Results Surgeons were significantly taller than physicians (mean height 179.4 v 172.6 cm; P=0.01). Controls had significantly higher good looking scores than surgeons (mean score 5.96 v 4.39; difference between means 1.57, 95% confidence interval 0.69 to 2.45; P=0.013) and physicians (5.96 v 3.65; 2.31, 1.58 to 3.04; P=0.003). Surgeons had significantly higher good looking scores than physicians (4.39 v 3.65; 0.74; 0.25 to 1.23; P=0.010).

Conclusions Male surgeons are taller and better looking than physicians, but film stars who play doctors on screen are better looking than both these groups of doctors. Whether these phenotypic differences are genetic or environmental is unclear.

You can read about the research here.

Not to downgrade our male physicians counterpart, the study also showed film stars acting as doctors look better than both groups. But then again their not doctors anyway.

The research is not the level 1 type of clinical evidence and there are many loopholes you can find. But I never expected such research will actually be undertaken and much less be published in a reputable journal.

Now I can see the wide grin in so many surgeon’s face. Or the film stars.

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