It’s good to be back

It’s good to be back and thankfully not from the grave.

Last Thursday, May 15, I was getting ready to drop off my daughter at a nearby coffee shop, return home and proceed to write a weekend column. Instead, I felt my heart pumping in an unusual manner, accompanied by a heaviness in my chest.

As a precaution, I popped an emergency medication that was prescribed to me during a similar situation two years ago and immediately sought medical attention.

If you have a pre-existing medical condition, consult your MD about emergency medication or what to do. In the time it takes to buy meds that are not in the house, you could go from bad to worse to dead. This precaution has saved me twice.

After taking the meds, I made my way to the Rizal Medical Center (RMC) Emergency Room, passed through Triage, given a mandatory face mask and entered the main ER, then Boom! The ER was more than a room, it was a large hall made tiny by 25 to 30 “patients” seeking medical attention.

I won’t sugar coat the scene. It was sad and made me angry why every government hospital ER I’ve landed in or visited as a journalist is stereotypical of congestion, human anguish and physicians so exhausted and stressed.

You might ask: why go to a public hospital when you can afford to go to a private hospital? Well, as a “public” health advocate, I cannot be promoting the virtues and blessings that government hospitals are to Filipinos but go to a private hospital for my personal comfort and need. I would be a hypocrite if I did that.

So, while waiting for Dr. Andrew Francisco a.k.a “Doc Kiko,” head of the cardiac department at RMC, my wife Karen and I started to study the RMC ER, took notes, while doing “management problem solving” to write about.

When we go to ERs of private hospitals, it looks just like on TV – very few people and full of interns and residents more than patients. The reason is A) government ERs are cheap, so cheap, people head there first; B) people wait until the last minute when they are in severe pain or already scared of dying, then instinctively go to a government ER.

When I went to the Philippine Heart Center two years ago, the old lady next to me was complaining about arthritis that could have been treated as outpatient or OPD – and certainly not at the Heart Center ER.

ERs should be restricted to life threatening cases or cases like unscheduled birthing or trauma involving injuries such as broken bones, laceration. Screening of patients admitted to the ERs should be more stringent and the public better informed.

An even better solution would be for guys like PBBM, Secretary Ted Herbosa and DILG Secretary Jonvic Remulla and Senator Bong Go to get their heads together and review the set-up of Barangay Health Centers (BHC) and health workers.

The Barangay Health Centers should literally be the “first responder” and consultation before going to a secondary or tertiary hospital. BHCs should have full-time or daily doctors per unit, paid or volunteer MDs. Government can pay MDs and volunteers by way of cash or tax discounts on real estate tax or professional tax.

Practically every barangay now gives a 20 percent discount on realty tax if you pay on the first month or quarter of the year. Every barangay has doctors living in their area. If that’s not enough, then revive the “Doctors in the Barrios” program, but include urban or urbanized areas and barangays.

The process should be for patients to confidently go to the barangay, knowing there will be a doctor or emergency medical responder. The barangay will then give the primary care, determine if the patient needs to go to the nearest government ER.

If so, the patient should automatically be transported by barangay ambulance or patient transport. In the course of this determination, the BHC has gathered all pertinent information on the patient and can provide a copy to the ambulance team and electronically transmit another to the ER destination.

One of the serious cause of delays in many hospitals, especially ERs, is information gathering. There are long forms to fill up, difficult interviews to conduct and very little space and time to work with. Another problem I heard is that the Privacy Law has complicated the matter of transmitting personal or medical data. Lawmakers should go back and check on this.

As for the swamped and overwhelmed doctors, residents and nurses in the ER, I have often heard that many hospitals, especially government hospitals, can’t get people. Some distance themselves because of the workload, others would rather work or take residency in air-conditioned ERs and swanky hospitals.

Speaking of air conditioning, the DILG should check how cities, towns and barangays can have air-conditioned multipurpose halls, even air-conditioned sports complexes, but most government ERs are sweat boxes!

As for getting MDs and nurses, the DOH and Congress should implement a “lottery system” regarding where graduates or interns etc. are assigned. Back in the day, residents or interns prefer to work in government ERs where all the action and learning is.

In my next column, I’ll write about the great and professional people at the RMC ICU, the modern ICU, Sleep Lab and how friends and readers should channel some of their wealth to government hospitals. As I was reminded again: “You can’t take it with you when you kick the bucket!”

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