Doctor-Patient Relationship: How Far Am I Willing To Go?

Bonedoc, my colleague in more ways than one (fellow orthopod, fellow blogger, fellow...nature lover :D) posted a link to an interesting read in our Facebook group page hours ago. Titled "Can Patients Be Facebook Friends With Doctors?", the article is something that I could have probably written a few months earlier. It is not a secret to most of you who have come across some of my posts that I am not much of a Facebook fan mainly because of security and privacy concerns, though I am still holding on to my present account for purposes of keeping in touch with family and friends.

Of course, doctor-patient relationship is but one of the many relationships that I have to protect, not just in Facebook world. I may still be (relatively) young in the specialty practice, but already I am quite aware that most patients appreciate it so much when their attending physicians take time out to know them a bit more. Things like remembering the patient's name and being able to associate the name to the right face are just but the first steps in helping the patient speak more openly, not just about his illness, but also his concerns about its impact on his personal and social life. However, and this is a personal opinion, a line has to be drawn somewhere, somehow. And "friending" in Facebook is just one of the places where this line has to made distinct. 

Cartoon comes from this link: http://doccartoon.blogspot.com/2010/07/facebook-friend-requests-i-will-refuse.html

Endocrine-witch did make me think about how much I would want to get involved in a doctor-patient relationship, and I came up with this list.

1. I would not be so inclined to accept Facebook friend requests from patients. Probably the only exception to this is when my account is created for the purpose of disseminating general information relevant to the medical field; however, I have no such account.

2. For security reasons, I do not also wish to give my mobile number to patients. In the past, I had been a victim of numerous stalkers. Sadly, some stalkers actually got my number from my co-workers (one incident involved a stalker asking for my number from a nurse(!)). While I have many times contemplated to get another number solely dedicated to patient calls, at the moment the hospital landline seems to suffice.

3. Will I accept invitations to attend social affairs from patients? (i.e., birthday party, wedding etc) Filipinos are generally the type to involve everyone in their social affairs; I say generally, and yes I think is a cultural thing. This is quite an iffy situation that has to be answered out on a case-to-case basis.

4. What if I fall in love with my patient? I have never been in this situation, have never envisioned myself to be in this situation, and I do not, by all means, intend to be in this situation. As far as I am concerned, carrying on a love affair with a patient is so out of the question. The only acceptable time for me to be in a romantic relationship with a patient is when that person first became my partner before becoming my patient - certainly not the other way around. 

There are likely more situations where the extent of the doctor-patient relationship will be tested. I am not one to impose my personal beliefs, and I welcome opinions and constructive criticisms. Let me know what you think. :) 

By the way, the absolutely cute cartoon is courtesy of this entertaining blog A Cartoon Guide To Becoming A Doctor. Do check it out.

THE BLOG ROUNDS V.2 Ed.1: Implementing The Universal Health Care System In The Philippines

For this edition of the newly-revived The Blog Rounds (yipes, this is a super-late submission, I know), we are to discuss if the Philippines is ready for a universal health care system.

This is a very tough theme to tackle. Health issues in the Philippines are never too easy to discuss, and the applicability of the universal health care system in our country is no exception. Some of you who have read my previous posts are familiar with my disillusion as far as health provision is concerned, my partiality to the ideals of community medicine, and my thoughts on issues such as the Morong 43. The topic of the universal health care system as being applicable in the local setting definitely challenged my understanding of the matter and my analytical capabilities.

Apparently left to our own devices. Community health workers in action, circa 1990s, Mindoro.

The issues for and against the universal health care system (a general definition can be read here) are discussed in a lot of venues. Health groups in various parts of the United States are pushing for the implementation of universal health care (links here and here), with the present US health care system addressing only selected population groups and failing to provide for the general population. There is likewise a collection of links that discuss the demerits of this system (click here).

The Philippines can definitely benefit from the universal health care system. The current health system (or the absence of it) does not provide for the majority of the population. (What does one expect from a 1:800 doctor to patient ratio anyway?) Many Filipinos may not be able to see a doctor in their lifetime (this is no exaggeration), and if they are lucky, they may be beneficiaries of medical missions that come by on an occasional basis. Only very few have access to hospitals with top-notch facilities since admission deposits in regular rooms of these hospitals run to 5 figures. Want to know the minimum wage of the average Filipino worker? Not even a fraction. Find out here.

However, financing the system will always been the biggest obstacle in considering the implementation of the universal health system, given the rampant bureaucracy and corruption in the government and the society. Some ideal solutions are as follows. The government, for one, can increase the budget percentage allotted to health care. Health expenditure accounts for a measly 2.9% of the gross domestic product. Maximizing the role of PhilHealth may help, as many Filipinos do not have PhilHealth. Additional taxation and borrowing are other less palatable-sounding options but are likewise worth considering. Of course, all are easier said than done ... but one has to start somewhere.

Among the presidential candidates, Noynoy Aquino and Gibo Teodoro are vocal about their desire to implement the universal health care system. (Read here and here.) I am not out to blatantly endorse anyone, but wouldn't it be nice to see, within our lifetime, someone who will step forward and provide concrete solutions to the unhealthy state of affairs of the Philippine health care system, whether that be the implementation of the universal health care system or not?
This is my submission to The Blog Rounds v.2 ed.1, hosted by Dr. Prudence. Yes I am late, so shoot me, hahahah!