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 Rejuvinated Blog Rounds (Yes!), And A Nice Poem

Some two or three years ago, a fellow named BoneDoc plucked me off my indifference to the virtual world by inviting me to The Blog Rounds. If you are wondering what the green banner at the side rail was all about the whole time, then your answer is finally here. The Blog Rounds is an aggregate of local (Filipino) doctors who took to the cyberspace to express their sentiments on a common topic, which is decided upon the week's host. The blog posts are then collated in a single article where the end-user (i.e., the reader) is treated to a melange of opinions coming from doctor bloggers of various backgrounds, exposures, and upbringing.

The Blog Rounds seemed to have gone into hibernation the past year, but it is now back, and hopefully this blog can participate as much as possible. I have had the pleasure of hosting TBR a couple of times, and it was fun, really, to be reading the posts (ditch the stereotype: many doctors are eloquent and introspective, and yes, creative - they're not all seriousness and science and boring stuff) and seeing the similarities and contrasts of opinions and such. TBR is yet another avenue for healthy forums, medical or not-too-medical.

If you are a Filipino doctor living in the Philippines or elsewhere you may want to participate in The Blog Rounds. It would be cool to have fresh faces! The mechanics for participating can be found in BoneDoc's site. Click HERE. Do drop a message that you are new and would like to be part of this lively group. Trust me, it is going to be fun. ^^

*****

My classmate in medical school, Lenn, a person I have come to know as tough and yet sensitive underneath all the trappings of a toughie, showed me a door to an opportunity to explore the works of Angela Manalang Gloria. She was said to be Jose Garcia Villa's rival in poetry, and her works were radical during the colonial times (in other words, feminist). I will write more about her next time.

For now, a poem by her.

WORDS (1940)
by Angela Manalang Gloria

I never meant the words I said,
So trouble not your honest head
And never mean the words I write,
But come and kiss me now goodnight.

The words I said break with the thunder
Of billows surging into spray:
Unfathomed depths withold the wonder
Of all the words I never say.

(Mots. My gift. my curse.)

Is It All Worth It? (Random Ponderings On The Morong 43 Issue)

(This post should have adopted the more apt subtitle "Not Only Is It Frustrating, Being A Doctor Is Also Hazardous To Health", but damn it, it is too long.)


More than a week ago, I was preparing to leave my clinic when I decided to linger for a moment. I picked up the newspaper (I usually read the news online) and leafed through it until I saw the news about the 43 health workers abducted by the military in Morong, Rizal last February 6. (Read about it here, here, and here.)

I felt a pinch in my heart as I impulsively looked around. In my mind was the thought, I am here, perhaps a struggling specialist trying to create a niche in the medical world, and yet sitting comfortably in a well-equipped air-conditioned clinic, while 43 of my colleagues and fellow health professionals were being harassed by the military on accusations of being "communist rebels in training".


For the latest Philippine news stories and videos, visit GMANews.TV


At this point in my career, I should be over and done with this self-persecutory thought. It is a choice I have made years ago: a healer, regardless of time, location, social status, regardless of the disposition and affiliation of his patients, remains a healer. I can say that I have seen and served a wide spectrum of patient groups - from the very rich to the very poor - and not all doctors have had this privilege. In the end, I have made a choice to be in a specialty that I love very much.

However, regardless of choice - whether to be a specialist in the city, or a doctor in the countryside, here in the Philippines - I am quite certain: one way or another, this thought has crossed the minds of every person who chose to take up healing as a profession.

Is it all worth it?

Cases of healers being persecuted are not new occurrences. It should be remembered that Jesus Christ, the great healer himself, was persecuted and put to death by crucifixion. Healers did not really have it all too easy, whether they be based in the city or in the countryside.

However, the countryside doctors definitely had it worse.

In the Philippines, probably one of the most well-known cases of doctors as victims of killings and other human rights violations during the Marcos regime is that of Dr. Bobby De La Paz, a doctor serving the people in far-flung Samar who was gunned down in his own clinic by unidentified assailants. (Click here for archives regarding Dr. De La Paz's murder.)

[I will not even want to cite specific cases of doctors in the provinces who being harassed by armed men from both ends of the political spectrum. But true, it is happening, even at this day and age.]

I am aware of the hazards that medical practitioners in the countryside face, for I was once "out there", too. To be a practitioner in a city like Manila is hard in itself, and yet to be in impoverished areas is an altogether different matter. Being a doctor in the countryside is never just about doing medical missions and giving medications for free. It is, more than anything else, about people empowerment through knowledge of body functions, disease conditions, and ways by which they could help themselves.

The profession of healing in itself entails much time, thought, patience, and sacrifice. To be a community doctor requires even more. For this reason, I have enormous respect for the community doctor and all the members of the allied health professional who have chosen to serve the countryside.

Unfortunately, not even the doctor or anyone from the health field is spared from the crutches of political power struggle and breaches of human rights.

(Photos from my personal files. First photo, a nurse friend discussing the physiology of breathing to the Mangyans. Second photo, immunization in Montalban, Rizal.)