Doctors ask doctors: Give up jobs abroad

[rolour]

From the Manila Standard

Rey P., are you signing the covenant?? :wink:

Doctors ask doctors: Give up jobs abroad

A call to arms.

Here comes the next crisis — a severe shortage of doctors and health care practitioners who are leaving for abroad virtually en masse.

The Philippine College of Physicians (PCP) thinks it has the answer: It will ask its more than 6,000 members to put the welfare of the nation above personal comfort and financial security by signing a covenant to stay in the country for the next three years.

PCP hopes their move will snowball and other organizations of doctors will follow suit to help stanch the hemorrhage of migrating doctors and nurses.

“Thousands of doctors shift to nursing and flee the country. In 2002 around 2,000 doctors enrolled to become nurses. In 2003 this increased to 3,000. In 2004 a projected 4,000 doctors will shift to nursing,” said Dr. Willie Ong, a PCP fellow.

Dr. Jaime Galvez-Tan, vice chancellor for research at UP, observed that five hospitals in Mindanao are without doctors or nurses and are staffed only by midwives.

Call to sacrifice

In response to the challenge, PCP under its president, Dr. Adrian Peña, will call on its members to sign a covenant during the PCP 16th midyear convention on Sept. 30 at the Bacolod Convention Plaza Hotel in Bacolod City.

The covenant will ask members to practice in the Philippines for the next three years, from 2004 to 2007. The doctors will also be asked to spend a portion of their time —say one day in a month — to do charity work.

As the covenant is not a legal document, those who sign will not be legally bound, according to project coordinator Dr. Jaime Montoya. What it is is a covenant with God to serve the country.

PCP is the premier association of internists in the country, according to its vice president, Dr. Venancio Gloria. Other than its 6,000 members it also has 13 component and affiliate societies and 11 chapters nationwide.

Question of pay

The main reason for the exodus of doctors and nurses is financial.

As Dr. Atenodoro Ruiz Jr. wrote in the April 2004 issue of the Philippine Journal of Internal Medicine, 50 percent of doctors in the country earn less than P20,000 a month. Only the elite doctors, about 11 percent, earn more than P1 million a year, in contrast to what a licensed nurse in the US earns: P3 million to P6 million a year.

Philippine College of Surgeons (PCS) president Edgardo Cortez said nurses are in such great demand in the US that immediate members of their families are given immigrant status as soon as their work permits are approved.

Cortez said anesthesiologists are the most susceptible to the allure to migrate to the US because they become nurse-anesthetists who perform the same job that they have been doing here.

Meanwhile, a mind-boggling paradigm shift has occurred in the last few years: Medicine, a 10-year-course, is now a prenursing course.

Noble profession

Ong feels that because of the present situation media has created an unfair portrayal of Filipino doctors as greedy and incompetent:

“The truth is that many doctors will stick it out in this country in good times and in bad. Many doctors will continue caring for their countrymen in times of crisis. And many doctors put their lives on the line every day caring for high-risk patients with drug-resistant tuberculosis, AIDS and hepatitis.”

Ong insists that Filipino doctors are compassionate and medicine is a noble profession.

They’ll have every chance to prove it at the covenant-signing in Bacolod.

[radenip]

RG asked:
Rey P., are you signing the covenant??

I honestly don't know man. In one of our organizational meetings for the midyear convention (shucks, next week na and toxic na kami tanan diri), we were told that the national officers will unveil this covenant-of-sorts during the opening cermony requesting the members of the PCP present in the midyear convention to sign. I heard some members crying unfair, others were just silent, the rest shrugged their shoulders. We will see during the ocnvention, will update you on this.

[rolour]

435 doctors pledge: 3 years in RP first

By Reuel Vidal

BACOLOD CITY — While thousands of doctors leave to work abroad as nurses, at least 435 doctors promised yesterday to stay for three years to avert a severe shortage of medical practitioners.

These doctors, who should be considered heroes at a time when they could make big bucks in other countries, answered the call of the 6,000-member Philippine College of Physicians to serve their countrymen before migrating.

“It is not by fate that our country will survive. It is not by destiny that medicine will remain to be the noble vocation to live by. It will come only by choice, our choice. It will come because of our decision to stay and serve,” PCP regent Dr. Jaime Montoya said at the start of the organization’s 16th midyear convention held here yesterday.

3-year vow

PCP members signed the covenant to stay and render voluntary service for three years before going abroad in response to the exodus of health professionals bound for foreign shores.

PCP is considered the premier organization of medical internists. Two other organizations, the Philippine Medical Association (PMA) and Philippine Heart Association (PHA) threw their support behind the PCP initiative.

PMA vice president Jose Sabili said one way of countering the allure of shifting to nursing and going abroad is to instill a sense of patriotism in health professionals.

PMA is the umbrella organization of physicians nationwide, with over 51,000 members.

“The educational system produces about 1,000 doctors a year. But about 2,000 doctors leave for abroad every year to work as doctors or nurses. So we have to arrest that trend or there will be no doctors left to take care of the sick and elderly,” said Dr. Sabili.

PHA, for its part, said it is encouraging its members to sign the covenant as a show of support.

Dr. Willie Ong, the PCP fellow who initiated the campaign, said it was an “encouraging start,” considering that a projected 4,000 doctors will shift to nursing this year and go abroad later on.

“I am happy with the way it is turning out. I am hopeful that by the time the convention ends tomorrow, all 1,000 doctor-attendees will have signed the covenant,” Ong said.

Ong credits Manila Standard’s Sept. 21 banner headline (“Doctors ask doctors: Give up jobs abroad”) for helping raised awareness of the covenant.

Bacolod City Mayor Evelio Leonardia, who was present during the opening of the convention, said he hopes to see fewer doctors leaving to work as nurses.

While a very small elite of doctors earns more than P1 million a year in the Philippines, a licensed nurse in the US earns about P3 million to P6 million a year. Even more surprising, more than 50 percent of doctors in the country earn less than P20,000 a month.

3 years of service before leaving = 2 years for a nursing course + one year processing your papers. I will sign that covenant without thinking twice.

This covenant is not only a wrong solution. It's stupid. :crazy . Nothing more than a PR stunt.

Even more surprising, more than 50 percent of doctors in the country earn less than P20,000 a month.

Geez, give us something new. Are these people living in a cave or what?? :mad:

[radenip]

At the end of the convention there was a total of 589 doctors who signed the covenant. These were mostly young doctors -in their residency training or just newly graduated internists about to start their practice, or internists in their practice and other doctors who attended the convention .

The actual PCP Covenant reads as follows:

We, the doctors of the Philippine College of Physicians,acknowledge our role in the caring for the health of our people. We understand the crisis in the medical profession as we are losing our health workers to other countries. As doctors, we will not abandon our sworn duty to assist our people during this crucial time in our nation's history.

Therefore, I__________ make these promises on my ow volition.
1. I promist to practice and be based in the Philippines for the next
three years.
2. I promise to spend a portion of my time for charity work. To spend
at least one day in a month for charity, or to give free consultation
for my poor patients.
I ask God Almighty to guide and sustain me with His grace, wisdom and strength to fulfill this covenant; and to make me an instrument of healing, peace and unity for our people.
_______________ ______________________
Sign over printed name Adrian C. Pena, MD, FPCP
PCP President

The purpose of the covenant are as follows: to mend the tarnished image of doctors; to boost the morale of young doctors and students; to set an example for other doctors, even other professions to follow; to fulfill our Oath to serve our fellowmen; and as our contribution for the country.

As to RG's question:
Rey P., are you signing the covenant??

I attended the opening cermony and , I didn't sign the covenant because in all honesty I cannot meet the first part of the covenant, my wife will be leaving anytime and we might follow her within the next 2 years. It doesn't mean however that I can't fulfill the second part of the covenant which is service - almost all doctors have been doing this already but at least it will remind us of what being a doctor is all about.

Docjoy attended the convention and was there during the opening ceremonies. What say you Docjoy?

[rolour]

Thanks for posting it, Rey...

(part of my response over at Pinoy.MD) I'm sure Dr. Ong is a good man and any criticism of the covenant is certainly not an attack on his character nor an attack on those who signed it. But the problem is more than just one's commitment to his patients and country or lack thereof. The problem is more than just one's lack of patriotism. Sure, we can call it a little something better than nothing but those who signed did not achieve anything other than be called heroes in the papers. So what does that make the rest of us?

[Hippocrates]

435 doctors pledge: 3 years in RP first
BACOLOD CITY — While thousands of doctors leave to work abroad as nurses, at least 435 doctors promised yesterday to stay for three years to avert a severe shortage of medical practitioners.

These doctors, who should be considered heroes at a time when they could make big bucks in other countries, answered the call of the 6,000-member Philippine College of Physicians to serve their countrymen before migrating.

“It is not by fate that our country will survive. It is not by destiny that medicine will remain to be the noble vocation to live by. It will come only by choice, our choice. It will come because of our decision to stay and serve,” PCP regent Dr. Jaime Montoya said at the start of the organization’s 16th midyear convention held here yesterday.

I laud these doctors for initiating this campaign of sacrifice, IMHO it stems from a noble intention and sincere concern for the state of our country's health care system and the welfare of the Filipino People.

In the same way as I applaud the MD-RNs and other OFWs who sacrifice their personal comfort to the point of risking their lives in foreign lands. These modern day heroes do so to feed their families and in the process help keep our country's economy afloat.

I'm sure you will agree with me that we are of the same mindset: we LOVE the Philippines, we are concerned about the future of our children.
Honest and Patriotic Filipinos here and abroad face a common enemy: Fellow filipinos who propagate a mindset of dishonesty and corruption, Fellow filipinos who do not pay the proper taxes,
Fellow filipinos who bend our laws in order to suit their selfish ends.
THESE ARE THE FILIPINOS WHO ARE BRINGING OUR COUNTRY TO THE BRINK.

We need to support each other especially our honest public servants in the executive, legislative, judiciary, armed and police forces.
They need our support because they are OUTRANKED and OUTNUMBERED by our enemies. Every little bit helps; we ALL need to pitch in for the sake of our country's survival.

[docjoy62]

I was at the PCP convention alright, asked Rey if he will sign the covenant...he told me the same thing as what he wrote earlier! And to answer your question Rey, I did not sign too! Firstly, I'm a Fellow of POGS & not PCP, hehe...and secondly, I don't want to sign a covenant which I know I cannot fulfill anyway! So what's the point? But honesly, if other specialty societies like POGS or PAFP, which I am a member of, will also have this kind of convenant signing...I will not sign also!!!

[rolour]

Docs vow to stay in RP for 3 years (http://www.philstar.com/philstar/News200410136601.htm)

http://www.philstar.com/philstar/main/20041013/images/sf.jpg

[rolour]

As I See It : Philippine medical profession in crisis

Updated 01:04am (Mla time) Oct 15, 2004
By Neal Cruz
Inquirer News Service

Editor's Note: Published on page A14 of the October 15, 2004 issue of the Philippine Daily Inquirer

IN THE OLD days, churches were the sanctuary of people trying to escape arrest by the men of feudal lords. Now hospitals have replaced churches as the refuge of people trying to escape the long arm of the law. Whether the person is trying to stay out of prison, like convicted rapist Romeo Jalosjos, or a general trying to dodge questions regarding his wealth, like Major General Carlos F. Garcia, they pretend to be so sick they need to be confined in a hospital. And law enforcement authorities are often only too willing to accept the word of their doctors who are, for their part, only too willing to lend the weight of their reputations to convince the authorities that their patients indeed need to stay in the hospital.

Read more... (http://news.inq7.net/opinion/index.php?index=2&story_id=14924&col=56)

[radenip]

The following was the speech given by Dr. Jaime Montoya during the opening ceremonies of the PCP 16th Midyear Convetion held last September 30, 2004 at the Bacolod City , during the launching and signing of the PCP Covenant. Its a little late, but I only received a copy of his speech a few days ago and I would like to share it with everybody.

Today, the30th of September 2004, in this beautiful City of Bacolod is truly a momentous occasion for the Philippine College of Physicians and for all of us. Never before in our nation’s history was there an opportunity as significant and as crucial as today for physicians to make an important decision in their lives that will make a difference in our country’s future. Indeed, we are now given the chance to make a stand and take the driver’s seat in charting our country’s course and shaping our children’s future.

The medical profession is confronted with the daunting reality of social, political and economic upheavals. The Philippines is facing probably one of the most difficult and challenging fiscal crisis to date. There are talks of increasing taxation to an already burdened populace that will inevitably result in an increase in prices of basic commodities and cost of living. There will be more demands from government for provision of basic services despite the eminent budget cuts and reduction of government funds. There are also predictions of further devaluation of the peso. There is increasing loss of confidence in the country’s leadership, both in the executive and legislative branches of government due to perceived rampant graft and corruption.

We, as doctors are threatened by issues and events that potentially undermine the very fabric of our calling and existence as physicians. The Philippine health system continues to bleed profusely from a hemorrhage on the verge of irreversible shock. Doctors are leaving the country seeking greener pastures. Whereas before, we would be losing them as medical doctors and specialists to foreign lands, now we are seeing physicians leaving as doctor nurses or MD RNs. Enrollment in medical schools have dropped significantly and less and less doctors are choosing to pursue subspecialty training. We dread the thought that the time may come when most Filipinos will live and die without having seen a medical doctor.

The practice of our profession in the country has also become more difficult. Efforts of young doctors to start a practice is hampered by the need for significant financial investments, lack of support from peers and even outright discouragement from threatened more senior colleagues. Doctors are overworked but underpaid. There is also a looming shadow of malpractice suits and the malpractice insurance bill that further burden starting doctors.

But will we allow these events to overtake us… to rule our lives… to rob us of a bright future for our children and our children’s children? We have to take control. We have to let our voices be heard.

In the midst of all these challenges, I still believe that the Filipino spirit will prevail. We, physicians, have the ability to rise above adversity and crisis. The medical profession can now take up the challenge drawing strength and fortitude from our members !

The Philippine College of Physicians has embarked on this endeavor – the PCP Covenant to show our countrymen that Physicians do care for our country’s future. Consistent with the vision of the PCP to be a dynamic community of ethical and compassionate internists committed to excellence, integrity and service above gain, Dr. Ong, an accomplished cardiologist and fellow of the college initiated this project. Dr. Ong truly represents the new breed of Filipino internists, highly capable, dedicated, fired by service for fellowmen and imbued with love of country. With the able leadership of Dr. Adrian Pena the President of the PCP and the unwavering support of the members of the Board of Regents, we have put our stakes on the ground. We have laid our claim for physicians to rise up and meet the challenge- to show to one and all that we do care… for our country!

We ask each and everyone of you to sign this covenant. You will signify you intention to stay in the Philippines for the next three years and render charity services to our less fortunate countrymen. This symbolic commitment of physicians in the PCP will serve as an inspiration for all of our colleagues in the medical profession to follow- across the specialties and across the regions of our country.

The PCP will sustain and maintain this momentum. We plan to institute reforms in the organization and implement programs that will encourage internists, both young and old to practice in the Philippines. We will exert all our efforts to ensure that we will have the best environment for growth and adavancement in the profession of medicine through relevant and empowered training programs and support systems for practice in the countryside.

Our countrymen and generations to come beckon us all! It is not by fate or destiny that our country will survive. It is by choice-our choice… our decision to stay and serve. Join us in this PCP covenant. Let us all rise and be counted. Kailangang ka ng Inang bayan!

[rolour]

Thanks for posting this, Rey.

BTW, what's the capacity of Dr. Montoya in the PCP?

[docdan1]

Good news! Especially from the PCP. :idea:
It is good that Dr. Ong is heading the endeavor. I have worked with him in Manila before (as PGI) and he is both brilliant and pasionate. I hope the medical profession will not further deteriorate soon. Let's see what the PCP can do.
:???:

[radenip]

Rolour asked:
BTW, what's the capacity of Dr. Montoya in the PCP?

Dr. Jaime Montoya is a member of the Board of Regents of the Philippine College of Physicians.

[rolour]

Reaction to Neal Cruz' article:

Gov’t must act on medical crisis now

Updated 11:19pm (Mla time) Nov 02, 2004
Inquirer News Service

Editor's Note: Published on Page A16 of the November 3, 2004 issue of the Philippine Daily Inquirer

NEAL Cruz’s Oct. 15 column, “Philippine medical profession in crisis,” should be lauded because it is one of the rare instances in which a non-doctor, a media practitioner for that matter, has objectively tackled and shown a good grasp of such relevant, sensitive and complex “medical” issues in a surprisingly fair and enlightened manner. The column depicted the struggles and grim realities facing today’s physicians.

read more >> (http://news.inq7.net/opinion/index.php?index=1&story_id=16881)

[docjoy62]

I was at West Negros College here in Bacolod City for the past few days to submit my grade sheets & class record (since I taught Pharmacology in the College of Nursing last 1st sem)...and looking at the number of enrollees for Nursing falling in line...and looking at the faces of these people hoping to be nurses in order to work abroad....really made me think that the economic situation here is getting worse! I saw familiar faces among the enrollees....MDs who I thought looked down on us who were studying nursing then about 2 years ago....but now they also joined the new craze in town....Nursing course for Professionals....that's how the school placed their ad in the local newspaper! I also heard that some of my classmates in med school, who at first jokingly "ridiculed" me for studying nursing...are now enrolled at the Sanitarium Hospital's nursing course for MDs! I guess they too felt the effect of the country's economy in their private practice....so what happens next? How many more MDs or other professionals will be wanting to become nurses in order to work abroad for better pay? The only thing I heard the gov't is desperately trying to do.....is to stop nursing graduates from leaving the country! I really cannot understand why they can't do something to make the nurses stay voluntarily....instead of stopping them from leaving the country? Why not give the hazard pay that was supposed to be long over-due? Why not increase the salaries & give more benefits? This not only apply to nurses, but to all health care providers, including MDs, midwives, health aides, etc. I cannot understand why the government can spend thousands or even millions for infrastructure & for tourism projects & the likes....but when it comes to health care....they cut down the budget without a blink! Oh well, I can only give a sigh & a shrug....maybe someday....when hospitals start to close down, clinics left unattended & patients go back to herbolarios... that maybe....just maybe....they will realize the importance of health care in the country!

[rolour]

That, indeed, is a sad, sad scene...

Oh well, I can only give a sigh & a shrug....maybe someday....when hospitals start to close down, clinics left unattended & patients go back to herbolarios... that maybe....just maybe....they will realize the importance of health care in the country!

And by then, it will all be too late :cry: .

[Manny Moraleda]

How do you treat a person who can not afford the medication or procedure you prescribe or pay you just enough to make you survive ?
How about the future of your children from the meager income you have ?
Are you really happy that you are being held back from going abroad for better opportunities ? A longer lifespan was achieved by solutions in public health such as better sanitation and nutrition than any discovery in medicine. I am not too worried about it. I am more worried that those individuals are missing out on professional opportunities available to them abroad. During the Vietnam war, the Vietnamese suffered from a lack of resources, medical etc. How did they recovery and even surpassed the Philippines ? Filipinos just have to accept the fact that they should stay healthy the best that they can (no tobacco, safe sex, healthy Pinoy diet, good sanitation, mosquito control) and leave the rest to the Almighty.
Politicians can always twist this apparent crisis into an opportunity to hoodwink the people into believing that their good health is because of the doctors who were retained against their will.
Manny

[docdan1]

I second the motion Doc Moraleda. Take note of the "Covenant":
The covenant will ask members to practice in the Philippines for the next three years, from 2004 to 2007. The doctors will also be asked to spend a portion of their time —say one day in a month — to do charity work.


It is has noble intentions, but insensitive and not the solution to the problem. :sad: The problem is poor pay and benefits. Therefore, the solution should be ways to increase pay and benefits for healthcare workers. What is the proposal instead? TO BIND SOMEONE in a state of hunger, poverty, and despair. :mad: Signing the covenant can mean losing oppurtunities to earn more, feed your family, and actually send more money back to the Philippines. The covenant is not the solution.

Why don't they make rich politicians sign a similar contract, i.e. stop stealing from the people for three years and spend a day a month actually giving money back to the poor? :?:

[holland park]

My thread to this topic is quite late if not very late since I just came back to this present world.

I WAS a Regular Member of Philippine College of Physicians until 2003. WAS because I have not yet paid my annual dues since then because im OOTC (out of the country! he he he)

I would like to give a drop of my comment in this topic. Docdan is right to say that the covenant has a noble intentions, but insensitive and not the solution to the problem which is poor pay and benefits. He concluded that the solution is to increase pay and benefits for healthcare workers which I agree.

What the PCP should have done is a position paper of the internists regarding the present problem concerning the medical profession and suggests some solutions so that our government will wake up to the reality.

The covenant has three points:

1. To practice and be based in the Philippines.

I strongly believe that as physicians, we should treat, serve, care our patients IRREGARDLESS of race, religion, sex or other beliefs. Yes we Filipinos are suffering but other people also need attention. Take malaria for example. Malaria kills 2 to 3 million people a year and 90% of that people are from Africa. I believe that there is maldistribution of doctors in our country. Take for example Iloilo City, there are hundreds of doctors and most are specialists, however in Mindanao, there are less. This is the job of our government which it has neglected since.......I could not remember exactly when.

2. To practice and to be here in the philippines for the next
three years.

Why only three years? Why put a limit when you can practice and stay in the philippines for life. We are now in 2005 not in prehistoric times or in other times where freedom to choose is being suppressed.

3. To spend a portion of time for charity work at least one day in a month or to give free consultation to poor patients.

Again, why only one day in a month. I know almost all doctors are practicing that EVERYDAY. Probably some are not even doing that at all!

In the end, I believe each and everyone of us has a dream and we have been reaching for that dream for a long time. If we have reached that dream, will we stop dreaming for another one?

I dreamt to be a doctor and I succeeded to be one. Now my dream is to help my family and continue serving people IRREGARDLESS of race, religion, sex, or political beliefs.

[docdan1]

I dreamt to be a doctor and I succeeded to be one. Now my dream is to help my family and continue serving people IRREGARDLESS of race, religion, sex, or political beliefs

Ditto!! :smile2: