What Can I Do?

For the past three years, I only knew a little about the real health economic status of my country. Most of the patients I have encountered "can afford" basic laboratories, common medications. I was fortunate that the hospital where I went at have complete (well, almost complete) facilities. They follow-up at your out-patient clinic (as instructed), and everything goes well. In the ER where most patients are HMO holders or employees of affiliate companies, requesting for laboratories and/or ordering for medications was simple - just write it on the chart, nurses either encode the lab/get the medicine from the pharmacy, and patiently wait for the outcome. Sana ganun sa lahat, pero hindi.

This month, I started to work as a medical officer in a public hospital (primary-type, based on hospital bed capacity). Since most of my duty schedule was concentrated in the emergency room, I am always faced with the concern that the relative and/or patient has little to no money. I usually encounter a dilemma on how to come up with even just an initial clinical working impression (among my differential diagnosEs) when my patient cannot afford to pay for a simple laboratory examination. I cannot treat a patient who comes at the ER because he doesn't have the means to pay for a medication. Worse, the hospital has incomplete facilities - the laboratory can only process urinalysis, fecalysis, capillary blood sugar requests; the rest have to be sent or done outside. Likewise, the pharmacy has incomplete stock of medications. As faced with this scenario, paano naman kapag emergent na or urgent yung case? I pity the patient.

Just like in 1 of my previous duties - I saw an unstable patient. We sounded the "code blue" but we were really slow and delayed with our approach because of incomplete stock of medications. The relative was out & late in buying the needed medications. We can only use whatever is available. Eventually, the patient expired. I can only shake my head in disbelief & dismay. I believe we could have saved him. If only... I wonder if the management is really concerned about their patients. Of course, probably not. Imagine if there was a customer satisfaction survey conducted, the hospital could have failed in all aspects, big time.

I know that this is not unusual. For colleagues who have trained in public hospitals, this is very common & this always happen. Kawawa naman si Juan dela Cruz kapag nagkakasakit siya. He ends up six feet under.