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More Doctors Weigh In On The Issue Of Reckless Journalism

A hornet's nest has been stirred as one journalist from Mindanao recklessly wrote an article recently, the clipping of which was snapped and posted on social media.

A response by Alexander Tan Jr. went this way:

This is in response to an opinion piece titled “Are resident doctors really doctors?” written by Fely Viloria Sicam. There are some egregious statements which I would like to refute.

She writes “I guess a probe should be made not only on this fake doctors, but also with doctors who believe that they are already licensed doctors because they are called “doctors” even if they are only “resident” doctors.” This displays a complete lack of understanding of the hierarchy in medicine. Resident doctors are general practitioners who have embarked on a training program in his/her chosen specialty. They are licensed doctors. One also has to take offense at the use of the word “only.” This belittles the hard work needed to achieve the position of a “resident” doctor: (1) a bachelor’s degree (4 years), (2) a doctor of medicine degree (4 years), (3) internship (1 year), (4) pass the board examinations (this confers the license to practice medicine and the title of general practitioner), and (5) pre-residency (anywhere from 1-3 months). In truth not all doctors are lucky enough to enter/finish residency. Some remain general practitioners for life but this doesn’t mean they are less deserving of one’s respect and the right to be called “doctor.” Lest you think residency is easy think again because it takes anywhere from 3-5 years. After residency there’s specialty board examinations. For the very motivated few there’s subspecialty training which can take 1-3 years. You might notice that I’ve emphasized the decades spent trying to learn the art and science of medicine. It is a lifelong commitment. General practitioners, residents, fellows, consultants, specialists, subspecialists­ – we are all doctors and we are all licensed.

She writes “For me, I would only call and respect a doctor when he acts like one doctor who cares, who has the compassion, who has the attention, who has the heart and who has the hand that cures the sick.” This presents a very narrow and limited concept of a doctor. Some doctors are on the fringes of patient care. There’s the pathologist who cuts and studies the specimen submitted by the surgeon. There’s the radiologist who reads x-rays. These doctors spend very little time in direct patient contact but nevertheless they perform a very essential part of patient care. They have practically no opportunities to show the “compassion, attention, heart and the hand that cures the sick” which seems to be a prime requirement to be deemed worthy of being called and respected as a “doctor” in Ms. Sicam’s eyes.

She writes “When I asked who she is, she said, “Nurse ako. Ano po ba ang problema?” Then I replied saying, “Ikaw ang nurse, dapat alam mo ang problema kaya nga dinala dito. Eh, nasaan ba ang doctor?” This exchange suggests a lot of things: (1) the nurse is trying to do her job by taking a history which is always the first part of patient care, (2) the nurse is trying to maintain respect towards the patient’s companion by using “po” and (3) Miss Sicam displays her arrogance by replying “Ikaw ang nurse, dapat alam mo ang problema, ….” A paragraph later she bemoans the fact that the “sandali” took an hour. Again this displays an ignorance of the concept of “triage.” An emergency room doesn’t operate on a first come, first served basis. Triage is the medical term that describes the technique used by emergency room doctors when they have several emergencies at the same time. To save the most lives, doctors separate patients into groups: those who require immediate medical attention, those who will die regardless of intervention, and those who can afford to wait a little while. The routine patients are left until last. Either way all patients will be attended in due time. This system holds true whether in a government hospital, private hospital, clinic, lying-in, in short -- everywhere. The doctor makes the judgment when a patient should be attended to (not the patient and certainly not the patient’s companion).

She writes “’Sir, may I know if you are the doctor?’ ‘Ako nga,’ he replied. ‘But you’re not in uniform.’” Miss Sicam then goes off to conclude that the resident is a fake doctor because “he was discourteous, he was arrogant too like the nurse, he was not in uniform, he has no name tag, or insigna [sic], he did not answer in English.” With all due respect, a uniform does not make a doctor. I can remember times wherein I had to rush to the hospital wearing casual clothes in order to deliver a baby in my role as an obstetrician. Needless to say wearing the proper “uniform” is the least of my priorities in those emergency cases. I have a colleague who’s wearing trunks and was just enjoying swimming on the beach when somebody almost drowned. Thankfully he was there to save the day. What this means is that our attire has very little to do with the way we perform our jobs. Like any other doctor I love the dignity bestowed by wearing my blazer/long coat but I have no problems dispensing with it in emergency cases.

As a doctor I am well aware that communication is an important part of therapy. The patient must understand the correct way of taking medications. The patient must be able to follow advice regarding his current condition. As a practicing physician for 10 years I’ve had to tailor my language according to a specific patient’s needs. I’ve had experience talking to patients from all walks of life: children, adults, educated, uneducated, literate, illiterates, etc. This means that I always have to translate medical jargon in layman’s terms. This is something that holds true for each and every patient. There’s no sense in talking in terms the patient cannot understand. Most Filipinos know how to speak English but this doesn’t always mean it’s the best way to communicate with our patients. And neither is it required for that matter. In most cases our national language works just fine. Maganda ang wika natin; dapat lang nating gamitin at pagyamanin ito.

She writes “I guess if this is the situation in almost all hospitals in the country, 90% or even 99%, who are patients in ERs will just die because nurses and doctors are not humane to patients.” Where did that 90% come from? Do you have the mortality reports from the hospitals to back up your assertions?

I will cut this piece short by saying how deeply offensive this opinion piece is. If it purports to the lofty goals of journalism then it is a dismal failure. The mere fact it was published says a lot. It is (in the words of Renata Adler) simply, jarringly, piece by piece, line by line, and without interruption, worthless. I AM SHOCKED AT THE DISMAL SITUATION AND CONDITION OF JOURNALISM IN OUR COUNTRY!!!

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