THE CHALLENGES OF COMMUNITY MEDICINE

Over the weekend, I visited Dr. Jesus “Jet” Comia, a good friend of mine who practices in a not-so-remote town in Unisan, Quezon Province.  His dedication is noteworthy.  Twenty-four hours a day, seven days a week, he is available to render medical services to everyone from newborn infants to geriatric age groups.  He may not be your typical highly-paid medical specialist from the big city, but his experience is evident in  the trust and confidence given to him by his patients.

It is a great challenge to practice community medicine in this country.  There is a perception that the best doctors are practicing in the metropolis, with its high cost of health care.  While the modernization of medical management necessitates the use of complex machines and diagnostics, there is one thing that will never change – human interaction.  After all, medicine was, is, and will always be a relationship business.

Upgrading the Philippine health care system is not just a matter of bringing in the technology.  Above all, there be must be a paradigm shift – a substantial change in the perception, attitudes, and practices of the doctors and the population they serve.  For younger physicians, they must stop thinking that the only route to become a respected doctor is to specialize.  There are a lot of opportunities to start a practice in a rural setting.  This is what my friend did.  It may not sound glamorous for some, but beyond the flashy cars and the expensive outfits, the essence of being a physician is to be of service to those who need you most.  Besides, Jet is not doing bad.  In fact, he now has his own car and a beautiful and spacious 2-storey mansion with his wife and 4 kids.

For the non-physician, it is also important to find a good physician whom you can trust for the rest of your life.  Never underestimate the value of continuity of care.  Doctor shopping or having multiple specialists taking care of your body is, in my opinion, counterproductive.  While multispecialty care is essential in acute cases, for long-term care it pays to have just one trusted doctor overseeing your progress.  Not only is it less costly, it also furthers the relationship between patient and the physician which unfortunately is starting to disappear these days.  It’s no wonder why the number of medico-legal cases is on the rise.

Our public health system has a lot of wrinkles that must be ironed out in order to upgrade our morbidity and mortality rates and improve patient satisfaction.  But no matter how complicated things are right now, the starting point is always found in the smallest, remotest of areas.  We may have a lot to learn about medical care from those humble and faceless health care practitioners whose dedication and commitment are a blessing to the least of our brethren.

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