It was in 1979 when a young doctor by the name of Nona dela Fuente first set foot on Veterans Memorial Medical Center (VMMC) in Quezon City. She was an eager first year resident in Pathology and had no idea her hard work, devotion and loyalty to her profession and the medical institution would propel her career to remarkable heights.
Unlike two past presidents of the republic, Dr. Nona dela Fuente-Legaspi voluntarily chose to remain at the VMMC even after she was free to go, upon completing her specialty. A truly gifted doctor, who also happens to be blessed with leadership skills, she rose through the ranks of the hospital in the last four decades, and assumed the hospital’s highest position as medical director in 2010.
On a daily basis, Legaspi assures the efficient and organized operations of all VMMC departments; decides on and implements policies to maintain its standards; and acts as an overall manager of the 700-bed capacity government-run military hospital.
“I never imagined I would be sitting as director [of VMMC]. Not in my wildest dreams!” the lady physician and top executive exclaimed. “But I assumed leadership because I knew what it takes to run this hospital—I know what is needed and what should be done for the interest of the veterans, which is also my interest.”
It turns out that Legaspi’s husband is a retired official of the Armed Forces of the Philippines (AFP), thus making her and their family dependents and beneficiaries of VMMC’s public health services.
“My husband is an AFP retiree, so that makes me a veteran too. I can relate to what the veterans need,” she declared. “When I assumed leadership, common sense dictated that I look into areas where there are heavy transactions, such as OPD [out-patient department], for improvement.”
It was the beginning of many modernizations for the 58-year-old medical institution, which is a 5.9-hectar facility on North Avenue, Quezon City. The VMMC was established in 1955, through a $9.4-million grant from the 80th United States Congress, allocated to provide quality medical care for war veterans and their dependents.
As a public servant, health care provider, and because of her family’s personal stake in the services of the VMMC, Legaspi willingly dedicated her entire career to the medical institution, with the unwavering determination to “find the root cause of [every]problem.” A quiet leader, she depends on “logic, reason, and systematic documentation” to improve and maintain the quality of health services at the all-important government hospital.
Perfect for Pathology
Like most doctors, Legaspi followed the footsteps of one of her parents. Her father was also a doctor, who demanded she pursue a career in medicine. She revealed to The Sunday Times Magazine that she originally wanted to become a civil engineer, but to be born and raised in the 1950s meant she had to obey her parents—and in this case, the doctor’s orders.
“I actually passed the exams [for Civil Engineering]but my father got mad,” she laughed at the recollection. “My father was the first hematologist in the Philippines so he was a very good doctor. It so happens that we both have the same birthday [December 4] so he insisted I become a doctor too.
“I reasoned with him that I would be the third doctor in the family [if I took Medicine]so it made sense to try something different, but he still said no. During that time, children were seen but they were not heard, so I followed,” she added.
The young Nona spent her primary and secondary years in St. Theresa’s College in Manila, before pursuing BS Biology at University of Sto. Tomas (UST) where she graduated Cum Laude in 1973. She went on to finish Medicine proper at the UST College of Medicine, and completed her internship at the Makati Medical Center before entering the residency program of VMMC.
“I chose Pathology because that was my interest. It gave me the avenue to deeply know the cause of a disease. I was not just interested in treating and seeing the patient just like that. I want to know what went wrong, and you’ll do that in Pathology because of the autopsies and tests,” she shared. “I sometimes think that it’s my mindset as a pathologist that plays well in my managerial position as well.”
According to Legaspi, Pathology entails “a lot of patience, a lot of documentation and laborious work.”
“I would spend hours in a laboratory looking through microscopes, conducting tests, and recording findings extensively. This is why some refer to pathologists as ‘introverts’ since we are always locked up in a room,” the doctor explained, thus revealing her reserved personality.
It was in 1986 that she eventually headed the Pathology Department of VMMC, spending most of her career in this position until 2004. It was during this time that she cultivated an interest in hospital management, encouraging her to attend the Ateneo Graduate School of Business. From 1988 to1990, she completed her Masters in Hospital Administration, spending her entire Saturdays in school for two years running the pathology department.
“I felt like I needed to study more even if I was already Chief of Pathology. Sometimes your common sense cannot sustain you—your common sense can get you to places, but to sustain it you have to study,” Legaspi wisely said.
And much as she never thought or planned to become a doctor, she never really thought of heading the VMMC, but through time and experience, she realized she can only make a difference in her beloved hospital if she reaches the top.
“You know, as the years go by you change. Namumulat ka [your eyes are opened]as the years go by. You become aware that there should be some changes; that we should do this and that; and that the only opportunity you can do it right is to go to the top. That’s the only time you can start moving things,” she conceded.
Challenges and achievements
The first real challenge Legaspi faced came when she headed the Pathology Department. It was in 1989 that her management skills were put to the test when she was told to organize a voluntary blood donation program. At that time, VMMC was purchasing P1.8 million worth of blood annually, with the hospital’s monthly consumption pegged at 600 to 700 units of blood.
In order to solve the problem, Legaspi had to think wisely. “We had to analyze our stakeholders; we had to analyze our linkages, those people who have interests in the hospital, and that was the military. When they retire, they become veterans. So I said, that is our target population,” she shared.
“When you come up with a plan you see to it that it’s going to survive. And how do you survive? Get someone who’s interested in you, and those who had interest in VMMC was the military. The Chief of Staff back then was General Juan Ponce Enrile, and so we talked to him and asked him to help us because we were going to put up a voluntary blood donation that will benefit the armed forces’ retirees.”
Enrile produced a Letter of Instruction to the Reserve Officers’ Training Corp. commandants nationwide, turning the VMMC challenge into a success. By 1997, the VMMC was already self-sufficient in blood supply, so much so that since then, other hospitals would even buy units from their blood bank.
Meanwhile, as medical director of one of the biggest government hospitals in the country, Legaspi made numerous changes in terms of physical structure and operational systems within all within three years of her leadership. She has spearheaded the renovation of the OPD, the renal dialysis department, the operating room, and established an eye center, which is so crucial for veterans.
This year, the VMMC received an ISO Certification (International Organization of Standardization) for its standardized operations and improved facilities, and Legaspi admitted that it is through her “strict policy on documentation” that they were able to institutionalize their day-to-day procedures at the hospital.
“Documentation is like saying that what was not written never happened. The ISO is just documentation. They will not stay here and watch you work. They will get your documents and review them, because your documents will say that you are following what should be followed, and that your operations are according to standards,” Legaspi explained.
She added, “The practice of medicine is highly documented in everything you do. I got that from Pathology, again a highly documented practice. You record one specimen as received, released, done, and out—all actions are documented. I think that’s what I brought into the management as well.”
On an average, VMMC receives about 400 to 450 out patients per day, with a confined population of about 600 patients, and Legaspi makes sure that everyone is attended to equally.
When asked about her opinion on hospital arrests—what the public perceives as an easy pass for big personalities with cases in court—Legaspi replied in a very professional manner.
“Doctors’ opinions are not welcome when you have a court order. The only problems I had when the former president [Gloria Macapagal-Arroyo] was transferred here was with the media.
“But otherwise, it’s just the same, she’s an obedient patient. Even the police are saying that she’s an obedient patient. If she requests something and I have to deny it, she follows. She also has to follow our visiting hours from 3 p.m. to 8 p.m., and gives us a list of visitors.”
Legaspi also revealed that Arroyo spends most of her time around her 150-square-meter quarters, and is permitted to walk outside and do some gardening for 30 minutes to an hour.
“She’s improving, very much improving—she has lost weight, and also the depression is something that needs to be consulted with the psychiatrist,” Legaspi said.
Although Arroyo is charged for the services of her medical team, it is in the Sandigan Bayan that shoulders the expenses for her utilities.
“Of course we have to follow the court—there’s space, there’s a room. She was a former president and there is no room for doctors’ comments here. We don’t take care of her security, we take care of her medical issues,” the doctor added with finality.
Bringing a touch of humor into the serious issue, she then recounted, “It was so funny when they asked me in court recently, ‘Would you accommodate Napoles?’ I said, ‘Show me the court order’.”
“When I started here, I did a checklist of what I needed to do. If I’m going to compare my performance, I’m only going to compare myself with myself in the past. I’m my worst critic, and I would like to see the difference from when I started here until I leave in three years’ time,” the 62-year-old Legaspi shared.
After her compulsory retirement, she told The Sunday Times Magazine that she intends to join the private sector. Having spent her entire career within the VMMC walls, the introvert doctor is looking forward to continue her practice in a private facility where she believes her ideas will be put to good use more efficiently.
Although most of her staffers are encouraging her to extend her tenure, the humble doctor believes, “There’s someone better than me with brighter ideas. So if it’s time to go, you go, because someone may be better than you.”
Before then, the VMMC head would like to see a cardio-catheterization facility built in the near future. She explained that of the top 10 morbidity cases in the hospital, the first five are related to cardiovascular diseases, and ironically the VMMC is still without a cardio-cath department.
As for her family life, she looks forward to more grandchildren. Despite the demands of her work at VMMC, she spends her free time with her family. Blessed with three boys, her oldest ones Antonio “Noli” Manuel, 34, and Viktor “Kakoy” Angelo, 31, are both married, while her youngest, Roberto “Bobby” Jose, who turned 27 on December 5, recently passed the medicine licensure exam. Apparently, the third-generation doctor is also interested in pursuing Pathology.
“I told Bobby that to be a pathologist he needs to have a certain mindset because not everybody can do it. In our society, we’re not even 1,000 members,” said the proud mother.
Another advice she gave to her son, as well to the future directors of VMMC as she looks ahead is this, “You have to study. You can get this position with connections, but to sustain it for six years will be very hard if you don’t study, just as you have to in med school.”
And while her lifelong career in the VMMC is nearing its end, Dr. Nona dela Fuente-Legaspi vows to carry on her Hippocratic Oath. Because even as the rest of her gets old, the mother, doctor and public servant is convinced her mind is seasoned for more challenges in her remarkable field.