BAWAL magkasakit. [Getting sick is forbidden.]
Getting sick and needing a doctor are two different things – related but independent of each other. You can get sick without needing a doctor. But if you need a doctor you are not just sick. You must be really sick — seriously ill.
You would think that politicians should be aware of the fact that the country needs 930,000 doctors this year. The Philippine Medical Association says so. And the need will surface this year when the country’s population reaches 100 million – with or without gynecologists or pediatricians.
In an interview earlier last year, PMA president Leo Olarte said of the 130,000 licensed doctors in the Philippindx only 70,000 “active” PMA members are practicing to serve some 100 million Filipinos.
The “internationally-suggested” ratio is one doctor per 100 persons. To achieve that correct ratio, the Philippines must have one million doctors.
Where did the 60,000 Philippine doctors go?
Olarte said over the past 10 years, around 10,000 doctors shifted to nursing and then worked or migrated.
Doctors have taken the Hippocratic Oath to “heal the sick…devise and order for them the best diet, and take care that they suffer no hurt or damage.” Regardless of where or when a physician is, when he or she, a doctor, enters a house, the visit shall be “for the convenience and advantage of the patient…to refrain from doing any injury or wrong from falsehood, and (in an especial manner) from acts of an amorous nature, whatever may be the rank of those who it may be his or her [my]duty to cure, whether mistress or servant, bond or free.”
Academic curriculum shows that during Hippocrates time, Greek doctors practiced privately. Some were occasionally employed by a city-state for a year at a time. While doctors were paid for their services, the profession required that they do not “make too much money” hence the moral standard was for physicians to – when necessary- treat their patients for free.
At the time, the patient to doctor ratio was not an issue.
Fast forward to the present.
3 doctors for every 10,000 Filipinos
The Professional Regulation Commission (PRC) officially puts the total number of licensed doctors at 72,000. Roughly translated there are only three doctors for every 10,000 Filipinos says DoH Undersecretary Teodoro Herbosa.
Resigned Secretary of Health Enrique Ona disagrees.
Ona contradicted PMA President Olarte February last year emphasizing his view that the country has “more than enough” doctors. Thirty medical schools produce 4, 500 MDs every year. And of the medical school graduates, 74 percent pass the Board, Ona argues.
Even if 10 percent of doctors die every year, the Philippines would have enough doctors and medical schools. A shortage of doctors is not a problem especially since the DoH – in one program – sends doctors to rural areas. They get paid anywhere from P54,000 to P60,000 a month, said the resigned Health Secretary according to the February news report.
In a manner of self-correction, however, Ona admits that in some fourth and fifth class municipalities in the country, doctors earn as low as P25,000 a month. With such paltry professional fees after obtaining a degree that cost millions of pesos – not to mention involuntary servitude in post-grad internship – Ona hints doctors will not stay in municipalities.
The shortage is artificial. There are enough doctors, but they are in rural areas, in the cities where pay is “good.” No, make that “better.”
In 2001, congressmen and senators officially got P40,425 a month. The Vice President got slightly higher at P46,200. The President got P57,750. This according to the Department of Budget and Management.
But why do they spend millions to get elected? The benefits are way, way too good to ignore. Each congressman received P70 million a year, senators P100 million each and the president, a billion.
In contrast to doctors, politicians stay in the rural areas where a political dynasty will flourish, passes on power and office to the wife, mistresses, children and relatives, illegitimate or not.
And unless caught for plunder or threatened with impeachment or forcible abdication of power, politicians do not migrate.
They are servants of the people. In fact, President B. S. Aquino emphatically swears that the Filipino people are his “Bosses.”
You would think that as public servants, politicians would be aware of the paltry pay of physicians; that such criminal treatment of them becomes a main reason for doctors to move from rural to urban areas – and subsequently from the Philippines to other countries where they are appreciated, paid commensurately for treating the people and saving lives.
The annual pay range for new doctors in the US is $197,000 – $300,000. In Australia, $196,527 to $309,000, the UK £199,829 to £234,265, and in Canada $95,094 to $137,000.
Since Philippine doctors cannot practice their professions in these countries without taking and passing the specific licensure examinations, how much would they be paid as Physician Assistants if they decide to work abroad as such before obtaining their license to treat?
In the US, Physician Assistants are paid $65,000 a year; Australia, $88,540; the UK £36,917; and Canada, up to $90,000. Such salary amounts translate to anywhere from two to three million pesos a year as physician assistants, compared to P540,000 a year as licensed doctors in the Philippines assuming they are paid P45,000 a year.
This situation contributes to the push factors of doctors’ migration from rural to urban areas – and from the Philippines to anywhere they are treated as professionals.