Yuppie MD, with a Twist

Back in medical school, our teachers always told us to be the best possible doctors that we can be, and to aim to become a "five-star physician" in accord with the World Health Organization model of the same name. I'd like people to use that model to understand my present job, what I do for that job, and what I'm looking forward to in the long term.

The Classic Q&A

Case in point: during friendly conversation initiated between myself and someone I haven't met before, it is but natural for both of us to ask each other (or sometimes, volunteer) what we do for work. Mine is easy to relate to - or so I thought.

Upon mentioning that I am a doctor, the next question for me becomes either "What hospital do you work in?" or "What's your specialization - internal medicine, surgery?"

If I happen to be in a light social situation when asked that question, I would simply reply that I just graduated from medical school, and that I am aiming for a career in Internal Medicine, or even Family Medicine. That is my standard, run-of-the-mill reply, which saves time in small talk. I use it whenever my work circumstances do not really matter in my relationship with the person who asked. It may not be an accurate answer, but it is not a lie either - note that I simply said that I just graduated, and that I am aiming for a career in IM or FamMed.

However, if there is the luxury of time, and the person I'm talking to has a little background info on me (or is sincerely/necessarily interested in my occupation), then I answer with the full details: I work with the UP Econ - Health Policy Development Program, or HPDP, as a Health Policy Fellow.

I started work with the HPDP last Wednesday, November 12, and I'm fast beginning to like what I'm doing.

Am I still a Doctor?

After giving my HPDP answer, some would awkwardly ask if I still "heal" people/patients. My straightforward answer is Yes. Being a registered Physician at the Professional Regulations Commission (PRC), I am a holder of a Philippine Medical License, and that allows me to practice medicine - to see patients, to interview and examine them, to arrive at a diagnosis of their illness, and to prescribe/perform the appropriate treatment. In case the question of my medical practice still persists, I refer the inquisitor to my short stint as a Resident-on-Duty at the Ospital ng Muntinlupa, where I worked at the medical wards and at the Emergency Room.

There actually is what I'd like to refer to as the Doctor Stereotype. Because most of us are acquainted with the doctor being a 30ish to 40ish white-coated healthcare professional working in a clinic or hospital, it is easy for the general public to think of the doctor in terms only of a Clinician, or a physician that sees and treats individual patients. I'm also one of them clinicians, in the sense that I am capable of and legally licensed to practice General Medicine.

But I have decided that I can't limit myself to clinical practice. I'm not saying that clinical practice is just that - something that is limited. No, I have the deepest respect and highest regard for the expert clinicians - doctors who heal individual people. Their training is very technical and rigid, because they literally are entrusted with individual lives.

The Five-Star Model

The WHO Model of the Five-Star Physician envisions a physician to be 1) a clinician, 2) an educator, 3) a researcher, 4) a manager, and 5) a social mobilizer each at some point in his career, or perhaps be a combination of any of the five at the same time.

The doctor stereotype everyone knows is at least #1; if s/he belongs to a training hospital with a medical school, s/he can also be #2 and 3; if s/he is part of administration, s/he can also be #4. Sometimes when there's an advocacy, or in the case of the practitioners of Community Medicine, #5 comes into strong play.

Health Policy Fellow

HPDP Health Policy Fellows (HP Fellows) can either be medical doctors or not, but all the same they work under a United States Agency for International Aid (USAID)-funded project that helps the Philippines' Department of Health come up with health policies that seek to improve healthcare in the country, in general. Think of the HPDP as a "think tank". In my work as an HP Fellow, initially the educator, researcher, and social mobilizer roles come into play:

Educator, because when HP Fellows provide technical assistance to their assigned Department of Health (DOH) agencies, we make new concepts (or rediscovered ones) available for use. We give this knowledge to our agencies not as the classic classroom teacher, but all the same we still impart new concepts.

Researcher, because in the course of our work, we need to turn to scientific literature to have hard evidence as the basis for our policy recommendations.

Social Mobilizer, because our work results in policies that are bound to be used for programs and projects on a public health scale.

Multiple Levels of Care

To drive home the point, allow me to use the example of one of our HPDP Consultants - Mario M. Taguiwalo.

Let's say that an expectant mother dies of severe hemorrhage on the delivery table. Who's at fault? It's may not be just the Obstetrician who attended the delivery. The patient may have not availed of pre-natal check-ups, which makes the Primary Care delivery system also at some fault. And higher up, perhaps it's the lack of funding for the Primary Health system that's causing the inability to make pre-natal check-ups available. The bottomline is there are multiple levels of care in our health system.

In the clinical scenario above, I may not be the clinician (Obstetrician), but I'm part of a team who is analyzing the policy factors surrounding the scenario - the systems, so to speak. And in doing my work, I hope to contribute towards a future wherein the above mortality would be avoided, on a larger scale.