Respect, appreciation for doctors felt more in rural areas

20170301100000, Elma Sandoval
Salary will always be an issue when it comes to serving as a rural doctor in the Philippines. This is especially true if the assignment is in what is referred to as Geographically Isolated and Disadvantaged Areas (GIDA), those remote areas that can only be reached by several hours' walk after a bus and boat ride.

Health officials, who remain at a loss in solving the shortage of medical personnel in the country, suggest the problem is not so much because there are not enough physicians but that majority want to practice in urban areas.

Dr Francis Paul Jagolino, professor of Physiology at the Emilio Aguinaldo College - School of Medicine, and a general practitioner, feels many of his peers don’t want to serve in provinces or rural areas not only because of salary issues but because they don’t want to get out of their ‘comfort zones’.

“I think what stops doctors [from serving in rural areas] is a lot of them are afraid to move out of their comfort zones,” he tells MIMS. “That’s the reason why most physicians are concentrated within the cities because this is their comfort zone.”

While there are medical professionals who set up practice in provinces, they still opt for urban areas, where they eventually thrive.

Still, the problem remains serving the health needs of the poor and marginalised, who are without access to properly manned and fully equipped health facilities.

Bigger market

The market in the countryside, according to Dr Rosalind Vianzon, of the Department of Health’s Intensified Disease Prevention and Control Unit, is just as big - if not bigger - than in cities. And the people there need health services just as much, and perhaps even more so since health facilities are not within easy reach.

Dr Jagolino, aside from teaching, has a thriving practice outside of the metropolis. Cavite is a province contiguous to Metro Manila and about an hour or less drive away. One advantage he sees in holding clinic in a smaller town is not having to be burdened by typical problems of city-living - traffic, in particular.

“I have no practice in Manila. All my practices are in Cavite. I can move around anytime, any day,” he shares. He has a co-practice with his doctor-father, and they see an estimated 30 patients per day.

He has also had his share of doing community health work prior to teaching, and being assigned in far-flung Apayao province opened his eyes to the fact that physicians are more appreciated in these parts of the country, and highly respected, something which he feels is not the case in big cities.

Like a king

“You really feel that special treatment,” Dr Jagolino recounts his experience in Apayao.

At the provincial hospital where he was assigned, they cooked meals for everyone. But the doctor’s meal is especially cooked for him. While everyone is sweating with electric fans, including patients, the doctor has air-conditioned quarters, he recalls.

“They treat you like a king. You feel that they really treasure their doctors, which is what you do not feel in some hospitals here,” he rues.

So if there is one argument as to why getting into community health - especially provincial hospitals - is a good career move, it is being able to practice the profession with nobility while being given the respect and appreciation that a doctor deserves.

That experience, where Dr Jagolino found himself serving as sole physician in a 200 to 300 square kilometer radius, has made him love the profession more.

In fact, the impact it had left on the Physiology professor pushes him to relate what he went through to his classes, which in turn have encouraged his students to follow in his footsteps.

Asked about the salary of government doctors, Dr Jagolino said it was “not bad, but it could be better.”

Lawmakers are pushing to pass legislation that would set public doctors’ salary at PhP56,000 with benefits, They hope the move will encourage more new doctors to serve their countrymen in areas where health services are hardly given priority.

Local government officials, too, must step up and do their share to ensure that doctors, farmed out to their localities by the Health department, will continue to serve the community once the deployment programme ends.

Dr Vianzon said if they [local governments] see this as a priority, then they must throw in the necessary support by way of allocating the necessary budget to be able to absorb the doctors assigned to their locality. MIMS

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