A physician’s right
Are you happy with what you do? That question, if and when asked during the early years of training, would probably have merited an unsure answer. Why? Because back then, fresh out of fellowship, I had not even begun living the life of being one. Residency and fellowship were introductory courses, and during those early years, we did not have the biggest responsibility: to be answerable for our actions. It was either your senior or your consultant who carried that for you as the captain of the ship. Being young and untutored, we had plenty of room to make missteps. As trainees, monthly hospital morbidity and mortality audits were always tension-filled events.
While one can joke about it now, remembering how hard it was to move on after being berated and the possibility of being permanently scarred for life, we were kept afloat and not immobilized through the help of mentors who believed that we had some degree of competence, guided us to do our best and reminded us of the need to pray that our judgment calls would lead to saving a life and not losing one.
Through the years, by choice or by circumstance, we now hold that privileged position of guiding our younger colleagues. While we may draw from what we have learned through the years, things are vastly different now, even complicated. Aside from the pressure coming from training and the medical community after graduation, there is the stark reality of living decently from one’s profession. Life may be a little bit easier for those whose parents are clinicians, who have hospital stocks to inherit, or who have generational wealth that enables them to do so. Unfortunately, this does not hold true for the majority.
In recent years, through various threads, we have encountered requests not only for prayers but for financial help for colleagues who have fallen gravely ill or been struck by chronic and debilitating conditions. If you are of the notion that all doctors have enough resources, let me correct that by saying that getting sick easily can diminish life savings.
While what is to be discussed is a prickly matter, it warrants attention. We always talk about universal health care and its benefits, forgetting that people are needed to make it run. The paper by Pepito et al. on health workforce issues that hinder the implementation of universal health care was helpful not only in pointing out the gaps but also in providing solutions to overcome the problems.
Reading through, I felt a little guilty for having, at one point, questioned how my younger colleagues could just pack their bags and leave. This study spelled it out for me. Bottom line, if asked to summarize the results, it boiled down to funding, restrictive policies, limited opportunities, lack of adequate compensation, and security of tenure. Last year, I saw a sign on the hospital billboard recruiting doctors and wondered, with a mile-long list of requirements, not to mention the process that they would have to go through before being considered for employment, how could anyone be encouraged?
To further support these findings, while interviewing an applicant for training, I was taken aback to learn that she had been given a limited window of time to secure acceptance into a program. If she failed to get in within that period, her position would have to be offered to someone else, and she would have to personally fund herself if she chose to pursue further studies. When asked about how she felt regarding the arrangement, she said it was fine with her because she understood the dilemma that her institution was facing and the need to comply with the requirements.
So how do we get around it? Amongst the solutions that were provided were: return of service agreements, postgraduate training opportunities, and free tuition for dependents of health care workers. With the high cost of living, the latter would be the most attractive, knowing how getting a decent education nowadays translates into paying higher fees.
I would like to believe that the younger generation remains idealistic and eager to do their share for the country. This hope is kept alive, for on a daily basis, I see my young colleagues struggling to finish their training. Privy to their plans, these involve going back to their home provinces, establishing themselves in their community, and, if fortunate, in the academe as well.
For those who plan a different path, there is still time to convince them, if there are enough reasons to make them stay. I see many people who are eager and willing to bring this country forward in terms of improved and world-class health care delivery, and I am constantly inspired by their efforts.
Hopefully, those in influence can hear us and take real action.
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timgim_67@yahoo.com
