Unveiling the burden on private health care
The Department of Health (DOH) should change its mindset regarding private health-care facilities like ours, viewing them not as adversaries or competitors but as potential partners who significantly improve people’s health-care.
This is the story of our clinic, the Vicente L Danguilan Memorial Clinic, in Solano, Nueva Vizcaya, but it reflects the stories of other clinics in this province. We are a multispecialty clinic with 19 staff members who provide quality health services, including diagnostic and laboratory services, to people in Nueva Vizcaya, Ifugao, Quirino, Mountain Province, and Isabela.
The provision of health services is one aspect of our clinic’s operations. The other is how we comply with the regulations required annually by the DOH and other government bodies.
Compliance with regulations is a DOH requisite for a clinical laboratory to secure its annual operating license. Failure to implement the regulations results in the DOH issuing a cease-and-desist letter. Partial compliance leads to the DOH downgrading the clinical laboratory’s level, meaning previously offered services will no longer be provided.
We understand the importance of contextual and thoughtful regulations based on evidence that brings about mutually desired changes, such as higher standards of care, better health outcomes, increased accountability by health providers, and reduced malpractice risks. And we welcome these.
We recognize that regulations intend to create order and ensure that health-care practices and services are implemented and delivered safely, effectively, and sustainably.
However, the DOH’s regulations often leave us perplexed. They seem out of touch with technological advancements and divorced from our everyday realities. Furthermore, they defy logical reasoning. Although the DOH provides explanations for these regulations, they are often inadequate.
Consider these regulations.
The DOH mandates that medical technologists manually copy laboratory results from computerized printouts generated by machines that analyze blood, urine, and other specimens. Despite the presence of electronic medical records, the DOH insists that medical technologists log the results in physical log books.
Our chief medical technologist, Sean Bulan, believes that manually copying lab results from computer printouts to physical log books is prone to errors. Correcting these errors and copying the results wastes the time and energy of the medical technologists, who could otherwise use that time to focus on other critical tasks, such as processing and analyzing specimens.
DOH further requires laboratories to have five medical technologists without considering whether patient volumes are high or low. Additionally, the DOH is mandating an expansion of the area designated for drawing blood.
When DOH regulations require significant and disruptive changes in private health-care facilities, it does not offer support services or feasible options to help them comply. The imposition of these regulations—inspections, audits, and the actual implementation of changes—entails disruptions in clinic operations, delays in patient services, increased stress among staff, and increased complexity in managing the clinic’s daily operations.
These regulations are challenging to implement due to financial constraints and real-world barriers such as limited space, physical infrastructure, and technical know-how.
The DOH Licensing Team audits our clinical laboratory annually, but the team members change yearly. For instance, the team that audited us in 2022 had different interpretations of the guidelines than the team that audited us in 2023. This inconsistency in their assessments has led to frustration and confusion on our part.
What is more disheartening is that the regulations and their execution are often adversarial rather than collaborative in spirit. This stifles health-care facilities’ willingness to innovate, erodes trust, and strains relationships with the DOH and other government agencies.
We provided the first ultrasound services in Region II in 1987—no public health facilities offered ultrasound services at that time, which started only in early 2000. We were the first in Region II to provide electroencephalogram services in 1992. Our partners and we made CT scan services available for the first time in Region II in 1996. Together, we established the first dialysis clinic in Nueva Vizcaya.
We did this without any help or encouragement from the government.
But imagine if we could do this together with the government. We could have helped many more people, at lower costs, and the impact on health care would have been much more felt.
So, it would be in the public interest that DOH and other government agencies view the private sector not as competition or an enemy but as a valuable partner in advancing public healthcare.
Dr. Marilen J. Danguilan is an adviser, and Deogracias Victor M. Danguilan is the Vicente L Danguilan Memorial Clinic administrator in Solano, Nueva Vizcaya.
