Revisiting DOH Doctors to the Barrios Options

[pbisnar]

While legions of Filipino doctors are leaving the country, there are remaining small resistance forces manning the frontline of our health system. These are the doctors to the barrios. They entrenched themselves in the far-flung 5th and 6th class municipalities guarding and protecting our poor rural countrymen against sickness and diseases.

To read the full-text visit: Revisiting DOH Doctors to the Barrios

[journey]

very good. i reiterate my stand that incoming medical students must realize that it is preferable that they have vows of celibacy and poverty, otherwise economic pressures will force them to look for greener pastures.

[bvbraga]

it deployed a total of 337 doctors to these targeted areas and 26 % of these doctors remain and continue to serve our countrymen. According to DTTB website, of the original 271 municipalities identified, 198 of them were already served and most of them were served more than once due to exigency of service.

-Doctor retention was never an objective of the program (IMG:style_emoticons/default/mad.gif)

Last July 2002, tripartite partnership between Pfizer Foundation Philippines, Ateneo Graduate School of Business, and the Department of Health promoted “Leadership Health Program”. Doctors to the barrios are given a free chance to earn Master in Health Care Management degree.

-Where have all the graduates gone? (IMG:style_emoticons/default/sad.gif)

Senator Flavier is active in promoting DTTB. He even went to UP College of Medicine and encouraged the medical students to join the program. In 2001, he initiated Senate Committee on Health Awards for Community-Oriented Student Batch or Organization in enticing students to practice community medicine.

- (IMG:style_emoticons/default/rolleyes.gif)

[butiki]

dito kami sa states (IMG:style_emoticons/default/eyebrows.gif)

[pbisnar]

Dear Bvbraga,

I agree with you that there is no retention program. According to Dr. Pastor, a veteran of DTTB, after their DTTB contract expires, some of them are absorbed by Local Government Units and continue to serve the countryside.

Regarding where the graduates had gone, that is a difficult question. I hope some of them continue to serve. Our colleagues who serve in the rural areas deserve a credit as much as we equally serve our patients.

Thank you for the comment.

[tortuga]

I agree that they are heroes. But they have to live too. Especially once their children starts going to school. That's why the lack of a retention program is very telling on it's sincerity.

[doc_roy]

Im a City Health Physician similar to the DTTB, but unlike them im working at my hometown which is a component city. One of my collegue was one of the first batch of the DTTB, he told me that during the initiation of the DTTB Program - Dr Flavier calls for the Graduates of UP to be DTTB yet only one answered his call. Its a shame that those who are expected to serve choose not to. Im also a product of a government institution - PLM and that opted me to serve (as a small tribute for the small cost of my medical education). Two of my batchmates (Class2002) are doctors to the barrios serving in Abra and in Mindanao, its a great option for nubies and pays well also- they told me. (IMG:style_emoticons/default/cool_old.gif)
My collegue told me that being an CHP/RHP is a good job for starting MDs and for those who are retiring/planning for a laid back life. Earning P25T to P30T is not enough when you have kids going to school. If the govt does not improve the salary of govt physicians in the next few years - most of us will move on. Me - im planning to finish my advance course at PCOM to pursue a carreer in Occupational Medicine or migrate to Canada?NZ?. (IMG:style_emoticons/default/crazy.gif)
Im still hoping for best (for us physician) in this country.
FILIPINO PHYSICIANS are for FILIPINO PATIENTS!
MEDICINE BEGINS WITH INTEGRITY!

[almariao]

FILIPINO PHYSICIANS are for FILIPINO PATIENTS!
MEDICINE BEGINS WITH INTEGRITY!

you're right, doc roy (IMG:style_emoticons/default/icon_razz.gif)

and i guess, i'm going to be one of those heroes.. that is, if i won't change my mind after i get the MD (IMG:style_emoticons/default/cool_old.gif) (IMG:style_emoticons/default/cool_old.gif) (IMG:style_emoticons/default/cool_old.gif)

[tortuga]

Its a shame that those who are expected to serve choose not to

It's really difficult to judge the intentions or reasons of other people. In fairness to some state school, with regionalization of admits, a lot of those who graduate and stayed are actually practicing in their own provinces but not as DTTB (most as generalists/specialists). Also the situation in certain areas are volatile. You can be accused as a communist just because you graduated from certain school. A lot of my idealistic classmates are working in rural areas via NGO's which I think are effective on achieving their specific goals.

[doc_roy]

(IMG:style_emoticons/default/au_revoir.gif) Dr. tortuga,

Your right, its wrong to generalize but im just speeking in the context of Dr. Flaviers invitation for the DTTB during its conception. I apologize - if i had offended you and other pinoy MDs out there, again my apolgy sir.

Medicine begins with Integrity! (IMG:style_emoticons/default/flag.gif)

[wolverine]

Would it be more cost effective for the government if they will give full scholarships to deserving students who hails from these far flung doctorless barrios supporting them until they completed postgraduate specialty training? I'm very sure that these people would be more than happy to return to their native land and served their own community.
I have had experience with summer CBH programs through the PYHP during my med school days and one thing that I learned during those days was the difficulty in adjusting/adapting to the barrio way of life and how to gain the trust and confidence of the people who had been cared for by traditional healers and albularios.

[journey]

wolverine, it does not always work. we have had programs like that to train rural physicians for certain specialties---sadly, most do not go back to their rural roots. they stay in the city.

[butiki]

basically the same reason most of us have realized, there is no facility and equipment in a rural setting for a specialist to practice and fewer income.
I have my classmate working in the province. kung dati binibigyan ang doctor ng manok, ngayon sa hirap ng buhay itlog na lang. sabay sabi doc pisain mo na lang itong itlog kung gusto mo ng manok! (IMG:style_emoticons/default/lol.gif)

[jennifer]

basically the same reason most of us have realized, there is no facility and equipment in a rural setting for a specialist to practice and  fewer income.

Depende din sa lugar. Marami na ring mga diagnostic clinic sa iba. I tried practicing in Manila and in a rural area. Mas maganda ang practice ko sa probinsya. Ang maganda lang sa probinsya mas mura ang cost of living at simple lang ang buhay. Mas gusto ko pa ring balikan ang practice ko sa rural area.

[cruzin]

Mas gusto ko pa ring balikan ang practice ko sa rural area.

Promise yan ha! Quoted ka na.. (IMG:style_emoticons/default/biggrin.gif)

[jennifer]

Promise! (IMG:style_emoticons/default/unsure.gif) ..... anyway they are made to be broken (IMG:style_emoticons/default/wink.gif)

[kyuks]

hello doctors,
i'm one of last years graduating batch of doctor's to the barrios, in fact i was the "president " of our batch. hope i can make a little insider addition to your chat. how was it in the program? moneywise-lets begin where many see things noweadays. slary grade 24 only translates to 18,000+ basic salary. BUT many of ue are able to bring home around 25t because of additonal honorarium from the ocal government unit. this aside from the hazard pay and a sprinkling of other magna carta benefits. and mind you one of us got to bring home around 40t a month--because the LGU gave him such a large honorarium. the catch? reaching the area means being in a banca for 10-12 hours upstream and he did survive the two years. and was interviewed by raffy tima for the correspondents prior to the end of the program.
majority of our areas are really far. banca rides, motorcycles, rought roads. but majority were women out of 32 only 7 of us guys. guess women have a more helping heart. and that is what i said in my speech--" it may not be fashionable to profess love for country nowadays, but that was one thing i learned from talking to our batchmates, there was a willingness to serve the poor" in our graduation we had a gallery of pictures and stories and im proud to say i belonged to such a batch. even for just two years, the common tao had someone caring, looking out for them and yes fighting government bureacracy so that what is due them will reach them. i guess that is one experience common to us all DTTB's and MHO's- the frustration of lobbying for funds and support.
there were 32 of us but only 3 remained to be absorbed by the LGU's. and one of them was an area raided by the NPA last year while the doctora was there! her story could be found in the inquirer. but she went on and volunteered to stay after two years. i visited her area on a medical mission and one can only admire the courage looking at her bullet ridden RHU. 2 of those who opted to continue are graduates of UP-Palo. being a UP alumni myself i know their campus and facilities are no way at par with UP-Manila medicine but WHY IS THIS??? just because they are the doctors who are midwives and nurses they dont get the same funding from the university. and experience has shown they serve. perhaps not in high rise hospitals but they are out there forming the fragile backbone of the health care system. my rhu nurse is such a graduate. the doctor in the next municipality to me is also a graduate. and her RHU is one of first to receive one million pesos under the sentrong sigla program.
so many stories, so many realizations. thats why i encourage young doctors to try even for just two years. the hospital you can come back anytime. there may be something wrong with a system that only brings doctors to these areas for only two years but thats for another post.
as for the leaders for health( LHP)project. they are our more illustrious brothers studying in the ateneo.hehe. but they stay for a total of four years and they have to get their masteral and its the ateneo were talking about so its no walk in the park. lets say the LHP is an evolved form of the DTTB. the masteral component previous dttbs clamored for.
any question guys i'll be happy to answer. much shorter next time i promise.
PS. right now i'm about to start residency in PGH pediatrics. were am i sending this from? from catarman, northern samar. the provincial capital of my assigned area. it's one thing i gained from the two years. a second family, and friends i could visit anytimeand wish merry xmas. and the knowledge of unkown beach areas and coves which someday will rival boracay--if only a bridge and a paved road could be built going to the municipality. Haaay, gobyerno talaga.

[pbisnar]

Kyuks, thanks for the very informative blog.

[jennifer]

Hi Alexis! (IMG:style_emoticons/default/biggrin.gif) I'm proud of you housemate for having the heart to serve (IMG:style_emoticons/default/thumbsup.gif)

Is the program for two years only?..or there's an option to extend? Meron bang hindi nakakatapos ng term nila? If yes, what are the most common reasons?

I think the DTTB is more suitable for single doctors, right? Malaki na rin ang 25-40K na take home. Makakaipon ka na rin kahit papano.

[cruzin]

PS. right now i'm about to start residency in PGH pediatrics.

Out of the frying pan into the fire.. (IMG:style_emoticons/default/lol.gif) Seriously, Good Luck kyuks. With your experience, residency will be a breeze. By the way, PGH peds can be overrated at times...