By Dr. Daisy Joy A. Espejo-Torina
(Last of two parts)
Apparently this was common practice. Recently, I received a premature baby, barely a kilo, only 27 weeks in his mother’s womb. While humanity would have dictated a doctor to let the baby inside the ER and keep him warm notwithstanding the unavailability of an incubator, I don’t know how a doctor could turn the baby away, not just once but six times without even checking if the baby is still ok. By the time I received the baby, he was so cold the thermometer couldn’t register a temperature. Several times, I received a patient with dengue, transferring from one hospital to another, being turned away each time, the patient not being an “emergency case”. When I saw them? Dengue shock.
While in the past we referred patients to social service to gauge their incapacity to pay, now all need to go through the social service to gauge their capacity to pay, and those classified as charity patients are at risk of being turned away if there are no vacant beds in the ER or wards. The classification system is not even fool-proof: a pay patient wanting to avail of cheap rates could easily fool the social worker (A patient adorned with jewelry and arriving in a Toyota Fortuner classified as indigent? Are you kidding?!) while middle class patients wanting to be admitted as private patients have difficulty getting passed off as such. The fees are exorbitant and, the way I see it, disproportionate to the quality of care (The doctors are no doubt competent but the waiting time for lab results is terrible, not to mention the discomfort of sitting in a hot, bug-infested lobby.). It’s not uncommon that parents would plead with me to reduce the fee a little but unfortunately I don’t have a say on that matter. There are times the social worker (perhaps confused about her job description) would even tell the parents to “ask the doctor” when they knock on her door to ask for a “discount”, which is really disturbing because it makes the doctor come off as insensitive and greedy.
The problem is I can’t be heartless. If a mother comes to me crying in the wee hours of the morning because her child has fever and wants her child admitted for observation, that to me is reason enough for admission. I understand that a mother would not rush her child to the hospital needlessly. If a mother is anxious over her child then almost always she has a reason to be, and that should not be taken lightly. That’s why a few days ago it offended me that a grandmother would comment that if I had a child of my own I would understand them. Her grand daughter had a urinary tract infection and she was vomiting, but I couldn’t admit her. The 10-bed capacity ER already had over 30 patients. I then realized I was becoming someone I don’t want to be. I don’t want to be that someone who turns away patients, who sets a limit to a patient’s access to health care. I don’t want to be a part of this system.
We do have many government hospitals. We do have many competent doctors. But the health needs of the marginalized underclass remain neglected. Perhaps I am ignorant about funds and logistics. Perhaps believing that universal health care for the Filipino people is possible and achievable through hard work, dedication and political will makes me naïve. But I do hope, and I’m still hoping.#