Saturday, October 8, 2011

"Doc, ello pOh! I hv stmch ache..."


I still get text consults every now and then. Something like this:
"Masakit ang tiyan ko. Ano kaya ito?

Whoah. Of course, any doctor could think of countless medical possibilities there are in a simple stomach ache. 

My husband already knows my facial expression when I get these sorts. I reply to most, something like a medical history -  by installment. You could imagine the exchange, not to mention the tangential answers to utterly simple questions like "since when did it start?" (noon  pa..), "where exactly?" (basta masakit lahat), "how would you describe the pain?" (basta masakit lahat). 

The last one was not a typo error. And many times, they end up.. er, demanding for a pill. 

I used to be easy on text consults, especially when I was a doctor to the barrio. I had no choice but to trust everything that my midwife on the next island relays. Many times it works, of course she has training too and many times the information is adequate. Sometimes it doesn't work, and I will have to ask that the patient be brought to me or somewhere else.

Phone consults, or SMS consults in particular,  leaves a doctor to certain risks in making the correct diagnosis. For example, even the best doctor won't commit to an appendicitis during its earliest stages. Or what seems to be a simple rash can actually turn out to be something else. That's why, in medical school, we were taught to correlate the medical history AND the physical examination. Ok, oftentimes, a good medical history is actually enough to arrive at a good decision. But many times, a  physical examination is necessary. Taking a step further, some situations even necessitate diagnostics like blood tests, x-rays, CT scan,  MRI, etc.

Next time you text your doctor friend, be patient (as he or she is with you). Next time you text your doctor, be patient too. The number of questions asked does not correlate with the quality of doctor that he/she is. The fact that he/she takes pains to ask instead of giving you an instant text prescription, for me, actually means that the doctor cares enough.  All the questions are "pertinent", as doctors love to say. Doctors are trained to sift through all the information and streamline questions towards the goal of arriving at a good clinical decision. My non-medical husband is getting good at this too, because some text-in referrals land on his phone! Haha :)!

Oh, and doctors have personal lives to live too. That is why they have clinic hours :) So again, please be considerate if they don't reply at an instant. What many patients consider as emergency, does not really count as one in medical terms. Blunt. Don't get me wrong, I understand! Before I became a mother, I thought some were overacting over their children's sneezing bouts. Now, it almost counts as an emergency to me. And this is why I have renewed respect for pediatricians. 

The story is different if it IS an emergency, and your doctor's phone says "cannot be reached" . And that is  why we have emergency rooms. 

As for me, I still happily and patiently answer to text consults. That is, after the installment medical history. After all, I am a doctor and not your manghuhula. :)

Tuesday, October 4, 2011

Tips for Renewing your PRC ID

After 2 weeks, I got my renewed PRC card delivered straight into my front door :) It only took me less than an hour to complete the application process.

3 Basic Requirements:

  1. Duly accomplished form. You can also get this at the INFORMATION area.
  2. Two ID pictures (passort size, close up, colored, plain white background, with name tag) 
  3. Photocopy of recent PRC ID

(source PRC website)

What the PRC website will not tell you:

Bring all the requirements so you could breeze through the whole thing. Photocopying services in the PRC compound are long and winding, remember? And the webcam photobooth kiosks for the instant ID pictures are not really worth your P 80. Also, not a good idea if you want an impressive shot, doctora.

PRC Fees.
P 450   Renewal Fee 
P 450   Additional fee if you want Express service*, but this is optional. 

* ID usually takes 2 weeks to be released but if you pay, it only takes 4 hours.         Makes me wonder, if they can do it fast, why do we need to wait or pay more? I hope they can improve on this soon :) Anyay, if you need this service, just tell the guy at the information when you get your form.     

Other expenses.
P 80    Photo ID at the webcam kiosk. Very good business. Very bad quality.
P 80    Door to door ID delivery. Check the DHL booth. I just did out of curiosity.             
            
After you are done with the application, you will be given a claim stub which you or your authorized representative should present upon claim. If like me, you just want to wait for your ID in the comforts of your home or clinic, head towards the DHL Express booth.  (I almost paid for the Express service, good thing I asked why they were there. ) You will have to fill up some forms and leave your claim stub with them. No more authorization needed.  

There. Hope this helps! :) Happy birthday to you, whoever you are in need of this!

Monday, October 3, 2011

Terminal Leave for DOH DTTBs

Ok, this entry is for Doctor to the Barrios who are ending their contract with the DOH. I know. My entries are diverse. I don't have time to manage more than one blog, so please bear with me :)

I am trying to recall the process I had. If there are any revisions, please feel free to feedback for the benefit of others. Here are the requirements:

1. Application of Leave form (the usual one)
     -- you can get this from the Central office

2. Clearance from DOH

  •  Municipal Clearance - best to do this before leaving the area, unless you have plans of coming back or you can ask your staff to do this for you  :)
  •  CHD Clearance - in MiMaRoPa, Mam Baj helps us with this. Kudos!
  •  Central DOH clearance -- bloodier than hacking wounds..

3. DTR for October

  • Kindly check if this is required for everyone. I was on maternity leave already during that time but they still asked me for this. 


Short and sweet list di ba? :)

The real task is the Central DOH Clearance. Twelve signatories, excluding you. Guys, I suggest that you get someone to process this for you as a group. (Hire someone if you have to!!!! It's not worth your precious time to wait for a signatory on travel, especially if you are staying in a 5 star hotel in Manila or would have to rebook a flight!)



TIPS: 

1. Do not agree to be disallowed on the basis of "unliquidated vouchers" that you already liquidated. All received documents can be traced through the HHRDB receiving desk. They have a computer database, and they have a log book for reference. I was told that DTTBs in the past had this similar problem. 

2. Always always keep a duplicate of documents, have a receiving copy. Get the name of the person who received especially if that person zigzagged his initials . And I mean just that. 

3. Some mean people would go as far as asking "Sinong may sabi?". It would probably good to have a notepad to write down important commitments verbatim. Or a tape recorder. Haha.

4. Try to be nice to everyone. There are commendable people particularly : Mam Yolly, Mam Dina and Mariel (from Personnel), Sir Daniel, the best (Accounting), Sir Andy (Budget), Ms Rosanna (Legal).

5. Handy numbers: 
       Personnel 7812722
       Budget  7116091
       Accounting  7116110 

When I filed my clearance, I left it with the HHRDB because someone told me they would process it for me. After a month, I found that my document didn't move. Apparently, they changed policy and did not want to process clearances anymore. My husband and sister continued to do it for me. It took more than 2 weeks for mine to be completed despite their frantic efforts because of the following:

1) An important signatory died and it took some time for a department to decide for a replacement signatory

2) Some signatories were on travel

3) My DEPLOYMENT vouchers, sent twice by me, were lost.  I didn't want to pay for funds that I justly used and carefully accounted for so I went through great lengths to trace my "lost" files.  I succeeded - they were complete, neatly filed, unprocessed after over a year - and never got an apology from whoever was (ir)responsible.

4) Of course, there was the hazard pay overcompensation issue that we all need to contend with.

Finally, I was cleared. I only had to  wait for 2-3 months for my terminal pay.  After 3 months, to my horror, my documents  didn't even move because of one lacking document - my October DTR. Worse, I was not even notified. (What's new). I had to wait another round only to find out that my benefits would not even cover my hazard pay disallowances. In fact, I still owe the government.

After having done my clearance, my husband thinks that for such a basic and repetitive procedure, it shouldn't be as difficult for us. In some private settings, instead of having each employee go through each department one by one, they do it on a per batch basis with a circular coming from the HR. Each department would be given a deadline to revert back to HR for any accountability. If the department doesn't take action, by default, the employees will be considered free from accountability. Takot lang nila ano? However, if the employee has an accountability, then he/she would be notified and has to take responsibility.


After what I have been through, talking with the HHRDB doesn't really top my list. I would rather write to inform you, so that you could take action. Please do feedback for your benefit, and for the benefit of the younger batches. 

Lastly, it is no excuse that the office lack manpower. Didn't we all experience this problem back in our areas? Still we did our best to serve, not withholding anything that was within our power to give. I sincerely hope that your process would be easier :)  After all, you guys deserve better treatment after serving the underserved.