07 Jul2013

Kiss My Ass!!!

by Marketman

I hope there is more than one competent urologist in Manila, because I just “wrote off” my doctor at Makati Medical Center yesterday morning… If there is one thing that will curdle my blood, it is unprofessional behavior by supposed professionals. And yes, I consider excessive and unexcused lateness (or a no-show) to be HIGHLY UNPROFESSIONAL. I know, I know, Filipinos supposedly have a Latin (or is it a Malayan?) propensity for being tardy, but I would argue vehemently that it isn’t genetic, rather something learned, tolerated and eventually, habitual.

More than two weeks ago I made an appointment to see my urologist on Saturday, July 6 at 10am. My grandfather had prostate cancer, my father died of it and numerous uncles, cousins and a sibling have had prostate cancer as well. Suffice it to say it’s in the genes, and I have a very high probability of getting it… Dad had his first prostate exam in his late 60’s and that was far too late… I distinctly remember that day. We had lunch and he proudly announced he was going for his first “digital exam” and he was quite impressed with technology those days. Hours later he showed up at our home, stuck his middle finger out and pointed it at Mrs. MM and indignantly declared “DID YOU KNOW THIS IS CALLED A DIGIT?!?” Whoa, did he have a rude afternoon surprise or what? :) On my 40th birthday, I vowed to get regular medical check-ups to avoid the worst surprises. I found myself a reputable doctor, did the required exams every few years, and in-between got blood tests for PSA readings. So far, so good…

Saturday morning I headed to the hospital at 9am, to bring the Teen to a different medical appointment. My Chief of Stuff headed over to the urologist to tell them I was in the hospital and he signed me up at 9:45am, already number “6” on the list of folks told to show up at 10am (what is the use of an APPOINTMENT time if a dozen people are told to show up at the exact same time?). At 9:50am, I showed up at the urologist’s office and was told to wait outside. The doctor hadn’t arrived yet. Several other patients were waiting, including one elderly man who arrived in a wheelchair, and he sat beside me. 10:15 comes along and not a single patient has been summoned. 10:30 and we are all still waiting. Apparently the doctor isn’t there yet. 10:45 am and still no advice. Now there are 8-10 people who have travelled to the hospital from near and far, who have waited patiently for 60-80minutes long and there is still no doctor in sight. At this point, there is already an estimated 700 or so minutes in wasted patient time, the equivalent of 1.5 man days of work! If the average patient valued THEIR time at say just PHP500 per hour, that would already be PHP6,000 in wasted time. Double that cost and we are up to PHP12,000 in lost value, lost time, and mounting irritation. Some folks, perhaps like the doctor, might value their time at say PHP8,000 an hour (if they charge PHP800 per person and see a 10 folks per hour) and if that were true, then we are talking PHP80,000+ in wasted time value…

At roughly 10:49, the doctor’s secretary emerges from her office to announce that the doctor would be late (DUH?!), and that he wasn’t expecting to get in before 11:30am, and that was not certain either. Would the 10 patients be willing to wait that long? F#@!&%$ ABSURD. For a 10 am appointment, she was now asking all of us if we would wait until AT LEAST 11:30, and since I was number 6 on the list, I would most likely be seen at say 12:15 or later, assuming he arrived. I told her this was TOTALLY UNPROFESSIONAL and asked her WHY he was late, and she answered “kasi traffic eh, he’s still in Greenhills…” to which I BLEW A GASKET. I would understand if he was held up in an operating room, or if he stopped to save a car accident victim, or if a previous patient tried to blow up his car with a stick of dynamite … but to be told that he was simply “stuck in traffic” at 10:50am many kilometers from the hospital when he should have been at his desk at 9:45am is really begging for a rant. The elderly gentleman beside me, heaved a heavy sigh of frustration. He said he waited THREE HOURS the day before and the doctor NEVER EVEN SHOWED UP. He had waited 1.5 hours today and he left, limping, with the aid of a cane, clearly disgusted. Note that 10 patients, some of whom were from the North where the doctor was driving in from, all managed to get to the hospital before 10am, while he was 1.5+ hours late. Of course, the doctor was leaving on a foreign trip the next day, so if you didn’t suffer the wait today, they couldn’t reschedule a missed appointment for a couple more weeks… And there was no guarantee he would show up then, either!!!

I told the secretary that I wouldn’t wait, and I would also never come back and would find another doctor instead. I asked her to write on his paper that I had indeed arrived before the appointed time, and that they waited nearly one hour before advising patients he would be yet another 45 minutes late or more, and I asked that she write the reason for the delay and sign it with her name. Of course she plain outright LIED. She refused to write that she informed us of the delay at 10:50 or so, and instead of writing “traffic” as she had said in front of several patients, wrote “because of an unfortunate event.” Not only was the doctor acting in a totally unprofessional manner, what should have been the hapless secretary in the middle, decided instead to add fuel to the fire. Stupid, stupid, stupid.

The doctor, was, in my opinion, simply unprofessional. Ideally, he should have exerted every effort to get to his office on time. He had paying and some SICK patients waiting for him. If he couldn’t arrive close to the appointed time, say within 15 minutes or so, he could have EASILY called his secretary ahead so she could then advise patients by text or phone that the doctor would be late and they could try and use the time a bit more productively. The doctor was simply arrogant if he thought that wasting a good 1.5-2.5 hours of 8-10 patients time was acceptable behavior, almost regardless of WHATEVER he was doing during that time. A professional, thoughtful, well-mannered person would only HAVE TO CALL to let folks waiting know what was going on. Expecting them to wait for him for several hours is poor form, period. Like I said earlier, an unforseen medical emergency might be an acceptable excuse, but not informing his office while 10 clients sat waiting, is simply inexcusable, in my opinion.

I personally consider chronic lateness (particularly in a professional setting such as a doctor’s office) to be the ultimate sign of arrogance and self-centeredness. It is disrespectful, displays a complete lack of manners and wastes an incredible amount of time/effort. Yes, it is a pet peeve. Professionals should show up on time, particularly when you have made appointments weeks in advance and customers are paying for the service. I try never to return to a professional who doesn’t have the basic ability to show up for an appointment on time. In this case, the doctor in question lost several clients that day, and probably permanently. Did he care? Probably not. Another sign he was lacking in the professionalism department… Neither he nor his secretary bothered to call the patients who left in disgust to try and re-schedule their appointments, or simply to apologize for the hours they were forced to wait for the doctor to arrive. I will NEVER go back to this particular doctor and I will tell everyone I know to avoid him like the plague. If more people stuck their middle fingers at twerps like this, the less of them we would have to tolerate in future. Hospital administrators should police their own ranks and get rid of bad apples that spoil the rest of the bunch. As much as possible, I am taking my business to another hospital from now on. Isn’t it amazing that in thousands of flights I have taken in my lifetime, not once has a delay been blamed on a pilot not showing up on time. Nor have I been to a major sporting event like a boxing match, tennis final, NBA game, NFL match that started more than a few minutes late because the pros were stuck in traffic. And yet I have run into several doctors who thought they were so important and valuable that they regularly forced patients to wait excessive amounts of time just to pay for their consultations with the doctor…

On a brighter note, I have noticed that this kind of arrogant doctor behavior is not necessarily the norm at Makati Medical Center… in recent months, appointments our family members have had at OB doctors, dermatologists, cardiologists and pulmonary specialists have all been done on an appointment basis, with minimal waiting time, and the doctors have all shown up. They are far more patient-centric and I hope these types of doctors flourish in future. I fully understand that patients can also be no-shows, and just as I would be livid if a doctor didn’t bother to show up, so should patients be charged if they made an appointment and didn’t cancel out beforehand.

If you didn’t read one of my more amusing rants on MMC doctor appointment experiences from six years back, you may wish to read this amusing post.

 

COMMENTS:

  1. Khew says:

    It’s called a feudal attitude. Such people are habitually and chronically late because they abhor moving to someone else’s drumbeat, which in this case is the appointment time. They feel they have “lost something” or lost their standing if they catered precisely to the demands of the ‘unwashed’. They don’t see their work as a business but deem it a favour performed to the undeserving. The fact that much of their livelihood depended on their patients doesn’t elicit gratitude but becomes instead a festering sore in their psyche. They have psychological issues and unfortunately their patients and dependents pay the price.

    Jul 7, 2013 | 8:23 pm

     
  2. Footloose says:

    @Kiss my ass!!! Would this not fall squarely under the purview of a proctologist?

    Jul 7, 2013 | 9:02 pm

     
  3. Dreaming says:

    I Canada they charge the patient for a NO SHOW CAD 50.00 to 75.00. Perhaps, they need to charge the doctors here.

    Jul 7, 2013 | 9:12 pm

     
  4. Hiddendragon says:

    Sadly, fairly common.

    In these parts where I live, there’s a doctor at St. Pauls who refuses to step into her office until the waiting room is full or at least has ten patients. All the while, she waits in the coffee shop right in the same building.

    Jul 7, 2013 | 9:37 pm

     
  5. Hiddendragon says:

    Jul 7, 2013 | 9:39 pm

     
  6. Hiddendragon says:

    As I was posting the above, I noticed a single letter spelling error, clicked Edit, corrected the error and clicked Submit within half a minute. Marketman’s blog then sends me a message.

    “You are posting comments too quickly. Slow down.”

    Got the screenshot for that. Quite appropriate for a post about too slow doctors.

    Jul 7, 2013 | 9:43 pm

     
  7. edel says:

    i feel bad especially for the elderly gentleman … he shouldn’t be made to wait

    Jul 7, 2013 | 10:48 pm

     
  8. Cora says:

    One experience that served me well was telling the receptionist after waiting for half an hour that I have to leave if not seen by the doctor in an hour. I left, went home, and made an appointment again. The longest I’ve waited since then was fifteen minutes. With new doctor’s appointment, I tell the receptionist that I can only wait for half an hour. It feels good to build a reputation that I will not tolerate their abusive behavior.

    Jul 7, 2013 | 11:39 pm

     
  9. Monique says:

    Aaaaargh! What a waste of your time! There was one time where I had to wait for an OB gynecologist who was busy on his Facebook account…. instead of attending to his patients.

    Jul 8, 2013 | 12:33 am

     
  10. Eina says:

    Your dad’s reaction to the digital exam reminds me of a cartoon strip which showed how we have all sorts of advanced diagnostic equipment while the rectal exam relies on “the educated finger”.

    I remember that when I was a kid, one of the first questions my guardians would ask the secretary upon entering the doctor’s or dentist’s office, whether coming for an appointment or as a drop-in patient, was “Dadating ba si dok/doktora?” I had two dermatologists and an orthodontist who were pretty much always late (if they showed up at all) because they worked in the North in the AM and in the South in the PM and clearly had not allotted enough time for travel (+traffic) in their schedules.

    I currently live in a country where healthcare is free save for a small co-pay. The co-pay is refunded if you have to wait more than 30 minutes after your scheduled appointment and you’ll be billed for the co-pay if you don’t show up unless you cancelled at least 4 hours in advance.

    Jul 8, 2013 | 12:53 am

     
  11. Monty says:

    At least your doctor was just late. My mom went to a celebrated cancer surgeon there in Makati Med. She felt a lump in her breast, which a mammogram from St. Lukes indicated a high likelihood of cancer. The doctor disregarded the mammogram after doing an ultrasound, saying it was probably nothing and to return after 6 months.

    Feeling uneasy about the diagnosis, she had another mammogram which confirmed the results of the first. The doctor then reluctantly did a lumpectomy, and aggressive form of cancer was found. A second operation was then done to check if the cancer had spread to the lymph nodes, which luckily it hadn’t. We were told by other doctors that the first operation should have included a removal of some lymph nodes as a precaution, thereby eliminating the need for the second procedure. A half-hearted apology was made for the initial diagnosis, as the surgeon said that she was not god and was prone to mistakes. My point was a mammogram was presented, yet she chose to disregard it. She may have studied in an Ivy League school, but her arrogance just made her look stupid. My mom survived the cancer, but had she followed the initial advice, I doubt if she would still be here.

    Jul 8, 2013 | 12:57 am

     
  12. Pink Carnations says:

    What could be the consequence if the supposedly professional’s name be printed so we can all avoid this unprofessional like the plague. I wonder if it’s the same rude urologist i consulted in MMC only a few years back.

    Jul 8, 2013 | 1:20 am

     
  13. marilen says:

    Why, oh, why, does this sound so familiar – because I had the same unhappy experience at Asian Hospital in Alabang (ear nose throat specialist in my case)- the lies, the excuses resorted to by the receptionist after a few hours wait and the minuscule waiting room packed with waiting patients who all had the same 10 am appointment – why the doctor is late, blah, blah – and to top it all, after several attempts to see this doctor, got charged with obviously very expensive bill (porque balikbayan ka, mam, says the receptionist)!!!

    Jul 8, 2013 | 2:28 am

     
  14. crabbychef says:

    MM, I felt your stress and rage just reading your post. I can only imagine what it was like waiting for the doctor. Thing is, I think that waiting for doctors actually causes us to get sick of something. Know what I mean? :(

    Jul 8, 2013 | 6:42 am

     
  15. Ellen says:

    Very common occurrence even in the premier hospitals. Parang palaging utang na loob ang pagpapatingin mo sa kanila.

    Jul 8, 2013 | 7:23 am

     
  16. Marketman says:

    Footloose, yes, proctologist as well. Except that for a prostate exam, urologists stick it up the back end… :) Pink Carnations, I have left his name out so my lawyers don’t send me texts about potential libel cases, but honestly, I wish there was a site on the web that you could rate various local doctors on measures such as appointments, tardiness, professionalism, competence, prices, etc… a kind of “doctoradvisor” where patients could weigh in. That would do wonders for getting rid of doctors like the one I describe above. Monty, that’s horrible. I personally wouldn’t have had the operation with that doctor based on her initial comments… would have found someone else! Khew, you nailed it on the head, feudal indeed.

    Jul 8, 2013 | 7:24 am

     
  17. Rita says:

    WOW. just simply wow. Really. I’m so sorry you had to go through this dilemma.

    Yes, I completely agree that he is arrogant, pompous, rude and extremely unprofessional. Back in the States, and here in Germany, this kind of behavior is highly unacceptable. In fact, the Board of Medicine could pull his license in a heartbeat for doing such. Also, here in Germany, if a patient missed his/her appointment, that patient will have to pay a fee. Maybe, they should implement that in the Philippines. As for the Secretary… tsk, tsk, tsk. What a shame.

    I really hope that you find a very professional Medical office, staffed with doctors and assistants, who have excellent work ethics. Good luck! And kudos to you, for being pro-active about your health and future. By the way, why don’t you try complaining to the Board of Medicine about this doctor’s behavior?

    Jul 8, 2013 | 7:38 am

     
  18. renee says:

    MM, there are a couple of websites that I use to find out the schedule and contact details of doctors. I never signed up to be a member, so I’m not sure if they allow/show doctor feedback when you do. If you want to check it out, it is: thefilipinodoctor.com and rxpinoy.com.

    Jul 8, 2013 | 8:13 am

     
  19. khrishyne says:

    sadly. a lot of doctors do this. :(

    Jul 8, 2013 | 8:55 am

     
  20. Gli says:

    they are all the same. sorry for the generalization but i have no experience with an on-time doctor. i pity my parents who frequent st luke’s and wait a couple of hours for every appointment.

    Jul 8, 2013 | 10:00 am

     
  21. Andrea says:

    PRC should do something about this very unprofessional attitude of some doctors. They can have their licensed cancelled/suspended! Another case, a dentist or rather, an orthodontist refused to do a simple dental jacket to a patient, because, according to her, as an ortho, she only handles more complicated cases, and just refers simple cases (extraction, prophylaxis, etc) to her dentist mother.

    Jul 8, 2013 | 10:37 am

     
  22. Joe-ker says:

    MM, can you email me the name of the doctor? So I could avoid such an unprofessional SOB.

    Jul 8, 2013 | 10:40 am

     
  23. madel says:

    It seems to be a common thing. My mom and brother’s pulmonologist never arrive on time. Instead of saying clinic hours are 9am-12nn, but arriving at 10:30am, they should adjust their clinic hours to have a more realistic allowance for travel time and other hospital duties. Isn’t it frustrating to be sick, taking a day off from work, only to have your time wasted by the doctor?

    Jul 8, 2013 | 10:49 am

     
  24. SpaceDog says:

    Gah, the habitual lateness annoys me, but it’s more annoying that it’s just so ‘accepted’. Timing is flexible and there’s no fall out when things start to slip … I’ve no idea what you can do to change it short of making it clear that these things aren’t acceptable to you. Generally I’ve learned to live with it, although I occasionally still flip out when required.

    Anyway, have you tried HealthWay? I’ve used the Ortigas clinic and really liked it, although I’ve only been a few times and things didn’t happen bang on time but they seemed fairly good about everything.

    Jul 8, 2013 | 11:10 am

     
  25. cecile says:

    Good morning MM! Para kong binabasa ang isang pangyayari na ikinainit ng ulo ko last June! Nagpa-sched po ako sa isang dentist sa Blue Molar Clinic sa isang mall sa Dasmariñas, Cavite. Around the third week of May po ng magpa-sched ako, para sa 2 kids ko. And then sinabi ng nurse na full na ang sched ng dentist unti next week so kako sige sa Saturday after next week na lang.
    Then on the day itself, while we were preparing to go, the nurse sent a msg saying na kung pwede pa-postpone daw sa thursday next week! I msgd her back na we can’t çoz we have work na that day. Then she replied wala raw available na dentist sa appointed date namin and on saturday of next week!
    Kako, bakit ganun? ang tagal na naming nagpa-appointment tapos sasabihin na walang dentist, bakit pa kami ini-schedule? And she again replied, kaya nga po kayo sinabihan ng maaga! WHATEVER! Maaga pa raw yong magtetext sya hours before the said appointment at sinabi nya na “sinabihan nya ako ng maaga!” when she herself gave us the scheduled appointment 2 weeks before the said date! Napaka-unprofessional ng clinic, dentists, and staff!

    Jul 8, 2013 | 11:44 am

     
  26. kikas_head says:

    I always call before to find out when the doctor will actually be there (some come in after rounds so are always late). It would be slightly more bearable for me if there was a comfortable place to sit. I usually go to Cardinal Santos (despite St Luke’s being closer) and all the clinics are tiny meaning you are left sitting on a bench in a hallway that is barely big enough for wheelchairs to pass once all the seats are filled. On the plus side, all the waiting for doctors has made my Sudoku game awesome. I have mad Sudoku skills now.

    Jul 8, 2013 | 11:54 am

     
  27. Ge says:

    Sadly, most of the doctors here in the Philippines arrive late in their clinics, late meaning beyond their clinic hours. The patients are left waiting along the corridors where they are exposed to illnesses of other patients.

    Jul 8, 2013 | 12:30 pm

     
  28. friedneurons says:

    A punctual doctor is as rare as a flawless canary yellow diamond.

    Jul 8, 2013 | 12:42 pm

     
  29. Odit says:

    It seems to be a practice with many doctors in the Philippines to be late for their patients. They seem to have no qualms with having their patients wait for many hours. Many of them rush from one clinic to another to see their patients. I had a doctor who has a clinic at the Mall of Asia and he would rush to St. Lukes in QC. I don’t think it’s an excuse to be delayed because of an operation, making rounds, or whatever.

    Jul 8, 2013 | 12:56 pm

     
  30. Dan says:

    I had my share of misfortune with the doctors. I met many arrogant doctors. I’m very leery of the doctors

    My sister was born in the 60’s. The hospital put her inside an incubator without covering her eyes. She is still alive but blind and not enjoying the life of a normal person. She is using a cane to feel her surrounding and to avoid bumps and physical injuries while walking around the house. I found out from medical studies that during the 60’s the incubators are still in its infancy and not regulated hence the pure oxygen made my sister blind.

    I used to think of my elementary and high friend as one of my best friends but when he became a doctor, he thinks HE IS GOD and must be obeyed. When I asked him for a recommendation when I had a liposuction way back in 2002, he bragged that the doctor that will operate on me is the best surgeon in the Philippines and I almost died due to paralytic ilius. The doctor was nowhere to be found and we were told he was in Palawan fishing. I told them to send me to the hospital he is working and they told me to go to MC. For few days I was there, they did nothing to cure me but dextrose. The surgeon never showed up.

    My Mom had a stroke in 2006. A friend of mine who works for our municipal hospital recommended a certain cardiologist whom he said is one of the best in the Philippines. He is one of the most arrogant doctors I met same with his secretary.

    I do take care of my dermatologist and and one internal medicine lady doctor. Both fo them treated my family with care and compassion.

    Jul 8, 2013 | 1:16 pm

     
  31. leigh says:

    I’ve had my fair share of this kind of thing – the most recent experience was with an allergologist in Makati Med (and I believe he’s the chief). A good friend who’s a doctor advised me to wait because he’s supposedly really good and it’s just the way his clinic works all the time. I couldn’t stand this attitude though. Why is his time more valuable than mine or his other patients?

    Jul 8, 2013 | 1:52 pm

     
  32. t says:

    Unfortunately, it seems like majority, if not all, of the doctors and dentists here in the Philippines are like that, my parents included. You’d have to take a day off from work just to visit the doctor or dentist. I think most of the doctors have clinics in different hospitals, and their schedules would be something like, let’s say, 10am-12nn at a certain hospital, then 12nn-2pm or, 1pm-3pm at another. My problem with that is these doctors don’t account for the travel time or even lunch. Why would you schedule your clinic hours like that when you know that most likely, you will not make it on time for your next clinic schedule at the 2nd hospital? They’re probably thinking it’s better for the patients to wait for them than the other way around. Unfortunately, most of us don’t have a choice but to wait. I’ve never experienced that in other countries. This is one of the things I hate in the Philippines, professionals not being so professional when it comes to time.

    Jul 8, 2013 | 3:43 pm

     
  33. lurker_no_more says:

    This is the same reason why my blood pressure shoots up whenever I see my cardiologist.

    Jul 8, 2013 | 3:53 pm

     
  34. MiMac says:

    Same thing here, MM! Just 2 weeks ago, had to wait for our doctor for 3 hours at a hospital in Taguig. Our appointment was at 11 am and when we got there at 10:40, 4 other patients were aleady waiting.

    The secretary announced at 12:00 noon that the doctor will be late. Duh. Reason: ‘nag-ra-rounds pa.” Imagine, my turn came at 2:30 pm! No decent lunch as I had to buy something that’s easy to eat along the corridor. During the wait, I managed to have my eyes checked by an ophtalmologist a few doors down. When I told the eye doctor if I can have my eyes checked first since Dra. **** was late, it was amusing to hear the eye doctor reply, “palagi naman, di ba?” Touche!

    I wish there really is a system here in the Philippines were doctors are fined for tardiness (or we pay them less for every minute of delay) without valid reason. Doing the rounds is NOT a valid excuse.

    Jul 8, 2013 | 4:28 pm

     
  35. Corinne says:

    Nakaka Highblood nga naman talaga yang mga ganyang tao,tsk! Pero sobrang tawa ko sa previous post mo. I lap out lawd! hahahaha! nakakalito naman talaga c manang secretary…hahaha you are frevious fatient naman fala!

    Jul 8, 2013 | 4:43 pm

     
  36. Rie says:

    That’s the sad common practice here, I agree with Leigh above. anyway I read the other post & had a laugh thanks MM.

    Jul 8, 2013 | 5:42 pm

     
  37. Enrico Paolo Banzuela says:

    hi marketman. I’m a doctor too, so let me give a different perspective when it comes to these things:

    Why are doctors always late? Several reasons:

    1. Most doctors work multiple clinics and multiple hospitals. They have to do this because, in their opinion, they don’t really earn enough (at least, enough to enrol your kids in an exclusive school, buy a decent car, and a decent house – that’s how most doctors define “enough”) from working in just one hospital. Iba yung economics (for the doctor) of staying from 8am-5pm in one hospital vs, say, 8am-12am at one hospital and 1pm-5pm at another hospital. Mas ok yung pangalawa for most doctors. Doctors of course, would prefer to practice at just one hospital for convenience, but economics dictate otherwise. And most established doctors do NOT used the LRT/MRT, they either drive their own cars or have drivers. Kaya prone sila malate because of the traffic, emergencies, etc. If they are working in just one hospital, it would be much, much easier for them to come on time dahil taas-baba na lang sila ng ospital.

    2. Medical rounds means you visit each admitted patient, diagnose their current medical problems, treat them as necessary, and write progress notes on the chart. The time allotted for making your medical rounds IS NOT fixed, since it would depend on the status of each patient. This can definitely contribute to TARDINESS of the doctor concerned, especially if he has clinic appointments at another hospital. Personally, this is a VALID excuse for me since ADMITTED patients usually require greater medical attention from his doctor because of his condition (kaya nga naospital eh) compared to patients consulting at the clinic. Out-patient department (OPD) patients usually do NOT present with medical emergencies or even medical urgencies; if they do, and the doctor is not present, the patient will be rushed to the ER of the same hospital immediately.

    3. Emergency surgeries/consults before these medical rounds which can last for hours, will have a “carambola” effect on the schedule of these doctors. e.g. if you have an emergency surgery from 1am-6am, and you have to do your medical rounds from 7am-9am in another hospital and attend to your clinic in another hospital from 10am-12pm… well, malelate talaga lahat yan.

    Marketman, please remember that very few doctors actually like being late for their appointments sa clinic for several reasons:

    1. Patients get pissed off, and may seek consult with their competition
    2. Most of the time, they still have to see these patients no matter what, and if they come late, they would have to leave the clinic at a late hour too – which would mean less time for rest.
    3. Doctors in the Philippines earn by seeing as many patients in a day as they can – being late for your clinic means loss of income for most

    Shouldn’t an appointment system solve all of these?

    Unfortunately, no.

    If you’re going to look at how much a single medical consult costs in the US and compare it here in the Philippines, and the prevalence of medical insurance there vs our country, and how the proliferation of HMOs decreased doctors income far the past 2 decades, you will realize why most doctors do NOT limit the number of patients that they can see in the clinic per day.

    What we have is a pseudo-appointment system. Actually, first-come, first-served basis ang system being practiced by doctors. Most doctors go for volume. Again, a reason why it’s not in the best interest of these doctors to be late.

    But they are late. And it’s almost cultural sa medical profession. And I believe it has more to do with the system in place rather than egoistic behavior of the doctor. No doctor likes to be late – it’s part of our training. If you’re late for your surgery, your patient can die. If you’re late in giving your meds to your patient, your patient can get worse. If you’re an OB and you’re late for your patient, baka nakadeliver na ng baby yan. That’s why most med schools and hospitals give sanctions for doctors who are late in their duties, or in their classes. Doctors therefore have this sense of urgency all the time.

    Most doctors carry that sense of urgency when it comes to their clinics once they become consultants and are practicing privately. Kaso lang, because of the reasons I cited above, late pa rin sila.

    If you go to another urologist, and visit enough times, in one of those visits malelate din yan.

    What can you do? In my opinion, the best thing to do is to talk to your doctor nicely about it. Ask why he was really late and remind him to advise his secretary early kapag malelate sya. Most doctors mapapahiya na pag naremind sila nicely, (hindi mo kailangan pagalitan) and will exert greater effort
    to be there on-time next time, around. (which by the way can sometimes be dangerous since they might rush their surgeries or medical rounds)

    Of course, if tardiness is at totally unacceptable behavior for you, you can always find another doctor who’ll be always be there on time. Unti-unti na rin silang dumadami. Most of these doctors are practicing in a single hospital – e.g. Medical City.

    But for me, competence of the doctor is paramount, and I tend to look for the best possible doctor that I can find for myself, and for my relatives. if I have to wait a few more minutes or even a few more hours for him, it’s ok as long as the diagnosis is correct, treatment rational and in accordance with the latest guidelines or kung surgeon, magaling ang kamay. But that’s just me. =)

    Finally, you blew your top because the secretary told you that the doctor was late because he’s stuck in traffic? =)

    Give your doctor the benefit of the doubt. Have you asked him why he was late?

    There’s a possibility that the doctor is stuck in traffic because he had an emergency surgery, or he has just finished his medical round because of an emergency that took up much of his time before that. Or maybe (which happens a lot), nasa ibang ospital pa yung doctor attending to a patient. Medyo kulang lang sa customer relations training yung secretary for giving a poor excuse na stuck in traffic yung doctor to waiting patients without any additional information. And for not making you guys comfortable while you are waiting.

    Of course, there will always be good doctors and bad doctors. So may mga kupal pa rin dyan na deliberately magpapalate because they want the patients to wait. (e.g. para mag mukhang marami silang pasyente, therefore nagmumukha silang magaling)

    However, I believe that most doctors do want the best for their patients, and they prefer being on time rather than being late because they know that it’s in their best interest to do so.

    Give your doctor the benefit of the doubt, talk to him nicely about the incident that happened at the clinic. See what happens.

    Chillax lang Marketman. =) I remain your biggest fan. Thank you so much.

    Jul 8, 2013 | 11:12 pm

     
  38. marbles says:

    Just curious, does his first name start with a J or an S perhaps? hehehe

    The main difference in medical care here and abroad (especially the subsidized ones) is that majority of specialists here are in private practice (mostly paid from out-of-pocket) and are mostly unregulated (if such a thing is applicable) so even if they have specified clinic hours, they can do whatever they want (sad but true); unlike in countries where medical care (and therefore doctors/specialists) is subsidized and the regional/district health board can penalize or impose fines if either doctor or patient has erred (eg. late/no show).

    Afaik, the hospital you mentioned has a policy on their doctors being late for clinics, procedures, OR, etc. so if you could drop them a line or a formal letter to the Patient Relations Office to let them know about your complaints/concerns, maybe they can help. I think every JCI accredited hospital has one (required kasi).

    Complaining about it does nothing to curb that behavior unless you course it through proper channels and authorities. Some patients today give immediate feedback to the services & care they receive while at the hospital through either the patient feedback form or the aforementioned office and are reported every month in every department.

    Hope this helps.

    Happy doc hunting!

    Jul 9, 2013 | 1:44 am

     
  39. Dennis says:

    I hope it’s all “behind” you now MM.

    Jul 9, 2013 | 1:51 am

     
  40. MD says:

    Like Dr. Banzuela’s post from above, I too, am a medical doctor, and would like to weigh my opinion regarding the issue. (BTW, I’m a long time reader, and I post comments too, but I changed my name, since I work at the same hospital that you just ranted about haha)

    Anyway, Dr. Banzuela brought a lot of good points already, and our opinions might overlap, but I will go ahead.

    First of all, I came from a family of doctors. I stated it not to brag, but to let the readers know that from an early age, I had a background on how doctors work. Before I became a doctor, I HATED waiting for an appointment, whether it be for the dentist, hairdressers, or even government offices. I also shared your (and the reader’s) disappointments and frustration when it comes to doctors not being able to show up on time. However, I felt that I needed to comment something, not to make “tanggol” the doctors, but somehow to enlighten your readers, and at least give everyone another perspective when it comes to scenarios similar to yours.

    Sadly, I hate to admit that doctors really are very poor when it comes to coming on time for the clinics. It might sound bad to hear (or read) but doctors work on the triage system, meaning, we look at things and we prioritize those that needed our time the most. And more often than not, those are (in this order) the emergency procedures (surgeries, ER consults), in patients (hospital rounds, basically all the patients confined or admitted in the hospital) AND LASTLY (unfortunately), clinic patients. I said this because some of your readers felt that doing hospital rounds, or having an operations aren’t VALID REASONS to be late for clinic hours, but for me they are, not because the clinic patients aren’t important, but because those needing emergency surgeries and those patients admitted inside the hospital are more important than the ones in the clinic waiting area. (Your readers may hate me for it, but I don’t know if I can phrase it better). Some surgeries, even though scheduled, may take more than the “estimated” time. And like what Dr. Banzuela stated, doing hospital rounds isn’t just going up to the patient’s room and chatting with the patient, after we talk with the patient, we update their charts and medications, complete some paperworks that they need, and some doctors can have around 20 patients distributed in all the hospitals he practices in.

    It would also be hard for doctors to “plan” a definite schedule everyday. Sometimes, they may have 3-5 surgeries/day, some days they don’t have any, sometimes they have 20 admitted patients, sometimes they have 5, sometimes on the way to the clinic, they would have an emergency procedure, and they would have either to cancel the clinic, or be very late. It’s inconvenient for the people in the clinic waiting room, but for the guy in the ER whose life depends on the doctor, it might be a matter of life and death. As dramatic and self serving as it sounds, every day is different for a doctor, we might get called in at 6am today even though we just got home at 3am. And to look at it another way, even though doctors put clinic hours on their clinic (and most of you would argue that doctors never come on time), I think no doctor would say to a room of waiting patients that “oops, it’s 5pm, my clinic is closed, come back tomorrow folks”. Most of the time, a doctor will extend way beyond his clinic hours to finish all the patients waiting, provided that no medical emergencies take place.

    While I agree with most of the readers (and you marketman) that there are doctors who are chronically late, and arrogant, and yes, your urologist probably stepped over the line when he failed to inform the clinic as early as possible that he will be late, I strongly disagree when some of the readers stated that hospital rounds and surgeries aren’t valid reasons to be late for the clinic. That was the only part that I would like to justify, but the other issues (attitude, chronic “unexcused” tardiness, incompetency), I’d just like to say, as with every profession, one person’s qualities doesn’t reflect the whole profession in general.

    I really admire this blog, Marketman, and the readers, and I believe we are a community of educated and understanding people just exchanging our opinions. What I posted is not an argument waiting to be disproved, nor a defense for the doctors in general. I stated my profession to give the readers a different perspective, and to offer my two cents, as a doctor, that people not from the medical profession might have missed. Good night and good day to everyone.

    Jul 9, 2013 | 2:46 am

     
  41. natie says:

    …alas…

    Jul 9, 2013 | 6:12 am

     
  42. Danney says:

    THIS IS ONE OF THE BEST BLOGS YOU EVER HAD. It’s like opening a can of worms and venting all the anger and frustration regarding medical malpractice. Many have suffered and many have died due to doctors’ malpractice, arrogance and “Do I Care?” attitude. Napakarami nating kababayang Filipinos na nagsuffer sa kamay ng mga doctors and all they can do is cry and mourn. At least we are intelligent enough to express our frustration via blog but what about those naghihirap at walang pang ospital o pang doctor? Like those living along the riles, under the bridge, from those rural areas na halos camote na lang araw araw ang kinakain at madalas wala pa nga. Iyong mga kafamilia nilang maysakit ano maghihintay na lang ng kamatayan>

    But how can we correct this?

    I admire those doctors who who responded to this blog and stated the fact behind this doctors’ unprofessional and unethical attitude. Kudos to you. I met a doctor who told me not to visit him in the hospital but in his home clinic sa may San Lorenzo Village near Enchanted Kingdom to save money? Not only did he fixed my nephew’s dislocated wrist but he did not charge us alot.

    Jul 9, 2013 | 10:33 am

     
  43. Marketman says:

    To Doctors Banzuela and MD, I appreciate your taking the time to comment and bring up the viewpoints you have. I agree with some of the points, and recognize that delays are sometimes justified.

    But in this specific instance, I note that I DID ask for the reason for the delay. And the doctor was “in traffic”. Not from another hospital, not from a consultation, not from an operation, not from hospital rounds. As I mention in the post above, I would have readily considered medical concerns to be an acceptable reason for a delay. But any decent doctor could simply take the time (15 seconds or so) to inform his office/secretary so she could act accordingly, and the urologist didn’t bother to do this until 10:49, and then only to say he would be at least another 41 minutes late at best.

    What is missed here is that MANY other doctors at Makati Med seem to be able to handle their appointments rather well, as I also mention in the post above. Many of them do spend time in maternity wards, have emergency operations, have procedures that go longer than expected. And they are sometimes late. But they are better at managing the time, and letting their clients know about it.

    Excusing the urologist’s behavior and making up plausible explanations is fine, but the bottom line is the whole doctor visit/appointments process can and often is FAR MORE efficient in other offices and in other parts of the world. Doctors do not have a God given right to act this way. Dr. Banzuela mentions several times that it is I that should ask the doctor for an explanation. Frankly, I am the paying patient, the one asked to wait, the one inconvenienced. In any such similar situation, it would be the person in the doctor’s shoes that should go out of his way to explain his side. This urologist has all of our telephone numbers and contact information, did he bother to text or call us after this arrival to explain the delay? Why should he be exempt from the normal course of acceptable behavior or basic manners, just because he is a doctor?

    You both also seem to have set aside the tidbit that the same doctor was late three hours the day before and never bothered to show up, according to the wheelchair bound patient beside me who was there for the second day in a row. Even if he was attending to a critical patient, again, informing his office would have taken no more than 15 seconds, so that the 10+ waiting patients wouldn’t have wasted some 40+ total hours sitting and commuting to the hospital for their non-existent consultation. That was 5 man days of work wasted by a doctor who didn’t show up, for whatever reason, good or bad.

    I write about these incidents because I hope readers will stop tolerating the most excessive abuses or examples of this type of doctor behavior. Once sufficient competition in hospitals/healthcare/doctors/etc. sets into the Manila landscape, you will naturally find that the hospitals that are run better and who look out for their patients welfare better (including doctor’s appointments) will hopefully succeed more. And now don’t get me started on doctors who ask patients of obvious means to do more medical tests than they really should. After all, don’t doctors receive a percentage of the revenues generated from various tests in their hospitals? I think that would open up a whole new pandora’s box if someone really did a study to see if certain doctors order tests that aren’t really necessary (that would be unethical, no?)… Two interesting mainstream articles on the overtesting issue, in Forbes, and in Time. And since there isn’t a culture of excessive malpractice litigation in the Philippines, the argument of preventive or defensive test taking doesn’t apply as strongly as it might in the U.S., for example. I know folks who get an annual pap smear, for example, when one of those articles suggests that they are fine if taken only every three years… There are obvious ways to ferret out such doctors, it’s a question of whether administrators or government regulators are prepared to tackle this issue at all…

    Jul 9, 2013 | 10:37 am

     
  44. Danney says:

    As I said earlier still bulag pa rin ang kapatid ko due to medical malpractice but what can I do but shower my sister and my family with love and compassion.

    Jul 9, 2013 | 10:48 am

     
  45. pixienixie says:

    I keep coming back to this particular post not only because of the “can relate” factor but because of all the insights I’ve gained while reading readers’ comments. I usually just go through very long comments but the two doctors’ posts piqued my curiosity. Their take on the matter is both interesting and enlightening. Yun nga lang mukhang hindi nila gaanong na-take note yung details that MM provided. :)

    Jul 9, 2013 | 11:24 am

     
  46. joyyy says:

    Totally unrelated but let me share anyhow…

    I am single. I visited an OB to inquire about contraception and pregnancy. I explained that my boyfriend and I are thinking about having a baby and wed a few months later (to answer our maddening curiosity if we can get pregnant). The first words that came out of the OB’s mouth is:

    “Did you know that sex before marriage is a sin? Pray and ask forgiveness from God.”

    Our minister would have told me that for FREE.

    Jul 9, 2013 | 11:35 am

     
  47. ed says:

    A lot of these doctors are certainly experiencing a God complex that’s for sure. I look at this kind of doctors, and I’ve encountered a lot of them- and most of them are specialists, and all I see are heartless people confident that in their field they are but only a few and they don’t really give a flying f#% about patients… if they do they would at least care enough to make really suffering sick people not wait any longer than they have to.

    Also, funny how some of them even entertain the med reps first before the patients. And we all know why that is so.

    Jul 9, 2013 | 12:09 pm

     
  48. Marketman says:

    joyyy, OMG, that’s OUTRAGEOUS, simply OUTRAGEOUS! I would find another OB…

    Jul 9, 2013 | 12:26 pm

     
  49. Dee says:

    Like my doctor dad always say, there should always always be a doctor in each generation of a family. It is easier if your doctor knows his colleague is your family, you wont be just a random stranger to them.

    I think this is the same urologist my husband went to. Is his office in the circular portion of Makati Med? He also left in frustration one Saturday that this doctor didnt bother to show up! Needless to say, he also changed doctors after that.

    Jul 9, 2013 | 1:19 pm

     
  50. MD says:

    Yup, I missed the fact that he was late the day before, my bad. I reacted too quickly with regards to other reader’s posts and I failed to double check the facts that MM did post, as I concentrated on the surgeries and hospitals as a not a valid reason argument.

    Your urologist is/was unprofessional, that I totally agree. He could have handled it better, and his secretary should have followed up with him and the patients at least.

    It really saddens me that there are doctors who act unprofessionally. I myself do not like to introduce myself as a doctor, unless it’s relevant, and I totally avoid to have a sense of self entitlement or “God Complex” as some people call it. I must admit it’s very very tempting though, being the “captain of the ship” in the hospital, and of course, the prestige that comes with being a medical professional, it’s soooo easy to think a lot of yourself, and personally, I try to avoid that. But I can only speak for myself.

    I posted my comments because there are a lot of doctors who aren’t really bad persons. The majority of us really just doesn’t know how to express ourselves well, while some really do have the God complex. I personally know some doctors who are very very good in what they do, and they do not intentionally do it, but they come of as arrogant and mayabang. When i asked them about it, they didn’t know they were acting that way, and they wouldn’t know because no one would stand up to them (anothe cultural thing that I hate, honestly). Most doctors aren’t really people persons like the lawyers and the politicians and the CEO’s. Doctors spent 8 years being full time students, with little to no social life, with not enough money to earn during the early part of their career, and with a lot of responsibilities. I stated it not to gain sympathy or as an excuse, but to mention that a lot of doctors have “flawed” personalities. Believe me haha. I argued with my classmates a lot back in med school, because a lot of them had “immature” opinions and narrow minded reasonings, that might have been improved with social life and really just normal lives, but med school did not let them have that. Of course, I do not like to generalize, but those things happen, and those again are some of the reasons why a doctor might not be the most sociable person you may know,

    I rest my case with your urologist tho haha, he’s a piece of work. But I hope that the majority of the readers here would still admire and respect the medical profession. Even with the poor time management, and the awkward social skills, at the end of the day, our goal is to save your lives. As dramatic and cliche as it may sound. We do the things we do to make you better, and some doctors might not show it, but behind the scene, they stress over your diseases long after you leave the clinic, and even if you pay us a thousand pesos per consult, I’ll gladly give your money back if it would guarantee that you would not die in my hands. Your wellness comes first, the money of course comes second.

    Jul 9, 2013 | 2:54 pm

     
  51. Marketman says:

    MD, I have no doubt that the vast majority of readers, and myself, truly appreciate their doctors. And appreciate that they had to toil for many years of study and internship before they could practice… and frankly, I would be one of the few to say they should charge more for what they do. It is a few bad apples that always shed light on a whole group of professionals, most of whom uphold professional standards across the board I would hope…

    My grandmother, who was born in 1898 was one of the first female doctors who studied and graduated in this country (I think she may have actually been in the first class that included female doctors — there were just a handful of them I was told) and a general practitioner. She was present at the deliveries of my older siblings and probably in the delivery room when I emerged, and she would have been 66 years old then. By the time I got to know her, in her mid-seventies, she was retired and working from home. Every weekday and possibly Saturdays, she used to have a line out her front gate of people seeking medical consultation. Few if ANY of these patients paid for their consultations, my grandmother provided them for FREE. Sometimes patients returned with chickens, eggs, a piece of ancient ceramics dug up in their backyard or town, an old coin, etc. as a thank you, but never were they required to pay for the services rendered. She was not a fabulously wealthy person, but was an avid collector of antiques in an amateur way, and she never once acted as though she could use her profession to enrich herself, rather to serve those who were less fortunate. I think that is one end of the spectrum of doctors… my ex-urologist, would perhaps fall at the other end of the spectrum. And yes, my grandmother’s patients just had to wait in line along with everyone else. No appointments allowed. “Clinic” hours in the morning, and two hour break for lunch and siesta absolutely necessary before she continued in the afternoon. I always fainted at the sight of blood. So no chance of my following in her footsteps… :)

    Jul 9, 2013 | 3:56 pm

     
  52. Christine says:

    Hi MM! I too am a practicing MD, and agree that your doctor was at fault. But I would like to point out that the tardiness of some of my colleagues should not be generalized for doctors having a God complex. As was already mentioned by Drs. Banzuela and MD, some specialties do have emergency cases ( surgeries/anesthetist, birth deliveries, ICU cases ) that would require them to be on call ANYTIME of the day. And having a complicated case can sometimes require a doctor to spend hours at a time with their patient – a simple 1 hour surgery can turn into a grueling 3-5 hour case, an expected normal delivery suddenly requiring an emergency cesarean section because of the baby showing distress, or an ICU patient suddenly showing heart or kidney complications. MM, I am not defending your doctor, with his excuse of being “stuck in traffic”. But there are times that a doctor may be allowed to be late, excluding traffic obviously. For a single delayed/prolonged surgery, that can snowball to affect the rest of the surgeries of the day. And this can happen even in the best hospitals in metro Manila. So even a well meaning, always punctual doctor who arrived on time for a surgery would have to wait 30minutes to 1 hour for an operating room suite to be cleared for his surgery, thereby pushing his clinic hours to be late by the same amount of time.

    I just want to remind everyone that tardiness is a bad trait that can attributed to your values and upbringing. I come from a family of doctors and was raised to be punctual. I arrive a good 30 minutes before the start of my clinic hours, oftentimes earlier than my usually tardy nurse. So don’t generalize please. ;)

    Just to answer those living abroad – we cannot compare healthcare in the Philippines to that of other countries. For one, we do not have a comprehensive insurance system that would cover out patient consults. Doctors here are paid per patient seen or paid by the hour (insurance based clinics). Second, most patients don’t even consult a doctor for medical illnesses. With the trusty faith healer, hilot, arbularyo, or even pharmacies that dispense medications without prescription, we have seen a lot of cases in the complicated stages (don’t even get me started on the supplements/no approved therapeutic claim tablets). And third, even if a patient does see a doctor, majority of these patients would be unable to continue with the medications/consultations because of the cost of treatment.

    Jul 9, 2013 | 4:06 pm

     
  53. bYS says:

    from Dr. Banzuela: ” the best thing to do is to talk to your Doctor NICELY about it ”

    Nicely? Sorry, but I dont agree. There are a lot of competent Doctors around and I dont have the patience to tolerate such tardiness and that Doctor for being so inconsiderate. :-( Hello! May celphone na, why not call your office?
    Oh, Yes, believe me. I understand. I currently work in the Medical field ( & Dental in the Phil.)
    I’ll find another Doctor and a medical facility as fast as I can!

    Jul 9, 2013 | 4:07 pm

     
  54. MD says:

    MM, my lolo too graduated in 1947, from the same school I graduated in, my mom in 1983. My lolo told my mom, who taught me, that we should give the patients all the time in the world whenever they are in our clinics. My lolo had the same story as your lola, he worked in the province, he would get long lines in the house clinic, and he had no clinic hours. Patients would go in his house anytime, and he would see them even in his kamiseta and tsinelas. He taught my mom to value her patients, and my mom taught me that too. I owe my “clinician and patient skills” through both of them.

    Actually, I appreciate you standing up to your urologist (or his secretary). Like what I said, almost nobody stands up to a doctor, and as much as I honestly enjoy it, I feel bad whenever patients get short changed, intentionaly or unintentionally. I hope this blog posts inspire people to stand up for what they think is right, provided they do it reasonably, and nicely, no matter who is in the position. I just hope they do not misinterpret or generalize, as some readers tend to do.

    Jul 9, 2013 | 5:28 pm

     
  55. ChiquiP says:

    Punctuality, regardless of profession or stature in life (doctor, manager, messenger, laborer) is something we should uphold ALL the time. While there will always be unexpected or unforesseen incidents that may come in the way, we should show respect by notifying the other party of such incident, and with today’s technology this isn’t too hard to do.

    For me, it’s just as simple as that.

    Jul 9, 2013 | 7:59 pm

     
  56. Marketman says:

    Chiqui, my sentiments exactly. MD, thanks, and yes, I would caution readers against generalizations.

    Jul 9, 2013 | 8:15 pm

     
  57. Footloose says:

    Great read as always. I gather that what the good doctors are saying is, be patient.

    On a lighter though morbid mood, I find myself chuckling at your dad’s expectation about a digital exam assuming it was newfangled and modern. If the examining physician hailed from the North, I guess it would have been dijaytal.

    In this, I can liken my attitude to yours. Since I do not waste my time, it makes me raving mad when others do it for me.

    Jul 9, 2013 | 9:17 pm

     
  58. robin castagna says:

    Marami talagang walang respeto sa oras ng iba!

    On another note, still about doctors. My mom’s regular doctor doesn’t even give senior citizen discount. And she’s a cardio which of course means TONS of senior patients. On top of that she still doesn’t issue official receipts! Kapal din naman, ‘no?

    Jul 9, 2013 | 10:12 pm

     
  59. Enrico Paolo Banzuela says:

    Marketman,

    Sorry if it seems that I’m defending your doctor, (i honestly don’t know him/her) but it’s in my personality kasi to give another person the benefit of the doubt unless proven otherwise. =)

    If the reason cited by the secretary to explain his tardiness is that he is stuck “in traffic”, isn’t that an effect rather than the cause of his tardiness?

    What if he indeed have an emergency surgery and he is currently rushing towards the clinic?

    Of course, the secretary does not know what the doctor is doing all the time, kaya nagbigay na lang ng stock answer: “natraffic kasi.”

    One tidbit that you yourself might have missed: one possible reason why the secretary did not write “stuck in traffic” is that she doesn’t know the real reason why the doctor was late.

    If the doctor is stuck in traffic because of an emergency surgery that simply took too long, and the secretary (because she’s new, or tamad magexplain, or medyo tanga lang talaga at di nag-iisip ng consequences ng sasabihin nya), explained to the doctor’s patients that the reason he’s late is because of traffic, of course you’ll have very angry patients, and if one of these patients brought this to the attention of the doctor, then you’ll have one doctor who’s going to be very angry at his secretary.

    That’s why when you ask her to write the real reason why the doctor was late, she might have realized her error, kaya iba ang sinulat nya. It’s more defensible to write “emergency surgery that lasted till 10 am – currently stuck in traffic.” One entirely plausible reason why the secretary wrote “unfortunate event” is because she doesn’t know why the doctor was late. And the doctor might be in such a hurry to get to the clinic (because some of these patients he had failed to see the day before due to another emergency) that he didn’t bother to explain the reason for his tardiness to the secretary.

    Doctors were never trained in customer relations, or organization and management that’s why these problems occur. Med school, and hospital residency focused on gaining competence, and not the day-to-day management of clinics.

    I agree with you wholeheartedly that you should have been informed much earlier that the doctor will be late. A system should have been put into place to prevent patients from waiting too long. The secretary also should have done proper damage control measures and apologized to everyone in the clinic in behalf of the doctor. And for those not willing to wait anymore, she should have rescheduled their appointment or referred you to another specialist if you asked for it. Sometimes, i really wish na may “clinic management” na subject sa med school. =)

    But consider this reality Marketman: it’s against the best interest of the doctor to be late (angry patients –> poor reputation –> lost income). That’s why, in my opinion, if they are late, 9 times out of 10, the reason is VALID: emergency surgeries, deteriorating patients etc. Being “stuck in traffic” is just a natural consequence.

    BTW, why didn’t the doctor apologize to you other patients in writing, thru text? Probably the same reason why companies do not apologize in writing to their customers (especially individually) when it comes to poor service – legal and business reasons. While doctors were never trained in business, they know this almost by instinct: “cover your ass.” Of course, it’s not the decent thing to do, but they’ll get into more trouble if they admit being late in writing. (the same way that companies might get into trouble if they apologize to specific individuals in writing)

    The medical profession does need to change its strategies when it comes to clinic management. Group practice might help, with doctors going on “duties” to the clinic, wards, operating rooms to ensure that there will always be a doctor managing these clinics all the time and that patients wouldn’t have to wait for so long.

    Also, the reason why I advised you to talk to your doctor about his tardiness is that most doctors nagbabago pag kinakausap ng maayos at mahinusay.

    Here is something I’ve noticed about most doctors: If you’re going to to berate them the way a demanding customer might treat lazy,incompetent waiters, they’re bound to clam up and tune you out. They’ve experienced being shouted at, being humiliated in public and being treated as a virtual slave all the time during their residency training from their seniors, and the response is reflexive: dedma. However, if you talk to them nicely about your negative experience, they will feel shame, or at the very least it will make them pay attention, and most of them will change for the better. =)

    Talk to the doctor, not to the secretary. See what happens.

    Thanks Marketman. Good luck and God bless.

    Jul 10, 2013 | 12:15 am

     
  60. PITS, MANILA says:

    I know of one who holds clinic … 5-7pm. All the while I thought it meant 5:00 to 7:00 pm. It had to be explained by the secretary that it meant “5 minutes to 7:00″ … so the next time i heard of clinic time, I had to ask if 10-12pm meant “10 minutes to 12 noon” … and they thought I was being cute.

    Jul 10, 2013 | 7:03 am

     
  61. mayk says:

    I have to agree on most points by Dr Banzuela. Staying calm and composed do work most of the time. Doctors do deserve the benefit of the doubt. There maybe doctors with attitude problem but we should never generalize. On another point i usually avoid makati med and st luke for their astronomical rates. It simply amplifies the lose of temper on unprofessional conduct. If still talking to the doctor nicely doesn’t work that maybe the time to dump the doctor. I for myself do feel bad about the wrath of generalization on the comments cause i know a lot of good doctors and is more tolerable on their tardiness. somehow some patients also have god complex. It still best to properly relay to the doctor in a nice way the concerns so he could work on it.

    Jul 10, 2013 | 8:51 am

     
  62. Marketman says:

    Dr. Banzuela, nice try, but it won’t work. There are several other urologists in Manila/Cebu and I am happy to get a new one. It’s just a routine check up after all. If I knew what to look for, I might do it myself. I jest, of course.

    As for your generalization that businesses never apologize, I run a restaurant business with 7 branches. We respond to EVERY SINGLE complaint sent to us verbally or in writing and we respond either verbally or in writing and admit fault if we are at fault. I find most if not all clients respond positively when we address the issues head on and don’t hide. We handle some 600-1,200 customers across all of our outlets every single day of the year, so it’s not a surprise if 3-4 people are upset enough to contact us or tell us to our face that something went wrong that day. Our Managers are trained to respond, and while they may fail on several occasions, it is built into our systems. We respond to negative comments on our facebook, through email, and even on occasion, our tripadvisor page which we didn’t even set up. We record all such incidents, and they are discussed in detail at monthly management meetings so we can find ways to avoid the same thing happening again. So yes, if a provincial lechon restaurant can think about customer service this way, so can a doctor with a whole lot more education and experience behind him/her and usually with just one front line staff member to deal with patients.

    Jul 10, 2013 | 9:05 am

     
  63. Enrico Paolo Banzuela says:

    Marketman,

    The way you run your restaurants – with appropriate and timely responses to negative feedback and complaints, and admitting errors – is exemplary, but I think is more of an exception rather than the rule. =)

    For example, I don’t think Globe or Smart will ever apologize to their customers in writing for making them wait for an eternity sa customer centers. Same with most companies with poor customer service.

    Doctors run their clinics more as mom-and-pop stores rather than organised business entities. Medical education focused on gaining competence, and not the business and management side of practice. I’m ambivalent on whether medical education should also focus on the business and management side of practice – ultimately, it might result in better experience for the patient, but perhaps more costly, and less personal.

    Jul 10, 2013 | 12:53 pm

     
  64. Mimi says:

    I can understand your frustration as I have a special needs child who is always at the doctors. I do notice that waiting for specialists take two hours even with an appointment. I just put my mind on “waiting mode” and try to do other things to pass the time.

    What is also good here is the SMS alert services, which is activated once you register your presence. You get an SMS alert that will say “there are 4 patients before you.” The nurses will also suggest that you take lunch first, and you can request for a call if it is near your queue.

    I have also seen a locum doctor even if the doctor is there. The nurse will advise you when there are too many patients to be seen and say that the locum doctor can see you as well. Basically the locum doctor will do the routine checks, then call the main doctor by handphone, then if you just need a new prescription he issues that and you can go. Or you really have to wait for the main doctor for some concerns which you want discussed with the main doctor. The fee is just for one doctor even if you saw two of them.

    Jul 10, 2013 | 1:56 pm

     
  65. sunshine says:

    I, too, have several bad experiences in Makati Med…one with a noted neurologist who was so ornery and bitchy during the consultation.. i waited for hours for him and when i told him about my concerns (ie, vertigo, unexplained bruises, dizziness) all he did was tap my head with an instrument and said ” alcoholic ka ba? alam mo nakakalbo sa may likod”

    another was with a noted pulmonologist… ang tagal tagal ko sa pila, wala man lang syang warmth or concern sa pasyente…para lang syang robot na nagdidispense ng reseta…. again, ubos oras na naman ako kakaantay sa kanya tapos she acted as if she couldnt wait to get rid of me

    the last was with a noted dermatologist, i complained of rashes… she asked :nangangati ka ba?:” i said ” hindi po, doktora” she replied ” o eto gamot to sa pangangati, bayaran mo na lang sa secretary ko” then dismissed me. when i looked at the ointment it was something she made
    i told her secretary i have to withdraw money first but never came back to pay for her stupid medication

    add ko lang din that the frontliner at their xray dept is so masungit… lalo ako magkakasakit pag kausap yung aleng yun,

    Jul 10, 2013 | 3:00 pm

     
  66. mayk says:

    We all know you take your fishpan issues seriously.
    Sometimes anger leads to more anger.
    I think your example does not fit the proof of generalization lets face the truth you are one of few that has a sense of good business practice.
    Somewhere along the way i was a practitioner of losing temper easily.
    The usual ending is no resolution of the issue at hand.
    Being calm and compose has its merits.
    I usually channel my anger somewhere else for example in your case the benefit of the doubt.
    I think communicating the issue offers more resolve than walking out or boycotting.
    If that person is indeed an a-hole most of his patient will eventually realize that and that would be bad for his business/reputation.
    At the end of the day we are what we are.

    Jul 10, 2013 | 3:17 pm

     
  67. Marketman says:

    mayk, perhaps you misunderstood, I mention the service issues and not generalizing in direct response to the Doctor’s assertions. And I quote “BTW, why didn’t the doctor apologize to you other patients in writing, thru text? Probably the same reason why companies do not apologize in writing to their customers (especially individually) when it comes to poor service – legal and business reasons.” That assertion is a GENERALIZATION. I was making an example that not all companies act that way. And so what if I am the exception, does that justify that the doctor acts the way he does? Is it expected behavior, the norm? Of course not. As other doctors and patients here point out, there are good doctors and bad, service oriented ones and not, and I simply won’t tolerate ones who don’t get it service wise. That’s all.

    Sometimes anger leads to more anger. True. And sometimes anger leads to results and change. After all, I have repeatedly stated that I tend to “Choose Frustration over Indifference” It bothers me not at all if you prefer to choose indifference, that is your choice. Go ahead and wait in line regardless of excuse or reason. Let folks cut in line ahead of you at the grocery. Ignore repeated mistakes in your billing and a lack of official receipts. Remain calm at all times. That’s absolutely your prerogative.

    There have been bloody/angry revolutions all over the world for centuries, to positive results. So too, would folks of your ilk argue that there have been bloodless revolutions (Gandhi’s and Cory’s perhaps the most obvious examples of recent times) with positive results. Or not. See, I would argue that the Philippines and even India still needs dramatic and earth-shattering change, and without it, the hopes of 90% of the population that live just above or below the poverty line cannot hope for real improvement, but that’s another rant altogether. You can read my previous ones in that regard.

    Your sentence “I think your example does not fit the proof of generalization…” is completely nonsensical. If you see the context in which the comment was made, you would understand. If you don’t get it, no need for me to waste effort to help you do that.

    “Being calm and composed has its merits.” Totally agree. No arguments there. But I still wouldn’t stick with a doctor who did what the urologist did. After all, in my 49 years on this planet, I have only stuck my finger (figuratively) out at ONE doctor ever, and have come across dozens of them without incident.

    I said the doctor was acting unprofessional. I never said the doctor was an ASSHOLE, that is your term. Maybe deep down inside you think he is an ASSHAOLE, that was not my terminology. Though I am sure he sees more than his share of assholes daily. Literally. :)

    And yes, at the end of the day, we are indeed what we are. So it shouldn’t bother you in the least if someone points that out to you, particularly if you are unable to give a decent reason why you have made twenty patients over two days wait a total of 100+ manhours for you to show up when a simple phone call would have prevented much of the wasted time…

    And while numbers will never win the day, it might interest readers to know that nearly a dozen male readers have indeed emailed me privately to ask if their doctor was the one in question or if I would share the name of the doctor, as they would most certainly not consult with them in future. So if only for that reason, I feel this rant, as with all my rants, serves a positive purpose to either improve service, warn consumers, or teach folks how to stand up for what is right.

    Jul 10, 2013 | 3:34 pm

     
  68. bYS says:

    Very well said MM.
    I understand and totally agree.

    Jul 10, 2013 | 6:20 pm

     
  69. Natie says:

    I would wait days and days for a world class neurosurgeon and cardio thoracic surgeon!!! Any SPECIALTY of medicine, I’ll choose and take my pick!!! I WILL NOT wait…

    In NYC, initial visits cost Big Bucks and if you have NO HMO too bad…kiss yourself if your Insurance covers even just 80% of this visit. Last time I went to Ortho, I waited—because I was off the whole day. The sofas were comfy, and the magazines were NEW….oh there’s always eMed….

    Jul 10, 2013 | 10:41 pm

     
  70. tes says:

    The way I see it, its the secretary who was fueling the fire. Her attitude would made you more angrier than the lateness of the doctor.
    Doctors should always have a competent secretary, to do customer/patient care, to lingaw the patient while waiting, and to cover for whatever his doctors shortcomings be it punctuality, unreadable prescriptions and for advance info that a VIP or bagolbolan patient is in the house or to do triage.
    Being in the surgical specialization, I hire licensed and competent nurses to do all this for me, rather than hire a college level or high school graduate with a guaranteed low salary. It might be expensive to hire nurses as secretaries but they can save your ass a lot more than an ordinary secretary can. Nurses can take vital signs and can understand medical terms as well. And they are trained to have compassion and empathy with the patients.

    Jul 11, 2013 | 1:43 am

     
  71. Natie says:

    Thanks, Tess , for the acknowledgement.. But many time we don’t appreciate patients and their family members ” killing” the messenger… No compensation is enough for this… Many times, in frustration, we just ” throw MDs under the Bus”.. Your nurses deserve awards and recognition for loyalty to you. Even a pen or a bag of chips would do..hehe.

    I retired with many scars, some of which are still healing.. I jest… When we took our oath, little did we know we had to be Middlemen… Evading bullets takes years of practice and is an art and science of Nursing in itself… Class of ’74…..retired RN .. BS queen for survival.

    Jul 11, 2013 | 2:23 am

     
  72. Eina says:

    Okay, there’s no quote function here but I’d like to respond to what Christine wrote “Just to answer those living abroad – we cannot compare healthcare in the Philippines to that of other countries.” Marketman brought up no-show fees for patients at the end of his post and (as far as I can see) 3 people living abroad (one of which was me) related how no-show fees work where we are. I mentioned that healthcare is mostly free where I live, just to put the fees in context and I’m fully aware of the different realities.

    ___

    As for prioritizing patients, I fully agree that you have to attend to the patient who most urgently needs your care first and that emergencies, surgeries that drag on, something coming up during rounds, etc. are legitimate excuses for lateness. With regard to rounds though, one thing I’ve seen attendings do when they’re pressed for time is to perform quick rounds — just check that things are under control with all the patients — and then come back later in the day to do it more thoroughly. Of course, that won’t work for everyone especially if there are long travel times involved, but it’s just another approach.

    Jul 11, 2013 | 7:54 am

     
  73. Marketman says:

    Natie, I just finished reading an interesting book “The Power of Habit” which had a brief chapter or so on the goings on at a Rhode Island Hospital that nearly imploded several years ago. It was about the enmity between doctors and nurses and how nurses were often tasked with making sure doctors didn’t screw up. It got so bad, at one point a doctor opened up a patient on the wrong side of the brain, and of course the hospital got sued. It happened many more times and on the brink of collapse, they decided to look into it all and figure out how to make it work. It was fascinating. And while I do not support generalizations about doctors or nurses or doctor’s secretaries, this chapter had some interesting views…

    I would have to agree with you that beggars can’t be choosers, except in the most idealized of worlds. So if I did need the world’s best specialist, I suppose I would wait for him/her wherever he might be in the planet… Alternatively, I do have a rather dour view of modern medicine extending our lives a bit too long now… so I am ready to go when I am supposed to go, not years later after numerous procedures and millions spent. :) When you hear the statistics that say 60-80% of all healthcare dollars are spent on the last year of a patient’s life, then one wonders why dying a year earlier is so bad after all. If those 80% of funds can go to other more important uses, I would be all for it. Of course, there are complications of all sorts figuring out when that last year is actually the last year… A very healthy and happy 70-75 years is totally fine by me. Anything beyond that in good health is an absolute bonus.

    tes, yes, the secretary was a bit dopey, but increasingly, as Natie suggests, I don’t go after the messenger, but look for the manager. In this case, it is the doctor and the secretary, that’s it. If they had some simple rules like 1. If doctor doesn’t arrive 10 minutes before hours, call him. 2. If he is going to be more than 15 minutes late, let patients know and why he is late (medical reasons totally understandable) 3. If he is going to be very late, re-schedule. etc. If I were the elderly gentleman who arrived in a wheelchair, and who had already waited 3 hours the previous day to a no-show, and again 1.5 hours for another no-show, then I think I would deserve to be told about the doctor’s whereabouts and reasons for delay. Even if that meant the doctor had done an emergency penile decapitation or if a family member of his passed away. With cellphones and computers today, the lack of advise was just inexcusable.

    Jul 11, 2013 | 10:45 am

     
  74. elaine says:

    This is so enlightening, after reading through all the comments. I don’t see the need to talk nicely and calmly to a professional who is being unprofessional and doesn’t even have the courtesy to inform or even apologize to his patients…they will make your condition worse due to stress and the negative emotions we experience because of people like these. We are not at the mercy of our doctors as there are others out there who can provide the same service and competence but courteous and caring. Hindi pa naman sila obsolete lol.

    Jul 11, 2013 | 1:25 pm

     
  75. Natie says:

    As patients,,we are our best ADVOCATE! Kind of research on your signs and symptoms. If its your kidney, read on it what makes it tick, etc.. There are grade school texts that don’t require a course in Anatomy and physiology… I pity the less fortunate populace who have less resources ….

    MM, in our Interventional Radiology Department, and ALL ORs, there should be a TIME OUT done Always before a patient is wheeled in , and before the procedure.. The Specialist asks the patient, Pre anesthesia, his full name, date of birth, a two person check of the medical record #.. Then the patient is asked what procedure he will have. SHould the patient be in a confused state, a name band is double checked by the Specialist and the RN. Wrong name band will be detected if chart has different name… Even the Scalpel HAS a sign: STOP! time Out.

    Should errors still occur, then the patient gets to own the department or a huge compensation awaits….

    We have a Chief Secretary who is well compensated, who is excellent in what she does.. No need for certificates and post grad diplomas on the walls..department just needs dedicated and well-mannered individuals who like what they do..and as always, team work.

    Jul 11, 2013 | 9:52 pm

     
  76. Gej says:

    If I were the patient needing emergency penile decapitation, I’d be very happy if the doctor didn’t show up. But I don’t think I’d like to be waiting around for him as well.

    Jul 11, 2013 | 10:09 pm

     
  77. ERNIE D BAUTISTA says:

    I AGREE WITH YOU A 100% WAITING TO SEE A DOCTOR FOR 2 HOURS OR MORE IS UNACCEPTABLE AND UNETHICAL. PATIENS ARE ALWAYS AT THEIR MERCY. WHY CANT THEY BE ON TIME WHEN PATIENTS CAN. MAYBE THEIR REASONING IS YOU NEED ME AND I DONT NEED YOU .

    YOUR COMMENT THAT IT WOULD BE NICE IF THERE IS A WEBSITE IN THE PHIL TO SEE THE MD’S PROFILE LIKE EDUCATIONAL BACKGROUND, TRAINING AND SPECIALTIES, MALPRACTICE AND ANY DISCIPLINE AGAINST THE DOCTOR BY THE PHIL MEDICAL ASSOC. IN THE US THERE SUCH A WEBSITE THAT YOU CAN READ ABOUT THE DOCTOR BEFORE YOU MAKE AN APPOINTMENT.

    OVERBOOKING IS VERY COMMON PRACTICE I NOTICE IN THE HEALTH CARE BUSINESS. IT IS A BUSINESS LIKE ANY OTHER BUSINESS.THEY OVERBOOK JUST IN CASE THERE IS SOME CANCELLATION.

    HOPEFULLY SOMEDAY IT WILL BE BETTER. I DONT THINK THEIR GOD LIKE ATTITUDE WILL CHANGE IN OUR LIFETIME

    Jul 11, 2013 | 10:19 pm

     
  78. JB says:

    I couldn’t agree more. My wife and I are always on time, or early, so we can’t stand it when people show up late for appointments. What’s the point of setting up an appointment if you can’t honor it? It’s like they’re telling you that their time is more valuable than yours.

    I stopped seeing a psychiatrist recently because of this. What irritated me the most about her chronic tardiness was that I couldn’t exactly get upset about it since I was seeing her for anger management therapy. What a waste of time.

    Jul 11, 2013 | 10:36 pm

     
  79. Jaimie says:

    I had a similar experience with a pulmonologist in the same hospital. There was an office on the ground floor for hospital complaints and suggestions. Long story short the pulmonologist called me a few days later to apologize.

    Jul 11, 2013 | 11:34 pm

     
  80. Faithful reader says:

    Very well said. I applaud you for this! In California, if you
    Miss an appointment, whether it is a medical, legal or even sometimes hair nail appoinment , you are charged a $25 fee. If you don’t cancel within 24 hours you will be charged the fee. If you are late by 15 minutes then you miss your appointment.

    So here it would be rare for the doctor, hair stylist, dentist or lawyer for a no show. And at times they are late for your appointment due to uncontrollable circumstances, but at least they are there.

    Also we have ways of reporting bad services and providing feed back. Either by reporting to the better business bureau, or even websites like yelp. I usually read feedback first every time I’m trying out someone or something new.

    Jul 12, 2013 | 12:14 am

     
  81. Getter Dragon 1 says:

    Before I get into it, @Faithful Reader – there is no California mandate for such a fee in these cases. I consult and help with a private practice and the owner-doctor does no such thing although many places of business do. Other than that, as a Yelper!, Yelp is just a glorified social media for people to share their experiences and hardly ranks with the BBB, which has no enforcment power either.

    This post and comments is symptomatic (pun) of the social dynamic of the Philippines. I had to read the post (and the related post) and comments a few times to let it all sink in. To me its a clash of western sensibilities with Filipino mannerism. Not to say that other cultures have their own quirks, but it seems that Filipino mannerisms have permeated into western culture. Which is fine and their are examples of this in the mainstream. But to experience such in an exchange is disappointing. It really shines a bad light upon us as Filipinos and to those who think its ‘unique’ or ‘cute’, it really isn’t.

    Jul 12, 2013 | 2:31 am

     
  82. Carmina says:

    The least that I wish for this kind of doctors is to have their karma.

    Jul 12, 2013 | 4:28 am

     
  83. Mart says:

    Seconding the “god complex” vibe from most doctors in the Philippines.
    I think it comes with the cultural turf in the Philippines. Most of the populace accepting the tardiness and the “attitude” as the norm certainly goes a long way in reinforcing such behavior.

    But then again, most of the populace won’t even have the idea of switching doctors. If they did switch doctors, they’d probably commute much farther away which will add their time in traffic to the doctor’s tardiness. :P

    And then there still is a large number of the populace that don’t even go to doctors primarily because they can’t afford them. If you don’t have a job, you probably don’t have medical insurance. And those who can’t afford “western medicine” would go to the arbularios and still have to wait a couple of hours in line just because of the long lines.

    Sigh.

    It would be great to have a free medical system like they have in Canada. One less thing to worry about if you happen to be unemployed or can’t afford medical treatment.
    I haven’t threshed out the details but it should be a win-win situation. The populace gets proper medical treatment. The doctors get paid. And the bad doctors start behaving professionally or eventually get weeded out when patients have the option to switch doctors.

    Jul 12, 2013 | 8:12 am

     
  84. Zantha says:

    As a patient myself and caregiver to my late father, I can say that when it comes to doctors, there are so many personalities in the whole spectrum — punctual, responsible, genuinely concerned types, as well as the “God complex”, “I-am-all-knowing-and-don’t-you-dare-question-my-authority-nor-ask-any-questions”, irresponsible, cold, heartless, “out-to-milk-you-dry” types.

    In my experience dealing with doctors, and as an educator, I would like to propose the following: (1) include a course on ‘cura personalis’ (caring for the whole wellbeing of the person) and good communications and interactions with patients in the medical school curriculum, make it mandatory; (2) patients should be firm, yet polite, and assert their rights as patients, so that doctors and other medical practitioners will learn to be more responsible with their actions and decision making, knowing that they are fully accountable to patients in their care.

    Will add more later…

    Jul 12, 2013 | 4:48 pm

     
  85. Faithful reader says:

    @Getter Dragon 1. I don’t know what part of California you are from, but where I am from they charge those fees.

    Any feed back from either yelp or the BBB helps. You don’t have to believe all that you read, but at least you know what or what not to expect. Everyone still makes their own choices.

    I like the fact of being charged if you don’t cancel an appointment on time. We are always told of the fee for a missed appointment without following their rules. It makes you aware of what your’re in for. It would be your fault if you don’t follow the rules. It’s no different when you don’t cancel a reservation at a hotel in a timely manner. You would still get charged for that day.

    Rules, regulations and policies must be followed. And no one should be exempted!

    Everyone has a right to voice out their opinion. As well as anyone has a right to disagree with you!

    Jul 12, 2013 | 9:17 pm

     
  86. Natie says:

    Woooohooooo! Read somewhere: You come into my life (my Blog), the door is open. You want to get out of my life (my Blog), the door is open. Just one request. Please don’t stand at the door. You’re blocking traffic. Apt….

    Jul 12, 2013 | 11:49 pm

     
  87. Getter Dragon 1 says:

    @Faithful ‘Reader’ – I live in Silicon Valley. Not under a rock. And again, there is no such madate for fees for being late, canceling, etc. Those are established by businesses as they see fit. And yes, I understand the importance of policy and such. What YOU need to understand is to not spin things under the premise of ‘rules’ in a vague attempt to present yourself as authority. And if as such, consider yourself, shut down.

    Jul 13, 2013 | 2:18 am

     
  88. Getter Dragon 1 says:

    Oh speaking of Yelp!, let’s clarify that the site does not provide ‘feedback’, but rather is a forum for user and the public to voice an opinion on a business. The BBB is a consumer advocacy group and has no enforcement power either. That said, an aknowledgement from the BBB puts a business in a confident light.

    Jul 13, 2013 | 2:23 am

     
  89. angela says:

    Hi Marketman! My Mom is a Nurse supervisor at National Kidney & Transplant Institute in Quezon City. If you’re still looking for a urologist, perhaps I can refer you to Dr. Dante Dator. Actually, all the urologists in NKTI are very good. God bless you!

    Jul 13, 2013 | 8:07 am

     
  90. Marketman says:

    angela, thank you. And what I can say, but just a resounding “Bingo!”… :(

    Jul 13, 2013 | 8:58 am

     
  91. Natie says:

    Networking.. Nice!

    Off topic.. Another James Bond movie 2015!!

    Jul 13, 2013 | 9:46 am

     
  92. Footloose says:

    @Natie, and the 007 book has been contracted to William Boyd who wrote Blue Afternoon (1993) among many other titles. It is an excellent yarn that’s mostly set in Manila around the turn of the last century when it was still under Martial Law imposed by the new American occupation. It naturally reads as though the author has some Philippine connection.

    Jul 13, 2013 | 12:08 pm

     
  93. Faithful reader says:

    @Getter Dragon 1, yes I do enforce regulations and policies. And if a company has rules or policies that they have created, then It’s my choice if I want to follow it or not. If I need their services then I follow it. If I choose not to, then I take my business somewhere else!
    Companies make their own rules or policies. Yes it’s not mandated everywhere, but to those that I have been too, they have those policies in place!

    Yes yelp is a place where one voices out their opinion and where others use it has feedback.

    Are you guilty of something??????

    Jul 13, 2013 | 7:10 pm

     
  94. Getter Dragon 1 says:

    @Faithful Reader – Yes, I’m guilty of reading your inane comments.

    Jul 14, 2013 | 3:37 am

     
  95. Natie says:

    ….I wish there is a LIKE button…

    Jul 14, 2013 | 4:33 am

     
  96. cesbdu says:

    The Filipino “culture” of being late for an appointment and not having the courtesy of informing the other party involved is really not amusing at all. It is also a pet peeve of mine. From what I’ve noticed, most of the “appointments” at doctor’s offices in the hospitals are actually more of a first come, first serve type of thing rather than a specific scheduled time. I agree that the doctors and their secretaries should have a more professional approach with how they run their offices, most specifically the scheduling and especially when they need to see a lot of patients, but unfortunately this is really up to the doctor and how they want to run their practice.

    we all hate waiting and I understand the frustration of having to wait but I wonder how many of those who voiced out their opinion about their “late” doctor do actually show up on time to their own appointments whether at a doctors office or at a dinner party, given that they bother to set or agree on a specific time or not.:))

    In socialized care, the complaint is how long it takes to get an appointment or even see a specialist. In the US, you hear complaints about their doctors not having enough empathy for the patient. There is no perfect system but there is always room for improvement and courtesy to one another.

    Thanks MM! Sorry to hear about your bad experience with this doctor. Very informative entry.

    Jul 14, 2013 | 10:26 am

     
  97. JCP says:

    MarketMan,

    One patient waited 3 hours the day before (and the doctor was a no-show), and waited an additional 49 minutes the following day (and even asked if willing to wait for another 51 minutes)? Time to write Makati Med.
    The good doctor deserves at least a warning from the hospital administration.
    Or, at the very least, should inform clients of any “foreseeable/controllable” tardiness not more than 15 minutes after the appointment. The secretary should have elaborated, and made every effort to apologize/ advise all patients of the reason for the delay. Sometimes, it is all in the way patients are told, advised, informed — respect.

    This was a 10am Saturday appointment. Presumably, there were no clinic hours earlier than 10am (at another hospital) for the doctor?

    Malala yung sa mga weekday afternoon appointments. Doctors usually hold clinic-hours at two different hospitals, and when patients who come in for the morning appointments present complicated cases, patients waiting for the afternoon appointment will really have to wait. Seems more than a statement on tardiness and professionalism, the situation points us to the fact that we have few doctors in the country. Too many lawyers, too few doctors?

    Jul 14, 2013 | 1:51 pm

     
  98. Christine says:

    The no-show fee would not apply for the Philippines, unless we have a unified insurance program for all. That way, both the doctor and patient would be able to collect for either’s no show. Also, most of our doctors see patient’s on a first come, first serve basis. Only specialists with expected numerous patients set appointments for consultation. We are actually lucky in the Philippines, since we can go directly to a specialist for consultations. Abroad, you would be seen first by a primary care physician and managed for whatever ailment you have. Only if the condition becomes complicated will you be referred to a specialist. And the wait for a specialty consultation may take you months, not to mention set you back hundreds of dollars for professional fees (US$600-1000 mind you).

    I echo JCP’s view on having too few doctors. For certain sub specialties, there are sometimes to few of them serving the NCR area. Heck, in some provinces, 1 specialist serves 2 whole regions!!! These sub specialists (endocrinologists, oncologists, gastroenterologist, neurologists and even urologists to name a few) have a list of 20, even more patients queued up for out patient consult in their clinics in the bigger hospitals. These patients sometimes have no choice but to wait their turn, even if it means sitting for more than 2 hours – kasi they travelled all the way from far flung provinces. All because walang specialist sa bayan nila, or they were initially managed by general MDs but have turned to become complicated cases. Also, the bigger hospitals in the metro have the newer, state of the art machines and are able to perform breakthrough procedures not seen in their provincial equivalents.

    Jul 15, 2013 | 11:04 pm

     
  99. shalimar says:

    I had dental appointments when I was in Cebu. I had made it clear to my dentist that I keep a western time ;-)

    Once I was stuck at the traffic , although I still had ample of time I called his clinic to let them know I was few mins late. The secretary could not believe it.

    Jul 16, 2013 | 1:38 am

     
  100. Sui says:

    To me, this is plain and simple courtesy and respect for others. In whatever profession you belong to and when you offer your service to the paying public, you owe them at least an explanation on why you could not come on time – period. If an emergency prevents you from doing so at the exact time that you should have been in your office, the paying public will understand as long as you say the real reason and be sincere about it. As MM says, it will not take even 15secs to inform your secretary or representative about it. Again, plain and simple COURTESY & RESPECT!

    Jul 20, 2013 | 5:03 pm

     
  101. Sunny may says:

    I was born and raised in the Philippines and only moved to California in my mid 20′s. One of the first things I noticed when I started accessing health care here was the effort placed by my doctors in making me feel at ease. I was greeted with a smile and a firm handshake at each visit. Each doctor introduced himself or herself and called me by my first name. Each exam was thoroughly explained and I was always given the chance to ask questions before the doctor proceeded. At the end of each visit, I was always asked if I needed anything else. This was such a different experience from my doctor/ hospital visits in Manila. I would hate to say this but 90% of the time, the doctors in Manila were condescending, arrogant an d made me feel like I was wasting their time. And I never felt like I had any recourse but to accept that kind of behavior. Maybe I was young and naïve then, but I was not much older when I got to California but I did not have the same experience. A couple of years after I first moved here, I had a bad experience with a fertility doctor which left me shaken and upset. The attending nurse noticed how upset I was and immediately asked me what was wrong. Let’s just say that by the end of the day, I had the head of the Reproductive clinic on the phone apologizing for the doctor’s appalling behavior, and I was promised that I was never going to have to deal with him again on future visits to the clinic . Now tell me, are doctors in the US less educated than Filipino doctors? Did they spend less time in med school and therefore have more social skills than Filipino doctors? No, they are not. But what they’re better trained in, is treating each patient with dignity and respect. None of the “doctor ako, so I am better than you” attitude. None of the ” I am the one in charge so shut up” feeling. I know that there are doctors in Manila who are not arrogant and condescending, but gosh I’ve never met one, so pardon me if I can’t attest to their actual presence.

    Another thing, don’t you guys notice how stuck some people are on their titles? Everyone has to be called “doc” or “atty” or “engineer ” in the Philippines. I have never yet met a lawyer here in the US that asked to be called “attorney” or “esquire”. I call my lawyer by her first name as I do my boss and my boss’ boss. My son had a classmate in preschool whose dad introduced himself as Jim. I only found out he was a doctor when I chanced upon his picture a hospital poster. No airs at all.

    Love your blog Marketman!

    Jan 18, 2014 | 4:01 pm

     
  102. Lia says:

    Here is a blog for all of you.
    I came to clinic at 9.15 am the other day. I was held up in the wards and was fifteen minutes late. My patient, a 40 year old housewife with poorly controlled diabetes was fidgeting outside my room. She was unhappy. I could tell. She entered my room and started berating me for my seeming lack of consideration for her time. By the time she was done, I had apologized a dozen times. We started with the consultation and to my chagrin, she forgot to bring her home sugar monitoring chart. Her blood sugar control was abysmal and her kidneys were starting to leak protein. She was obese and still gorges on fast food despite being counseled by a dietician. She has defaulted her appointment to the eye doctor because she felt ’her eyes are just fine’. She has not been taking her medication for the past week as she was visiting her sister and forgot to bring it along.

    Before walking out of the room she had the temerity to say this: “ If only you could spend more time with me, you could have treated my diabetes better. You just had to be late.”

    My years of training in medicine kicked in: “I’m sorry. It’s my fault. It won’t happen again”

    She walks out. The next patient walks in. And the cycle repeats itself…

    This is a common scenario faced by doctors. We bear the brunt for everything that goes wrong in a patient’s life. The poorly managed disease, the horrid weather, the ungodly waiting hours, the uncomfortable waiting room chairs, the grumpy nurses, the lazy attendants and at times the odious smell that emanates from the person sitting next to them.

    We face these frivolous accusations and absorb them, giving our patients an outlet to vent their frustrations and anger. We tell ourselves, “This is part of the job”.

    We live by the same mantra regardless of our nationality, color, religion, race or creed… “The patient is ALWAYS right”.

    I have listed the following complaints based on my experience and that of my colleagues.

    The doctors are inconsiderate towards the patient’s time.

    You are probably right. We are inconsiderate. We are inconsiderate for abandoning our health so you could be healthy.

    We are inconsiderate for skipping our meals and not giving in to the excruciating pangs of hunger so we could monitor your fluids when you are down with severe dengue.

    We are inconsiderate for not returning home to have dinner with our family and loved ones because we are too busy consoling yours.

    We are inconsiderate for missing our daughter’s dance recital or our son’s football match because your child was admitted to the intensive care unit and without us being there, will probably never make it through the day.

    We are inconsiderate for forgetting our wedding anniversary because our mind was filled with the thoughts of our patients undergoing complications in labour.

    We are inconsiderate for placing our patient’s well being above all else, including our own personal time. We should have considered our family and friends before spending so much time at work. We are very inconsiderate indeed.

    The doctors are selfish and spend very little time during consultation with their patients

    An average doctor sees ten to fifteen patients in clinic and this number varies according to hospitals around the world. The larger the pool of doctors, the lesser the number of patients they see, and the amount of quality time they are allowed to spend with their patients increases.

    Bearing in mind this simple logic, if the consultation time runs from 9 am to 1 pm, which is exactly four hours, and in a clinic with roughly ten patients per doctor; we are only allowed 24 minutes per patient.

    This does not take into account the walk in patients, the forced bookings, the late comers, the ’missed appointments’ who decide to turn up on that day, the ’selective amnesiacs’ who got their appointment dates wrong, and finally the ’self anointed VIPs’ who probably donated a few dialysis machines and built the entire south wing of the hospital.

    If you have been to a hospital, have you ever wondered why our clinics don’t finish on time? Have you ever wondered why the doctors are still seeing patients during their lunch hour? Have you asked your doctors if they have had their lunch or at least a bite to eat from morning?

    If you do, I guess you will find out how ’selfish’ they really are.

    The doctors have ’special preference’ over certain patients compared to others

    You are absolutely right! We won’t even bother denying this.

    Picture this scenario. A patient presents to the emergency department with a massive heart attack. Time is of essence. In case you didn’t know, every second wasted is detrimental to the patient’s life. The doctor knowing this well, rushes to the emergency unit, pushes the patient to the cardiac care unit and performs a life saving procedure called ’angioplasty’. He may have to leave his clinic or the wards, where the stable patients are waiting to see him, who are at present in no danger whatsoever, except probably a bit annoyed of having their discharge from the ward delayed.

    We may have to delay your MRI appointment for an hour, as patient may come in with a spinal cord injury requiring urgent radiological diagnosis and surgical intervention.

    A pediatrician may take an hour of her time to review a child in an acute cubicle but may only spend minutes with your child who is well and awaiting discharge.

    We recognize the ‘frequent visitors’ to our emergency department. And we know the ‘funny feeling’ you have around your fingertips at 3 a.m can wait while we attend to a patient brought in unconscious after an accident.

    There are times the operating theaters are fully booked, that we need to postpone elective surgeries to accommodate urgent life threatening cases. We can’t proceed with removal of a lipoma from your hairy back if a mother with fetal distress arrives in labour. If an emergency Caesarean Section is not performed in time, we could lose both the mother and her baby.

    You can’t imagine our trepidations when we approach your bed, as we prepare ourselves mentally for the verbal abuse that is about to follow, knowing in full knowledge that you have fasted the whole night prior to surgery.

    You will inadvertently be mad. We know. And we can’t help it. We do have ’special preferences’. But what you don’t realize is this; it’s best not to be one of our ’special preferences’.

    The doctors are supposed to know everything about us and don’t have to keep looking at their notes

    Patients have accused me of showing little interest in them if I can’t recall every detail of their symptoms, admissions history and medications, especially if I have to keep referring to my notes.

    I am often left embarrassed by the cynical looks some patients give me when I am unable to answer all the questions. Even when I say with all honesty , ’I will look into it and get back to you’, the disparaging remarks can be quite hurtful.

    I have often wondered if a lawyer is able to recall with exact precision every case he has tried? Can a teacher recall at will the details of every one of his students examination results? Will a bank manager remember every single detail of his client’s account?

    The doctors are responsible for our health and it’s their fault if we don’t get better.

    We are responsible for our patient’s well being. Only a fool would say otherwise.

    We can continue to admonish obese diabetic patients to lose weight and control their diabetes but they don’t heed our advice. They return time and time again for more medication and continue deteriorating and get upset with the doctor when they develop complications from the disease. They assume it’s our responsibility to fix things as they pay taxes.

    We can only counsel a patient with scarred lungs to stop smoking and to be more compliant to their medication, but if they choose to continue smoking and disregard our advice, are the doctors to be faulted when they have done nothing to help themselves?

    It’s still difficult for us to comprehend the unrealistic responsibilities placed on doctors.

    There is a quote by Rumi, “Out beyond ideas of wrongdoing and rightdoing there is a field. I’ll meet you there. When the soul lies down in that grass the world is too full to talk about.”

    We are not perfect. We are not trying to be. But our patients often forget as they tend only to look at the ’thorns’ in their lives, that we, the doctors, are ’patients’ too.

    And it is not always our fault.

    From Dharmaraj Karthikesan’s blog.

    Feb 23, 2014 | 1:38 pm

     

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