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One of
the main roles of every physician's is to help improve the health of the
community which he or she serves. This practically means diagnosing illnesses
and prescribing medications. However, not only this, for physicians to do this
well, some must devote themselves to further studies and some into research
where we learn: how certain diseases behave; whether certain medications are
appropriate cures or not; whether and how certain health problems can be
prevented. All of this requires a sound understanding of how the human body
functions in theory.
In the
Holy Scriptures, we find God repeatedly calling us to take responsibility for
the welfare of the poor, the carrying out of justice, the stewardship of the
physical world. The health care professionals can make a big contribution in
this call.
But first,
what qualities make up a good doctor in order to be effective in this chosen
health ministry?
Is it just about brains and skills? Compassion and empathy? Or courage and
credibility?
Let me cite some of these qualities:
1. Sense of responsibility - this quality is very essential in a physician. A
strong sense of responsibility to his/her patients and colleagues breeds
dedication and motivates one to do what is right, even though that might mean
going above and beyond the call of duty even one is tired. It makes you do the
right thing even if it involves sacrifice, without ulterior motives, even when
no one else is looking. Even if many or majority will go against what you believe in.
2. Compassion and empathy – People need a physician who is kind, compassionate,
humane, considerate, tolerant, generous, empathetic and sensitive. It is a
quality that brings forth dedication to the patient, but rather than from a
sense of duty, it comes forth from genuine sense of concern
3. Professionalism - The quality that ensures that the patient's rights,
autonomy, modesty and privacy is respected at all times. Being a patient is
difficult, and many patients feel that they are vulnerable, not just physically,
but also emotionally and psychologically. Being professional is not a quality
that is innate, and I think many do not realize that. Being professional at all
times is difficult because we are only human, and human nature with its needs,
weaknesses and desires do often run contrary to being professional.
4. Fund of knowledge - Needless to say that every physician needs to have an
adequate knowledge base as a foundation from which to practice. After all it is
only possible to diagnose a condition that you know about. However, medicine is
a rapidly advancing field and is not possible to know everything in medicine,
and this is where a referral/consult is appropriate.
5. Humility - Arrogance, pride and overconfidence are dangerous qualities for a
physician. They trick us into thinking we know it all, and lead us down the path
strewn with medical errors and misdiagnoses. Humility helps us recognize not
just our strengths but also our weaknesses. It helps us realize that we are not
God, despite dealing daily with life and death. It allows us to understand our
limitations, to be humble enough to ask for help and make that appropriate
referral/consult.
6. Clinical acumen and judgment - The ability to differentiate between 'sick'
and 'less sick' is crucial. Patients almost never present as 'text-book' cases
with a 'slam-dunk' diagnosis. The ability to sort through the patient history,
picking up the pertinent details (and disregarding the red herrings), examining
the patient and obtaining the appropriate tests to come up with a diagnosis.
Also knowing when to intervene, when to treat, when to admit, or when to just
observe and do nothing is a skill learnt with time and experience.
7. Communication skills and bedside manners - Communication plays an important
role in medicine, whether it be interacting with patients, colleagues or the lay
public. The ability to give bad news, counsel, comfort, discuss treatment
options and alternatives, is as important as making the diagnosis. Patients
don't just want treatment of their physical disease, but often have emotional
and psychological needs and issues that go along with a disease, especially
chronic diseases. Without good communication with their physicians, a patient is
more likely to go 'doctor-shopping' and be non-compliant with their
medications. In summary, being a good doctor is more than just board scores and strong
academics. It also involves a right attitude, aptitude, character, commitment,
demeanor and a heart of service.
Beside the
above mentioned qualities, what matters also is credibility as a healer.
In disease
prevention which is the defined as the deferral or elimination of specific
illnesses and conditions by one or more interventions of proven efficacy via
primary prevention, which is a "primordial prevention,". This refers to creating
an environment where certain challenges to health are eliminated, and thus no
other preventive interventions are necessary. A perfect example of primordial
prevention is the global elimination of AIDS.
Another
general source of disease prevention is through appropriate individual and group
behavior. Part of the disease-prevention burden lies with the individual, who
must practice behaviors that minimize disease risk and occurrence, and maximize
health states. Some obvious examples are maintaining an appropriate weight,
never taking up or ceasing the use of tobacco products, avoiding exposures that
may lead to unwanted pregnancy or passage of sexually transmitted diseases,
avoiding carcinogenic sun exposure, maintaining active exercise habits
appropriate for one's health status, appropriately using prescription drugs or
other substances, refusing to drive a vehicle after consuming alcohol, and
discouraging participation in social behaviors that may lead to disease or
injury. Some persons are more prone to risk-taking behaviors in general, thus
proper and a continued re-enforcement of info with values must be offered. As it
is very clear, people must have sufficient and accurate information in order to
assist in initiating and maintaining disease-preventing behaviors.
On the
other hand, things could somehow be different when we talk and deal about a
nearly totally incurable disease – AIDS. AIDS is already 28 years old and basing
on the UNAIDS report, so far, 35 millions are infected with an estimate of over
a million new infections this year.
The only
good news so far is less HIV-infected people are moving towards full blown AIDS
because of the availability of anti-retroviral regimen offered in a limited
scope. Thus, prevention thru factual information remains the principal weapon in
fighting against this dreaded disease.
But could a
physician make a difference? By combining his hard-earned profession,
credibility and expertise, he can make a big difference.
I will use
and share to you my own Philippine experience. In 1992, that was the year I
finished my special training on HIV Medicine. Being trained by a government
institution, I was expected to work with them. But I insisted to go on my own,
establishing a non-government organization named, AIDS-Free Philippines. Despite
some odds, I managed to tie-up with a lot of anti-AIDS NGO’s in the fight
against one common enemy- HIV. During the early 1990’s a lot of NGO’s mushroomed
all over the country due to heavy foreign funds available.
Scared by
the forecast of WHO that by the year 1998, Philippines will have at least 60,000
to 80,000 HIV and AIDS cases plus the heavy and open promotion of condom sex by
both the government’s Dept. of Health with all the other NGO’s, in 1994, I
jumped to the Catholic Church and asked the Catholic Bishops’ Conference of the
Philippines, CBCP to use my group for whom I served as the CEO and sole member.
Happily, all the 89 bishops accepted my offer, thus AIDS-Free Philippines became
the official anti-AIDS program of the CBCP. AIDS-Free Philippines is the only
pro-chastity and abstinence based anti-AIDS group in the whole country.
Nearly
everyday, I moved from one town to another, city-to-city and province to
province delivering same message, “let’s fight against AIDS” and selling one
product – ABSTINENCE carrying my personal slogan to all of my audience, “Trust
me, I’m a Doctor”. Incidentally, the most widely promoted brand of condom in the
country is Trust.
In 1996, a
top WHO personality for Asia and the Pacific came to my office offering funds in
millions of pesos and a car only I will jump to their bandwagon and start
singing alleluia to their mighty savior called “condoms”. Outright I rejected
the offer. I can’t gamble my credibility and hard toil preaching and defending
the truth about AIDS and condoms.
One time, I
engaged in a debate with the Undersecretary of the Dept. of Health about condom
use. The government insisted on their own ABC against AIDS which is Abstinence,
Be faithful but which they insisted are both not effective and impractical and
pushing Condoms as the best option. While mine is ABCD, Abstinence which is 100%
effective, Be faithful to one’s lifelong partner, use your Common sense and
conscience and avoid Drugs.
I
challenged that government official asking him why insist on condoms when we
know it’s now 100% effective against a100% fatal infectious virus. His answer
was, “at least with the help of WHO, we are doing something”. I assure him that
I will promote condoms right after the debate, it he could show me any brand of
condoms sold worldwide indicating that their product can offer 100% protection
against HIV. That a condom is 100fool-proof, that the promotion and use of
condom does not encourage sexual promiscuity especially among the young and that
he could show me a name of a country, even just one country which after pushing
condoms it resulted in a diminished number of HIV cases. Poor guy, he can’t
utter any word.
My best
example is my own neighbor Thailand. Look, in 1984, we in the Philippines
recorded the first case of AIDS, a homosexual male nurse who worked in the USA.
At that time, there was no reported case from Thailand yet. The following year,
Thailand got their first case with over a hundred in the Philippines. However,
the Health Minister of Thailand launched his 100% compulsory condom use
especially in Bangkok, Pattaya, Chiang Mai and other tourist havens.
Now, after
23 years, looked what happened, see the statistics. Thailand with a population
of just over 67 million recorded over 1.5 million cases of HIV and AIDS already
versus the Philippines of 90 million people with only nearly 4,000 combined
reported HIV and AIDS cases.
Four years
ago, a BBC Correspondent called straight from London and asked me this question,
“I don’t understand why, because we got this report from New York Times, that
UNAIDS is puzzled as to why, despite the fact that all the major ingredients for
a potential epidemic on AIDS is found in your country like prostitution,
poverty, gay lifestyles, sex tourism and drugs yet what UNAIDS feared of and
forecasted did not realized. UNAIDS earlier forecasted that your country will
have at least 80,000 cases of AIDS by 1999, but as reported your country only
reported a little over than 2,000 cases. What do you think Dr. Bullecer is the
reason why?
My quick
answer was, “simple, first, we in the Philippines got a very high literacy rate
or know-how on HIV and AIDS and its prevention, majority of our people
especially the young still do not believed in condoms and most important is our
religion, this helped a lot and on top of it our unique Filipino culture and
traditions”.
My dear
friends, if we must insist on promoting and defending only what is true at the
same time pursuing the belief that we cannot compromise truth amidst the black
propaganda which I think is designed not to stop the spread of HIV but to push
their own agenda which could include business and controlling population.
IN AIDS,
the truth makes a difference! Thank you very much. GOD bless us all. |
