The Challenge of Care Coordination

As an endocrinologist, care coordination is something I struggle with in my clinic. There being only 200 or so endocrinologists in the Philippines, I often see patients from places where there are no endocrinologists. They travel great distances to see me. As you can imagine, persons with diabetes will need care from others such as an ophthalmologist, cardiologist, nutritionist, dentist etc. These healthcare professionals may or may not be available where the patients live. If they are not available where they are, I have to choose who to refer to in the faculty medical arts building (attached to a medical school and a university hospital) where I hold clinic and ask my secretary to schedule an appointment for them. While all medical specialties are housed under one roof, scheduling can be hit or miss. Sometimes, the patient can be seen that same day before they travel back home and sometimes not. Tracking whether the patient has indeed been seen is another problem. I can find out months later when the patient comes to her appointment with me that she was not seen for example by an ophthalmologist despite my referral.

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What I Learned from Peer Review on #DigitalScholar

The project is an online course announcement. How to make one? Use the rubric. Easy right?! Until I see the rubric! So I submitted my course announcement on time but was late finishing my peer reviews. It was more difficult than I had anticipated. I ended up on Reda’s list of #DigitalShame for submitting only two reviews (of three required) on time. I had to banish thoughts of Cersei of Game of Thrones walking onward even as people shouted Shame, shame! Continue reading


Let’s build a culture of privacy!

Let’s build a culture of privacy! That’s my main takeaway from the public consultation held by the National Privacy Commission for the implementing rules and regulations of the Data Privacy Act of 2012 last July 13 at the University of the Philippines Diliman. No less than the Commissioner himself said it. Continue reading


Day 4 on #DigitalScholar: Jean-Jacques Rousseau

Today’s learning shard at #DigitalScholar is from the philosopher Rousseau. He said this about education –

Teach your scholar to observe the phenomena of nature; you will soon rouse his curiosity, but if you would have it grow, do not be in too great a hurry to satisfy this curiosity. Put the problems before him and let him solve them himself. Let him know nothing because you have told him, but because he has learnt it for himself. If ever you substitute authority for reason he will cease to reason, he will be a mere plaything of other people’s thoughts …

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#DigitalScholar Day 1

I’m planning to blog daily about my Digital Scholar experience. Let’s see if I can keep this up!

Today’s assignment is to post an update about your proposed course title. Why it matters and for whom is it. The ultimate deliverable is either a course outline or a learning module. I am hoping that I can work enough during the next few weeks (in between my day job hehe) to complete a learning module. Continue reading


Social media and healthcare, anyone?

Looking at my Slideshare gallery of slide decks for the past year, most of my presentations are related to either technology or social media. For more than a year, I’ve been toying with the idea of creating my very own Social Media & Healthcare seminars. As scientific committee chair of the past two #HealthXPH social media and healthcare summits (#hcsmph), I put together a day-long program which (I’d like to believe) was well-received.

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#HealthXPH: It’s Handled!

I’ve been following Olivia Pope on Scandal. Don’t you just love it when she says, “It’s handled.” I remember her every time someone tags me in the latest social media mishap in Philippine healthcare. As an advocate for using social media in healthcare, people often buzz me whenever an MD has a social media faux pas, a patient complains on Facebook about a healthcare encounter or a picture violating patient privacy surfaces. Not that I can do an Olivia Pope (nor would I want to) but they want to know what I think. Well, here’s what I think 🙂 I think we should discuss this at the #HealthXPH tweet chat on Saturday March 12 8 am EST (9 pm Manila time). Continue reading


Becoming Dok Bru

I haven’t written a post here for a few weeks. I was busy writing posts at and Yes, I was busy becoming Dok Bru. Bru is short of course for Bruha or witch. 🙂

It was raining cats and dogs in Manila last July 8 so I decided to stay home. At #Doctors20 I had announced that I might revive my Facebook page after a long pause as now provides free access via one major Philippine telco. Continue reading


Where are your (bedside) manners?

This exploded in my Facebook network two days ago. Doctors and nurses were furiously sharing it with angry comments.

Are resident doctors really doctors?

I wanted to finish writing this blog post yesterday but I had to collect myself first and calm down. The author of this now viral newspaper article, is talking about THE government hospital where I trained as a resident in internal medicine. My internal medicine residency is unique in that I spent ten months in the emergency room (ER) as part of the transition batch where the ER rotation was transferred to second year residency. Thus, I rotated at the ER twice – as a first year and second year resident. I am very familiar with the setting of the story. Continue reading


Why does self-diagnosis annoy doctors?

This picture has circulated in my Facebook feed since last month. It didn’t feel right but I decided not to say anything as I saw some colleagues sharing it. I was wary of offending someone. However, there was one post in particular recently where I simply could not in good conscience keep quiet. And I said –

I am a physician and I find this picture offensive.

So what happened? The person who posted the picture deleted my reply! That’s what made me decide to write this blog post. Continue reading


#HealthXPH: To Err is Human

I am attending the First ASEAN Patient Safety Congress next week June 25-26. The theme is Towards a Unified Approach to Patient Safety: The ASEAN Perspective. A colleague will be presenting our work in the medication error study group.

Then I saw this on my Twitter feed –


My first thought was, is there Philippine data? ASEAN data? I guess I’ll find out next week at the congress.

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#Doctors20: Mind Mapping for Health

Day 1 of Doctors 2.0 You conference. I’m at the master class for Mind Mapping for Health with Margot Vanfleteren (@MargotVF). We were to give a physician and patient’s point of view respectively, to the discussion by Jose M. Guerrero (@infosegS).

Jose is the founder and CEO of Infoseg, a company dedicated to research and development of mind mapping automation applications. He is also  co-author of Introduction to the applications of mind mapping in medicine. More about Jose here. Continue reading


#Doctors20: Evaluating 20 Connected Objects

Day 1 at Doctors 2.0 and You conference. After my session with Dr. Carlo Caballero (@carvicab), I transferred rooms to catch Dr. Berci Mesko (@Berci), the medical futurist. I’d been following him for awhile on Twitter and was excited to meet Berci in person. I also wanted a picture with him as I had promised this to the rest of my #HealthXPh team mates who were also his fans. Continue reading


#Doctors20: Patient Opinion Leaders

The first session I attended on Day 1 at the Doctors 2.0 and You conference was Patient Opinion Leaders + Pharma. Denise Silber moderated the session. The speakers were –

  • Seth Ginsberg (@creakyjoints). Seth is cofounder of CreakyJoints, an online patient community for those with arthritis. Seth was diagnosed with spondyloarthritis at age 13. More about Seth here.
  • Andrew Schorr (@andrewschorr). Andrew is a medical journalist who was diagnosed with chronic lymphocytic leukemia. He is the founder of and More about Andrew here.
  • Nuria Zuniga (@TuLupus). Nuria was diagnosed with lupus at age 14. Nuria blogs at She was given a travel scholarship by the Society of Preventive Medicine to attend the conference. Read her qualifying essay on why she wanted to come to Doctors 2.0 here.

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How are clinicians using social media to get messages across?

It’s been awhile. Busy with … everything! So we’re back to answering a question from the 26 questions of Doctors 2.0 by Denise Silber.

I picked this question because I’ve grappled with this for some time now.

In the beginning it was about drawing the line for communicating with patients on Facebook. In 2010, I wrote about whether doctors and patients can become friends on Facebook. I decided I wouldn’t. I wrote another post on what doctors should do when a patient makes a friend request. Continue reading


Whose Choice is it Anyway?

At #PCP15, I listened to a symposium on how physicians communicate risk to patients. It reminded me of a recent post I had written on scaring patients. There was a patient on the sympo panel. She talked about surviving breast cancer and how when her surgeon sent her to an oncologist, the oncologist began writing down a chemotherapy regimen without even asking her if she wanted chemo or not. Continue reading


Five-star Hospital: Is it all About Patient Experience?

If you’re planning to stay at a hotel you have not visited before, it’s de rigeur to check out the hotel ratings at TripAdvisor. The five-star rating ranges from 1 star Terrible to 5 stars Excellent. A rating is also given for the following parameters: sleep quality, location, rooms, service, value and cleanliness. Reviews are even classified according to the type of traveler: families, couples, solo and business.

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#HealthXPH at #PCP15

Leading in Social Media. That was the title of the #HealthXPH symposium at the 45th Philippine College of Physician’s annual convention.

We were scheduled to start at 3 pm but the previous session ended late. Really late, that we had to start at 4 pm. My heart sank when the full ballroom nearly emptied before we could start. We had only 20 people or so left to listen. It was the last session of the day after all. But I told myself, even if there was only 1 attendee 🙂 I would still talk about #HealthXPH! Continue reading


The Ripple Effect

This was a presentation I shared with medical students at the Association of Philippine Medical Colleges (APMC) student conference last February 6 in Davao. After my lecture, some students came up to me for pictures. I also met some students from St. Louis University in Baguio City who told me they were so excited to share what they had learned from me, with their classmates who were not able to attend. Continue reading


#HAWMC: I Wish I Would Have Known

#HAWMC Day 30.

There’s a reason why we have the saying, “Hindsight is 20/20.” What do you wish you had known at the beginning of your patient journey that would have made it easier and less scary?

I differ from the rest of the #HAMWC community because I’m a doctor. I was a patient once but I’m ok now. The blogging prompt made me think though of how I talk to my patients about diabetes complications. Continue reading


#HAWMC: Bye, Bye, Bye

#HAWMC Day 27.

Living with an illness, you are more likely to face people who don’t understand your daily struggles. Sometimes, these people can be inconsiderate and hurtful. Have you ever wanted to tell them how you really feel, but didn’t feel like you were able to? Now is your chance! Write an open letter to the people who have hurt you. What would you say to them? What lessons would you like them to learn?

Although I’ve had my share of health problems, I’ve been well! But most of the #HAWMC community as I’ve learned in the last few weeks are brave people coping with chronic illness. I wait with bated breath to see how many open letters in #HAWMC will be addressed to doctors. Continue reading


#HAWMC: The Continuing Saga of #HealthXPh

#HAWMC Day 23.

Write about whatever you like! Got a great story, opinion, or tip to share? Tell us here.

I was at the UPMAS CME last Wednesday where I talked about #HealthXPh. It was nostalgic, recalling how it all started December 2013. I told the audience right away – I’m a Twitter evangelist! #HealthXPH is a tweet chat I co-founded with Dr. Gia Sison, Dr. Narciso Tapia and Dr. Remo Aguilar. We’re on every Saturday 9 pm Manila time. Continue reading


#HAWMC: Reflection

#HAWMC Day 21.

This is a day to reflect. For the WEGO Health family, we reflect on the inspiring and tireless work Health Activists do every day. Reflect on your journey today. What are your thoughts and hopes for the future?

Is the #HAWMC prescient? Now is a good time to recall my life goal and reflect on my earlier blog entry – the key to happiness. Continue reading


#HAWMC: Life Goal

#HAWMC Day 16.

What’s one thing that your 10-year-old self thought you would do? Can you still do it? How would you approach it to make it happen?

At 10, I wanted to be a doctor. I’ve wanted to be a doctor for as long as I can remember! And I wanted to have it all – a career, loving husband, kids and the Nobel Prize … cue in a witch’s cackle. Continue reading


#HealthXPH: Patient Peer Mentoring

I was browsing #HAWMC on Twitter and came across someone who said she is paying it forward by volunteering her time as a patient mentor for those newly-diagnosed with psoriasis. I googled the mentoring program of the National Psoriasis Foundation – it’s called Psoriasis One to One. There is a mentor page where one can find out more and choose a mentor based on their profiles. They are patients who have had psoriasis or psoriatic arthritis. Continue reading


Consent for Medical Photos on Facebook

I’m a doctor and so it’s not surprising that I have many doctors on my list of Facebook friends. Not often but not as rare as I would want it to be, I’ve seen various photos I’d rather not see on my Facebook feed: a dismembered hand reattached, a humongous ovarian tumor, an eye socket with a knife sticking out of it, a patient unconscious on an operating table, patients in the background at the emergency room, and hands in bloodied surgical gloves around a draped boy’s body at circumcision missions. Continue reading


What makes a five-star physician?

Throughout medical school I was told to strive towards becoming a five-star physician: clinician, educator, manager, researcher and social mobilizer. And so this is what I measure myself against when I turn introspective now on New Year’s eve. What have I accomplished as a clinician, educator, manager, researcher and social mobilizer in 2014? How can I become a better five-star physician in 2015? Continue reading