Category Archives: Physician

On Your Graduation

For my endocrine fellows who graduate today.

I was pleasantly surprised to receive a book from you yesterday. A parting gift as you graduate today. From the Eyes of A Healer, an anthology of medical anecdotes. I saw what you wrote on the back of the front cover. Consider this my response.

Last night, as I sat in the car on my way home, tired but strangely content to finally have some cash in my pocket (I had been away from clinic for a week) – I thought of giving you a thousand peso bill as my graduation gift. I wondered if I still had some crispy ones, like what grandparents give out on Christmas.

It is not an original idea. Because someone had done the same for me, more than a decade ago. Though I don’t remember now how much cash that was.

Everyone loves graduations. I’m sure someone will tell you that today is the beginning and not the ending. How many graduations have you had as you pursued a career in medicine? Too many perhaps, but this is probably your last. Now, you will start an endocrine practice. You’ll be on your own, finally.

The one thousand peso bill. For me it evokes that ad which asks, Saan aabot ang 20 pesos mo? What is it for? My small contribution to the days ahead when you will no longer receive a fellow’s stipend.

Enough to buy a few cups of coffee as you sit waiting for patients in an empty clinic. They will come, eventually. And someday, you might wish you had time to drink coffee when the line at your clinic is long. No worries. A grateful patient will buy you coffee, and more.

Enough to buy load if you needed to call me to ask something. Once I had to call her to ask, How do I give endocrine clearance for gynecomastia? Sure, I knew the endocrine workup. But I also knew it was expensive. The guy just wanted to be a waiter in the Middle East. Surely, gynecomastia was the least of his worries.

Enough to pay for a few minutes of surfing online. You might need it to go on Pubmed to search for answers to an all important clinical question, for your very first confined patient. Enough to make phone calls to the nurses station hourly, to adjust an insulin drip.

So what will you do with this one thousand peso bill? It’s all up to you. Graduation is about possibilities. Someday soon, I’d like to hear how you spent it and how you’re doing. Good luck!





Consumerism in healthcare and the Physician-Patient Relationship

On, Dr. Rick Nauert writes in this post entitled Money Changes Physician-Patient Relationship – 

“We have forgotten that aspect of professional folk wisdom,” Hall said. “Doctors need to make their treatment recommendations in the context of what patients can and can’t afford, with the understanding that some patients can’t afford what they might recommend.”

Continue reading