Category Archives: Physician


Social Media & Healthcare: An Opportunity in the Philippines

Social MediaThe Department of Medicine of the Philippine General Hospital hosted the Symposium on Healthcare Improvement Strategies in the New Millennium: Mobile Health Applications and the Digital Media last October 21 at the Science Hall. The Department Chair, Dr. Agnes Mejia asked me to give a short presentation to preface the lecture of Dr. Leonard Achan, Jr on social media and healthcare.  Dr. Achan is currently the Vice President of Digital and Social Media and Executive Services at Mount Sinai Medical Center. More of his talk in my next post …

I began my presentation by showing an infographic (Social@Ogilvy) of Facebook users by continent. Did you know that with 139 million users, Asia is the 5th largest nation on Facebook? The Philippines was ranked 5th globally earlier this year though we sank to No. 8 this October. That’s still a formidable 26,721,920 Filipinos on Facebook according to Well, that was last week. As of today there are now 26,752,000 Filipinos on Facebook! Despite being ranked 8th, the Philippines is still the Social Networking Capital of the World! And that’s because estimates that 90% of our online population are Facebook users.  That’s an amazing 27% of our total population – one of every four! And according to, Filipinos are loyal Facebook users averaging 26 visits per month and logging in 6.2 hours per visit. estimates that there are 4,016,345 Filipinos on Twitter as well! These data only shows that an incredible opportunity exists locally, to harness the power of social media i.e. Facebook and Twitter, for healthcare. Major private hospitals ( like The Medical City, Asian Hospital, Makati Medical Center & St. Luke’s Medical Center) are already on Facebook and Twitter advertising their services, and dishing out helpful nuggets of health information.

I’ve a little experience on using Facebook as a platform for patient education, as I put up the Hormone Hotspots fanpage earlier this year. Hormone Hotspots is a lay magazine published by quarterly by the Philippine Society of Endocrinology & Metabolism (PSEM). It contains health information for patients with endocrine problems e.g. diabetes, goiter, etc. The magazine is given to PSEM-affiliated endocrinologists who then give these out to patients at their clinics. Funding for the publication had run out this year so I asked the PSEM Board’s permission to post the magazine articles on a Facebook fanpage instead. We had only a hundred likes in the beginning – and most of them were our own PSEM members and not patients! I decided to try out Facebook ads. In a month, at the cost of only five cents a click, I managed to grow our readership by a thousand! I was happy with this but our Facebook ad statistics showed a click-through rate of only 0.1%.  That meant our ad was shown nearly two million times to get that one thousand likes. 🙁 I’m still learning how to target our ads better. 🙂 After all, no one mentions their interest in learning more about diabetes or goiter in their Facebook profiles! Or maybe, our ad was too boring:

Do you have diabetes or a goiter? Get reliable health information from the Philippine Society of Endocrinology & Metabolism.

The Hormone Hotspots fanpage is linked to the PSEM website where our readers can download a pdf of the magazine for free. Hopefully, when they visit the website they can also learn more about other PSEM activities.

The use of social media for healthcare is just in its infancy here in the Philippines. After all, none of the private hospitals I mentioned earlier in this post have more than 10,000 likes on Facebook or more than 600 followers on Twitter yet. But we can only expect the numbers to grow!


Diabetes and Pre-employment Clearance

Last November 10, the Maritime Association of Doctors and Clinics (MARDOCS) invited me to talk on diabetes and obesity. MARDOCS had their first convention which gathered manning agencies doctors, nurses and staff of pre-employment clinics at the Hyatt Manila.

Diabetes and obesity are important concerns for the seafaring industry as these conditions continue to increase in the workforce. Endocrinologists like myself often receive referrals to evaluate seafarers who are diagnosed diabetic, or who for the first time have been found to have glucosuria, or elevated fasting blood sugar / HbA1c. Are you aware of Administrative Order No. 2007-025 from the Department of Health which discusses the “Revised Guidelines for Conducting Medical Fitness Examinations for Seafarers”?

DOH AO 2007-025 defines “Fit for Sea Duty” as a seafarer who is “able to perform safely the duties of his position aboard a ship in the absence of medical care, without danger to his health or to the safety of the vessel, crew and passengers.” Fasting blood glucose is NOT required for new applicants and serving seafarers less than 40 years old though a routine urinalysis is.  Glucosuria on urinalysis often triggers measurement of fasting blood glucose though, in most of the referrals I receive. Lab work-up for seafarers 40 and above include fasting blood glucose, creatinine, uric acid, total cholesterol, triglyceride and ECG.

Under this guideline, the following endocrine conditions require further investigation and complete assessment:

  • Acromegaly
  • Adrenal insufficiency, uncontrolled
  • Uncontrolled type 2 diabetes mellitus
  • Diabetes mellitus requiring insulin
  • Hyperthyroidism, diffuse toxic goiter, toxic nodular goiter, thyrotoxicosis, thyroiditis
  • Obesity, incapacitating or body mass index of 34 and above with or without co-morbid pre-existing conditions
  • Osteoporosis
  • Pheochromocytoma

In my presentation, I defined diabetes, impaired fasting glucose, impaired glucose tolerance and prediabetes. I enumerated the risk factors for diabetes and who should be screened. I also talked about the use of HbA1c in diagnosing diabetes, in addition to fasting blood glucose and the glucose tolerance test. I’m often “rushed” to give endocrine clearance for seafarers with elevated blood sugars, so I also had a slide explaining when we can reasonably expect glucose to go down when an oral hypoglycemic agent is started. More importantly, I shared with them the current glycemic targets recommended by the American Diabetes Association. Finally, I defined obesity and compared the BMI cut-offs according to the WHO and the Asia Pacific classification.