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Indigent Patient Help Program - Mine, Ours, Yours

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Indigent Patient Help Program

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Indigent Patient Help Program - Mine, Ours, Yours

  1. 1. Indigent Patient Help Program – Mine, Ours, Yours Reynaldo O. Joson, MD, MHA, MHPEd, MSc Surg Annual Conference of Tripartite Training Institution in Manila March 27, 2015
  2. 2. Indigent Patient Help Program – Mine, Ours, Yours In all hospitals in the Philippines, both government and private, there will always be indigent patient incidents.
  3. 3. Indigent Patient Help Program – Mine, Ours, Yours Likewise, in the practice of our medical / surgical profession, we will encounter indigent patient incidents.
  4. 4. Indigent Patient Help Program – Mine, Ours, Yours What are indigent patient incidents? These are the incidents in which the patients don’t have or don’t have enough money to secure the medicines, supplies, and tests needed for their medical management if these cannot be given for free.
  5. 5. Indigent Patient Help Program – Mine, Ours, Yours Setting of indigent patient incidents? • hospital’s emergency department • inpatient services department • outpatient department • private medical clinic of an affiliated physician • more common in government hospitals
  6. 6. Indigent Patient Help Program – Mine, Ours, Yours The “indigent patient incidents” are primarily a result of the presence of indigent patients in the community (Philippines, provinces, cities, municipalities, etc.)
  7. 7. Indigent Patient Help Program – Mine, Ours, Yours Indigent patients are present in the community • because of the inherent presence of citizens • who are jobless • not working to earn • struck by unfortunate events in life that drain their financial resources and reserve, etc.
  8. 8. Indigent Patient Help Program – Mine, Ours, Yours In short, there will always be a segment of the citizenry in any community in the Philippines which consist of indigent patients.
  9. 9. Indigent Patient Help Program – Mine, Ours, Yours The “indigent patient incidents” are secondarily a result of increasing costs of healthcare compounded by absence of hospitals which can continuously give out totally free medical services.
  10. 10. Indigent Patient Help Program – Mine, Ours, Yours The “indigent patient incidents” are tertiarily a result of a national health insurance system (specifically, PhilHealth) which cannot cover all the medical expenses of every citizen whenever the latter get sick.
  11. 11. Indigent Patient Help Program – Mine, Ours, Yours There won’t be indigent patient incidents in the community if all individuals and families are economically productive and have a system to adequately meet the demands of current and future medical expenses. This scenario, however, is extremely difficult, if not possible, to achieve.
  12. 12. Indigent Patient Help Program – Mine, Ours, Yours Controlling the costs of healthcare and strengthening the national health insurance system can only mitigate and reduce the number of indigent patient incidents.
  13. 13. Indigent Patient Help Program – Mine, Ours, Yours There will always be indigent patient incidents in our midst, in our hospitals, whether government or private, and in our private clinics.
  14. 14. Indigent Patient Help Program – Mine, Ours, Yours The presence of indigent patient incidents is a daily challenge to hospitals (both government and private, but more for the government ones) which have limited resources and budget for free services, medicines, and supplies to give out.
  15. 15. Indigent Patient Help Program – Mine, Ours, Yours It is a bigger challenge for the government hospitals because of the citizens’ expectation that these hospitals should cater to all indigent patients in the community using taxes paid to the government.
  16. 16. Indigent Patient Help Program – Mine, Ours, Yours For both government and private hospitals, the challenge is not limited to the quantity of free services, medicines, and supplies they can give to indigent patients in their midst.
  17. 17. Indigent Patient Help Program – Mine, Ours, Yours More importantly, the challenge is on the indigency associated quality and ethical issues. Specifically, these are, • there should be NO delay in treatment because of indigency reason and • NO patient is deprived of proper medical/surgical treatment because of indigency reason.
  18. 18. Indigent Patient Help Program – Mine, Ours, Yours For private practitioners with indigent patients in their clinics, the challenges mentioned for the hospitals are essentially the same though in lesser degree and urgency.
  19. 19. Indigent Patient Help Program – Mine, Ours, Yours The private practitioners are not expected to have stocks of medicines and supplies in their clinics that can be given to indigent patients for free when the latter consulted them. What are usually and given free are the free consultation services and advices when there are indigent patients in the private clinics.
  20. 20. Indigent Patient Help Program – Mine, Ours, Yours The issue of delay in treatment because of indigency reason is not that great as compared to that in a hospital setting because usually patients seen in private medical clinics are not in life-threatening condition.
  21. 21. Indigent Patient Help Program – Mine, Ours, Yours Likewise, the issue of deprivation of proper medical / surgical treatment because of indigency reason is not that great compared to that in a hospital setting because there is usually time to refer the indigent patients to appropriate institutions with indigent patient help programs.
  22. 22. Indigent Patient Help Program – Mine, Ours, Yours The phenomenon of the indigent patient incidents is a reality and a challenge that all of us, working in the hospitals, both government and private, and running a private clinic, have to face and must know how to manage.
  23. 23. Indigent Patient Help Program – Mine, Ours, Yours We must admit that all these years all hospital administrators, the entire physician workforce from all the clinical medical departments and all private practitioners have always been trying their very best to manage the “indigent patient incidents” by assisting the indigent patients in securing the needed medicines, supplies, equipments and diagnostic tests to be done from various sources. They should be commended for their compassion and resourcefulness.
  24. 24. Indigent Patient Help Program – Mine, Ours, Yours A question I pose: is there a structured, comprehensive, effective and efficient indigent patient help program that we can adopt to mitigate our coping, if not to use the word struggling, with the indigent patient incidents in our midst? If there is none, let’s brainstorm and share experiences with the goal of coming out with such a program.
  25. 25. Indigent Patient Help Program – Mine, Ours, Yours I will start the ball rolling by presenting my experiences, thoughts, perceptions, opinions, and recommendations on an indigent patient help program in my private clinic and for Ospital ng Maynila Medical Center Department of Surgery. After me, we will listen to the indigent patient help programs from Manila Doctors Hospital and Manila Med.
  26. 26. Indigent Patient Help Program – Mine In my private clinic, every now and then, I encounter indigent patient incidents. I always try my very best to help to make sure these indigent patients get the medical management they need.
  27. 27. Indigent Patient Help Program – Mine Below are the measures that I had done and will continue to do as indicated for indigent patients consulting in my clinic.
  28. 28. Indigent Patient Help Program – Mine • Practice value-based health care services which is providing services in such a way that the cost of the health care management is kept to the lowest minimum possible or most reasonable expense possible while continuing to maintain and improve quality and safe outcomes.
  29. 29. Indigent Patient Help Program – Mine Value-based health care services emphasizes the importance of • accurate clinical diagnosis to avoid unnecessary expenses • no unnecessary paraclinical diagnostic procedures • no unnecessary treatment procedures • no unnecessary drugs and miscellaneous expenses • but still maintaining quality and safe outcomes
  30. 30. Indigent Patient Help Program – Mine Value-based health care services emphasize the use of management options with minimum possible or most reasonable expenses yet maintaining and safe outcomes.
  31. 31. Indigent Patient Help Program – Mine • Help them with recommendation of measures on how to minimize the costs of medical management (which diagnostic centers to go to; which hospitals to be admitted; room accommodations; which doctors to go to in case of referrals; etc.)
  32. 32. Indigent Patient Help Program – Mine • Encourage them to use the benefits from PhilHealth. • Treat and operate on them with the least or affordable professional fees. If indicated, give pro bono services.
  33. 33. Indigent Patient Help Program – Mine • Give them medical and surgical supplies, if I have. • Assist them in getting into government hospitals, if needed. • Assist them in getting external sources of help like Philippine Charity Sweepstakes Office (PCSO) and other institutions.
  34. 34. Indigent Patient Help Program – Ours (OMMC Department of Surgery)
  35. 35. Indigent Patient Help Program – Ours (OMMC Department of Surgery) I started an Indigent Patient Help Program in 2001 when I became Chairman of the Department of Surgery of Ospital ng Maynila Medical Center.
  36. 36. Indigent Patient Help Program – Ours (OMMC Department of Surgery) Managing patients without the needed medicines and supplies can be very frustrating and depressing for the physicians, especially during emergencies. This was the main driver for creating the Indigent Patient Help Program of the OMMC Department of Surgery.
  37. 37. Indigent Patient Help Program – Ours (OMMC Department of Surgery) The other driver for the Program was the need to provide quality and safe patient services even for indigent patients.
  38. 38. Indigent Patient Help Program – Ours (OMMC Department of Surgery) The objectives of the Indigent Patient Help Program of OMMC Surgery have been: 1) NO delay in treatment because of indigency reason and 2) NO patient is deprived of proper surgical treatment because of indigency reason.
  39. 39. Indigent Patient Help Program – Ours (OMMC Department of Surgery) The program consists basically of the Indigent Patient Help Boxes which contain stand-by surgical supplies and medicines to be used for indigent patients when the inventory of the hospital is depleted.
  40. 40. Indigent Patient Help Program – Ours (OMMC Department of Surgery) Each resident has an Indigent Patient Help Box whose inventory has been maintained through donations from external benefactors, consultants, and alumni.
  41. 41. Indigent Patient Help Program – Ours (OMMC Department of Surgery) Each resident has an Indigent Patient Help Box whose inventory has been maintained through donations from external benefactors, consultants, and alumni.
  42. 42. Indigent Patient Help Program – Ours (OMMC Department of Surgery) The program also consists of a stand-by emergency fund to be used for emergency purchase of supplies that are not available in the Boxes.
  43. 43. Indigent Patient Help Program – Ours (OMMC Department of Surgery) Another aspect of Indigent Patient Help Program is to get external donors for needed surgical equipments like cautery and suction machines that cannot be supplied by the hospital.
  44. 44. Indigent Patient Help Program – Ours (OMMC Department of Surgery) • Providing cost-effective management, not only to avoid premature depletion of funds for “indigent patient incidents” of the hospital but also to control the medical expenses of the patients.
  45. 45. Indigent Patient Help Program – Ours (OMMC Department of Surgery) • Giving advices on how to minimize the costs of medical management • (which diagnostic centers and other hospitals to go to in case diagnostic and treatment procedures are not available in the hospital; which doctors to go to in case of external referrals; etc.)
  46. 46. Indigent Patient Help Program – Ours (OMMC Department of Surgery) • Encouraging them to use the benefits from PhilHealth. • Assisting them in getting external sources of financial help like PCSO and other institutions.
  47. 47. Indigent Patient Help Program – Ours (OMMC Department of Surgery) • Conducting free in-house surgical missions (such as Operasyon Bosyo and Kanser sa Suso) using funds from external donors.
  48. 48. Indigent Patient Help Program – Yours (MDH; MCM)
  49. 49. Indigent Patient Help Program – Mine, Ours, Yours Reynaldo O. Joson, MD, MHA, MHPEd, MSc Surg Annual Conference of Tripartite Training Institution in Manila March 27, 2015

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