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    Lecture 1 - Health System in The Philippines

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    Anonymous IJah4m
    This document discusses the roles of physicians and patients in the Philippine health system. It provides details on: 1) The process to become a doctor which involves undergraduate studies, medical school, internship, and residency. 2) The relationship between physicians and patients which is consensual and fiduciary in nature, with physicians having duties to provide competent care and maintain confidentiality, and patients having rights like informed consent. 3) The obligations of both physicians and patients, with physicians required to practice competently and ethically, and patients expected to provide accurate medical information.

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    Lecture 1 - Health System in The Philippines

    Uploaded by

    Anonymous IJah4m
    144 views38 pages
    This document discusses the roles of physicians and patients in the Philippine health system. It provides details on: 1) The process to become a doctor which involves undergraduate studies, medical school, internship, and residency. 2) The relationship between physicians and patients which is consensual and fiduciary in nature, with physicians having duties to provide competent care and maintain confidentiality, and patients having rights like informed consent. 3) The obligations of both physicians and patients, with physicians required to practice competently and ethically, and patients expected to provide accurate medical information.

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    LEGAL MEDICINE INTRODUCTION

    Original Title

    Lecture 1 - Health System in the Philippines

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    This document discusses the roles of physicians and patients in the Philippine health system. It provides details on: 1) The process to become a doctor which involves undergraduate studies, medical school, internship, and residency. 2) The relationship between physicians and patients which is consensual and fiduciary in nature, with physicians having duties to provide competent care and maintain confidentiality, and patients having rights like informed consent. 3) The obligations of both physicians and patients, with physicians required to practice competently and ethically, and patients expected to provide accurate medical information.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    144 views38 pages

    Lecture 1 - Health System in The Philippines

    Uploaded by

    Anonymous IJah4m
    This document discusses the roles of physicians and patients in the Philippine health system. It provides details on: 1) The process to become a doctor which involves undergraduate studies, medical school, internship, and residency. 2) The relationship between physicians and patients which is consensual and fiduciary in nature, with physicians having duties to provide competent care and maintain confidentiality, and patients having rights like informed consent. 3) The obligations of both physicians and patients, with physicians required to practice competently and ethically, and patients expected to provide accurate medical information.

    Copyright:

    © All Rights Reserved
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    Download as ppt, pdf, or txt
    of 38

    LEGAL MEDICINE

    Gonzalo B. Roman Jr.MD.,FPSP

    Wesleyan University Foundation


    John Wesley School of Law
    Gonzalo B. Roman Jr.,MD.,FPSP, MBAH
    • Medical Degree, University of Santo Tomas, 1980
    • Residency Training in Anatomic and Clinical Pathology – Rizal
    Medical Center, 1986
    • Masters Degree, Business Administration in Health, Ateneo Graduate
    School of Business, 2014
    • Fellow, Philippine Society of Pathologists
    • Former Chairman, Board of Pathology
    • Former Board of Governors, Philippine Society of Pathologist
    • Former President, Philippine Society of Pathologist
    • Associate Professor Of Pathology – Angeles University Foundation
    Gonzalo B. Roman, Jr.,MD, FPSP
    Legal Medicine vs. Medical
    Jurisprudence
    • LEGAL MEDICINE – branch of medicine which deals with the
    application of medical knowledge for the purpose of law or simply put,
    medicine applied to legal cases.
    • MEDICAL JURISPRUDENCE – branch of law which deals with the
    organization and regulation of the medical profession, with the
    contractual obligations existing between the practitioner and his
    patient, and the duties imposed on the practitioner by the state.

    - Maligaya, Renato, MD, LLB


    The Philippine Health System
    Health System in the Philippines
    • Department of Health
    • Different types of hospitals
    • Doctors
    • Nurses
    • Other paramedical personnel
    • Financial matters
    • Patients
    Different types of Hospitals
    • PRIMARY HOSPITALS
    • SECONDARY HOSPITALS
    • TERTIARY HOSPITALS
    • MATERNITY AND LYING-IN CLINICS
    • SPECIALTY HOSPITALS
    • Philippine Heart Center
    • National Kidney and Transplant Institute
    • Research Institute for Tropical Medicine
    • Philippine Lung Center
    • Orthopedic Hospital
    • National Center for Mental Health
    Different types of Medical Doctors
    • Student Doctors – Medical Clerks, Post Graduate Interns
    • General Practitioners
    • Resident Physicians
    • Consultants/Specialists
    Health Financing
    • Four main sources of financing
    • National and local government
    • Insurance (government and private)
    • User fees/out of pocket
    • donors
    If confined where does the money come
    from?
    Sources Confined in Private Confined in Public
    Hospital (%) Hospital (%)
    Salary/Income 48 51
    Loan 17 23
    Savings 37 32
    Donation 17 23
    PhilHealth 51 24
    SSS/GSIS 4 2
    HMO 6 1
    Others 0.82 0.32

    Source: National and Demographic Health Survey, 2008


    Health Care Delivery System
    • Devolved to the Local Government System (LGUs) in 1991.
    • Health facilities
    • Government hospitals
    • Private hospitals
    • Primary health care facilities
    • Birthing clinics

    • 721 of all hospitals (40%) are government owned.


    • 70% are managed by the DOH
    • 30% are managed by the LGU

    Source: DOH, 2009


    Number of Hospital beds
    • WHO recommendation is 2 hospital bed per 1000 population

    Region Number of beds Rate per 1000


    population
    Ilocos Region 4163 0.84
    Central Luzon 8218 0.84
    ARMM 586 0.17
    NCR 27779 2.47
    PHILIPPINES 94199 1.04
    Human Resources
    • Main drivers of health care system
    • Huge reservoir of human reservoirs in the Philippines but unevenly
    spread. Most are concentrated in urban areas such as Metromanila and
    other cities.
    Utilization of Health Facilities
    • Consultations:
    • 50% sought consultation in public facilities
    • 42% went to private facilities
    • 7% sought alternative or traditional health care

    • Child delivery
    • 36% still delivered by “hilots”
    Department of Health
    • Licensing and
    Regulatory powers.
    • All public and private
    hospitals including
    Rural Health Units
    Physician
    How to become a doctor
    • Elementary
    • High school
    • Four years of Bachelor of Science degree
    • Four years of Medical education
    • One year of Post Graduate Internship
    • Board Examination
    • Residency to any specialty
    Different specialties
    • Internal Medicine
    • Surgery
    • Obstetric Gynecology
    • Pediatrics
    • Anesthesia
    • Psychiatry
    • Pathology
    • Radiology (Diagnostic Imaging)
    Prerequisite to the practice of medicine
    • 21 years of age
    • Passed the Medical Board Examination
    • Holder of valid certificate of registration.
    - Section 8, Medical Act of 1959 as Amended (R.A. 2382)
    Candidates for Board Examination
    • Citizen of the Philippines or of the country which permits the Filipinos
    to practice under the same rules and regulations governing citizens
    thereof evidence by competent and conclusive documents confirmed by
    the Department of Foreign Affairs.
    • Good moral character.
    • Sound mind.
    • Not have been convicted of any offense involving moral turpitude.
    • Holder of degree of M.D. or equivalent from duly recognized college
    of medicine.
    - Section 9, Medical Act of 1959 as Amended (R.A. 2382)
    Acts constituting practice of medicine
    • A person shall be considered as engaged in the practice of medicine
    (a) who shall, for compensation, fee, salary or reward in any form, paid to him
    directly or through another, or even without the same, physical examine
    any person, and diagnose, treat, operate or prescribe any remedy for any
    human disease, injury, deformity, physical, mental or physical condition or
    any ailment, real or imaginary, regardless of the nature of the remedy or
    treatment administered, prescribed or recommended; or
    (b) who shall, by means of signs, cards, advertisements, written or printed
    matter, or through the radio, television or any other means of
    communication, either offer or undertake by any means or method to
    diagnose, treat, operate or prescribe any remedy for any human disease,
    injury, deformity, physical, mental or physical condition; or
    (c) who shall use the title M.D. after his name.

    - Section 10, Medical Act of 1959 as Amended (R.A. 2382)


    Exemptions
    • The preceding section shall not be construed to affect
    (a) any medical student duly enrolled in an approved medical college or
    school under training, serving without any professional fee in any
    government or private hospital, provided that he renders such service
    under the direct supervision and control of a registered physician;
    (b) any legally registered dentist engaged exclusively in the practice of
    dentistry;
    (c) any duly registered masseur or physiotherapist, provided that he
    applies massage or other physical means upon written order or
    prescription of a duly registered physician, or provided that such
    application of massage or physical means shall be limited to physical or
    muscular development;
    Exemptions
    (d) any duly registered optometrist who mechanically fits or sells
    lenses, artificial eyes, limbs or other similar appliances or who is engaged in
    the mechanical examination of eyes for the purpose of constructing or
    adjusting eye glasses, spectacles and lenses;
    (e) any person who renders any service gratuitously in cases of
    emergency, or in places where the services of a duly registered physician,
    nurse or midwife are not available;
    (f) any person who administers or recommends any household
    remedy as per classification of existing Pharmacy Laws; and
    (g) any psychologist or mental hygienist in the performance of his
    duties, provided such performance is done in conjunction with a duly
    registered physician.
    Nature of Physician-Patient
    Professional Relationship
    • CONSENSUAL
    • Mutual consent of both parties
    • When patient seeks consultation with a physician, it is an expressed
    consent to the professional relationship
    • When doctor attend to the patient, it is also an expressed consent to the
    professional relationship

    • FIDUCIARY
    • One founded in trust, faith and confidence
    Duties and obligations of the
    physician toward his patients:
    • He must possess that knowledge and skill possessed by an average
    physician.
    • He must use such knowledge and skill with ordinary care and due
    diligence, like a good father of the family.
    • He is obliged to exercise his best judgment in good faith.
    • He has the duty to keep the secrets and confidentialities of his patients.
    Rights of patients

    • Right to appropriate medical care and humane treatment.


    • Right to informed consent.
    • Right to refuse treatment.
    • Right to privacy and confidentiality
    • Right to information
    • Right to choose Health Care Provider and Facility
    • Right to a second or third opinion.
    • Right to Self-determination
    Rights of patients

    • Right to religious belief.


    • Right to medical records.
    • Right to leave.
    • Right to refuse participation in Medical Research
    • Right to correspondence and to receive visitors.
    • Right to express grievances
    • Right to be informed of His rights and Obligations as a patient.
    Obligations of patients to their
    physicians
    • To provide accurate and complete information.
    • To know and understand the terms and conditions that are not included
    in the physician-patient relationship contract.
    • To understand the purpose and cost of treatment.
    • To settle their financial obligations.
    • To accept the consequences of his own Informed consent.
    • The obligation to himself and others
    • To exhaust grievance mechanism
    • To report unexpected health changes.
    Rights of Physicians

    • Right to choose patients


    • Right to limit his medical practice
    • Right to avail of hospital services
    • Right to determine the appropriate management procedure
    • Right to receive just and fair compensation from his patients
    • Right of way in a call for emergency
    • Right to hold certain public or private offices
    Rights of Physicians

    • Right to perform certain services


    • Right of membership in medical societies
    Liabilities of Physicians
    • Administrative liability
    • Criminal liability
    • Civil liability
    PARAMEDICAL PERSONNEL
    • NURSES
    • MEDICAL TECHNOLOGIST
    • X-RAY TECHNICIANS
    • PHYSICAL THERAPISTS
    • PHARMACISTS
    • DIETICIANS
    • HOSPITAL AIDES/ORDERLIES
    NEXT WEEK
    • BASIC MEDICAL TERMINOLOGIES
    • ANATOMY, PHYSIOLOGY, BIOCHEMISTRY AND OTHER
    MEDICAL SCIENCES FOR LAWYERS
    • THE HOSPITAL
    • THE HOSPITAL CHART

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