Confessions of a Hospital Slave, Part II

“The essence of all slavery consists in taking the product of another’s labor by force. It is immaterial whether this force be founded upon ownership of the slave or ownership of the money that he must get to live.”
– Leo Nikolaevich Tolstoy

It was in March that I first wrote about the “irregularities” I experienced as a medical resident in training in the hospital.  Perusing the post, I feel that I’ve stated much of my views already on what is needed to be corrected in the system.  And in a way, a lot of events have already occurred since then.  Sadly, however, nothing much have changed.

A number of unaccomplished discharge summaries are still there.  It took several months of having to stay overtime just to finish writing and even asking help from other co-residents.  An agreement was made that the more senior residents can help the junior residents finish the number of charts, in time for the next Philhealth accreditation, provided that a certain amount of the junior residents’ salaries will be split among those who helped write the discharge summaries.  A large volume of the unaccomplished charts soon diminished and it was, for a time, fair and well, as the junior residents begin receiving again their monthly salaries.  However, because we still continue with our duties (everyday 8 hours or more in the hospital and 24 hours every 3 days), the charts began piling up again.  Some had to resort to “other means” just to finish writing the charts.  However, I do not have financial means to go that way.  So I remain buried in those unaccomplished charts, and currently, without salary. My ATM card (the one used to receive salary from the hospital) was blocked and they did not even consider that I STILL HAVE THE REST OF MY MEAGER SALARY OF THE PREVIOUS MONTHS IN IT THAT I HAVEN’T WITHDRAWN AND OF WHICH I’VE ALREADY RIGHTFULLY RECEIVED.  And the 13th month pay, which is not actually a salary, but a bonus, IS ALSO PUT ON HOLD.   The condition, of course, for being able to get back all these “benefits” is that I should finish all said charts.

But what is it again that I’ve read in the Labor Code?

In Presidential decree no. 851, Section 10:

Sec. 10. Prohibition against reduction or elimination of benefits. – Nothing herein shall be construed to authorize any employer to eliminate, or diminish in any way, supplements, or other employee benefits or favorable practice being enjoyed by the employee at the time of promulgation of this issuance.

I’m certainly not a lawyer, however, I think that’s already a clear statement that the 13th month pay, for no reason, should be put on hold.  And to put this in perspective, the charts isn’t the summation of a medical residents work; it is only a menial part of it, done to provide the hospital the means to its insurance claims.  It would be fine by me, getting buried in all this chart work, if only we weren’t also burdened with the things that isn’t part of our job, like the job of interns.  Rumor has it that soon, we’ll be part-time medical technologists too, at the ER, because the hospital is planning to buy a laboratory equipment that enables one to run lab tests with results in minutes.  Okay, so the hospital is so much willing to shell out a few hundred thousand pesos for this one tiny machine, but isn’t willing to expand its laboratory staff and would rather put on the additional burden on medical residents (which is helped by the fact that we come in almost FREE of charge since we don’t get paid for work outside the job description)?

Do I really need to emphasize the reason for undergoing specialty training?  IT IS BECAUSE WE WANT TO LEARN A SPECIALTY, NOT END UP DOING EVERYBODY ELSE’S JOBS BECAUSE THE HOSPITAL DOESN’T WANT TO PAY FOR THEM.

However, I think the strongest argument by the hospital, so far, is that residents-in-training are just trainees, not employees.  In section 15 of Rule X of Conditions of Employment, it was said:

SECTION 15. Resident physicians in training. — There is employer-employee relationship between resident physicians and the training hospital unless:
(1) There is a training agreement between them; and
(2) The training program is duly accredited or approved by the appropriate government agency.

And thus, as the medical director said, “you are just trainees (insert sarcasm here).”

I think there is much confusion still as to the right status of resident physicians in training and this should be resolved soon.  It affects much the way the training hospitals treat their resident physicians.  The work is almost 24/7 and it’s more than definite that the absence of resident physicians in such training hospitals would greatly affect the hospital business.  Who would attend to patients in critical condition in the ward or at the ER?  A house or ER officer?  The hospital do not even want to pay the salaries of residents.  What more of an ER consultant?  Who can update consultants regarding the status of their patients in the ward?   And yet, we, residents, are considered “just trainees”?

However, as I’ve said in the first part of this Hospital Slave series (yes, I think this is going to be a series), nobody has raised this issue in the proper forum.  Although Batanes Representative Dr. Carlo Diasnes has authored a house bill aimed at managing medical residency in the country (HB 05222 or Medical Residency Act of 2008), it is still pending at Committee of Health since October 2008 and nothing has been heard of it since.

Is this because the current system of enslaving the younger doctors in training more beneficial to health care?  Is this a rampant practice or just limited to several hospitals?  Are they forgetting that we’re already LICENSED medical doctors?  Licensed professionals?

So, for now, stop wondering why some doctors would choose to shift to a different career, health-related or not.  It’s not selfishness; it’s a means to survival.