03 October 2008


In our group of ten interns, I had a friend who has always maintained that she wants to pursue a career in geriatric medicine. I never told her this but I've always commended her for her choice, especially since I don't think I can keep up with that line of work for a long time.

Geriatric medicine in the Philippines, I imagine, is not that easy. How did I come to this conclusion?
1. Most of the elderly lived in a time when the migration to Manila, the economic center of the Philippines, was not so crazy, and they opted to stay in the provinces. However, healthcare to the provinces is limited (few and far between) and they prefer to keep quiet about their problems (so as not to be a burden to the family) until it worsens to an unmanageable degree.
2. Lifestyle diseases, such as cardiovascular disease and diseases attributable to smoking, were not in the public consciousness during their time. Of course, there's plenty of old people who are very proud to be up and about even if they smoked two packs a day since they were 12 years old but the odd, sporadic check-up will reveal unbelievable findings, like blood pressures in the 200's/140's. Their reaction? "MEH."
3. Those who do have check-ups tend to several diagnosed diseases, and therefore a long list of medications. A delicate balance! Then there's always the question of finances. Most don't have a pension, so they rely on their children.
4. My voice is soft. It hurts at the end of the day. Figger it out.

Who knows, maybe by the time I'm a consultant, the current generation of middle-aged adults will already be of geriatric age and these problems won't be as severe as before. (Wishful thinking.) But what is easier in this country in terms of caring for the elderly is getting family support. You won't usually need a social worker to get in touch with someone to help with your elderly patient-- they most likely live with one of their children, who is ready to pack up bags and bring the whole clan to the hospital at a moment's notice. And that's something that I hope never changes.


Kittymama said...

My sister-in-law chose geriatrics as her subspecialization, knowing full well that by the time she was ready to launch a fullscale practice, her own parents would be needing her more than ever. And she was right. Right now, she is the primary physician to all the senior citizens in the family (and some of us, too, with the beginnings of white hair and flaccid bellies). It's not an easy practice, especially since as we get older we get crankier and more set in our ways, but she does a heroic job of not only taking care of them physically, but emotionally and psychiologically, as well. Sadly, geriatrics is often the least of young medical graduates' priorities. Your friend's choice is commendable, indeed. :-)

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