Sunday, October 5, 2014

Meet AMSA Philippines' New Co-adviser!

AMSA Philippines would like to welcome Kenneth Hartigan-Go, MD, MD (UK), FPCP, FACP, FRCP (Edin), as its co-adviser! Dr Hartigan-Go is an alumnus of the organization and is currently working as Adjunct Faculty and Non-resident Research Fellow at the Asian Institute of Management.

AMSA Philippines EB 2013-2014 at last year's Outside the Box

Yesterday, 04 October, he gave a keynote speech to the newly-licensed physicians at their oath-taking ceremony. He is sharing this speech to members of AMSA Philippines:

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You Always Have a Choice
Kenneth Hartigan-Go MD
04 October 2014

PRC commissioners; honorable members of the esteemed Board of Medicine of the PRC, headed by Dr. Miguel Noche, Edgardo Fernando, Restitute Ocampo, Mildred Pareja, and Jose Cueto; honorable deans of medical schools; PMA President Dr. Minerva Calimag.

I also acknowledge my professors, teachers and mentors in the audience today.

New colleagues and proud parents, let me congratulate you all for making it this far; the next chapter in your life will be the interesting part.

Welcome to the Prestigious and Exclusive Doctors Club! The only club in the country, where majority of the global population respect us and where it is one of those club that you need to invest body and soul, money and time in order to be of service to humanity.

Let me share with you some thoughts and advice, but allow me to be irreverent first.

After 10 years today, you would not have remembered what your keynote speaker said today. You are all excited and eager to celebrate with your family; that's perfectly alright. But I will always remember this opportunity on my side.  Why?

When Dr. Miguel Noche called to invite me, I said yes impulsively. Who would pass this chance of a lifetime to shape the minds of the our youngest colleagues into medical world? Then I realized I had to cancel a planned trip with my family. This got me into trouble. But I had made a decision.

Today is my 54th birthday, and I renewed my PRC Medicine License on time; and today is my first day as a civilian - no longer a Govt Official of the country, where I served FDA for two full years - which felt more like four.

But today is not about me, but about our new physicians and colleagues.

Choices

Your life is made up of your choices. We all like to think of ourselves as basically good people. The evidence is in the everyday decisions you make. It is the everyday choices that make up our lives. Choices shape our character and character defines our choices. So be sure that you are making your decision that benefit not just yourself, but that it also brings positive outcomes for the benefit of others.

We are surrounded by examples of decisions that have been made for us. When we have bumpy roads, someone had made a choice for us. When we have traffic jams. Someone had made a choice for us. When we have serious floods. Someone had made a choice for us. When medicines don't work and are found substandard. Someone had made a choice for us. When mothers and children die. Someone had sadly made a choice.

Most people tell us not to regret the decisions that we have made and move on. I disagree. We all need to regret and then reflect. This singular moment shapes us into learning from this decision, our mistakes.  And we will make mistakes.

With your license comes the sad reality that you may inadvertently harm and even kill a patient.  You need to understand the seriousness of this privilege. No other profession come close to our discipline, privilege and inevitably, a lifetime of possible regrets.

Which brings us to another key message, my second point.

Integrity is a hard choice.  Ethics is often ignored and substituting the minimum requirement for following the legal rules.  We rationalize our poor decisions and actions and deny we are sometimes flawed.  As doctor we are not perfect.  He struggles with integrity dilemmas.  We can be corrupted, particularly when blind ambition and temptation for greed take the better of us.  Moral bankruptcy is a form of corruption.

Corruption is real. But corruption is not what we should be afraid of. It is corruption apathy we need to be afraid of.  It is when society accepts that corruption is normal event and we cannot do anything, a form of learned helplessness.

Government health service is a hard choice. In my work as FDA acting DG, there was no adequate medical education that could have prepared me for this difficult job. The work has to be a balance of public health, economic facilitation and national security.

Imagine a juggler, balancing five balls, high up on a tight rope, without a safety net below, and people below throwing stones at you while one dodge these, while singing a song.

Few people wants real reforms.  Because apart from the reality of change, no ones wants to feel invalidated for the past wrong practices of their work.

Let's dissect the anatomy of corruption: endearing traits in the Philippines... but not quite, these may be root causes of corruption.

  • Hiya: Afraid to challenge, embarrassed to confront
  • Utang na loob: Debt of gratitude
  • Palakasan: I have a backer, I have a political influence. I have financial influence. I have legal influence.
  • Pakikisama: We have a shared history, give me a break.


Perhaps in some cases, but life is about compromise, but  not when the decisions made can harm others in the process. Sometimes, I feel that corruption is in our DNA.  Fighting corruption loses friends. I found out.

In our reforms.  IT, a building block for efficiency and transparency in our health ecosystem was introduced, but refusal of  human adoption of IT leads to rent-seeking transaction.

  • Procurement: when goods are overpriced and bought, taxpayers and govt funds are misused. Someone made a conscious decision to steal.
  • Delayed release of business permits:  A supervisor told a clerk to keep signed approved business permits in a drawer, ostensibly waiting for a bribe. The supervisor made a conscious decision. The clerk had a choice not to obey. Every move we make is a decision.


The ingenuity of finding ways to be corrupt is awesome.

I come to my third and last point: Accountability.

Medical care and welfare is uncertain, is not free. Health system likewise is very complex, and we have to decide wisely how we conduct ourselves and shape this system.

I remember a story in MASH when a pilot soldier, whose job it was to drop bombs from the airplane unto the ground, never really knew the consequence of his actions until one day he was wounded and was placed in the same treatment area as the previously unseen victims of his bombs.****

Nurture each other. Our profession thrives because in many cases we collaborate with our colleagues beyond the confines and walls of our own schools. We need to transcend beyond our own institutions to work closely with other health professionals.

We need educated and sensible professionals like physicians to correct misinformation and disinformation. I witness much of these. Science education in very weak. And people no longer ask skeptical question. As a result, society is easily scammed and swindled. For the price of money, our colleagues forgot their accountability to society.

Reinvent yourselves, keep learning, use knowledge and apply wisdom. Share knowledge. The power is not in keeping information but when information is genuinely shared.

As we mature, we stop thinking of our individual rights but more what society needs and the right to basic need - health.

And because after today, you have a license to heal, leadership is expected from each one of us to do public good, and because physicians do really have a higher calling.

What it means is that beyond helping one patient at a time, we may be called to do more by boldly addressing and strengthening a much complicated health systems. And  within the lifetime of our professional calling, maybe not immediately, we will be asked to resolve our health system fragmentation. And you have a choice.

My new colleagues.  Our journey begins.  Thank you, all.

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