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Welcome To The Freudian Slip

The Freudian Slip

The Freudian Slip is a travel-journal written by a former Doctor to the Barrio. Read his (mis)adventures here and follow how 'Doc Bien' began his exciting journey and more

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Visita Iglesia

Visita Iglesia

While traveling in Europe, I made sure to visit the churches and Cathedrals in every town or city that I visited....

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Where To Get A Tan

Where To Get A Tan

If you are looking for a nice beach to hang out, read reviews of beaches and resorts in the Philippines and around the world here

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Where To Stay

Where To Stay

Whether you are backpacking alone or travelling with a group, whether for a business meeting or for pure leisure, you might want to check out some of these hotels in the country and around the world

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Masskara Festival

Masskara Festival

After many years, I decided yesterday to brave the streets of Bacolod once again and witness the Masskara Street Dancing and see whether this "new format" for Masskara was better than...

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Where To Have Fun

Where To Have Fun

You deserve a break and there are many opportunities that will provide you with all the recreation that you need. Read some of these hang-out spots where you can relax, have fun and enjoy life to the full.

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December 31, 2016

Cinemedicine 2017

Every year, I ask my first year med students under my Family and Community Medicine class to come up with a mini-film that would depict a family's journey and experience when one of the family member is ill. It is part of our discussion on Family Illness trajectory. Since I've been doing it, it has been called Cinemedicine. The following are now the entries for Cinemedicine 2017: Feel free to watch and share with friends. Talk about your favorite entry on twitter using their hashtags #cinemedicine2017 #hiraya #kontak #cinco #alma #marionette

Hiraya







Kontak







Cinco







Alma







Marionette




Now, viewers can choose the best film here. A percentage of the over-all score is for the Viewer's Choice. Poll is now open. It will close on January 9, 2016 6pm Manila Time.








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March 20, 2016

Health As A Platform: What I Want the Next President to Focus On

I am currently waiting for the second Presidential debate, I am thinking of how the next Administration should address the health challenges of the country. The facts are clear, our country still has to really achieve high performance in Immunization coverage, improve services in maternal and child health and address access to safe drinking water and sanitation. So, if given the choice, based on my experience as a former Doctor to the Barrios and working with more than 72 local government units and their municipal health offices, I want the next President to focus on the following items, from the most immediate to long-term:
1. Genuine Universal Health Care - the keyword here is genuine. The Aquino administration pushed for Kalusugang Pangkahalatan and although there have been gains it is not really Universal as what the current administration would like to believe. Universal Healthcare implies basic and essential health services are made available for everyone. And I mean everyone regardless of your economic class. For example, access to essential medicines should be made available not just to the "poorest of the poor", everyone should have access to these essential medicines made available in health centers. After all the middle class also contribute to Philhealth and through other taxes. There should be no consultation/medical fees in government hospitals for everyone. Sin Tax should be enough to cover major government medical centers and provide basic services. Why not download the money directly to these medical centers? In fact, National government must review the governance and relevance of Philhealth.
2. Focus on Preventive Health Care - more emphasis on preventive and promotive health care programs and interventions. Health Program should not be "hospital-centric" or just focus on "facilities" and "infrastructure". It is a given, infrastructure in some parts of the country is badly needed especially in GIDAs (Geographically Isolated and Disadvantaged Areas), but it should not stop there. Philhealth should start covering interventions that are preventive in nature. An example would be if a patient is diagnosed as hypertensive or diabetic in a rural health unit, he or she is enrolled in a registry wherein he or she undergoes regular monitoring by the Municipal Health Officer or Primary Health Care Physician. If patient is able to maintain BP or FBS within a normal range, in other words controlled hypertension and Diabetes, patient gets incentive as well as the doctor who ensures such. A patient enrolls in a Smoking Cessation Clinic, if patient was able to stop smoking over a period of time, he gets incentives as well as the smoking cessation clinic health worker. Philhealth pays for the incentives. If a mother was able to complete the immunization of her child on time, even if she is not a CCT beneficiary, she should get an incentive from PHilhealth, including the health worker assigned to her. Dental services as well.
3. Strict Evaluation of the Department of Health - program managers both at the National and Regional Offices should be evaluated based on outcomes and not just outputs. They should be evaluated based on the impact that their programs bring to the over-all health indicators of the country or the region. If they could not hit target within a specified time period, they should be replaced. THe government could not be lenient with its people working on the health of the citizens. Make DOH accountable for outcomes and improve the overall health information system. This is to ensure that DOH makes rational decisions based on timely and relevant data. In fact, you cannot be a program manager if you didn't have appropriate experience on the ground.
4. Review Medical Curriculum - As President he or she can give a directive to CHED/PRC to review existing medical and premedical curricula and redesign it to ensure that those who finish medical school and even nursing school should have a preference for public health and primary health care where most of the patients are found. We have too many specialists serving in urban centers where not so much of the health problems are found. The health problems are found in the rural areas, in the frontlines. The pyramid has to be inverted now. Government should make Public Health practice as the most lucrative in medical practice. This should encourage doctors and nurses to stay and serve in areas where their services are needed the most. Encourage other medical and allied health careers like midwives, medical technologists, etc.
5. Anchor other National agencies on Health - the President must understand that health is a complex issue that interventions should not just be "clinical" or "exclusively health related" to address the health issues. THere are many determinants of health that the government must consider. Like in the issue of nutrition, government must ensure access and availability of stable food sources that are nutritious and affordable. Access would entail construction of roads and markets closer to the people and exemption from taxes for organic and locally grown nutritious food. The most important factor is really access to safe drinking water. This would really require securing water sources and laying out the infrastructure that would deliver water from these sources to homes and communities.
6. Making Local Governments Accountable for the Health of their People - because delivery of health services is devolved to the local government units, National Government must make sure that these LGUs deliver health services to their people and it should have impact on the health indicators of their people. National government should engage local governments more especially in the planning and implementation of the programs. LGUs look at National Government as just "downloading" programs to them for implementation, even if at times these programs are not locally relevant or designed with the local context in mind.



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March 19, 2016

Community Medicine: Because Health is Not Health without Social Health


As a professor in medical school teaching Family and Community Medicine, one of my topics is to teach Primary Health Care. I would usually discuss the Alma Ata Declaration Document with the class and discuss historical and current events related to Primary Health Care in the Philippine experience. But I have always felt that the best way to teach Primary Health Care is to let the students experience it for themselves so for the past two years, I have been challenging my third year med students to come up with a community project with a partner "community" of choice where they would come up with a project for the community, particularly one that addresses a health issue. The objective is for them to practice the principles on PHC that they have learned in school. They would write a monthly progress report about what they have done. As a final output they would come up with a video documentary that would describe their project and experience. For this year, I had these amazing community projects initiated by the students together with their partner communities.










I think they went in with the thought that they are there to teach the communities and they came out taught by their communities. What was common among all their projects was that it was anchored on capacity building. Medical students became agriculturists, nutrionitists, peer counsellors, as they taught their communities knowledge that perhaps they learn from their other subjects. I would like to believe this experience was just a sneak preview to what community medicine is all about. They would need a lot more to learn and do to further deepen their understanding and appreciation of community medicine and working with communities.

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March 3, 2016

Passion Statement

Nowadays, we hear more often about pursuing one's passion at work and career. Especially in my kind of work where we are supposed to do the "impossible" that passion has become a key word and ingredient in driving the internal motivation to pursue the almost unachievable. Passion is such a big word and its true essence is sometimes hardly noticed. It comes from the Latin word passio which means "to suffer" or "to endure". So your passion is something you are willing to endure for or suffer. It is something that you are willing to do even if it hurts. Its oldest root word "pei" literally means "to hurt". And it is usually referred to the sufferings of Christ on the Cross. In other words, me ganung level ang "passion" yung handa kang magpakamatay. Pag hindi ka nasasaktan, hindi yan passion. Whether your passion is a person, a relationship or an advocacy or issue or set of values and beliefs, you are willing to offer you life for it(them) because that is what passion requires. Thus, even if the odds are against you, and the challenges are overwhelming, even if it already painful, you are still going to push through with it because "that is your passion". It's more than just a strong feeling. It is an expression of willingness to go through a lot of sacrifice.
Passion is quite abstract it is hard to describe and to measure. I am not aware if there is any metrics yet to measure how one person is more or less passionate than others. Perhaps it is because we have different passions so it is very hard to compare and even if we share "similar" passions, how each one perceives his or her passion to be would differ from the others. So usually passion is described figuratively. A classic example would be passion is like fire. Fire. After all in the early 1500's the word fire would be used in relation to "passion" or "ardent, burning feelings". Its old Latin root word is "egni- which means to ignite, to animate. Fire is seen as a life-giving force. Somewhat just like passion. Your passion is that one thing that will drive you to do things even if it's impossible to do. Many think that passion is more of an internal work. Perhaps it starts internally but just like fire, it needs external elements. You can develop your passion but it needs to be nurtured as well. To create fire, we learn that there are at least 3 basic elements: Fuel, Heat and Oxygen. The absence of one will prohibit the production of fire. For example, you may be very passionate in your job right now but if your working environment prohibits you from maximizing your fullest potentials, the passion can subside or it will seek out other environments which it will find suitable.
You need help in developing your passion but it starts with you. You have to choose to develop your passions. You have to invest time and effort on it. But just like fire, you need help. For example, you might need a coach to help you or mentor to guide you in honing your passions. Passions need to be nurtured. Because they are as transient as the candle flame. Like what Shakespeare wrote in Hamlet, "What to ourselves in passion we propose,The passion ending, doth the purpose lose." Thus the reinforcing emotions and situations that help sustain the passion should be further maintained in order for the passion not to end.
When work does not anymore feel relevant or align with one's values, the passion for the work usually dies. When one cannot answer with confidence the questions, "Why am I here?" or "What am I here for?" as confident as the first time the person was asked in relation to one's career or chosen direction, somehow there is a flickering of the passion. Experts would usually suggest, making a switch (because priorities can change) or reinventing one's job description or getting a coach or mentor. So, while nurturing passion can be internal work, external factors like employees or friends or family can kill someone's passion.

As taken from a website:
"Many employees — especially Millennials — use their day job to primarily support a parallel career or personal passion of some kind. Providing employees the opportunities and support to pursue their passions greatly improves their overall happiness and productivity. Yet many managers still feel the need to force employees to work within a little box, limiting their ambitions. Like any abusive relationship, they want the employee to believe that there is nowhere else to go and they should give up trying. Smart employees know better, and smart managers know that 65 percent of employees cite a lack of flexibility as a reason for quitting."(http://www.eremedia.com/tlnt/5-things-managers-do-that-just-kill-employee-engagement/)

But that statement is referring to how employees get "engaged" in their work, not directly referring to how people maintain and sustain their passions. Forbes, citing an external report, would differentiate between employee engagement and passion:

"Passion is different from, and more important than, engagement. “Employee engagement is typically defined,” the report says, “by how happy workers are with their work setting, coworkers, organization-wide programs, and their overall treatment by their employer. Employee engagement is important, and improving it typically will give a firm a bump in performance. But engagement is often a one-time bump; employees move from unhappy to happy, bring a better attitude to work, and possibly take fewer sick days. However, workers who are merely engaged won’t actively seek to achieve higher performance levels, to the benefit of self and firm; passionate workers will, though.”

By contrast, passion in workers relates to “how they respond to challenges. Do they get excited by, and actively seek out, challenges? How do they solve problems? How do they learn, develop skills, and build their careers over the long term? How do they interact with others to pursue those goals? … [They] help themselves and the companies they work for develop the capabilities to constantly learn and improve performance. Rather than a one-time performance bump, [passionate workers] deliver sustained and significant performance improvement over time.”
(http://www.forbes.com/sites/stevedenning/2014/10/08/debunking-myths-about-worker-passion/#1168ed0e2992)

John Hagel c0-chairman Deloitte Center For The Edge as cited in the same Forbes article aptly said, "Rather than just focusing on recruiting more passionate workers, the big opportunity is to look at the existing workforce and create environments that can tap into, nurture and amplify the passion of every worker already on the job. Without the right work environments, efforts to recruit additional passionate workers will likely be undermined as those new workers become frustrated in environments that do not support passion.

So just like the triangle of fire, I propose a triangle of Passion as well: Values(Attitude), Opportunity, Support.

What you currently do should align with your values. It something that you give high regard and willing to "die for" or "suffer for". You have to identify your values. Your values must be clear to you and that the work or career you choose should be aligned with your values. Your values act as your North Star. They steadily point to the right direction. And it clarifies your passion. This is perhaps the internal work of developing one's passion: clarification of one's values. Someone wrote that "It’s not a very popular message, but the hidden cause of personal dissatisfaction often comes from cultivating desires and passions that offend your personal values."

People need support to develop and nurture their passions. That is why others would consider having a coach or mentor. This is true in all aspects of life and in different forms of career. Support comes in many forms. The most valued support are usually the tangibles(fair compensation, benefits at work, logistics, supplies) but do not count out the intangible support as well like genuine support for growth and development. As one article from Forbes said, "High-potential employees want a leader that allows them to learn from their mistakes and guides them to overcome the burdens associated with failure. If a leader limits their employees’ ability to unleash their passionate pursuits of excellence, they will never discover their full potential.Employees want leaders to trust them, not micromanage them. They want leaders to encourage risk taking and exploration that allows them to learn and cultivate capabilities on the job. If not, how else will they earn trust?" I remember when I was the Municipal Health Officer of a town. The Mayor who is basically my boss allowed me to manage my health programs and approach the problems with my own "diskarte", basically giving me a free hand. He did not usually go over my shoulders and micromanage or interfere in how we manage the clinics. He trusted me enough that I could manage the health clinic.
All I needed to do was inform him of the current problems and lay out to him my plans. A classic example was his directive that his signature and approval was not needed in relation to the deployment of the municipal ambulance. All it needed was my signature and approval, a stark difference from the previous administration who required a lot of people to sign off before any patient can use the ambulance. And because of this, we were able to improve the health indicators of the municipality, dropping to zero the number of maternal deaths within a span of 2 years and decreasing the number of infant deaths drastically within the same amount of time. Of course, we needed the support, and the Mayor was willing to give it. One huge support was the renovation of the health facility. He knew that for us to fulfill our jobs and duties all we needed were the adequate logistics. The staff were passionate already with the work. Despite the small salary they were willing to travel to every village and perform their usual duties but willingness to do the work was not enough. The children needed vaccine, the mothers needed a birthing clinic, patients needed medicines.

Dean Nitin Nohria wrote in a blog, "I don’t think people should ever go to a place about which they don’t have a passion. They should not just chase opportunity. They should chase opportunity where they have a passion. And for me, one of the most exciting things that’s happening about this new global century is that it creates many, many more possibilities for people to find places where they have an opportunity and a passion.(http://bigthink.com/in-their-own-words/connecting-opportunity-with-passion)" There must be an outlet where your passion can be actualized. Finding opportunities come two-way. The individual has to seek out opportunities or opportunities have to be given to individuals.

So as I reflect on my own passions and how I manage to nurture them and how along the way there were critical moments when the passion flickered out, I remember today the Mayors and Municipal Health Officers I have trained in the past two years under the Health Leaders for the Poor training program of the Zuellig Family Foundation who will be graduating tomorrow from the program. I remember them and how they have also sustained their passion for better health outcomes for their constituents despite the challenging environment they are in (e.g. geographically isolated and disadvantaged areas, typhoon-prone areas). I remember their personal stories and how they inspired me to also nurture and chase after my own passions.



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January 23, 2016

Results of the Cinemedicine2016

The results of this year's USLS COM FCM-1 Cinemedicine2016 have been revealed today. I couldn't have been prouder of the outputs of the students. Since 2012, first year med students of USLS College of Medicine would produce minifilms as part of their requirements under my class in Family and Community Medicine, and the films usually highlight the illness experience of the family and the patient and the role of the health care professional along the illness trajectory. This year I would say the FCM-1 set the bar higher producing high quality films.

Results:
Best Actress - Erica Aragon of Recall
Best Actor - Mark Senoron of Marked
Best Screenplay - Marked
Best Production - Marked
Best Editing - Recall
Best Film - Marked
Marked also got the highest online poll votes. MOre than 10,000 votes were casted this year online and Marked got at least 33% of the votes.

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