Medical Miseducation, Part 5

Initially appeared on doktorko.com 12/12/2005.

Two words: financial viability.

Consider: hospitals (except for government- or non-profit-organization-run ones) are essentially financial corporations.  Physicians (or anyone else with an interest and enough cash - such as really rich people who want to be considered "philantrophists") buy stocks which finance the initial outlay required to put up the institution.  From there, it becomes the adminstration's duty to support the hospital financially: laboratory equipment is bought and the expenses recouped by doing CBCs, etc.; the same thing with imaging machines, monitors, and all the other equipment.  The final goal is to make money to eventually pay "dividends" to the "investors."  From what i heard on the grapevine, the time to break even is usually around five to ten years.  Some hospitals cut corners by stealing electricity and water ( i.e. illegal connections), which can shorten the break-even point to around two to three years.  Regardless, after a certain amount of time, the undertaking becomes profitable - at which point reinvestments and expansion take place, and more profit is made.  Just like a regular business.

The "engine" that powers the hospital (as everything) is labor  - nurses, residents (more on this in the future), aides, etc.  Usually they dance to the tune of "vision-mission statements" fed to them by the powers-that-be; statements like "striving to improve medical care," and other BS to make them feel like they're actually contributing to a good cause.  All the while they're underpaid (many nurses in fact make only minimum wage or even under - this is even more prevalent in the provinces) and made to feel guilty whenever they ask for what they deserve ( i.e. "responsibilidad mong alagaan ang pasyente kahit walang overtime pay!").  In the meantime, the lords of the land continue to buy their gas-guzzling BMWs, Benzes, and SUVs.  Make it better: cut costs even more by not employing any nurse aides, increasing nurse-to-patient ratios, and not raising nurses' salaries by passing their jobs off to someone else.  Sounds hard?  Sounds like a "sweatshop?"  Ah, it's easier than you or i would think.

Consider again: medical students doing nurses' (and aides') jobs like taking vital signs 24/7, drawing blood, and putting in all sorts of tubes; a mindless workforce who cannot complain about the job that they do because it's an "initiation" into doctorhood.  With threats of demerits and extended rotations hanging over their heads, they will do whatever pleases you - every Despot's dream.  You will have, in effect, slaves.  Free labor that you can coerce into doing anything.  To make it even more profitable, charge them tuition: to the tune of 100k pesos a year.

Suwabe.  Slaves that actually pay for their servitude.