AALVEZ’S MAR [15-08]:Duty Beyond the Hospital Premises

Indexing Title: AALVEZ’S MAR [15-08]
MAR Title: Duty Beyond the Hospital Premises
Date of Medical Observation: August 2015
Tag: Answering help outside the hospital premises
Category: Professional/Ethical – Reinforcement


It was around 7pm when I came home from duty. I was down, tired and hungry. Upon entry to our house, my mother told me she had been waiting for me because one of her friends needs my help. “Bakit? Anong meron? (Why? What’s the matter?)” I dropped my things and I followed my mother.

My neighbor was complaining of pain on her left hand radiating to her left upper extremity. She was wounded by a fishbone on her left thumb three days ago. As I inspect her hand, there was abscess (a swollen area with accumulation of pus) on her left thumb. It was already fluctuant. I advised her that the abscess needed to be drained and the procedure would occur at the hospital tomorrow morning. She agreed with the drainage but she asked me if we could do it in the nearby health center. I was hesitant to do it at first but I agreed. I told her as long as we can get permission from the head of the health center, it was okay for me.

We went to the health center. Fortunately, we were allowed to do the procedure. We gathered the materials needed. We proceeded with the incision and drainage. The patient was cooperative. The procedure lasted for a few minutes. I instructed her how to clean the wound. I also prescribed her medications she would take.

“Salamat Doc! (Thank you doctor!)” She told me with a smile as we went home after the procedure. I felt uplifted. But I was still tired and hungry.

(Physical, Professional/Ethical, Psychosocial)
(Discovery, Stimulus, Reinforcement)

It is our duty as a doctor to diagnose and treat our patients regardless of time and place. It is a choice however, for us doctors to treat outside our clinics and hospitals. I had a dilemma previously since we, as residents, are under training, if we can extend our help and treat those who came for help outside the hospital premises. However, I realized that as long as it may help our patient, it does not place them at risk, and it is under the scope of our skills and competency, we may choose to treat them. Still, it is recommended to persuade our patients to treat them in the hospitals to be guided and to be clear of consequences legally.

In medical school we learn and build our foundation of knowledge we need in the practice of medicine. However, we all agree that not everything is learned from books or simply from a four walled room. As the saying goes, experience is still the best teacher in life. In my medical training, I am still surprised how every day is actually still a learning experience. Our role as physicians is not confined in the walls of the hospitals, although I have to admit that in this hospital I have learned the value of compassion and appreciation not just towards our patients but also to my colleagues. I have seen my senior residents, being an example to us, put their duties first before themselves, and stuck in the operating room till wee hours in the morning attending to patients in need of their attention despite having empty stomachs or lack of sleep.

We invest our time and effort to learn, putting aside our needs to be able to be of service to others. But at the end of the day the greatest return of investment, in my personal opinion, is the feeling of  fulfillment whenever we are able to render our service to others and being able to give care, somehow contributing to the improvement of a patient’s daily life. . That simple “Thank you doc!” along with their trust is the most priceless professional fee I have received. But it is still important to remember that we need to take good care of ourselves to be able to serve others too. 

ROJoson’s Notes (17jan14):

A certified physician can treat any patient anywhere and in the best way he can.  He just has to know his limits.

This entry was posted in AALVEZ’S MARs, Treating Patients Outside Hospital Premise. Bookmark the permalink.

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