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SALAMAT PO!

#PRA2015

Clinic Cancellation

There will be NO clinic hours in Santiago on 7-Feb and 28-Feb due to acute illness and annual convention, respectively. Please make a note of it. We apologize for any inconvenience to you.

Life Begins at 60

 Some pointers on aging gracefully (for doctors, too).

Handout for Life Begins at 60

Eat this: Nutritional Guidelines

Eat this way. The 2012 Nutritional Guidelines for Filipinos gives 10 (ten) recommendations with accompanying reasons for the same.

2012 NUTRITIONAL GUIDELINES FOR FILIPINOS

 

1.     Eat a variety of foods everyday to get the nutrients needed by the body.

2.     Breastfeed infants exclusively from birth up to six months, then give appropriate complementary foods while continuing breastfeeding for two years and beyond for optimum growth and development.

3.     Attain normal body weight through proper diet and moderate physical activity to maintain good health and prevent obesity.

4.     Consume fish, lean meat, poultry, egg, dried beans or nuts daily for growth and repair of body tissues.

5.     East more vegetables and fruits everyday to get the essential vitamins, minerals and fiber for regulation of body processes.

6.     Limit intake of salty, fried, fatty and sugar-rich foods to prevent cardiovascular diseases.

7.     Consume milk, milk products, and other calcium-rich foods, such as small fish and shellfish, everyday for healthy bones and teeth.

8.     Use iodized salt to prevent Iodine Deficiency Disorders.

9.     Consume safe foods and water to prevent diarrhea and other food- and water-borne diseases.

10.  Be physically active, make healthy food choices, manage stress, avoid alcoholic beverages and do not smoke to help prevent lifestyle-related non-communicable disease.

 

An Exemplar exists among us! Help PCP look for one.

Are you enthusiastic, forward-looking with a healthy respect for tradition?

The PCP Awards Committee is looking for you!

This Committee is responsible for recommending to the Board of Regents, and disseminating to the PCP Public each year’s Exemplars. The Exemplars are in the categories of Healthcare Advocacy, Community Development, Clinical Practice, Clinical Education and Clinical Research. The highest award is the Gonzalo Austria Most Distinguished Physician award.

The PCP Awards Committee Member is expected to:
(1) Participate actively in three to four full committee meetings in the coming year,
(2) Observe (or even moderate) the proceedings of at least ONE Committee of Peers meeting, and
(3) Give time needed to finish specific assigned tasks related to the committee’s work.

We are looking specifically for representation from the following groups:
(a) General internal medicine practitioners
(b) Females
(c) Practice setting outside of the NCR.

PCP members from affiliate, regular member, diplomate and fellow categories are welcome! Please volunteer yourself (or recommend someone) ON or before 18-June, 2014.

Choosing antibiotics

I learned the following: (1) increasing MRSA rates may indicate a shift from oxacillin to other antibiotics like clindamycin in the future for empiric treatment of skin and soft tissue infections, (2) clinicians must utilize local (hospital) antibiotic resistance patterns for Enterobacteriaceae, and (3) the good news that the older drugs remain as good options for infections with streptococcus pneumoniae and gonococcus, and cholera.

2012 Summary of DOH Antimicrobial Resistance Pattern

2014 Clinic Schedule updated - 3

Clinic schedule up to Dec 2014 is now updated on the page "Clinic Schedule". Please note the change in clinic days and hours for UST Clinic which will be effective starting 14-Jul-2014. Thanks for your continuing patronage.

2014 Clinic Schedule updated - 2

Clinic schedule is now updated up to September 2014.

2014 Clinic Schedule updated

The clinic schedule for the Callang General Hospital (Santiago City) clinic has been updated up to July 2014. We have also listed the days where there will be NO clinic for the UST and St Luke's-QC clinics.

Santiago clinic day cancellation

We regret to inform you of the cancellation on short notice of tomorrow's Callang (Santiago) clinic 4-Jan-2014 due to post-holiday travel difficulties. We will add a new clinic date this month only on Monday 20-Jan-2014.

Clinic Schedule changes for 2014

The clinic schedule for Callang General Hospital is now posted in Clinic Schedule page. We regret to announce that the Citimedic Medical Arts clinic in Tuguegarao will be closed until further notice. Patients from this clinic may choose to go to the Callang General Hospital clinic. We suggest that you TEXT us at least a week before the clinic schedule to verify the date (CELL 0918-933445).

We are pleased to inform you that we have added clinic hours on Tuesdays for our UST Hospital Clinic.

Too lazy (or too smart) for primary care: which one are you?

My first role model as a doctor was a retired military surgeon in general medical practice in my hometown. He had a ready laugh. To my childhood eyes, he was the smartest guy around. He makes me feel better when I am sick!

The Annals of Internal Medicine point-counterpoint articles tries to answer the question on how to increase medical student interest in primary care by looking at what gets them interested. What do you think?

Too smart

Too lazy

How do YOU keep up with the medical literature?

     I have tried many ways of keeping up. I remember when I was a medical resident I tried to keep up by printing everything that I can get my hands on and ended up with piles of reprints that are unread. That does NOT work.
     The use of the educational prescription came next. This is one sheet of paper where I am supposed to keep track of my clinical questions from the description of the problem of a specific patient to the resolution of the problem by review of a journal article. I started that a few times with medical trainees but it does NOT get done. I am still working on a self-assessment module from ABIM using the same technology, and, you know the drill, it is still NOT done.
     Reading the following blog post, I am attracted to the "headlines, tweets, and abstracts" approach that is described. http://www.kevinmd.com/blog/2013/10/medical-literature.html
     What is the best way to keep up with medical literature for ME? I guess it would be what works for me at this time. I read somewhere, on a different subject, that is like riding a bike - you will never know until you try. Try different ways to keep up - until you find what works for YOU!

Changing your lifestyle works (even in the elderly)!

When seeing an older patient, we often hesitate to advice them to adopt healthier health habits. We think it is difficult to change lifestyles is difficult (true!) and changing late in life may not change anything. Two studies on the association of healthy habits and mortality challenges this thinking. In both studies, those who had more of the healthy habits are less likely to die during follow-up.

The list of healthy habits are different but overlap. One lists regular exercise, healthy diet, smoking avoidance, and weight maintenance. The other lists a Mediterranean diet, moderate alcohol use, physical activity and nonsmoking status.

The bottomline is: those who have more healthy habits live longer.

http://www.ncbi.nlm.nih.gov/pubmed/15383513

http://www.ncbi.nlm.nih.gov/pubmed/23733562

Should peripheral IV sites be changed routinely? NO

Peripheral IV sites are changed routinely every 3 days in at least one of the hospitals where I practice. The results of the 2013 Update of a 2010 Cochrane review comparing clinically indicated change versus routine replacement of peripheral venoous catheter sites continue to challenge this practice. There was no  statistical difference in rates of suspected catheter-related bloodstream infections between the two methods of replacement. Neither was there a difference in phlebitis rates. In their conclusions, the authors recommend that peripheral venous sites be inspected every shift and changed only if there is one of the following signs: inflammation, infiltration or blockage.

http://www.ncbi.nlm.nih.gov/pubmed/23633346?dopt=Abstract

Re-imagining geriatrics: an interesting geriatric care model

I like this geriatrician's model for delivering geriatric care. It sounds like a win-win for her and her patients. I wonder how this could be adapted to the Philippine setting.

http://www.over65.thehastingscenter.org/reimagining-geriatrics/

Who are more handsome - surgeons or internists?

In Barcelona, surgeons are taller and more handsome than internists. The 6-year old journal article was brought to my attention reading another physician's blog. Here is the link:

http://www.bmj.com/content/333/7582/1291

Change in Clinic Schedule

Clinic days in Santiago are re-schedule from 5- and 7-October to 28- and 30-Sep. Please make a note of this. Thanks!

Time off for the doctor: is it good for patients?

     "Do you have clinics on Saturdays?" one of my patients asked me today. "No," I replied. "The company told me you had Saturday clinics," she countered. I had to explain to her that I did quite a few years back.

     This conversation made me think about why I no longer hold Saturday hours in my city clinics. I need to take time off to renew myself every week.

     I have been taking time off more or less regularly on an annual basis. I spend time in silence, prayer and deep conversation. This helps me renew in mind, body and spirit. This has become a habit such that I look forward to it when it is due, and I long for it when I am unable to do it at the usual time.

     My provincial clinic is a different story. Because I only go there a few days a month and my patients get agitated when I don't keep my scheduled days, I have been sticking strictly to my published dates. That is until this year. This April and May - when medical school is out - I have cut down my scheduled days.

     I wonder how my patients feel about their doctor taking time off - for weekends, for school breaks, and yearly. I hope they would agree that it is good for the doctor, and for them as well.