Dr. Francisco D. Rivera IV, FPDS
PDS President (2021-2022)
Dear PDS Colleagues,
Medical practice in the whole world is in a crossroad. Some were able to easily and rapidly adapt because they already have policies in place that can both govern the profession and institutionalize the basic framework of the health system. In the Philippines however, the scenario is different since there are a lot of forces coming from different fronts; global, regional and local organizations with new policies and institutionalized regulations that affect the medical system in the midst of what we are experiencing today. These same forces trigger the reshaping of dermatological practice in the Philippines.
As your president, I’m taking the responsibility to renavigate PDS to this journey. I would like to assure everyone that I will remain focused on our vison for PDS to be the recognized and respected leader in dermatology by pursuing excellence in skin health.
The forces that trigger reshaping of the dermatological practice in the Philippines are the following;
1. The ASEAN Economic Integration
In 2015, the ASEAN Economic Community (AEC) was created to establish a common market that will promote freer movement of goods, services, investment, skilled labor and capital among countries of the ASEAN region. This resulted in the harmonization of the qualifications of professionals including that of the medical profession into standardized education and training as regulated by the Professional Regulation Commission. One of the initial steps done by the agency to carry this out is to create the Philippine Qualification Framework (PQF) that aims to classify medical professionals as specialists or generalists. The impact of this to PDS is the sudden rise of small organizations with special interest in dermatology all aiming to gain recognition as specialty societies thus challenging PDS long history of presence as the only Dermatological Society in the Philippines. A good development however has happened recently with PRC requesting PDS to create these learning outcomes to define the PQF in Dermatology and to submit distribution of all our members in active practice nationwide. This action alone from PRC might very well be considered a win for PDS as it gives recognition to our society as the qualified authority to define the specialty of dermatology in the country.
2. The Universal Healthcare
On February 2019, President Rodrigo Duterte signed the Universal Health Care Bill into law, ushering in massive reforms in the Philippine health sector. Among the salient features of the UHC Law are the expansion of population, service, and financial coverage through an array of health system amendments. Along with this is a planned paradigm shift to primary care, which is the core and center of all health reforms under the UHC. With this law, all Filipinos are guaranteed equitable access to quality and affordable health care goods and services, and protected against financial risk ensuring quality healthcare to every Filipino.
The impact of UHC law to dermatological practice is real. It might be vague for some but for those in government service this is something that they have been working on since 2017. The DOH formed a Technical Working Group (TWG) to create this “Stratified Framework of Dermatology Centers” across the nation identifying all DOH retained hospitals in every region across the country either as advance comprehensive or basic dermatology centers and clinics. These include PDS accredited institutions such as JRMMMC, EAMC, RITM, and SPMC, with the inclusion of two newly accredited ones (Rizal Medical Center & Region 1 Medical Center ) and more applicant institutions ( Jose Rodriguez Memorial Medical Center formerly TALA, Tondo Medical Center, Valenzuela Medical Center & Southern Isabela Medical Center).
All these dermatology facilities will be the end referral centers for skin diseases in every region. Since primary care will play a pivotal role in all health reforms under the UHC making these specialty centers/clinics as places where people can seek board-certified dermatologists, I would like to encourage our members to help out by either being part of these institutions or align themselves to this service delivery network system being developed by the DOH.
To move forward with these new developments, we as end-referral specialists must continually upgrade ourselves to gain advance knowledge in dermatology as we will be seeing more often not only common cases but more difficult and rare dermatological conditions.
The PDS is now proactively preparing for these challenges ahead. We are now strengthening different subspecialty societies, core groups and special interest groups to provide venues of advanced learning in dermatology for our members. The same groups are also the ones initiating the creation of standards of care for dermatological diseases to equip our members with established practice guidelines thus creating a better health outcome for our patients and eventually helping to decrease burden of the disease in the country. So far, we have developed three practice guidelines in line for this purpose: the Leprosy Clinical Practice Guidelines, the Clinical Pathway for Psoriasis, and the Consensus Guidelines for Atopic Dermatitis. More collaborative institutional researches among these subspecialty and interest groups are expected to continuously update these standards of care as new technology arises.
3. Covid 19 Pandemic and Technology
This pandemic has greatly changed the way we practice dermatology. As we live in a real world with fear of safety both for our patients and our own safety as healthcare providers, teledermatology has provided the safest interactive system between patients and dermatologists both in private practice as well in our training institutions. For almost 2 years that have passed, teledermatology has played a major role by which our dermatology residents are trained from proper diagnosis, management, monitoring and follow-up. We can only speculate as to whether the current deployment of teledermatology will continue at the same pace or diminish if and when the restrictive regulations that prevailed before the pandemic were reinstated in part or in total. However, we can anticipate that the wider use and heavy dependence on the underlying electronic technology in all sectors of society—including education, commerce, industry, transportation, entertainment, and communications—will ensure its continuing use in health care in one form or another. Acknowledging that teledermatology would stay even beyond the pandemic, the society has taken serious steps to integrate virtual consultation into a broader plan of health care reform for the way we practice dermatology in the country.
Unfortunately, majority of the telemedicine platforms available are not exclusive to board certified dermatologists but even to all those doctors with special interests in dermatology. Patients cannot recognize anymore who are the trained specialists. The PDS recognized this issue and through the efforts of the PDS board and the Practice Management Committee, we are looking into our very own PDS telemedicine platform – an exclusive and secured virtual space where patients can consult PDS board-certified dermatologists.
4. Health-seeking behavior of the public
In the recent years, our society has started to create some strides in the awareness of the Filipino public as the DermAuthority when it comes to skin, hair and nails. In this digital age however, when information is easily accessible through the click of a button, the threat to undermine this authority becomes bigger every day. Misleading information regarding skin health is found everywhere. The Communications Council committees (Public Relations, Social Media, Website and Newsletter) have been working non-stop to address this concern by coming up with relevant and relatable content to create a holistic and positive image of dermatologists in the public eye and extend the reach of the society. Alone we can do so little but together we can do so much. We would therefore like to make this social call to action for all members to actively subscribe, follow, like and share our society’s social media platforms:
FB: @Philippine Dermatological Society
YouTube: youtube.com/Philippine Dermatological Society
Website: www.pds.org.ph (public portal)Together, let’s engage, enlighten, and educate the Filipino public! Let’s make good noise for PDS!
Lastly, all these circumstances we are in right now is something beyond us, it is bigger than PDS! As an organization, we must be able to adapt to the changing world. I would like to appeal to everyone as we navigate through this journey that we stick to our core values of excellence, professionalism, integrity and open-mindedness. No PDS member will be left behind as we go through all these together as a family. Let us find strength in each other as we PURSUE PASSION AND PURPOSE for all that PDS stands for.
Mabuhay ang PDS!