Resort emergency medicine

My column last week on resort medicine elicited a number of responses that also promoted the concept of medical tourism. The two are not the same thing even if the two concepts share the need to change mindsets in the local medical community.

Despite what some folks think, we are far from having a really sustainable program in medical tourism. We don’t even have enough hospital beds in Metro Manila for our own needs. At last count, one source told me we just have 3,000 hospital beds. One really bad flu epidemic and we have a crisis.

Medical tourism is not a major concern for the moment. Let us go back to resort emergency medicine because this is important to save lives of local and foreign tourists.

I received an e-mail from a former health undersecretary who informed me that he tried to do something about this need during his watch. It was frustrating, he said.    

The DOH actually had a program on it back in 2005. The former health usec relates: “As part of this program, I had to visit our famous tourist spots to assess their capabilities to host medical tourism hospitals or even just primary or secondary health care facilities to cater to the medical needs of tourists, both local and foreign.

“The primary or secondary facilities were envisioned to provide at least emergency care to tourists who may be involved in accidents while swimming or engaging in water sports etc.

“I inspected a clinic in Boracay that time which had some facilities for emergency care, but which I found wanting to adequately manage simple emergencies like lacerations, much more complex and fatal cardiac, pulmonary, or cranial emergencies like a heart attack, bronchial asthma, or a stroke.

“There was a nurse and a general physician who goes on duty there every day for five days, and there was an anesthesia machine donated by a group of physicians from the USA who went there on a medical mission and donated the machine to the clinic. There were some medicines and antibiotics which were supplied by the Municipality of Caticlan.

“I talked with the DOH regional director at that time to possibly take the initiative in upgrading the clinic to at least a secondary health care facility with diagnostic capabilities like a laboratory for complete blood count, urinalysis and fecalysis, Xray to diagnose air or fluid in the lungs and fractures, and an ECG machine to diagnose cardiac abnormalities.

“With these facilities come competent health personnel like a nurse, a medical technologist, and a doctor. All well trained in emergency medicine and in basic life support to stabilize patients before being transported to more specialized health facilities in Kalibo, Aklan.

“I even thought of having a manned facility in Caticlan for the management of deep-sea divers who develop decompression sickness or diver’s disease – a hyperbaric chamber or a recompression chamber. This would be an added feature to tourist spots which have deep sea diving attractions such as in Batangas or Palawan.

“I also visited Tagaytay and I noted that there were retirement homes there as you mentioned. I also noted that there was a tertiary private hospital in Tagaytay, the Tagaytay Medical Center which I envisioned to be a medical tourism hospital in that area.

“I talked with the medical director of the hospital to transform it into a medical tourism hospital to formulate and provide a menu of services that they could offer to potential medical tourists. My office, the Office for Special Concerns at the DOH, would promote them.

“As an added feature of their retirement and medical tourism services, I encouraged the hospital to station a nurse and a general physician trained in emergency medicine in clusters of retirement homes to provide emergency care to retirees and even guests in resort hotels in that area.

“They would provide quick examination, assessment, and first aid to potential patients which they would arrange to be brought to the Tagaytay Medical Center for further specialized health care.

“The hospital would have an efficient communication system to the retirement homes and resort hotels to dispatch their ambulances.

“After several follow-up calls to the concerned persons, I didn’t receive a single positive response, even if I encouraged them to attend our meetings to discuss, and hopefully, start the suggested initiatives.

“When I left the DOH in 2009, only a few hospitals, mostly private, continued the vision, though in a lackadaisical manner. It was quite frustrating for me, to say the least. I have lost hope, so sad.”

Well… it is good to know that once upon a time, someone at DOH thought of this problem and tried to do something. Today, however, Health Secretary Francisco Duque made it clear that providing such health facilities is not the mandate of the DOH.

The Department of Tourism, through TIEZA, will have to step in at least for the major tourism spots. The law that requires developers to provide medical emergency services will have to be strengthened.

Hopefully, the private sector steps in to make it a business that can generate profits as it provides a needed service.

Michael Deakin, who runs the ambulance service Lifeline, wrote me to say that in Boracay it is possible “to cover all visitors for emergency medical response (including helicopter or plane medevac) for only P300 per visitor, or for P5,000 to P20,000 per month per resort, depending on size.

“It all comes down to volume; this is what would make it affordable. The proof of concept is Metro Manila. Lifeline has 350 corporate members that pay for over four million people to be covered for free by Lifeline’s Emergency Quick Response.”

That sounds reasonable. That’s not even the cost of a good meal in the better places in Boracay.

Because it is volume that brings down cost, government may have to mandate it. Better still, the hotel industry in the resort areas should voluntarily organize to provide that service.

As Mr. Deakin said, “there is no reason why the Philippines cannot be the best and safest tourism destination in Asia.”

Boo Chanco’s e-mail address is [email protected]. Follow him on Twitter @boochanco