Universal Health Coverage – Roles of Physicians, Hospital Administrators, and Governments

Universal health coverage is defined as ensuring that all people have access to needed promotive, preventive, curative and rehabilitative health services, of sufficient quality to be effective, while also ensuring that people do not suffer financial hardship when paying for these services.

Universal health coverage has therefore become a major goal for health reform in many countries and a priority objective of WHO.

Good health is essential to sustained economic and social development and poverty reduction.

Access to needed health services is crucial for maintaining and improving health.

At the same time, people need to be protected from being pushed into poverty because of the cost of health care.







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ROJoson’s Slide Projectors of Yesteryears

I acquired 2 slide projectors which I used for lecturing in the past when analoque (non-digital) slides were still in vogue.

First one was a 2nd-hand Kodak Carousel similar (not exactly) to the one shown below:


I bought this in 1977 or 1978, 1-2 years after I started my general surgery residency in the Philippine General Hospital.  I think I bought it for about a thousand pesos.  My stipend as a surgery resident at that time was about P700 per month.  I saved in order to buy this slide projector (at that time, it was hard to get avail of a slide projector in the Department).  I also saved money to buy cameras for my medical photography.  The cameras came first before the slide projector.  What happened to this slide projector?  I think I eventually donated it to the Department of Surgery together with several slide trays after several years of usage and when digital cameras came into vogue.

About 10 years after I bought the Kodak Carousal, I bought another slide projector, a more portable one, which I used to give lecture to medical students.  I cannot remember how much I bought it then.  It is shown below.  It is still with me.  I am ready to give it up, still working, as part of my clutter management (declog / de-own), either sell it or donate it to whoever is interested.




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Walking the dog enhances compassion in me

If I recall right, my wife adopted Jhun-Jhun Bato (a dog) sometime in 2014.   Since then up to this writing (18feb6),  I have been taking turns in walking Jhun.  Note: In 2014, I reached my mandatory age of retirement from government services and I retired from hospital administration.

Today, when I walked Jhun (morning and afternoon), I told myself that walking a dog enhances compassion in me and for anybody who walks a dog regularly.

Vocabulary.com defines compassion as follows:

“If someone shows kindness, caring, and a willingness to help others, they’re showing compassion.”

If I walk my wife’s dog everyday as a routine (every afternoon and sometimes, morning, when my wife cannot walk him), I feel I show kindness, caring and a willingness to help him.

The dog has to pee and poo.  The dog is trained to pee and poo in the street, not in the house.  Walking him at least twice a day enables him to pee and poo (good for his health).

The dog has to do some exercises.  Although we allow him to roam around the house (unless there are visitors), he still need to walk long distance for his daily exercise.  Walking him half a kilometer at least twice a day enables him to exercise his legs (good for his health).

The other benefits on the dog’s side when I walk him, he meets and interacts with other dogs whether friendly or hostile and also walking outside the house breaks his boredom (oftentimes, we bring him along for a short and long car ride and excursion to the beach).

Doing the above, I got the feeling that I am showing kindness, caring and a willingness to help Jhun the dog.  For this, I think I am showing compassion to our dog.   Being compassionate to our dog I feel enhances my compassion for people, particularly my patients.





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ROJOSON’s Lectures and Teaching Activities – 2017 (Registry as of December 31, 2017)

ROJOSON’s Lectures –Talks – 2017

Target: 12

Total:  15  (more if teleconferences and online coachings are itemized)

  Date Title Participants Place
1 January 26, 2017 Coaching on Hospital Administration – Dr. Rafael S. Tumbokon Memorial Hospital – Aklan Department Heads Kalibo, Aklan
2 February 4, 2017 Systematic Approach to Hospital Operations: The Unique Framework Applicable To Every Department UP-CPH MHA 202


3 February 8, 2017 Preceptorial on Physical Examination of the Thyroid UPCM LU 3 UPCM
4 February 11, 2017 Value-based Health Care Services in National Health Care Indonesian Hospital Directors Yogyakarta, Indonesia
5 February 15 – 16, 2017 Coaching on Hospital Administration – Salubris Medical Center Salubris Medical Center Staff Solano, Nueva Vizcaya
6 February 17, 2017 External Audit – Zamboanga City Medical Center Neonatal Death Management System Zamboanga City Medical Center Neonatal Death Management System Online
7 February 18, 2017 Organization and Management of the Emergency Department of a Hospital UP-CPH MHA 202


8 March 4, 2017 Organization and Management of the Department of Surgery of a Hospital UP-CPH MHA 202


9 March 13, 2017 Patient Safety Management Unilab Sharing Program –  Hospital Directors from Indonesia UNILAB
10 September 26, 2017 Preceptorial in Head and Neck GS1 Clinic UPCM LU 5 UPCM
11 September 29, 2017 Preceptorial on Physical Examination of the Head and Neck UPCM LU 3 UPCM
12 October 24, 2017 Systems Thinking Framework in Overall Hospital Management UP-CPH MHA UP-CPH
13 October 26, 2017 Management of Emergency Room UP-CPH MHA UP-CPH
14 November 2, 2017 Hospital Accreditation UP-CPH MHA UP-CPH
15 2017 – whole year Online coaching of staff of Salubris Medical Center Salubris Medical Center Staff Salubris Medical Center

Will maintain target at 12 per year for 2018.  Will try to keep the number at no more than 15.

Will slow down.  Will focus on my educational memoir before age 70.


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Clutter Management of ROJoson’s Photo Slides – How I did it

I seriously got into taking pictures or photos using slide films, mainly Ektachrome, starting 1976 when I started my general surgery residency training program in the Philippine General Hospital.

I was mainly influenced by my late mentor, Dr. George Eufemio, who had a vast collection of photo slides which he would use for lectures, teaching, research and other documentary purposes.  See samples of Dr. George Eufemio’s slides.  Notice he would put notes on the frame of the slides to tell what the slides were all about.  (I also did the same, and further, I cataloqued them.)

I bought several Pentax cameras using my hard-earned training stipend (about P700 per month).  I took photo slides during my entire 5 years of surgical training program.  In all rotations in the different surgical subspecialties, like Head and Neck, Breast, Colorectal, Hepatobiliary, Plastic, Pediatric, Urology, Neurosurgery, Thoracovascular Surgery, I took pictures of interesting, unusual cases and cases for lectures and research purposes. I also made word slides initially using Kodalith (black and white) for my lectures.  All in all, my estimate is that I had a collection of about 10,000 slides.

After residency, I continued to take pictures of interesting and unusual cases and those that I need for teaching and research.  I was doing this when I was consultant at the Philippine General Hospital, Manila Doctors Hospital, Medical Center Manila, and Ospital ng Maynila Medical Center.

I probably stopped using pictures circa 2006 when digital cameras were already in vogue.  I just relied on the digital cameras of my residents for the pictures.  In 2011, my sister gave me a digital camera and I resumed my picture taking of medical cases.  Up to the present, I am still taking pictures using compact cameras and not cellphone cameras which started circa 2008.

All in all, when I was doing my clutter management, trying to digitalize all my analogue slides, my estimate is that I had a collection of about 20,000.

I decided not to digitalize all the 20,000 analogue slides as I would be consuming a lot of time probably 2 months or more.  I decided on selective digitalization, those which I had sentimental values and those which I think are significant for my educational memoirs. I know for a fact that Dr. George Eufemio after retirement was also trying to make his collection of his slides as memoirs – trying to preserve all and categorized them. However, he did not complete his plans as his collection was able huge.

My justifications for not digitalizing all, aside from the time constraint, are one, there are already plenty of medical pictures in the Internet that one can see and use.  Second, I do not think, anybody, including my son, who will be training to be a surgeon in the future, will spend time going through all the 20,000 slides.  Thus, I decided to be selective, getting representative pictures (for example, representative pictures of the pectoralis major myocutaneous flaps that I had been doing before; representative pictures of the cases that we were seeing the emergency room of PGH – dart wounds, harpoons, etc.; representative pictures of other flaps; representative pictures of breast and thyroid pathologies; etc.).  I did not digitalize all the 20,000 slides.  I digitalized only those which are of sentimental values to me.

With this experience in clutter management of photo slides, especially medical ones, here are my thoughts, perceptions, opinions and recommendations:

  1. After taking pictures, this time, digital already, as soon as possible, select which ones to discard which ones to keep.  If you don’t do this, your pictures will pile up to the point it will be hard to manage or to do clutter management.  Discard blurred pictures, triplicates (just duplicates at the minimum), and pictures which do not have clear message content.  Keep those which you think are important – create your own criteria – example, for lecture, for research, unusual cases, etc.
  2. Label and categorize them into folders.
  3. If possible, make a slide show or presentation.  Post them in Slideshare or Google Photos or even Facebook.  Decide on the privacy setting.  Keep a digital back-up in your computer or external hard drive.
  4. Make your pictures useful.  Use them to teach.  Share your pictures to the public or to interested people.  Recommendation: at least once in the lifetime of the pictures.

Clutter Management of ROJoson’s Photo Slides


I had my old analogue slides in plastic jackets and suture boxes.


My estimate: 20,000 old analogue slides.

After selective digitalization, I discarded them.


Sorting and categorization (classification) of yesteryears (dated back to 1976) – using suture boxes.


Sorting and categorization (classification) of yesteryears (dated back to 1976) – using plastic jackets.







How I labelled and cataloqued my slides of yesteryears (with data – name, age, sex, date, tag, number, etc.)


Samples of Dr. George Eufemio’s slides of yesteryears.


About 20,000 slides of yesteryears discarded.

Goodbye!   Fond memories.  Memories of my experiences as a surgical resident and as a consultant.  Will miss you!





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ROJoson Medical Clinic Patient Contact Information – Continual Refinement

In the data sheet form that I ask patient to fill-up in my clinic, I include fields on contact information (landline number, cellphone number, and email address of patients and cellphone number of relatives).


Today, I will refine the strategies in my getting the contact numbers of my patients and relatives when I foresee that I may have to contact them right away.  A common situation is when patients are scheduled for admission and operation.  I may need to contact them right away if there is a need to change schedule.  Another situation is when patients are being closely follow-up by me.  I may need to contact them to check their status.

Starting January 7, 2018, before discharge from my clinic or from the hospital, I will ask for their cellphone numbers (patient and a guardian) by making them SMS or text me and my secretary their numbers and names.  So, what will appear in my cellphone log (also in my secretary’s cellphone log) will be a number that contains the name of the patient and of course the cellphone number and  another number that contains the name of guardian, his patient, and the cellphone number.

This way, I and my secretary will find it easy to contact them when we need to do.

Trigger for this continual refinement:

I have to change a schedule of admission and operation for a patient originally scheduled on January 9, 2018 (Black Nazarene or Quiapo Day).  I realize the need to do the change only on a weekend (Saturday evening).  Her records were in the clinic.  I did not have her cell number.  I decided to call up my classmate, Isa Ortega, who referred patient to me, for assistance.  Fortunately, Isa had the contact number of the patient.  On Sunday,  I was able to call up the patient and advised her on the change of schedule of admission and operation.  A little hassle which can be avoided by my new strategy. 

Additional strategy: for those with Facebook account, to tell them to keep in touch with me in Facebook.  However, this is not as quick as using cellphone communication.

Case in point:

December 19, 2017, a patient was scheduled for breast cancer operation.  She was supposed to check into the hospital on December 18, 2017.  At 5 pm on December 18, 2017, no news from her.  I tried the cellphone number of her relative given to me before.  I did not have her new cellphone number as she just arrived from Vietnam.  No answer.  She had to admitted on December 18, 2017 because December 19, 2017 was my last day of operation (I was leaving for abroad on December 22, 2017).  She had Facebook account.  I private messaged her at 6 pm.  Fortunately, at 7 pm, she responded through FB messenger.  She thought all the while she would check in and have the operation on December 19, 2017.  I said no. She had to check in the day before (December 18, 2017).  With this information, she right away packed her stuff and went to the hospital and checked-in at 10 pm.  The operation went on as scheduled.


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For those who want to be my friends in FB after my 5000 quota

December 24, 2017

As of December 24, 2017, I have a total of 5,227 friends in both my FB timeline (Reynaldo O Joson) and FB group (Reynaldo O Joson 2).

My primary FB Timeline is Reynaldo O Joson.

I reached my quota of 5000 in May 27, 2017 / June 12, 2017. I created a FB group (Reynaldo O Joson 2) in May 20, 2017 to accommodate those who want to be my FB friends after the 5000 quota.

I have been constantly cleaning up my FB timeline (Reynaldo O Joson) and constantly adding new friends to my FB group (Reynaldo O Joson 2).

For those who want to be my friends in FB after my 5,000 quota, pls. submit requests to Reynaldo O Joson 2.

Those who are already my friends in Reynaldo O Joson need not submit requests anymore.

Reynaldo O Joson 2 is an extension of Reynaldo O Joson (1).

Thank you!

Reynaldo O Joson

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