Patient’s Trust on the Attending Physician Still the Main Driving Force in the Selection of Place for Medical Management and ROJ TPOR

Patient’s Trust on the Attending Physician Still the Main Driving Force in the Selection of Place for Medical Management and ROJ TPOR

by Reynaldo O Joson on Wednesday, September 21, 2011 at 11:51am

Patient’s Trust on the Attending Physician Still the Main Driving Force in the Selection of Place for Medical Management and ROJ TPOR


[ROJ TPOR on Dr. Ariel Celzo’s Medical Anecdotal Report (September 20, 2011)]


Year after year, since 1991, as a student of hospital administration, I have always been asking myself and my colleagues in hospital administration the question: What is and should be the main driving force for patients to go to a particular hospital for medical management?  Although year in and year out, I perceive the patient’s trust in the attending physician is the main driving force, as a strategist in hospital management, I have been trying to shift the paradigm to having the quality reputation of the entire hospital be the main attractive force and the magnet.  Frankly speaking, I find this strategy very challenging, not to use the word, difficult, in terms of formulating and implementing a concrete action action to this effect.  I have proposed such a strategy to the hospitals I am connected with, both private and government, and that have consulted me.


On September 20, 2011, a Medical Anecdotal Report (MAR) by Dr. Ariel Celzo from Ospital ng Maynila Department of Surgery (see attachment below) made me revisit this issue.


In my feedback to the MAR and insight of Dr. Celzo, I expressed the following thoughts, perception, opinions, and recommendations:


1.      In this particular MAR, on the part of the patient and her relative, it was a matter of balancing the hospital facilities with the trust in the attending physicians in making a decision in the selection of place for the gallbladder operation. The other factors such as finances and convenience have been resolved and settled.


2.      In this particular MAR, although the patient could very well afford to pay the hospitalization bill in a private hospital which no doubt would have better facilities and more convenience and she was free to choose where she wanted to be operated on, she opted to be operated in a government hospital such as Ospital ng Maynila Medical Center under the supervision and assistance of Dr. Celzo.  The satisfactory experience with her daughter’s management under the hand of Dr. Celzo, which was translated to trust, was the deciding factor.


3.      A reinforced, if not new, learning arising from this MAR is that trust in the attending physicians can override quality of hospital facilities in the patients’selection of the place of medical treatment.  From my exposure in government and private hospital setting, I am confident in saying this statement is valid. The following observations support the above statement. In the private hospital setting, we see Private Hospital B having a lot of patients, if not more, than Private Hospital A, that has the most advanced facility.  In the government hospital setting, the Philippine General Hospital (PGH) is a good example. The private and charity sections of the hospital are always full.  Aside from having a reputation of low medical cost, PGH also carries a reputation of excellent doctors.


4.      The Department of Surgery of Ospital ng Maynila Medical Center (OMMC) still has problem of caseload in certain specialties.  An example is the caseload on breast disorders.  For the past 10 years, the Department has been wanting to increase it.  I asked the residents how can the Department use the patient’s trust as a strategy to increase breast patient load.  After brainstorming, our consensus was to formulate an action plan on how to gain patient’s trust as a group, as a department, and not on an individual physician basis.  It must be done on a consolidated effort.  The critical success factor should be the presence of a critical mass of doctors in OMMC Department of Surgery who can provide excellent, quality and safe services for patients with breast concerns.  One of the specific action plans will be to develop clinical practice guidelines to be practiced uniformly by all doctors of OMMC Department of Surgery.  This will result in a branding that should be felt by the public.


5.      As a strategist in hospital management, I have been having difficulty in trying to shift the paradigm from an individual physician magnet to a hospital magnet.  After the brainstorming and discussion with my residents in OMMC on Dr. Celzo’s MAR, I think I should now focus on developing a magnet from a critical mass of physicians working in a hospital to achive a hospital magnet.


Medical Anecdotal Report of Dr. Ariel Celzo



Indexing Title: ATCelzo’s MAR (11-08)

MAR Title: Better Facilities or Patient’s Trust

Date of Medical Observation: August 2011

Tag: Patient’s trust, hospital facilities




I recently met one of my former patients at the outpatient department. She came in with her mother. After a few moments of introduction, she told me that she wanted to consult for her mother’s condition. Her mother was a 58-year-old female with a calculus of the gallbladder. She had been complaining of right upper quadrant pain for a few months without any accompanying symptoms. I eagerly examined  the patient and after a while we sat down to discuss her disease. After a couple of advices, I laid down to them the possible treatment options. With the help of my former patient, we convinced her to undergo operation. She then decided to have her operation at our institution.


Even though she agreed to have the operation, I can see that there was some degree of anxiousness in her. I simply asked her why they still wanted to be operated in our hospital. I told them, with their means, they could easily have an operation in a private hospital where they could avail of better facilities. They surprised me with their answer.  She simply said, “ I’d rather be with a doctor whom we trust!” It just made my day.


INSIGHT: (Physical, Psychosocial, Ethical); (Discovery, Stimulus, Reinforcement)


It is true that with better facilities one can render better service, but it does not sum it up. It then boils down to patient’s trust. Better facilities could attract more patients but they do not guarantee that they would lay their life on a doctor’s hand. Treatment can never be started unless a patient entrusts his life to a physician and completely agrees with the plan. In my experience, I have learned that this trust needs to be valued and appreciated. This would leave a mark on our patients which would help us deal with them more appropriately.

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