“We’ve lost our best nurses and doctors to America…and got nothing in return,” says Brokenshire Hospital’s director Dr. Jack Estuart in a faded yellow operating room. His nurse manager led a team of 108 nurses for eight years before one day informing him she was going to Odessa, Texas.
“Odessa!” he says. “Where is that? Where? She’s gone from all this responsibility to nothing.”
To some extent, he understands the allure of the United States. Salaries there are ten times what he can offer. But he wants the U.S. to offer the Philippines something in return: assistance to the government for more high-tech equipment and training facilities. And he wants medical schools here to send students into rural Philippines to give them a sense of commitment to their own people.
But he’s up against a stiff challenge. He says over the past decade with more movies and TV shows coming from the United States, America’s medical image in the Philippines has grown all the more glorious. Of course, flexible immigration policies for medical personnel and higher pay have a lot to do with why Filipinos have moved to the U.S. in waves over the past two decades, but there’s more to it.
When Dr. Estaurt was in Ateneo de Davao Medical School in the 80s, social activists roused him, calling for the ousting of dictator Ferdinand Marcos, and urging him to devote his life to helping the poor and building a new Philippines. He stayed, he says, for this purpose.
So says head emergency room nurse, Ray Bleica.
Ray has been trying to get to the U.S. since 1997. Asked if he feels bad about leaving the Philippines, a country in need, for America, “the land of milk and honey” as he calls it, Ray says, "It’s frustrating, but here politics are bad, there is corruption and insurgency.” Fighting the system is too difficult. “I can only do so much,” he says.
At least in America he can be sure to earn a good living and send much of that money back to his cousins here, without government officials taking a cut. Ray makes US$400 per month now. In America he could make almost ten times that.
But more money has its price.
Currently he supervises a dozen nurses working underneath him. Like his peers, Ray will move from being a leader, a position it took him almost a decade to acquire, to becoming a low-ranking member of the staff again in a hospital in Ohio. He's not sure what city he's going to. (Many Filipino rural doctors are doing something similar, sacrificing their medical degrees to become nurses in the U.S.)
Ray worries about being under-appreciated, citing the Teri Hatcher remark. And he worries about being too overwhelmed in "the land of stress." He imagines action-packed hospitals with tech-savvy labs. Nothing like Brokenshire.
"They really teach me a lot," he says, about how hard American doctors work, how dramatic their lives are, and about America's technological edge. "I was amazed America has diagnostic departments like [the ones featured] in House," he says.
The big difference between American and Filipino healthcare styles, he says, is in the U.S. doctors rely on fancy machines to diagnose and treat patients. In the Philippines, doctors and nurses are “more sensitive to patients” and can diagnose just as well with fewer resources. The pace is more relaxed. The quality of care is more personal.
Dr. Gregory House, known for insulting his patients and going to technological extremes to get the right diagnosis, is a far cry from what he’s familiar with.
So do you expect to meet or work with a doctor like Gregory House, I ask. Would you like to?
Ray nods his head yes. “I hope so."