Numbers Game

One day, I was talking to one of the medical representatives covering me in the clinic. I asked about their never ending quest to get the doctor’s signature as they visit. I was told they are required a certain number of visits per week . The signature is their evidence. The more visits, the higher the chance their product or service is remembered.

My brother in law who is in sales also talked about prospecting. The more people they are able to talk to, the greater chance they will make a sale.

My dad calls it the numbers game.

How can the numbers game work for start up doctors? I learned a lot from my consultants when i was starting. Here a few things they shared:

1. Stay in your clinic. My dad emphatically states it “stay put”. Man your clinic. Even if no patients come for a string of days. One day he will and if you are not there you lose the opportunity. There are many variations to this nugget of advise. Some choose to stay all day in most days of the week. Some choose to start with just one or two clinics. You must be there when opportunity knocks.

2. Work on your ideal set up but do something while you wait.I spoke with my newly graduate mentee today. She is eyeing a mall clinic near her home. However the clinic is still up for construction. It can still take months. I told her she might benefit from starting her clinic in a nearby site that she can occupy right away. The time it will take for the mall clinic to be set up and get running is more than enough time to start building a patient base in an area just nearby. Should she decide to let go of the clinic in favor of the mall clinic, patients are most likely to follow.

3. Associate work is okay but but set up shop at the same time. Many busy consultants engage new graduates as associates in the clinic to help them with patients. This is fine as long as you also set up your own clinic schedule. If you do, you also start having your own patient who will see you and come back to you. Associate work provides an income we all need but the patients you see are not your own.

Build the numbers. Spend time for it. Remember,you only need one to get started.

How about you, can you share what you have done to improve your numbers?

If you like this article, go ahead and share to friends who may benefit from it.

photo credit: justt2shutter/

To HMO or Not to HMO

Health maintenance organization (HMO) is one of the ways our patients avail health care.

In most hospital settings particularly in bigger tertiary hospitals, HMO comprises a great percentage of patients. Sometimes the numbers may reach half or even more of those availing services.

Engagement in HMO as a health service provider is a personal decision you have to make. In some outpatient ambulatory set up, it becomes part of the arrangement. So, To HMO or not to HMO?

Lets take a look at the pros and cons.


1. Provides a steady stream of patients. This is helpful for start ups who are building their patient base.
2. It can be a source of referral. If the patients like you, they can tell friends and relatives, with HMO or not.
3. For pediatricians who offer other services other than consult like vaccination, patients are more likely to avail of your other services once you have engaged them in regular consults.

1. Fees maybe smaller than your regular consult or professional fee for in patients depending on where you practice.
2. Payments may take months. But if it is consistent, eg. every two months, then it becomes a cycle that evens out. If it becomes unpredictable,then the amount the HMO owes you becomes bigger through time.
3. You need to fill out forms for documentation. You will be required to submit these forms and provide summaries in order to be paid your fees.
4. You need to keep files and reconcile which services rendered has been paid or not.

But HMO or not, our patients deserve the same quality of care.

To HMO or not to HMO? What do you think? Please comment below if you can think of other pros and cons. If you find these information useful, please share or like us on facebook.

photo credit: naypong/


My brother who is a financial adviser shared a jar system that helps in setting aside money for different purposes the easy way. One of those jars is a personal and professional development jar. This jar is meant to help us improve ourselves and do the work we do. It can cover expenses for conventions, membership fees for societies, permits or clearances to practice our profession. How much do these add up to? What ways can we make it easy on the pocket to shell out for it? Since i am a pediatrician, I will make mine an example.

My society fees are:

Annual membership fee
Php 2000
Annual convention fee
Php 3360

I usually attend 2 to 3 other specialty or general pediatrics convention a year.

Specialty or general pediatrics convention
Php 3 x Php 2500 = Php 7500

I practice in a hospital where our department have annual dues too.

Department annual dues
Php 3000

These fees add up to Php 15860 .

Permits and clearances are required annually if you register your clinic as a business entity (eg. a multi-specialty clinic ). The fees may vary in different areas.
Mayor’s permit
Barangay clearance
Sanitation permit etc

If you also pay the above permits, the total can vary between 20 to 25k

The jar system allocates a certain amount to a particular jar each time you earn. Since registration expenses usually occurs in the first month of the year, setting aside for it will be easier to the pocket if done the whole year. For the other expenses that are spread out through the year, the system still works by providing you a certain amount available (could be in full or partial) that you could draw from.

Go get your jar now! Have you tried this system before? Share if you did.

If you find this useful, share and like us on facebook.

photo credit: photouten/

Turning your Downtime to Gold


Funny but true, start up doctors make quirky comments like “nabasa ko na paulit ulit lahat ng magazine sa clinic or na memorize ko na lahat ng crack sa wall kakatitig” while waiting for patients to come.

While i think everyone who started a practice went through such an experience, we can make good use of downtime including no clinic days.

Here’s a few downtime ideas my friends and I did:

1. Review all your practice guidelines and emergency protocols and medications. If you’re up for specialty board exam, its study time!

2. Learn a skill to produce a product you can sell. Bake cookies. Awaken your crafty self. I sold chocolates i made after attending a chocolate making class. This gave me extra income when the patients came in trickles. My friend turned to baking.

3. Refine and develop a skill you can use in the future. Earlier in my practice, i decided to take a 7 trimester Master’s program. The class is once a week. On a Saturday ( yup, of all days! ) . If you are a pediatrician,you know Saturday is a big day for us! Since the class ends at 4, i managed to have clinic for 2 hours after school! It can be an online certification for you or a short course.

How about you? What do you do during downtime?

photo credit: ambro/

What Else Can I Do?


Somewhere down the road….
either quite early in the game or in the middle of it all or sometimes as a last hurrah, we want to do something else. Its a good thing our profession provides many other opportunities.

Here are a few related fields or work you can get into:

1. Medical transcriptionist
2. Health writer for magazines,newspaper or blogs
3. Expert speakers pool
4. Medical consultant or director for corporations including hotels, pharmaceutical or nutraceutical companies, airlines, health maintenance organizations, insurance firms, ambulatory clinics, international organizations like WHO etc.
5. Hospital administrators
6. Medical researcher
7. Quality or medical officer for industrial firms
8. School doctor
9. Preceptor or teacher in medical schools
10. Curriculum or module developer for schools

Whatever you choose to do as long as it makes your soul happy and puts the zest back to your day…why not!

What else do you do? Please share ☺

photo credit: graur razvan ionut/

How to Apply for HMO Accreditation


Health Maintenance Organizations remain to be one of the major means patients access health care. As a service provider, you
can apply to be affiliated with HMO as long as you agree with their terms and conditions including fees and payment schedule.

If you are in a multispecialty clinic who accepts HMO, the arrangement is made by the clinic so you can accept patients who will use their HMO.

If you have a clinic of your own, you can apply and course it through their offices or clinics located in hospitals where you are affiliated.

I asked different HMOs about their application procedures. Requirements for most are similar which may include:

Letter of intent
Medical school diploma
Medical Board certificate
Specialty or subspecialty board certificate
Copy of PRC card, PTR (professional tax receipt),
Official receipt, TIN, VAT registration, Philhealth registration as a health provider

The HMO sends you a contract which stipulates the terms of your engagement,fees, payment,and documentation. The contract can be for inpatient or outpatient or both. Once approved, patients who wants to avail of your services will be given a form by the HMO each time they make an outpatient consult. This is the form you will fill up and include in your documentation so the HMO can pay your fees. For in patient, hospitals are given a list of accredited doctors. If you are in the list, patients can be admitted under your service using their HMO. Payment for your fees may range from 1 to 6 months.

photo credit: Stuart Miles/

A Letter to My Young Start Up Doctor Self

ID-10070921To my dear  start up doctor  self,



Hey! Excited? I hope this letter finds you a few moments away from wrapping up your training. In a few weeks you set out to start your practice.


I am your future self and let me tell you something: you did well.

You have a practice that you want and you have a life you enjoy. Lets not get ahead much. That’s not why i am writing you.


I am writing to share a few things i learned along the way.



Keep your passion alive.


Ours is a caring profession. Passion is the fuel that can sustain it. Our years of training tell us its no easy job. There will be difficult cases and this time you are on your own. You are the attending. You will make crucial decisions together  with your patient. You will be tired and challenged. Find comfort that you have been trained well for this. That there is a great resource out there for you including friends, mentors and colleagues. Bathe your efforts in prayers.


Build relationships.


Thats what patients are looking for. Be their friend. Confidant. Ally. Patients want to know first if you care enough.


Just aim to help.


If you do this, pleasing patients will be effortless. This can be tricky though. Ask  how you maybe of help. Listen to,  not just hear what they are saying.  Match your patient’s needs.  They may need you to understand what ails them and how to recover or improve their condition. But they may want you to understand and address concerns beyond the disease.


Continue to invest on yourself.


You are more than a doctor. Do not bury the gifts you have been given. Rediscover them. Learn new things. They will come in handy  many years into the future. You can be the  doctor who teaches,who bakes, who paints. You can be anybody.


Let your life purpose sustain you.


When patients come in trickles and income do not come as expected, remember what you are called to do. It will help you to keep going. I assure you , the money will come.


Time is an asset.


It has its value just like any currency. Be careful how you use it. Choose to spend each day doing things that leads to the fulfillment of your life purpose. Do not   be like  a fly that keeps on moving but not getting anywhere.


Mistakes have a silver lining.


Do not crucify yourself when you make one. Listen to what it is telling you. More often it can be your greatest teacher.


Choose your company.


Surround yourself with people who can  positively affect you and the world.


Preserve your integrity.


Let no company  or person buy or take it away from you.


Enjoy the journey my young self. Beyond the turns and twists is a life you have every opportunity to shape.

The best of years to come dear!



Your Future Self


photo credit:

Step Back, Look Forward


3 days, 1 place and 1 friend. And all the time in the world to slow down and step back. I call it my annual retreat. Not your typical reclusive , no talk type though. The most difficult part of doing this is commiting to the days that it should happen. Somehow it keeps on getting pushed back. There is always something that seems to be more important . I even needed someone to pin me down to do it.

Why do it in the first place?
If there are times you feel that you have too much on your plate and need to sort things out…
If you feel there is more that you can do, but can’t seem to find the starting point….
If you want to look into your varied roles and figure out how they align….
When you are about to take a big leap and you need to see the big picture …
When life gives you a second chance and you need to set things right….
When you are about to start a new phase and you want to set your sight on where the next chapter can take you…

Stepping back gives you that chance to look forward.

Here’s how to ” step back,look forward” my style:
1. Get a real big push to commit your days to do this (this seem to be the hardest step for me!).
2. Call a friend to be with you. Choosing the right friend is crucial. Someone who can listen when you think out loud. You don’t need answers when you do this. You just need someone to hear you out ( so you don’t look crazy talking all by yourself! Lol!) Talking out loud what’s going on in your mind may trigger further insights. My friend J is perfect !
3. Find a place that offers less distractions. Food should be readily available when you get hungry. Television or internet preferably not available.
4. Set your goal. Mine was to set my direction for the next 3 to 5 years. For some, it can be a long pressing question that needs a careful thought.
5. Write an exhaustive list of questions you want answered in relation to your set goal. Examples from my list includes:
At what age do I want to retire? What else do I like to do other than what I am doing now? What do others say I am good at? Who do I want to be with more often? How much do I need to keep the life I have now? What else do I need to provide for my family? Your list can be different but consider all aspects of your goal.
6. Ask what’s in it for you if your set goal is met. A stress free lifestyle perhaps. Happiness in pursuing a passion. More time with family. Financial rewards. List it down too! Doing this will excite you to pursue it relentlessly.
7. On the other hand, what can go wrong if you pursue your set goal? List it all down too. Don’t mince on this one. The more you think about this, the more you will be able to prepare for hurdles and challenges.
8. Identify things you can do now to set the ball rolling. How about those that you can do in a month? Within the next 3 to 6 months? Set the timeline based on the goal you have set.

Whoever you are, whatever you do, stepping back to do this is a good thing.

Residents or fellows who are about to end their training. Doctors on top of their career. Those experiencing a slump.

Here’s to making a life not just a living! Cheers!

The Power of A Simple Smile

Something  happened to me  this afternoon. Everything occurred in probably 30 seconds or less. Inside an elevator.  And that’s what amazes me!

I was off for home and I pressed the elevator button  to go down.  The elevator opened and no one was inside.  Two floors down, a lady and her companion came in . I smiled. Three others went in. She was on the other side of the cramped elevator and  I heard her say, “ang ganda naman ng smile ni doktora, derma po ba kayo? “ Without even seeing her by this time I answered, “ doctor po ako ng mga bata.” To which the lady answered, “anong floor po nyo, sayo ko na dadalhin ang apo ako!” I replied then she went off as the elevator opened 6 floors down.

How that lady made a snap decision to bring her apo to me  left me with much to think about.  She did not ask where I took my residency.  She did not ask what hospital  I  was affiliated with.  She did not know how long I have been practicing.  All I did was smile. All it took was about 6 to 10 seconds from the time she came in to the time she got off.

The power of  a simple smile.  No wonder why  any customer service training begins with   knowing how to smile.


How about you, do you believe in the power of  a simple smile?




photo by digitalart/

We’re Friends!

ID-10045041I’m back!

Pardon the hiatus! It’s been busy. It’s been tiring but it’s been fun too! It’s been a  great  past  weeks with all its twists and turns but all useful, insightful and for some reasons I may not know now, all for the greater good!


I have this urge to write about friends .  I am grateful for friends. You know… the kind who sticks with you…mirrors things to you.  Many things become possible when friendship reigns.  Work becomes easier. Differences become opportunities.  Difficulties become bearable.  Communication does not always mean spoken with friends. Isn’t that great?  Less noise, more understanding.  How’s that for a definition of friendship?


But this blog is about work, how can I be a friend?  Imagine patients as your friends. Imagine how powerful that is. Imagine how it can work wonders for you and for your patient.  The attitude is welcoming.  There is listening and focus as you get lost in each other’s company. Less judgemental. Spoken and unspoken words are captured. Candid but truthful.  Aren’t they all fundamentals in  a good patient – doctor relationship?


While others say friendship with patients can lead to ethical issues that may compromise care, it can go either way depending on how we choose it to be.

What’s your choice?


photo credit: Master isolated images/