Distinguished Clinical Specialist and Public Health Specialist
DISTINGUISHED CLINICAL SPECIALIST OR PUBLIC HEALTH SPECIALIST
ROJoson has distinguished himself both as a clinical specialist and a public health specialist.
AS A CLINICAL SPECIALIST
His declared specialties: General Surgery and Surgical Oncology (Head and Neck, Thyroid, Breast, Abdomen, Gallbladder, Stomach, Intestines, Hernia, Skin and Soft Tissue Disorders)
He manages the ROJoson Medical Clinic with main clinic office in Manila Doctors Hospital.
As a clinical specialist, he has been promoting and providing patient-centered care management, cost-effective management and intentional living program to his patients since 1982.
He has several advocacies and advisories for his patients and the public.
See details below.
AS A PUBLIC HEALTH SPECIALIST
He helped designed the Community Management Courses (in 1993) in the innovative problem-based and community-based medical curriculum of Zamboanga Medical School Foundation / Ateneo de Zamboanga University (ZMSF /ADZU-SOM) which enabled the medical students solve the health problems in their assigned community while they are still students.
He promoted Health Action Researches in the Department of Surgery of Ospital ng Maynila Medical Center which tried to resolve public health issues when he was the Chairman (2001-2009). He also advocated public health education with respect to potential surgical problems.
He served as a coach of the Zuellig Family Foundation in its project – Maternal Death Control in Zamboanga Peninsula in 2015 to 2016.
He has several advocacies and advisories for his patients and the public (public health education).
See details below.
AS A CLINICAL SPECIALIST
His declared specialties: General Surgery and Surgical Oncology (Head and Neck, Thyroid, Breast, Abdomen, Gallbladder, Stomach, Intestines, Hernia, Skin and Soft Tissue Disorders)
He manages the ROJoson Medical Clinic with main clinic office in Manila Doctors Hospital.
As a clinical specialist, he has been promoting and providing patient-centered care management, cost-effective management and intentional living program to his patients since 1982.
See the write-up in Essay entitled Patient-centered Care Management.
Some excerpts from the write-up:
ROJoson started his journey on Patient-centered Care Management (PCCM) in 1982 when he formally started his private practice in general surgery. PCCM was not formally and intensely taught when he was a medical student in UPCM and in surgical residency training in PGH. He would continuously improve his management of patients along the principles of PCCM using problem-based learning and self-directed learning. Circa 1985, he formulated his Management of a Patient Process including its maxims, rules and guides which would promote rational, holistic, professional, compassionate, and cost-effective treatment. [Link: https://rojosonmedicaleducation.wordpress.com/2017/06/13/maxims-rules-and-guides-in-the-management-of-a-patient-rojoson/]
Because of his promotion of the Management of a Patient Process, the surgery residents of PGH gave him a monicker of “Josonics” or “Josonic Disciples.” Here are some quotes on his monicker during his retirement in 2014 from PGH.
ROJoson’s Achievements and Contributions to Society in the Local and National Level
From 1982 to 2019 (37 years), ROJoson was deeply improving, practicing and promoting patient-centered care management. He has done at least the following:
· Practicing the “Management of a Patient Process” on his patients (in his clinic, in the operating room, in the nursing floors, and outside and also in his telemedicine).
· Teaching the “Management of a Patient Process” to medical students and surgical residents he have come into contact with (UPCM, PGH, Ospital ng Maynila Medical Center, Zamboanga City Medical Center, etc.)
· Incorporating the “Management of a Patient Process” in the problem-based medical curricula of the Zamboanga Medical School Foundation / Ateneo de Zamboanga University School of Medicine, Bicol Christian College of Medicine, and Southwestern University College of Medicine.
· Incorporating the “Management of a Patient Process” in the Quality and Safe Management System of Salubris Medical Center in Nueva Vizcaya (2016-2017).
· ROJoson Medical Clinic – NO Queueing, NO Long Waiting Time for Patients (Started 2015)
o Using a system of booked appointment time, ROJoson was able to promote no queueing, no long waiting time for his patients. The patients like his booked appointment time. Some of his students are following suit.
· Rain-Flood-Wind Situation Advisories from ROJoson Medical Clinic (First given out – July 2017)
o What to do when there is strong rain and flood situation – to coordinate with ROJoson whether to go or not to go to ROJoson Medical Clinic
o “These recommendations are made because we are concerned with the welfare of our patients. We don’t like our patients to go to the ROJoson Medical Clinic and, after arrival, just to be told that there won’t be any clinic for the day and that the clinic has been cancelled because of the rain-flood-wind situation. We don’t like our patients to risk the rain-flood-wind situation just to meet their appointment schedule with ROJoson Medical Clinic.”
· Medical Prices Data in the Philippines - ROJoson’s Online Publication (started 2012)
o In the patient management processes, in deciding on what option for diagnostic tests and treatment procedures to take by a patient, the “medical price” is factored in. ROJoson would factor in the price and would inform his patients. The four parameters used for comparisons for the different options of tests and treatments are benefit, risk, cost and availability or BRCA.
· ROJoson has online Advocacies and Advisories (partial list):
· Rational Patient Management Process [https://rojosonmedicaleducation.wordpress.com/2017/06/13/maxims-rules-and-guides-in-the-management-of-a-patient-rojoson/]
· No to Routine Circumcision [https://xtulepinoy.wordpress.com/]
· Beware of Santol Seed Swallowing [https://rojosonmedicalclinic.wordpress.com/category/santol-seeds/]
· NO to Unnecessary Operations and Diagnostic Procedures [https://rojosonmedicalclinic.wordpress.com/2017/10/22/rojosons-patients-advised-against-unnecessary-operations-and-procedures-a-registry-a-resumption/]
· Cancer Survivor Registry [https://sites.google.com/site/rojosonscancersurvivors/home; https://sites.google.com/site/rojosonscancersurvivors2/home]
· No to Patient Queueing [https://sites.google.com/site/rojoson70memoir/no-queuing---no-long-waiting-time-in-clinic---a-legacy; https://rojosonwritingsonhospitaladministration.wordpress.com/2019/03/02/feedback-on-rojoson-medical-clinics-booked-appointment-time-system/; https://rojosonwritingsonhospitaladministration.wordpress.com/2016/10/06/no-queues-by-appointment-only/; https://sites.google.com/site/rojosonmedicalclinic/booked-appointment-performance---december-2018-and-2018]
· Legible Physician Handwriting [https://rojosonmedicalclinic.wordpress.com/category/handwriting/]
· Healthy Lifestyle - (actively promoting healthy lifestyle among patients with role modelling) [https://rojoson.wordpress.com/2019/07/03/rojosons-diet-to-stay-healthy/; https://rojoson.wordpress.com/category/exercise/; https://rojoson.wordpress.com/2016/05/30/rojosons-stretching-and-flexing-exercises/]
· Intentional Life Plan – Intentional Living (Intentional Living (promoting intentional living among patients and how to live life to the fullest – how to productive, contented, enjoying, happy and to live long) [https://rojosonnotesonlife.wordpress.com/category/intentional-life-plans/]
· Keeping and Giving Medical Records to Patients [https://rojosonmedicalclinic.wordpress.com/category/keeping-medical-records/
Other Links on Medical Records:
· Medical Recordings in the Medical Clinic
https://sites.google.com/site/rojosontipsforgeneralsurgeons/medical-recordings-in-the-medical-clinic
· Physician Pad in my Clinic and How I Use It
https://rojosonfacebooknotes.wordpress.com/2012/11/02/physician-pad-in-my-clinic-and-how-i-use-it/
· Practice of giving medical records to patients
· Giving duplicate copy of medical records
· ROJoson uses telemedicine (through cellphones and FB messenger) to provide patients easy access to ROJoson when needed – pre-consult and post-consult and preoperatively and postoperatively.
· He always does a physical examination rather than relies totally on diagnostic tests (at least touch the patient).
· He prays with patients before latter are anesthesized for the operation - started July 2019.
· He sees and talks to patients before being anesthesized to assure them that he is around and be the one to operate.
· He requests his anesthesiologists to have Intravenous fluid line inserted at the operating room rather than at the nursing floor for elective surgery (to avoid multiple punctures by interns and nurses; to prevent repeated puncture when IV gets dislodged during transit from floor to operating room; and to allow patient to rest well prior to operation).
· He does his own preoperative risk assessment frowning on routine “cardiac clearance.” He will refer to a specialist only when indicated.
· He uses preop and postop antibiotics and other medications rationally and cost-effectively.
· He promotes rational and practical care of postoperative wounds such as wounds can be wet, using open dressing, etc.
· He checks accuracy of charges to his patients in the operating room. He checks accuracy of hospital bills of his patients.
· He does not allow use of unnecessary materials for patient’s use (sometimes stipulated by hospital administration) like ESONEX (P600.00) vs ordinary soap (P20) for full bath before surgery and like Intravenous fluid infusion pumps (he only prescribes this when needed).
· He subscribes to the following principles in patient-centered care management:
ROJoson has online Advocacies and Advisories (partial list):
· Rational Patient Management Process [https://rojosonmedicaleducation.wordpress.com/2017/06/13/maxims-rules-and-guides-in-the-management-of-a-patient-rojoson/]
· No to Routine Circumcision [https://xtulepinoy.wordpress.com/]
· Beware of Santol Seed Swallowing [https://rojosonmedicalclinic.wordpress.com/category/santol-seeds/]
· NO to Unnecessary Operations and Diagnostic Procedures [https://rojosonmedicalclinic.wordpress.com/2017/10/22/rojosons-patients-advised-against-unnecessary-operations-and-procedures-a-registry-a-resumption/]
· Cancer Survivor Registry [https://sites.google.com/site/rojosonscancersurvivors/home; https://sites.google.com/site/rojosonscancersurvivors2/home]
· No to Patient Queueing [https://sites.google.com/site/rojoson70memoir/no-queuing---no-long-waiting-time-in-clinic---a-legacy; https://rojosonwritingsonhospitaladministration.wordpress.com/2019/03/02/feedback-on-rojoson-medical-clinics-booked-appointment-time-system/; https://rojosonwritingsonhospitaladministration.wordpress.com/2016/10/06/no-queues-by-appointment-only/; https://sites.google.com/site/rojosonmedicalclinic/booked-appointment-performance---december-2018-and-2018]
· Legible Physician Handwriting [https://rojosonmedicalclinic.wordpress.com/category/handwriting/]
· Healthy Lifestyle - (actively promoting healthy lifestyle among patients with role modelling) [https://rojoson.wordpress.com/2019/07/03/rojosons-diet-to-stay-healthy/; https://rojoson.wordpress.com/category/exercise/; https://rojoson.wordpress.com/2016/05/30/rojosons-stretching-and-flexing-exercises/]
· Intentional Life Plan – Intentional Living (Intentional Living (promoting intentional living among patients and how to live life to the fullest – how to productive, contented, enjoying, happy and to live long) [https://rojosonnotesonlife.wordpress.com/category/intentional-life-plans/]
· Keeping and Giving Medical Records to Patients [https://rojosonmedicalclinic.wordpress.com/category/keeping-medical-records/
Other Links on Medical Records:
· Medical Recordings in the Medical Clinic
https://sites.google.com/site/rojosontipsforgeneralsurgeons/medical-recordings-in-the-medical-clinic
· Physician Pad in my Clinic and How I Use It
https://rojosonfacebooknotes.wordpress.com/2012/11/02/physician-pad-in-my-clinic-and-how-i-use-it/
· Practice of giving medical records to patients
· Giving duplicate copy of medical records
https://rojosonmedicalclinic.wordpress.com/2012/04/22/giving-duplicate-copy-of-patient-s-diagnosis-on-consultation/
IMPACT:
· ROJoson’s advocacies on patient-centered care management being promoted online, particularly in Facebook, have influenced at least some of his Filipino physician followers (medical students, residents and fellows, and established medical and surgical practitioners) to follow suit thereby improving health care delivery services in the Philippines.
· ROJoson’s advocacies on patient-centered care management being promoted online, particularly in Facebook, have influenced at least some of his Filipino patients and the lay Filipino people on what to expect and what to look for in their search for value-based health care services.
· ROJoson’s advocacies on patient-centered care management have protected and saved his patients from unnecessary medical procedures and their corresponding expenses and potential complications.
· ROJoson’s advocacies on patient-centered care management have empowered his Filipino patients and the lay Filipino people on at least a knowledge on how to have value-based health care services for themselves.
AS A PUBLIC HEALTH SPECIALIST
He helped designed the Community Management Courses (in 1993) in the innovative problem-based and community-based medical curriculum of Zamboanga Medical School Foundation / Ateneo de Zamboanga University (ZMSF /ADZU-SOM) which enabled the medical students solve the health problems in their assigned community while they are still students.
He promoted Health Action Researches in the Department of Surgery of Ospital ng Maynila Medical Center which tried to resolve public health issues when he was the Chairman (2001-2009). He also advocated public health education with respect to potential surgical problems.
He served as a coach of the Zuellig Family Foundation in its project – Maternal Death Control in Zamboanga Peninsula in 2015 to 2016.
See the write-up in Essay entitled Health Action Research.
Some excerpts from the write-up:
Zamboanga Medical School Foundation / Ateneo de Zamboanga University School of Medicine (ZMSF/ADZU-SOM)
ROJoson advocated action researches in the community health management courses in the curriculum of Zamboanga Medical School Foundation / Ateneo de Zamboanga University School of Medicine (ZMSF/ADZU-SOM) for which he was the primary designer and developer. The medical students have been producing researches that involved solving specific health problems in the specific setting of the community they have been assigned to (from 1994 to 2019). The action researches qualify the students of ZMSF/ADZU-SOM to get an MD-MPH degree.
The innovative medical curriculum of ZMSF/ADZU-SOM was adopted by Bicol Christian College of Medicine from 1995 to 2003 and Southwestern University College of Medicine in Cebu from 1995 to 2000. Thus, the medical students in these two medical schools had also tried to produce researches that involved solving specific health problems in the specific setting of the community they were assigned to.
Samples of action research outputs from Community Health Management Courses of Medical Schools Helped by ROJoson Circa 1994 – 2005:
From ZMSF/ADZU-SOM
Links: http://som.adzu.edu.ph/; http://som.adzu.edu.ph/research/index.php?pageNum_search=20; http://som.adzu.edu.ph/research/index.php?pageNum_search=21]
From Bicol Christian College of Medicine [https://rojosonmedicaleducation.wordpress.com/2013/03/04/outputs-from-community-health-management-courses-rojoson-circa-1994-2005/]
Community Health Management Plan on Health Problems – Format [Link: http://rjoson.tripod.com/bccmcomhmgt/comhmgtformat.htm]
Community Health Management Plan
on
Health Problem
(Specify health problem such as cardiopulmonary disorders, cancer, etc.)
(Name and Title of Contributor)
I. Describe the community and the selected health problem.
II. State the goal and objectives of the community health plan.
III. Formulate strategies and programs utilizing the concept of primary health care
Community participation: People
Intersectoral linkages: NGO, Government, Health Care Providers
Appropriate technology
IV. Formulate evaluation methods and indicators.
V. Cite references.
Evaluation Criteria:
Clear
Adequate in terms of content
Problem identification
Objectives
Strategies
Evaluation methods and parameters
Format followed
Presence of references
Community Health Management on Cardiopulmonary Diseases [Link: http://rjoson.tripod.com/bccmcomhmgt/cardiopulmo.htm]
Community Health Management on Cancer[Link: http://rjoson.tripod.com/bccmcomhmgt/cancer.htm]
OMMC SURGERY
ROJoson advocated health action researches (Health Action Research Project) in the Department of Surgery of Ospital ng Maynila Medical Center from 2001 to 2009 when he was Chairperson of the said Department.
Links: http://omsurg_research.tripod.com/; http://reynaldojoson.tripod.com/researches_unpublished03_04.htm
The Health Action Research Project was part of OMMC Surgery Social Responsibility Program which satisfied the WHO framework of values, namely, relevance, quality, cost-effectiveness, and equity.
Relevance – Solving situational health problems in the Department through research contributes to relevance of the project. With relevance, the output of the project benefits the patient-clients of the Department in terms of provision of improved health care. With relevance too, the project makes the surgical residents more motivated to do such kind of clinical medical researches and it facilitates formation of effective and efficient surgeon-researchers. The same reasonings and justifications for relevance go for the Multi-center Cooperative and Collaborative Action Research Study (MCCCARS) project of OMMC Surgery.
Quality - The Health Action Research Project improves patient care. Thus, quality service is being promoted. It also improves the teaching method on research to surgical residents. Thus, quality training in research is being promoted.
Cost-effectiveness – The Health Action Research Project promotes cost-effectiveness in patient care. It also promotes cost-effectiveness in teaching research to surgical residents, in terms of more research outputs and meaningful and useful at that in consideration of logistical constraints, compared to when traditional clinical medical researches will be emphasized.
Equity –Action researches, being situational, solve the health problems of the underprivileged and indigent patient-clients of the Department in the most effective and efficient way possible thereby still producing quality health care. They also solve the health educational problems of a scarcely funded health institution and still produce effective educational methods of research.
A paper entitled “Development of an Action Research Program in a Department of Surgery in the Philippines” was presented in the 4th Asia-Pacific Conference on Problem-based Learning in Health Sciences in 2004 with the following abstract:
Abstract
In the Philippines, action research is practically unheard of in the field of clinical medicine. This paper reports on the development of an action research program in the Department of Surgery of Ospital ng Maynila Medical Center. With the guidance of the Chairman of the Department and a research grant from the North Texas Association of Philippine Physicians, 4 action research papers were produced in 2003 by 16 residents and 16 papers by 16 residents in the following year. The action research program has produced tangible changes in patient care such as 1) use of selective preoperative screening leading to reduction of unnecessary laboratory examinations, reduction of average number of preoperative patient visits from 6 to 2 and preoperative medical expenses by 50%; 2) reduction of discrepancy in clinical and pathological tumor and nodal evaluation in breast cancer patients thereby improving accuracy of the pretreatment cancer staging; 3) reduction of incidence of sudden cancellation in elective operations from 10% to 5% thereby avoiding patient anxiety; 4) reduction of unnecessary appendectomy from 10% to less than 5%; 5) reduction of unnecessary fibrocystic breast excisions in young women from 35% to 7%; and 6) reduction of incidence of surgical wound infections in appendiceal and colorectal surgery. With the residents doing one small scale action research per year and with the motivating effect of relevance and tangible outcome of such kind of research, the authors are confident that the residents will imbibe the habit of doing high impact medical researches.
How do the Health Action Research Project contribute to the Social Responsibility Program of the Department of Surgery of Ospital ng Maynila Medical Center?
The health action researches promote and facilitate the development of useful surgeon-researchers through the motivating effect of their relevance and utility. The impact of this output consists of formation of more surgeon-researchers contributing to the health development not only in the Department of Surgery but also outside the Department and OMMC, in the communities where the graduates will be practicing and in the communities where the members of the MCCCARS (Multi-center Cooperative Collaborative Action Study) are practicing.
The health action researches improve patient care in the Department through improved governance, service, and training.
Thus, the Health Action Research Project of OMMC Surgery not only addresses the needs of its internal clients, the surgical residents, but also its external clients, the patients and the Filipino citizenry.
ROJoson’s Action Researches in OMMC Surgery won three awards (national and international):
· Winner, 2004 Asian Hospital Management Awards, Knowledge Management System of the Department of Surgery of Ospital ng Maynila Medical Center (October 7, 2004)
· Winner, 2005 Anvil Award, Wholistic Corporate Social Responsibility Program of Department of Surgery, Ospital ng Maynila Medical Center , February, 2005
· Runner-up, 2005 Asian Corporate Social Responsibility Awards, Conducive Practice Program of the Department of Surgery, Ospital ng Maynila Medical Center (September 9, 2005)
Zuellig Family Foundation – Maternal Death Control Program in Zamboanga Peninsula
https://sites.google.com/site/rojocilmmrrcommunity/end-of-course-report
ROJoson designed an Online Collaborative and Interactive Learning to Create a Structured, Comprehensive and Sustainable Design and Development Plan on Maternal Death Control Management System in Zamboanga Sibugay Provincial Hospital, Zamboanga Del Norte Medical Center, Zamboanga del Sur Medical Center, and Zamboanga City Medical Center.
Won an international award (AHMA) in 2015.
ROJoson’s Action Research in Zamboanga Sibugay Provincial Hospital won an international award in 2015: Winner – AHMA – 2015 – Community Hospital Improvement:
An Online Collaborative and Interactive Learning to Create a Structured, Comprehensive and Sustainable Design and Development Plan on Maternal Death Control Management System in Zamboanga Sibugay Provincial Hospital
ROJoson has online Advocacies and Advisories (partial list):
· Rational Patient Management Process [https://rojosonmedicaleducation.wordpress.com/2017/06/13/maxims-rules-and-guides-in-the-management-of-a-patient-rojoson/]
· No to Routine Circumcision [https://xtulepinoy.wordpress.com/]
· Beware of Santol Seed Swallowing [https://rojosonmedicalclinic.wordpress.com/category/santol-seeds/]
· NO to Unnecessary Operations and Diagnostic Procedures [https://rojosonmedicalclinic.wordpress.com/2017/10/22/rojosons-patients-advised-against-unnecessary-operations-and-procedures-a-registry-a-resumption/]
· Cancer Survivor Registry [https://sites.google.com/site/rojosonscancersurvivors/home; https://sites.google.com/site/rojosonscancersurvivors2/home]
· No to Patient Queueing [https://sites.google.com/site/rojoson70memoir/no-queuing---no-long-waiting-time-in-clinic---a-legacy; https://rojosonwritingsonhospitaladministration.wordpress.com/2019/03/02/feedback-on-rojoson-medical-clinics-booked-appointment-time-system/; https://rojosonwritingsonhospitaladministration.wordpress.com/2016/10/06/no-queues-by-appointment-only/; https://sites.google.com/site/rojosonmedicalclinic/booked-appointment-performance---december-2018-and-2018]
· Legible Physician Handwriting [https://rojosonmedicalclinic.wordpress.com/category/handwriting/]
· Healthy Lifestyle - (actively promoting healthy lifestyle among patients with role modelling) [https://rojoson.wordpress.com/2019/07/03/rojosons-diet-to-stay-healthy/; https://rojoson.wordpress.com/category/exercise/; https://rojoson.wordpress.com/2016/05/30/rojosons-stretching-and-flexing-exercises/]
· Intentional Life Plan – Intentional Living (Intentional Living (promoting intentional living among patients and how to live life to the fullest – how to productive, contented, enjoying, happy and to live long) [https://rojosonnotesonlife.wordpress.com/category/intentional-life-plans/]
· Keeping and Giving Medical Records to Patients [https://rojosonmedicalclinic.wordpress.com/category/keeping-medical-records/
Other Links on Medical Records:
· Medical Recordings in the Medical Clinic
https://sites.google.com/site/rojosontipsforgeneralsurgeons/medical-recordings-in-the-medical-clinic
· Physician Pad in my Clinic and How I Use It
https://rojosonfacebooknotes.wordpress.com/2012/11/02/physician-pad-in-my-clinic-and-how-i-use-it/
· Practice of giving medical records to patients
· Giving duplicate copy of medical records
https://rojosonmedicalclinic.wordpress.com/2012/04/22/giving-duplicate-copy-of-patient-s-diagnosis-on-consultation/
ROJ@19sept28