Sad day for doctors, sadder still for patients
UNDER THE MICROSCOPE
Doctors’ chat groups are all abuzz over the news of Dr. Benigno (Iggy) Agbayani Jr.’s criminal conviction for serious physical injury through reckless imprudence. This was a case from 2006 when a patient filed the cases due to a post-operative site infection.
Post-operative infections are not common nowadays due to modern-day practices of thorough disinfection of surgical instruments. But infections still occur, maybe through poor post-op care, or due to patients’ poor immune status, among other reasons. The patient had opted to have the infection treated at another hospital, obviously causing a disruption of patient-doctor relationship between him and Iggy. According to the case record, the patient was treated for a month, resulting in loss of income and additional expenses on his part.
The case dragged on until recently, when the case was decided with finality by the Supreme Court based on technicalities.
He was arrested May 25, 2023.
The conviction sent shock waves all over the medical community. This is the first time a doctor has been convicted and sent to jail for performing his duties as a physician-surgeon. Iggy was no ordinary doctor. He was the son of the renowned allergologist, Dr. Benigno Agbayani Sr., who was well-respected in the medical profession. Iggy himself was a UP College of Medicine graduate (1991) and a board-certified orthopedic surgeon, thus highly qualified. He had a flourishing practice in several top metro hospitals.
There are many questions now being asked. Why was it filed as a criminal case on top of a civil one for compensatory damages? How can we prevent this from happening again?
Iggy was sentenced to one year and one day jail time. This was clearly excessive, as there are precedents of civil cases for serious physical injury through reckless imprudence, such as a motor vehicle accident in which the driver was convicted and sentenced to only two months and a day. Unfortunately, after being confined for the past several months at the Manila City Jail, a notoriously crowded facility, the 58-year-old Iggy suffered a fatal heart attack on Oct. 5, 2023, no doubt due to his severe physical, emotional, and psychological distress during confinement.
But what is concerning are the implications of the court decision on medical practice. With this precedent case, ambulance-chasing will become rampant in the country, just as it is now in the USA.
Doctors will now become extra careful, ordering more laboratory and imaging (x-rays, CT-scans, MRI, ultrasound) to back up their diagnoses and be 100 percent sure. Some are no longer accepting lawyers and their families as patients. Others are restricting their practice to clear-cut cases and referring complicated ones to other doctors. Still others, especially those who have practiced for many years, will opt for early retirement rather than face possible malpractice suits. Those who have the wherewithal to go into business may do so and abandon their medical profession.
Will there be less people going into the medical profession once this case becomes public? The vast majority of those going into medicine do so out of altruistic notions of helping humanity in their future practice, not by the motivation of money. If money is a motive, they should opt for other professions with shorter education periods and less demanding requirements than medicine, which entails studying hard and undergoing sleepless nights on duty in the hospitals for a total of 10 years, counting specialization and for some, subspecialization. Iggy’s case will serve as a cautionary tale for those who will consider a medical career.
All these mean we will have fewer doctors in practice, more expenses for additional workups, longer lines for medical consultations, and an adversarial relationship with patients who may potentially sue them. In addition, this will provide the impetus to make malpractice insurance necessary, adding further to medical costs that doctors will have to pass on to patients, who mainly pay out of pocket. Medical care will become costlier and less accessible for many poor Filipinos. It is a lose-lose situation for all.
Perhaps this is not the long-term outcome the plaintiff had envisioned, though he obviously had no love lost for Iggy, filing civil and criminal cases. Iggy suffered and died for his convictions, so the plaintiff should have had the satisfaction he desired from filing the cases. But at what cost to the Filipino people?