Julia Abad (Presidential Management Staff Chief)

Julia Abad of the Presidential Management Staff

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One Response to Julia Abad (Presidential Management Staff Chief)

  1. francesa modesto, md says:

    November 23, 2010

    President Noynoy Aquino

    Thru: Miss Julia Abad
    Presidential Management Staff

    Dear Sir,
    It came out in the headlines of the Philippine Star’s November 21, 2010 issue… “Palace bares new appointees”… as reported by Aurea Calica, the deputy presidential spokesperson Abigail Valte announced the appointment of Manuel Chuachiaco as acting executive director of the Philippine Heart Center. We realize that Dr. Chuachiaco’s oath-taking is inevitable. Those of us at the heart center know Dr. Manuel Chuachiaco, Jr. to be in his 60’s(62 0r 63 years of age). He has long been the head of the department of Cardiovascular Surgery and Anaesthesia until about 3 years ago when he resigned. Most of the rank and file and specifically the young cardiologists of the Philippine Heart Center are not surprised by this appointment as almost everyone knows Dr. Chuachiaco is a schoolmate and an associate of Dr. Ona (Secretary of Health) who is a surgeon himself. But there are a variety of reasons why Dr. Chuachiaco is NOT FIT for the job as he:
    1. …is anti-poor… The search committee and the PMS should ask him if he has made comments like a) only taxpayers should be allowed to vote, and b) indigent women who are cardiac surgical candidates should be made to sign a waiver that tubal ligation be performed on them during the surgery… it is fairly reflective of the fact that, in his mind, aristocracy should be the rule in this country…he does not understand what democracy means… and he will govern this way…
    2. …will maintain the status quo of exorbitant surgical fees because he invented the “3-2-1 deal”… this 3-2-1 deal is the splitting of the team professional fees(PF) into 6 parts – the surgeon gets 3 parts out of 6, the cardiologist 2 out of 6, and the anesthesiologist gets 1 out of 6… as an example, if a patient is charged 300 thousand pesos as team PF, the surgeon gets 150 thousand, the cardiologist gets 100 thousand, and the anesthesiologist gets 50 thousand…this scheme had been initiated by Dr. Chuachiaco during the ‘80s… This will partly(albeit mainly) explain the exorbitant fees for cardiac surgery in this country. The usual package cost of a cardiac bypass patient admitted as semi-private is P 550,000.00(five hundred fifty thousand pesos). Only 250 thousand of that goes to the cost of the procedure(Operating Room expenses, anaesthesia, medications, Recovery Room stay, ICU stay, ward room stay)… 300 thousand goes to the team PF… compare this with the bypass cost in India which is only P100,000.00(yes, one hundred thousand pesos)… most of the cardiovascular surgeons in this country had been trained at the Philippine Heart Center and they set the standard in terms of professional fees… it will not be surprising to find that at St. Luke’s, or Chinese Gen, or Makati Med, or Cardinal, or Perpetual Succour of Cebu, and even Mindanao Heart Center the same 3-2-1 team PF pattern exist… there is a suspicion amongst us that he was forced to apply for the office because there is this mafia-like culture among the older surgeons like Dr. Chuachiaco(within the department of cardiovascular surgery) to have another surgeon lead the heart center to protect the surgeons’ interest/status quo. It is not common knowledge that surgeons comprise a very trivial minority at the heart center… The Philippine Heart Center(PHC) is populated mainly by the “cream of the Philippine crop” of cardiologists. The PHC mainly is about the various facets of cardiovascular (CV) medicine and not CV surgery. It is a fact that the predominant cardiovascular interventions nowadays are catheter-based procedures (e.g. angioplasty w/ deployment of stents)… There is this progressive trend that surgical referrals are diminishing. The thing is the surgeons have gotten a stranglehold of the PHC leadership since its inception in 1975. Since 1975, the CV surgeons even control the Heart Foundation for reasons that are totally undisclosed to the medical staff… The decline in the relevance of the PHC compared to the heart centers of the other developing southeast asian countries can only be attributed to a lack of vision and competence of its managers… Dr. Chuachiaco is a technically competent surgeon but there is no evidence that he will be a competent manager… He has been irrelevant to the PHC until this appointment…
    3. is intellectually and emotionally dishonest … Dr. Chuachiaco is quite selective when it comes to “righteousness”… Some examples may suffice: a) he was the department head of surgery and was eerily “silent” during the tenure of Dr. Romeo D. Zamora as director of the Philippine Heart Center when the surgery department procured the Trans-Myocardial Revascularization machine at a cost us 23 million pesos. This machine has not been in use after Dr. Zamora’s term; b) During the tenure of Dr. Ludgerio Torres as medical director, Dr. Chuachiaco resigned as department head… The reasons are unclear but after his resignation he has become a vicious critic of Dr. Torres (but only behind Dr. Torres’ back) citing the “irregular’ investments of the hospital particularly the multi-level parking that was eventually sold to a private firm…and, c) he had arrogantly moved for the removal from position or sanctioned unfairly some personnel/trainees of the heart center within and outside the department of surgery/anesthesia but failed to recommend sanctions for those surgeons who were involved in the TRICARE/Health Vision Corporation scam(identities of surgeons known to all of us)… If this is the kind of intellectual honesty that Dr. Chuachiaco has, how could he disclose the details of the contracts entered into by the PHC doctors who own/operate 7-Eleven, The Figaro Coffeeshop, Delifrance, Red Ribbon, Jollibee, Chowking, a jewelry shop, optometry shop, etc,etc.?… if one digs up archives of newspaper headlines, he was once accused of being a “ghost surgeon”… will he be a ghost director if he finds out that his doctor-friends or even local politicos are involved in anomalous contracts with the heart center…There really is not one bit of evidence that he has the courage and strength to do that…
    4. will perpetuate mediocrity at the heart center… Dr. Chuachiaco has been the department head of cardiovascular surgery since the time of Dr. Aventura… There is nothing in the way of meaningful cardiovascular research that came during his tenure… in fact, to date, there is no Coronary Artery Surgery database which could have been the basis for research among Filipino cardiac patients… How could he initiate and advocate one when his experience is solely as a surgeon-for-profit? It should be reiterated that beyond his technical know-how as a cardiovascular surgeon(but with fading technical skills at his age), there is no indication that he can manage a hospital…he probably will able to improve on the “3-2-1 deal” that he initiated but it is doubtful if he has any idea about sourcing additional funds for indigent cardiac surgical patients(we even suspect that he spells his pro-poor program p, r, o, f, i, and t)…

    According to John C. Maxwell, there are 5 levels of management and it’ll take a lot of time to go from level 1 to 2 … Let’s be honest – Dr. Chuachiaco’s age is not conducive to learning a new skill…Better still, let us be fair – mainly to the indigent Filipino cardiac patient. How could the indigent Filipino cardiac patient get quality care from one who does not empathize with his/her rights? How could Dr. Chuachiaco be a proponent for the mandates of the heart center (research, training, and service) when he is not competent enough, does not have experience, and when his interests can not go beyond his elitist self to pursue programs consistent with those mandates?
    We hunger for change… We hope to be of help to this government and its vision of all of us treading the ‘straight and narrow path”… One of the few and humble ways is to inform you about this mistake that has been made… and which we hope can be corrected…Here’s also hoping that even if it seems late (and highly improbable) that Dr. Chuachiaco could learn to be decent enough not to covet the position mainly for the sake of relevance…If it’s too late then it’s too bad… as mediocrity will be with us (like our shadows) as long as he reigns…


    Concerned Cardiologists
    Philippine Heart Center
    (once-named Philippine Heart Center for Asia)

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