Ramon Tulfo's 'PGH Experience' is a Learning Opportunity About ER Practices

In this day and age, it’s almost become a standard to resort to social media for justice. For Ramon Tulfo, the art of making sumbongis just part and parcel of his professional life—as seen on his radio show, aptly named Isumbong Mo Kay Tulfo.

Yesterday, he took to social media to file a complaint about a trip he took to the emergency room at the Philippine General Hospital (PGH).

In a video he titled "PGH Experience," Tulfo writes: "My driver bumped a six-year-old girl playing in a congested street of Navotas while we were on a convoy on the way back to our office at Ortigas Center, Pasig, from a relief operation in the town."

While we're still busy picking our jaws up from off the floor at this candid revelation that his vehicle hit a child, Tulfo goes on to redirect our anger:

My staff and I rushed the child to the Philippine General Hospital (PGH) emergency room. 

The ER doctor, Jay Guerrero, did not want to give the child first aid treatment, saying he didn't want it recorded on video.

No amount of pleading from me to attend to the young patient would budge the good doctor.

Tulfo adds in the comments section, "sasampahan ko siya ng kaso sa professional regulations commission (prc). may mga witnesses akong kasama."

However, as cooler heads have pointed out, the good doctor really was being a good doctor. What are we really looking at? The patient has been brought to the first stage of ER treatment, known as triage, where the triage officer has the difficult job of determining which patients are non-urgent, urgent, or emergent. Cases brought to the emergency room always start here, at the level of assessment. It doesn’t function on a first-come-first-served basis: emergent cases are bumped up, while non-urgent cases have to wait in queue.

“The way ER works is like this: when a patient comes in, there are trained personnel to assess the situation. That’s the problem with the ER: Everyone who comes in the ER feels like they are in an emergency. That’s why we do triage—to inform them," says a doctor of emergency medicine who we consulted (but who has asked to remain anonymous).

"Just by eyeballing the patient you’ll know—Is the patient awake? Is the patient breathing? Lethargic? Drowsy? Are there external signs of injury? Are there obvious injuries? From the onset, kita mo na yan," he continues. "It also boils down to the skill of the officer in asking the right questions—they have to get all the factors in. So many questions come to mind. This girl is sitting down, awake. Personally, I don’t see anything emergent. If there was anything emergent, she could have gone straight to a bed."

Perhaps one of the indicators that this isn't an emergency case that needed immediate attention is the choice of hospital—PGH, which is over 13km away from Navotas, where the accident occured, at least an hour away through congested city streets. PGH is also one of the country’s largest public hospitals, known for its high volume of patients. They take in up to 300 emergency cases a day. "First of all, if you felt like the patient was emergent, why would you bring them all the way to PGH?" says the doctor.

Earlier this year, PGH also announced their emergency facilities would be under renovation—as the ER in its current capacity is not enough—encouraging people to try and take emergency cases to other hospitals if they had the means.

Furthermore, the doctor adds, there is the problem of the video itself. “The policy in the hospital is patient confidentiality. If the patient wants to be videotaped, ok lang. Pero ang daming patients sa hospital! When we see a video, we always say no cameras because baka may madamay na iba. Even the doctors, the nurses, they don’t want to be videotaped while they’re trying to work. They’re already under pressure.”

So, at second look, Tulfo’s footage of the incident hardly reveals anything except the physician trying to do his demanding job, in the face of an even more demanding media man waving a camera. The mother of the child is also captured, at one point pleading that they stop shouting and attempting to cover the face of her daughter from the camera (which keeps rolling). There are so many questions: Why does Ramon Tulfo feel the need to film a trip to the ER? Why is he yelling? Finally, do you know any good ER doctors? Because we'd like to shake their hands and thank them for the hard work that they do every day.