A bit venting re: SLEC

[ryandgracey 2]

Hi guys. Thought i'd vent out a bit. The following paragraphs are lifted from a thread I had started about my child's visa annotation. SLEC is nothing, compared to SLMC. I don't know what kind of docs are working there but they are not doing a very good job of being docs...and Filipino docs at that. Looking back at the entire medical exam process, everything was done hurriedly, in my opinion as a doc. I am disappointed, really. Disappointed that these docs don't know how to classify let alone advise treatment or prophylaxis or even just give advise to patients about their medical exam results.

"Ok...I just met with my child's pediatrician and discussed her case a bit. The pedia was, uhm, aghast to say the least when I told her that the child had a TST of more than 10mm which, by practice, is indeed positive. Now, given the child's age (she is 6), by the standards of the Philippine Pediatric Society, even with a negative Xray --- and I really do not know what her resutls are--- this is considered a positive indication of primary complex and a treatment course of at least 6 months is warranted. Primary complex, in itself, does not disqualify the child for a visa since the child is basically non-infectious, i.e. the child cannot transmit the organism. A child who has not had primary complex before will not get it from another child with primary complex but will rather get it from an infectious adult. She attends a private school in a private subdivision but that does not exempt her from getting the disease elsewhere. All children are at risk of getting the disease simply because they are in the Philippines. US docs do not have much experience in treating patients with Primary Complex nor TB because the disease is not that common in the US unlike here. The Phil Pediatric Society set up these guidelines on aggressive treatment because TB is a common occurrence here.

Now, back to whether my child is Class A...I do not know. The annotation is "Class A OR B (TB)". I read the CDC guidelines for the civil surgeon and it basically says that Class A is infectious and Class B is Latent TB, meaning non-infectious. My child was classified as either, which leads me to believe that they either do not know whether or nor she has an infection, or do not know how to classify her and are just playng safe. As per recommendation of the PPS, my child will undergo treatment with triple-drug therapy for 6 months. This should ease the minds of the USPHS knowing that she would be in her 4th month of therapy when we enter the US.

I am quite disappointed with SLEC though....I saw on the coats of those in the immunization and TST rooms and some say PEDIATRICS. As a healthworker, it is their responsibility to make the patient aware of whatever is going on. According to medical ethics, THE PATIENT HAS A RIGHT TO BE PRIVY TO HIS/HER MEDICAL RESULTS. And we were not given any. All we are told is, "You passed. Go an have your immunization." And then you see an annotation such as the one on my child's papers. I don't care if they are following the Panel Physician's guidelines. They are PHILIPPINE docs, for heaven's sake! They should still follow guidelines of treatment according to the local setting. And inform patients of whatever results they have."

[sasha414 0]

i know how you feel Grace , i cannot seem to comprehend how and why they do things at slec .

[vichygurl 1]

Sorry Grace! I believe it's really unfair since she has a negative Xray! They will for sure ask another CXR here and as what dbears said since US law they will let her have the treatment for 9 months! You could explain the situation with the doctor here. SLEC at least should have just put annotation like PPD +. Sad thing is I don't think you could give her QTF test since I heard it's not yet advisable for children?

I dunno what to say but best of luck to you and to your baby!. Explain it to the doctor here.

Vida Taylor

[ryandgracey 2]

Sorry Grace! I believe it's really unfair since she has a negative Xray! They will for sure ask another CXR here and as what dbears said since US law they will let her have the treatment for 9 months! You could explain the situation with the doctor here. SLEC at least should have just put annotation like PPD +. Sad thing is I don't think you could give her QTF test since I heard it's not yet advisable for children?

I dunno what to say but best of luck to you and to your baby!. Explain it to the doctor here.

Vida Taylor

Sigh...

Thing is they did not say anything about her X-ray. Only that she was PPD +. NOthing else. No advise. Nothing! They are guessing her diagnois with the annotation they put, and are leaving it in the hands of USPHS to diagnose her...duh?

Look at what they told dbears....they made her choose what to do with her kids????? Isn't that why they are docs/healthcare workers? To offer proper medical advise and not let her doctor her kids?

Anyway...my baby will start her triple therapy tomorrow. Her dose is based on the lowest per kg body weight, since she is still a young child.

Thanks anyway...and am glad you are now in the clear

[forever_green 0]

Hi guys. Thought i'd vent out a bit. The following paragraphs are lifted from a thread I had started about my child's visa annotation. SLEC is nothing, compared to SLMC. I don't know what kind of docs are working there but they are not doing a very good job of being docs...and Filipino docs at that. Looking back at the entire medical exam process, everything was done hurriedly, in my opinion as a doc. I am disappointed, really. Disappointed that these docs don't know how to classify let alone advise treatment or prophylaxis or even just give advise to patients about their medical exam results.

"Ok...I just met with my child's pediatrician and discussed her case a bit. The pedia was, uhm, aghast to say the least when I told her that the child had a TST of more than 10mm which, by practice, is indeed positive. Now, given the child's age (she is 6), by the standards of the Philippine Pediatric Society, even with a negative Xray --- and I really do not know what her resutls are--- this is considered a positive indication of primary complex and a treatment course of at least 6 months is warranted. Primary complex, in itself, does not disqualify the child for a visa since the child is basically non-infectious, i.e. the child cannot transmit the organism. A child who has not had primary complex before will not get it from another child with primary complex but will rather get it from an infectious adult. She attends a private school in a private subdivision but that does not exempt her from getting the disease elsewhere. All children are at risk of getting the disease simply because they are in the Philippines. US docs do not have much experience in treating patients with Primary Complex nor TB because the disease is not that common in the US unlike here. The Phil Pediatric Society set up these guidelines on aggressive treatment because TB is a common occurrence here.

Now, back to whether my child is Class A...I do not know. The annotation is "Class A OR B (TB)". I read the CDC guidelines for the civil surgeon and it basically says that Class A is infectious and Class B is Latent TB, meaning non-infectious. My child was classified as either, which leads me to believe that they either do not know whether or nor she has an infection, or do not know how to classify her and are just playng safe. As per recommendation of the PPS, my child will undergo treatment with triple-drug therapy for 6 months. This should ease the minds of the USPHS knowing that she would be in her 4th month of therapy when we enter the US.

I am quite disappointed with SLEC though....I saw on the coats of those in the immunization and TST rooms and some say PEDIATRICS. As a healthworker, it is their responsibility to make the patient aware of whatever is going on. According to medical ethics, THE PATIENT HAS A RIGHT TO BE PRIVY TO HIS/HER MEDICAL RESULTS. And we were not given any. All we are told is, "You passed. Go an have your immunization." And then you see an annotation such as the one on my child's papers. I don't care if they are following the Panel Physician's guidelines. They are PHILIPPINE docs, for heaven's sake! They should still follow guidelines of treatment according to the local setting. And inform patients of whatever results they have."

I am not sure about this, but reading your post, I think that what the doctors at SLEC did was just to do the job that is requireed of them, that is, only to examine if an applicant will pass or not pass the medical exam for his/her planned immigration to the US. I mean, probaly they were briefed, or they were thinking that they are not there as attending physicians but only as PE physicians and therefore the actual management of a person's illness/ disease/case is not really included in their scope of responsibility.

FYI, a lot of doctors (am not sure if all of them, actually) are doctors at SLMC themselves.

[ryandgracey 2]

Hi guys. Thought i'd vent out a bit. The following paragraphs are lifted from a thread I had started about my child's visa annotation. SLEC is nothing, compared to SLMC. I don't know what kind of docs are working there but they are not doing a very good job of being docs...and Filipino docs at that. Looking back at the entire medical exam process, everything was done hurriedly, in my opinion as a doc. I am disappointed, really. Disappointed that these docs don't know how to classify let alone advise treatment or prophylaxis or even just give advise to patients about their medical exam results.

"Ok...I just met with my child's pediatrician and discussed her case a bit. The pedia was, uhm, aghast to say the least when I told her that the child had a TST of more than 10mm which, by practice, is indeed positive. Now, given the child's age (she is 6), by the standards of the Philippine Pediatric Society, even with a negative Xray --- and I really do not know what her resutls are--- this is considered a positive indication of primary complex and a treatment course of at least 6 months is warranted. Primary complex, in itself, does not disqualify the child for a visa since the child is basically non-infectious, i.e. the child cannot transmit the organism. A child who has not had primary complex before will not get it from another child with primary complex but will rather get it from an infectious adult. She attends a private school in a private subdivision but that does not exempt her from getting the disease elsewhere. All children are at risk of getting the disease simply because they are in the Philippines. US docs do not have much experience in treating patients with Primary Complex nor TB because the disease is not that common in the US unlike here. The Phil Pediatric Society set up these guidelines on aggressive treatment because TB is a common occurrence here.

Now, back to whether my child is Class A...I do not know. The annotation is "Class A OR B (TB)". I read the CDC guidelines for the civil surgeon and it basically says that Class A is infectious and Class B is Latent TB, meaning non-infectious. My child was classified as either, which leads me to believe that they either do not know whether or nor she has an infection, or do not know how to classify her and are just playng safe. As per recommendation of the PPS, my child will undergo treatment with triple-drug therapy for 6 months. This should ease the minds of the USPHS knowing that she would be in her 4th month of therapy when we enter the US.

I am quite disappointed with SLEC though....I saw on the coats of those in the immunization and TST rooms and some say PEDIATRICS. As a healthworker, it is their responsibility to make the patient aware of whatever is going on. According to medical ethics, THE PATIENT HAS A RIGHT TO BE PRIVY TO HIS/HER MEDICAL RESULTS. And we were not given any. All we are told is, "You passed. Go an have your immunization." And then you see an annotation such as the one on my child's papers. I don't care if they are following the Panel Physician's guidelines. They are PHILIPPINE docs, for heaven's sake! They should still follow guidelines of treatment according to the local setting. And inform patients of whatever results they have."

I am not sure about this, but reading your post, I think that what the doctors at SLEC did was just to do the job that is requireed of them, that is, only to examine if an applicant will pass or not pass the medical exam for his/her planned immigration to the US. I mean, probaly they were briefed, or they were thinking that they are not there as attending physicians but only as PE physicians and therefore the actual management of a person's illness/ disease/case is not really included in their scope of responsibility.

FYI, a lot of doctors (am not sure if all of them, actually) are doctors at SLMC themselves.

I have been a panel physician myself, screening patients for employment. So I, too, was not these patients' attending. Yet, in addition to recommending these patients as fit for employment or not, it is also upon my shoulders make recommendations regarding certain conditions they may have that does not affect their ability to work. While it the SLEC physicians' job to recommend us applicants for immigration to the US, it is also an unwritten duty for them as physicians to advise us on whatever condition we may have. Again...patients have a right to know about the condition of their health. Every self-respecting licensed doc knows this. But what the SLEC medical exam is, is an assembly-line kind of process. The human side of being a doc is lost and the applicants become products for evaluation.

Yes, sad thing is, most of these docs are SLMC docs.

[forever_green 0]

Hi guys. Thought i'd vent out a bit. The following paragraphs are lifted from a thread I had started about my child's visa annotation. SLEC is nothing, compared to SLMC. I don't know what kind of docs are working there but they are not doing a very good job of being docs...and Filipino docs at that. Looking back at the entire medical exam process, everything was done hurriedly, in my opinion as a doc. I am disappointed, really. Disappointed that these docs don't know how to classify let alone advise treatment or prophylaxis or even just give advise to patients about their medical exam results.

"Ok...I just met with my child's pediatrician and discussed her case a bit. The pedia was, uhm, aghast to say the least when I told her that the child had a TST of more than 10mm which, by practice, is indeed positive. Now, given the child's age (she is 6), by the standards of the Philippine Pediatric Society, even with a negative Xray --- and I really do not know what her resutls are--- this is considered a positive indication of primary complex and a treatment course of at least 6 months is warranted. Primary complex, in itself, does not disqualify the child for a visa since the child is basically non-infectious, i.e. the child cannot transmit the organism. A child who has not had primary complex before will not get it from another child with primary complex but will rather get it from an infectious adult. She attends a private school in a private subdivision but that does not exempt her from getting the disease elsewhere. All children are at risk of getting the disease simply because they are in the Philippines. US docs do not have much experience in treating patients with Primary Complex nor TB because the disease is not that common in the US unlike here. The Phil Pediatric Society set up these guidelines on aggressive treatment because TB is a common occurrence here.

Now, back to whether my child is Class A...I do not know. The annotation is "Class A OR B (TB)". I read the CDC guidelines for the civil surgeon and it basically says that Class A is infectious and Class B is Latent TB, meaning non-infectious. My child was classified as either, which leads me to believe that they either do not know whether or nor she has an infection, or do not know how to classify her and are just playng safe. As per recommendation of the PPS, my child will undergo treatment with triple-drug therapy for 6 months. This should ease the minds of the USPHS knowing that she would be in her 4th month of therapy when we enter the US.

I am quite disappointed with SLEC though....I saw on the coats of those in the immunization and TST rooms and some say PEDIATRICS. As a healthworker, it is their responsibility to make the patient aware of whatever is going on. According to medical ethics, THE PATIENT HAS A RIGHT TO BE PRIVY TO HIS/HER MEDICAL RESULTS. And we were not given any. All we are told is, "You passed. Go an have your immunization." And then you see an annotation such as the one on my child's papers. I don't care if they are following the Panel Physician's guidelines. They are PHILIPPINE docs, for heaven's sake! They should still follow guidelines of treatment according to the local setting. And inform patients of whatever results they have."

I am not sure about this, but reading your post, I think that what the doctors at SLEC did was just to do the job that is requireed of them, that is, only to examine if an applicant will pass or not pass the medical exam for his/her planned immigration to the US. I mean, probaly they were briefed, or they were thinking that they are not there as attending physicians but only as PE physicians and therefore the actual management of a person's illness/ disease/case is not really included in their scope of responsibility.

FYI, a lot of doctors (am not sure if all of them, actually) are doctors at SLMC themselves.

I have been a panel physician myself, screening patients for employment. So I, too, was not these patients' attending. Yet, in addition to recommending these patients as fit for employment or not, it is also upon my shoulders make recommendations regarding certain conditions they may have that does not affect their ability to work. While it the SLEC physicians' job to recommend us applicants for immigration to the US, it is also an unwritten duty for them as physicians to advise us on whatever condition we may have. Again...patients have a right to know about the condition of their health. Every self-respecting licensed doc knows this. But what the SLEC medical exam is, is an assembly-line kind of process. The human side of being a doc is lost and the applicants become products for evaluation.

Yes, sad thing is, most of these docs are SLMC docs.

Yes, I do fully understand, and, yes, I also agree with you. I am glad to find another physician here. Would you mind if I ask you what job are you doing now? I mean, did you take the MLE? Thanks.