Manila Doctors Hospital weathers healthcare worker shortage through school partnerships

MDH’s Dr. Rodolfo Borromeo said hospital-school alliance ensures standards and seamless transitioning in hiring healthcare staff.

A top private hospital in the Philippines developed a proactive approach by partnering with schools to fill in the medical workers’ shortage.

What Manila Doctors Hospital (MDH) does is leverage the source of manpower – schools. By partnering with them, MDH has laid a common ground for requirements and expectations from future health workers who may end up as its staff.

One of its recent collaborations is with the Chinese-Filipino school, Chiang Kai Shek College (CSKC), which seeks to provide quality and comprehensive healthcare services to CKSC’s internal and external community. This focuses on providing discounts to the school's community.

MDH's own college, Manila Tytana College (MTC), which it collaborates along with other local colleges and universities for easy integration programs for future healthcare workers. 

“This, in effect, allows the crucial part where you have to be seamless in transitioning the professional towards their actual work functions and responsibilities in the hospital,” MDH nursing services director, Dr. Rodolfo Borromeo, told Healthcare Asia.

It will also be beneficial to the nursing workforce because during the partnership, there will be terms of agreement such as the length of employment for students.

The first step to creating the partnership with schools includes mandatory recognition from a regulatory body like the Commission on Higher Education, said Borromeo.

A school’s accreditation should also be under the auspices of an international third party that will study how their systems are being implemented. 

The third and fourth steps require an assessment of the performance of the students and the employability of the school’s graduates, respectively.

Occupational safety

Borromeo said partnerships with schools are also necessary to ensure that standards are acceptable to the Philippine Department of Health (DOH) or international bodies.

The partnerships allow the hospital to look into occupational safety and ethics in order to ensure that healthcare workers are taken care of.

“When the pandemic happened we were only looking at patient safety, but a lot of healthcare workers were devastated. These people who were devastated were not able to report for duty,” said Borromeo.

Data from a 2022 World Health Organization (WHO) report showed that 23%–46% of healthcare workers admitted they had symptoms of anxiety and 20%–37% faced depressive symptoms, whilst 41%–52% suffered from burnout during the COVID-19 pandemic.

For its part, the DOH launched a programme to address the needs of healthcare workers suffering from mental health issues.

Aside from workers’ wellness, Borromeo said harmonisation of care modalities and care management would be created if a partnership were to be sealed between hospitals and schools.

“There’s no such thing as a perfect system. But of course, the mindset of people working in the hospital should be directed towards perfection. Those are very important when you grow in partnership, and the standard should start in the school, and with the school partnership altogether, you’re harmonised,” said Borromeo.

At MDH, students undergoing field training are given access to upskilling through the hospital’s training team.

Small hospitals’ closure

During the COVID-19 pandemic, the government enforced a deployment cap for healthcare workers to make sure that there are enough of them to man hospitals and healthcare centres. 

Almost a fifth of Filipino healthcare workers have been moving overseas for better pay and more robust infrastructure, according to a 2022 study by The Lancet. This was particularly evident during the COVID-19 pandemic when several nurses resigned and migrated because of low compensation, unreceived benefits and hazard pay, and slow payments in insurance.

Comparing the yearly income of a first-year medical resident in the Philippines is averaged at P720,000 (US$13,183), whilst their counterparts who migrated to the US earn P3m (US$54,000).

Borromeo, aware of such bottlenecks, noted that their hospital’s employment attrition of nurses is around 20%–30%. He said despite sending contracts to these potential employees from school partnerships, they cannot force these employees from leaving their institution for better compensation.

If the talent crunch in healthcare is not dealt with, Borromeo warned that it will not be enough to increase the number of hospitals in the Philippines. Even worse, it could close down some smaller hospitals. 

Hospitals may choose to increase the salary, but it will not be a viable option, he said.

“The moment we increase the salary, there’s another effect and impact to that. When you increase the cost for the healthcare workers in terms of remuneration, then you have to amp it up also, to the charges you’re giving to the patients,” said Borromeo.

To address possible small hospital shutdowns, big hospitals may help by merging or subsidiary extension, he suggested.

“Consider a strategic business plan that justifies profitability and viability,” Borromeo said. “Again, mainstream players are not obliged, so possibilities of 100% support are relative.”

The government may also help if they have the capacity to subisidise the healthcare budget to support small hospitals.

“But the call for re-structuring compensation packages both for private and public hospitals would address retention, however, such a move requires allocation from the national government to the private hospitals,” added Borromeo.

Recently, the government revealed plans to solve the nurse exodus by granting temporary licenses to unsuccessful board exam takers. It has yet to be completed but it has received criticisms from health practitioners.