A Role-Playing Activity for Medical Students Demonstrates Economic Factors Affecting Health in Underprivileged Communities

Figures & data

Figure 1 Student’s response to the question “Are healthcare professionals contributing to the widening gap between rich and poor?”.

Table 1 HCP-Related Factors Contributing to the Increasing Gap Between Rich and Poor

Themes	Concepts
Behaviors of HCPs	Demand for higher professional fees or profit orientation. Inconsistent attitude towards and disparity in the services offered to private patients and charity patients. Prescription of expensive or branded medicines often with the encouragement of pharmaceutical companies. Requests for unnecessary procedures in exchange for favors from diagnostic- and healthcare device-related industries. Failure to consider the financial capacity and other problems of patients. Late arrival or no show at all during scheduled clinic hours.
Health System Problem	Healthcare as a privilege of the affluent. Commercialization of healthcare. Disparity on the standard of care between public and private hospitals. Shortage of medical supplies and inadequate facilities particularly among public clinics and hospitals. Presence of corruption and poor policymaking. Insufficient funding for health services and workforce.
Work Setting and HCPs’ Choice of Work Location	Maldistribution of physicians in favor of urban districts over rural areas. Private sector practice instead of public service. Pursuit of greener pasture overseas.
Specialization	High level of specialization among the majority of health professionals. Mismatch between specialties of most healthcare professionals and the needs of the country.

Abbreviation: HCP, healthcare professional.

Table 2 Means for HCPs to Help in Poverty Alleviation

Themes	Concepts
Holistic approach to healthcare provision	Consideration of the background, context, and financial capacity of patients in requesting diagnostic examinations (patient-centeredness). Prescription of generic drugs. Application of the biopsychosocial approach and not just the biomedical model in patient management.
Advocacy and social action	Commitment to and/or support of progressive policies related to health. Promotion of the rights of patients to a better healthcare system. Leadership in community mobilization strategies to promote health and development. Participation in medical missions in far-flung areas. Engagement in public health information campaigns to empower the poor. Treating patients equally regardless of their capacity to pay. Attending to patients in private as well as government hospitals and clinics. Promoting health equity instead of health equality. Choosing to practice medicine in rural areas. Participating in the Doctors-To-The-Barrio Program and Nurse Deployment Programs.^Citation34,Citation35
Preventive healthcare	Prioritization of preventive healthcare strategies over curative measures.
Research and education	Undertaking relevant medical researches that will help improve the country’s healthcare system including investigations on locally available medications and practices. Promoting a more community-oriented medical education and training.

Abbreviation: HCPs, healthcare professionals.

Department of Health. Doctors to the barrios; 1993. Available from: https://doctorstothebarrios.com/about/.

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Department of Health. What are deployment programs? Available from: https://www.doh.gov.ph/faqs/What-are-the-deployment-programs.

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