Confessions of a School Doctor
Meet Dr. Tina Macabulos, one of three school doctors of a big elementary school. She is a member of the medical team that takes care of as much as 5,000 people in the school community. Dr. Tina attends to all patients who enter the school infirmary —whether the complaint is as simple as a tummy ache or a scrapped knee, or as serious as hot-burning fever or severe chest pains — with professional insight and motherly care. Here are some of her revelations on how it is being a school doctor.
What made you decide to become a school doctor?
I have two sons and they both go to the same school. I am always part of the parents’ committee. Because of my profession, I always look for opportunities to put health and wellness in the programs of the school. However, the committee that I am part of usually prioritizes bonding activities between parents and children. Since the scope of the parents’ programs is limited, it was difficult to include new topics or new activities into the agenda. After a meeting with the committee one day, I decided to pass my resume to the school’s HR department who called me in for an interview, which fit into my schedule. So here I am.
Is being a school doctor a full time job for you?
Since we go on shifts at the infirmary, I’m able to do other things outside the school. I’m a Clinical Preceptor in the Ateneo School of Medicine and Public Health and I also teach Microbiology there . I also have a charity clinic in St. Martin de Porres Hospital in San Juan.
How many are on the school’s medical staff?
There are three part-time doctors who go on shifts, two dentists, two full-time nurses and two nursing aides.
As the medical team, who do you serve, who do you take care of?
We serve the whole school population of about 5,000. That includes all the students, teachers, administrators and personnel of the entire grade school.
As school doctor, what is your role?
I, as well as the other school doctors, provide medical care for the school community. This is not only during class hours but also during school-sanctioned activities such as school fairs, Father & Son night, Kite-flying day, First Holy Communion and others.
We also have administrative responsibilities such as organizing the infirmary and coordinating with other school administrators. We are involved in health education, such as issuing medical advisories and creating the school’s wellness plan.
As far as community health is concerned, we serve as consultants of the cafeteria and various medical programs. Lastly, we are also involved in formulating the school’s health policies and procedures.
That’s a big scope of work. I’m sure many parents of your students don’t realize this.
Probably, but this is the role we want to take. We think of our school as a community of its own where we are not just a center that gives first aid but also as one that is concerned with their general health. Last year, our infirmary was the recipient of the Julia Denoga Award for Best School Health Center.
What kind of wellness program do you have in the school?
When I came in to work as a school doctor, we did a nutrition program. We wanted the students to know that there are alternative snacks like fruits to junk food. The fruit campaign was well-received. The campaign had several activities. We sought the help of UAAP players who were our ‘endorsers.’ We had games and contests. The campaign was so successful that up to now, students and parents are clamouring for a repeat (of the fruit campaign)!
At present, our campaign is focused on proper brushing of the teeth and hygiene. Part of the activities includes video presentations and storytelling sessions about cavities and tooth brushing.
Let’s talk about the students, how many students come into the infirmary per month due to medical complaints?
We get about 1,000 to 1,500 students per month or, close to 50 students per day.
What do the students usually complain about when they are sent to the clinic by their teacher?
Fever, allergies, asthma attacks, headaches, dizziness, stomach aches.
Are they all legitimate complaints?
Whenever a patient comes in, we always make it a point to look at him as sick unless proven otherwise by clinical diagnosis. We never assume he comes in “faking” a complaint.
But what do you do when you find out that a student is “faking” an ailment?
Upon diagnosing that a student is apparently well for resuming regular school schedule, we promptly send him back to the classroom. If there is student who comes in regularly and upon diagnosis is always well, we advise his teachers, parents and guidance counselors about the incident.
Has there ever been an outbreak of contagious diseases such as sore eyes, chicken pox and measles within the campus?
Our infirmary has an isolation room. Once a patient presents himself as having an infectious disease, he is isolated. His parents are immediately notified so they can fetch him.
How else do you prevent the spread of contagious diseases?
The school has very strict rules regarding infection control. We closely coordinate with the teachers. When students return to school after an absence due to infection, they undergo a check-up with the infirmary before being pronounced as well enough to report to class. If upon diagnosis, the student found to be not well and may still infect his classmates, he is sent home.
The medical staff also closely coordinates with the physical plant of the school. For instance, if a student was diagnosed as contagious while still in school, his classmates are requested to evacuate so that the classroom is sanitized. If evacuation is not necessary, there are hand sanitizers around the school and the students are encouraged to wash their hands or use the hand sanitizer.
Let’s talk about injuries. What type of school-related injuries do you treat?
The students here are very active so their injuries are mostly resulting from sports activities.
What types of treatment can the clinic perform? What happens if further treatment is needed?
We do first aid, primary and symptomatic care. We refer the students to their parents for the pediatrician of choice for definitive diagnosis and treatment.
For example, a child is not feeling. How should the parents decide if they should send their child to school or not?
The rule of thumb is: if the student is sick, he should stay home. Even if he is given pyretics (like paracetamol or ibuprofen and his fever has subsided. If there is illness still inside his system, the student should rest.
Any memorable or notable experiences you had as a school doctor?
I had a six-year old prep student come into the infirmary complaining of stomach ache. After a check-up, we found out that he was well. When I asked him why he thinks he has a stomach ache, he said that he was hungry and he forgot his baon.
Coming from a regular clinic where the chief complaints are described as “neck mass increasing in size” or “rashes spreading to the extremities,” it is only in the school setting where I get complaints described as “wawa in my tum-tum.”
On a more serious note, there was an incident where a patient was vomiting. We interviewed the patient and found out that a day before, he had hit his head in the swimming pool of their house. We advised his mother to bring the child in for a CT scan. It turned out that the patient had a concussion and he was undergoing signs of it.
Another time, one of the staff members came in complaining of dizziness and chest pains after a school event. After diagnosing and giving primary care, we had him rushed to the nearest hospital where he was diagnosed to have a cerbrovascular stroke. Thanks to early intervention, that man is still an active part of the school’s workforce.
Finally, do you enjoy being a school doctor?
Yes! The kids are terrific. Most boys are polite and sincere. Aside from giving them medical care, I also give them “mothering” care that I would like my own children to have now that they are on their own in school.
Photos from Dr. Tina Macabulos