Good morning.

Today, we stand on the cusp of a new chapter in healthcare, celebrated through your hard- earned achievement as the latest board-certified specialists and newly confirmed fellows in internal medicine of the Philippine College of Physicians.

You represent the best of us, equipped not only with a profound depth of knowledge but with the keen insight to navigate the complexities of adult medicine in a radically evolving landscape. Your dedication has now positioned you at the forefront of a field where every decision can change lives and reshape futures.

As I stand here today, my heart takes me back to that defining moment 32 years ago in 1992 in a seat much like yours, freshly recognized as a diplomate and fellow in Internal Medicine. I remember the anticipation, the eagerness to absorb every word from Dr. Gregorio Pataksil , our keynote speaker, as he painted a picture of our future and imparted his call to action in this noble profession. His words, have echoed through my career, shaping the kind of physician that I have become.

That moment, has stayed with me.

How quickly time flies... I look upon you with pride and joy, surrounded by the cheers of loved ones, friends, classmates and significant others cheer you today.

As we celebrate the remarkable journey that has brought you here, we pivot now to the core of what lies ahead, amidst the CONTEXT, the CHALLENGES, and CORNERSTONE of our being physicians--- individually as clinicians and collectively as a College. I boldly ask you two very simple questions that require some profound pondering and soul-searching:

1) WHAT DOES IT MEAN TO BE A FILIPINO PHYSICIAN TODAY? 2) WHAT DOES IT MEAN TO BE A PCP Physician today.

We ask these two fundamental questions as we are in the cusp of a new chapter in healthcare. We are on the brink of significant changes and advancements in how healthcare is delivered, managed and perceived. We are in the best of times; yet we are in the most trying times as well. We are being called to navigate these challenges and opportunities with innovative solutions and policies that aim to improve health outcomes. It is a time of exciting possibilities but also of crucial responsibilities.

Let me begin by affirming the essence of being an internist and re-igniting our sense of purpose then juxtapose this with what we, as a college, have journeyed through to address the strategic and emerging health care challenges of our nation.

The essence of our practice is deeply rooted in a holistic, thoughtful approach to adult medicine. It combines a high level of expertise and knowledge with compassion and personalized attention, aiming not only to treat but also to improve the overall quality of life of our patients. At the core of our calling is a deep commitment to understanding and managing complex adult diseases through comprehensive patient-centered care.

Being a Filipino Physician today means balancing the demands of medical practice with the cultural, economic and social realities of our Filipino community, oftentimes extending our roles beyond patient care to become community leaders and advocates for societal well-being.

The Filipino Physican is called upon to Teach. To Heal. To Lead as encapsulated in our PCP Mantra. A beautiful reminder of what and who we are , and what we are called to be– regardless of where we are, what we specialize and what ideological or political persuasion we adhere to.

Context and Challenges

The Philippine College of Physicians (PCP) is an umbrella organization, established in 1953 , and led by founder Dr. Gonzalo F. Austria plays a pivotal role in shaping the standards and practices of Internal Medicine in the country. Our main objectives are:

1. Continuing medical education of internists and other physicians; 2. Certification and regulation of the subspecialty of Internal Medicine; 3. Accreditation of the training institutions for Internal Medicine in the Philippines.

These goals are set against a backdrop of significant challenges that affect the delivery, quality, and accessibility of medical services nationwide. Issues range from shortage of health professionals and infrastructure deficiencies, to the prevalence of chronic non-communicable diseases and complex regulatory frameworks.

Addressing these challenges requires a multi-faceted approach from all stakeholders. The PCP, as a college, has done its bit in addressing some of these challenges.

1) The Philippine College of Physicians has pioneered initiatives like the HERO or Executive Order 595 or HEALTH EDUCATION REFORM ORDER launched during the term of Dr. Rene Juaneza. This landmark advocacy focused on preventive health education, marking the first time a sitting president attended our national convention. Pres. Arroyo emphasized during the 2007 convention how HERO SHIFTS THE FOCUS FROM “SICK CARE TO HEALTH CARE”, significantly enhancing well being by preventing illness.

Sin tax law of 2012

Moreover our active involvement in the passage of the Sin Tax Law in 2012 under President Benigno Aquino III helped restructure the tax on tobacco products. The reform has not only curbed smoking initiation and encouraged cessation but also significantly reduced the smoking prevalence rate in the country from 28.3% in 2009 to 19.5% by 2021. Yet new challenges such as vaping are emerging , with 14.1% of our youth between the ages of 13 and 15 turning to electronic cigarettes in 2019. Addressing these evolving threats is crucial for safeguarding future generations.

The law , considered a global best practice , changed the tax structure drastically by imposing higher taxes on tobacco products, leading to higher prices, preventing smoking initiation , promoting cessation and generating billions of pesos for Philippine Healthcare Insurance Corporation and the Department of Health.

2) UHC Law of 2019 Former President Rodrigo Duterte signed Universal Health Care (UHC) Bill into law (Republic Act No. 11223) promised a comprehensive health insurance for all Filipinos but largely remains largely unimplemented. As we assess this law’s alignment with the PCP mission, we must also consider the operational challenges, including the clear integration and alignment of PCP members within the UHC Framework. A resurfacing epidemic of non- communicable diseases further complicates our health landscape.

According to WHO, these diseases causes 500,000 deaths in 2019 alone, representing a significant economic burden. Our top causes of death now include ischemic heart diseases, neoplasms, and cerebrovascular diseases.

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Focus on Philippine College of Physicians members first

As a college, we can help shape the Philippine Healthcare landscape through our strategic health programs and policy reform advocacies – but it is through our personal practice as clinicians, in our roles as teachers, healers, and leaders where we can wield influence and make the world a better, healthier, happier place – one patient at a time, one colleague at a time,

Think about it. We can’t solely solve our national healthcare problems but we can focus on what we can control. I invite you to reflect on three simple but strategic questions:

First, What steps can I take to ensure happiness in my professional career?

Second, How can I maintain fulfilling relationships with family and friends while pursuing my career ambitions? Third, What strategies can I employ to consistently uphold my moral and ethical values?

These three questions are designed to lead us to our roles as physicians at this critical juncture of our Philippine society.

A few notable thought leaders have proposed some theories and insights that may guide us:

In addressing the first 1st question, behavioral theorist Frederick Herzberg teaches us that true motivation isn’t driven by money but by the opportunity to learn, grow in responsibilities, contribute to others, and be recognized for achievements.

Yet a recent survey shows that 50% of millennials prioritize becoming rich or famous as their main life goal. This shift indicates that traditional markers of success are evolving.

In this chart the traditional markers of achievement are no longer coveted by millennials and Generation Z.

Most of us we are constantly told to lean into work, to push harder , and achieve more. We’re given the impression that these are the things that we need to go after in order to have a good and successful life.

Regarding the 2nd question, Harvard Professor Clayton Christensen reminds us that our priorities are reflected not just in our intentions but how we allocate our time and resources. Ask yourself: where and with whom do you spend most of your time? If you were to invest now in your future best self, where would you put your time and your energy? It’s a challenging balance ,especially as many of us, driven to excel, might unconsciously underinvest in our families while overinvesting in our careers. Yet, it is the intimate and loving relationships with our families that are often the most powerful and enduring source of happiness.

We live in a time where high ambitions and the desire for quick riches and instant fame often drive our actions. where burnout and mental health issues are increasingly considered normal. We live in an age where bullying is often accepted as a part of the educational environment; sadly, even in some of our own learning institutions. Technology has come to replace human interactions in our daily lives. We live in a world where the distinction between good and evil is often obscured by pragmatism. Sadly, our profession is not impervious to these phenomena. Sadly our health care world is haunted by issues of corruption, malpractices and ethical aggressions. This unfortunately impacts on perceptions about our profession.

Steve Jobs heralded that the best use of technology is to improve lives. In the realm of medicine, AI’s growing application—from drafting doctor’s notes to suggesting diagnoses and monitoring real time health data—are both a challenge and an opportunity. It is crucial to integrate these tools to enhance diagnostic accuracy and patient outcomes while ensuring they do not diminish the human interaction so vital to patient care. Can AI help us get the latest and greatest evidence to make decision-making easier ? • How can we help families be efficient in their diets, their exercise, etc so that they can help patients but also PREVENT this from being a problem within families?

Steve Jobs left behind a deathbed essay about the meaning of life.. In his deathbed , he said,

“The six best doctors in the world are sunlight, rest, exercise, diet, self-confidence, and friends. Maintain them in all stages and enjoy a healthy life.”

I come to the 3rd and the final question I posed to you earlier: What strategies can I employ to consistently uphold my moral and ethical values? This question on Integrity is the hardest to answer.

Living with integrity in a pragmatic world means being willing to call out wrong behaviors and tirelessly seeking the truth. It involves holding oneself and others accountable, advocating for transparency and honesty, and standing firm in the practices or decisions that compromise ethical standards.

Living with integrity also means speaking your truth, even though it might create conflict or tension. Prof. Christensen stressed :“Decide what you stand for. And then stand for it all the time. “

Stanford psychologist Philip Zimbardo, in his book, explores how good people can turn evil. He calls it the Lucifer Effect. It is named after the biblical story of Lucifer, an angel who fell from grace to become Satan. The theory is based on Zimbardo’s own experiences with the Stanford Prison Experiment in 1971, where college students assigned to roles of either prison guards or prisoners rapidly assimilated into their roles, leading to abusive behavior from the guards. Zimbardo posits that situational forces and group dynamics can lead to behavior that might not occur in other contexts, effectively examining how circumstances can drastically alter one’s behavior

It reminds us that the line between good and evil is permeable and almost anyone can be induced to cross it when pressured by situational forces. Integrity, therefore, is not just about personal honesty but also about understanding and mitigating these forces.

Integrity is fortified by humility.

As we climb the ladder of success ,, REMEMBER THE IMPORTANCE of HUMILITY !

By the time you make it to a top medical school, or a hospital almost all your learning has come from people who are smarter and more experienced than you: parents, teachers, bosses.

But once your formal education is complete, you may find that not everyone you interact with will fit this description. If you maintain a humble eagerness to learn from every person you encounter, your opportunities for growth will be limitless. The philosopher Michel de Montaigne said, “The greatest thing in the world is to know how to belong to oneself.” True engagement with the world and continuous learning come from self- awareness and humility.

Every Physician a Hero

Every physician is called to be a hero. As we embrace this calling with humility and passion for lifelong learning, we follow the path to truly becoming the heroes we are meant to be. We are a nation built by heroes, and you, dear diplomates and fellows, are among those heroes.

Just a few days ago, I found myself on a journey through time, revisiting the days of my early residency program almost four decades ago.

This reflective voyage was sparked by the presence of young and inspiring finalists in the quest for the Most Outstanding Residents Award. Observing their fresh idealism and unwavering commitment, I was again reminded of the noble ideals we strive to embody and the profound impact we aim to have on the world through our calling.

I would like to acknowledge them again and by doing so, honoring what they stand and live for :

Dr Stephon Monique Oxley of Chong Hua Hospital Born and raised in the USA, she opted to come home to Cebu to serve especially the poor. She is pursuing a Cardiology Fellowship in Philippine Heart Center

Dr Arobe Goling of Amai Pakpak Medical Center A man of many gifts and talents, this very intelligent medical graduate from UPCM chose to serve in a government hospital in Marawi, Lanao del Sur.

Dr Louie Matthew Mercader of Davao Medical Foundation A natural teacher/professor at heart who readily and committedly imparts knowledge and skills with his colleagues, he will pursue Cardiology in Davao.

Dr Basille Christopher Lazaro of NKTI .Described by colleagues as one who would walk the extra mile both for patients and colleagues alike. His chosen destination: Sta Cruz, Laguna He will apply for Endocrinology fellowship.

Dr Regiel Christian Mag-usara of UP PGH The youngest among the finalists. An intramed prodigy who finished medicine in seven years. He is going back to his home city in Butuan to serve.

Let us collectively celebrate and honor these remarkable individuals. ( Applause )

They embody the finest among us, not solely through their knowledge and skills but, more importantly, through their profound humanity. They are, like you, heroes. These remarkable internists are returning to their origins, embracing the fundamental pillars of our profession: To teach with wisdom, To heal with expertise, To lead with integrity, To serve with compassion,

They fully embrace our calling as physicians to become HEROES of our times in the context and cusp of our country’s healthcare challenges.

These true patriots, fueled by a deep love for our country, display unparalleled courage in the face of adversity. They confront the imperfections of our health system with a boldness that does not shy away from the difficult tasks at hand. From them, and indeed from all of you, we can learn how individual journeys can shape and transform the ever evolving character and landscape of the Phil College of Physicians,

The inspiring examples of these outstanding new diplomates, remind us that we are not just medical professionals; we are the heart and soul of a health care system on the brink of transformation. Each of us carries within an inherent hero, poised to elevate the health and well- being of our nation..

To be a hero in internal medicine , you must occasionally step out of your clinics to educate, mentor, and inspire. You must challenge norms and resist conformity. You are called not just to find your purpose but to create a world where everyone feels a sense of purpose.

You’re an IM HERO.

You , our new diplomates and colleagues, are the heroes we speak of. You are the ones who will lead change, not just wait for future generations to take the helm. As a college, the PCP must innovate and adapt quickly, inspiring the nation with a new mindset and approach. The path to becoming a PCP hero is captured in our Mantra: To Teach. To Heal, To Lead.

Lastly, honor thy parents.

In his 2015 Oscar’s acceptance speech, ,American actor JK Simmons made a poignant reminder—call your parents. If you’re fortunate enough to have them, don’t just text; call them. Tell them you love them, thank them, and listen to them, for as long as they want to talk to you.

To our dear parents in the audience .Thank you for raising new heroes.

Life humbles you.

As we grow older … life humbles us.. We begin to value the simplicity of alone time, enough sleep, a good diet, long walks, deep conversations, and quality time with loved ones. Simplicity becomes, and defines us. How will you measure your life ? Clayton Christensen, beautifully sums it up: “Don’t worry about the level of prominence you have achieved,; worry about the the individuals you have helped become better people.” Let us measure ourselves not only by our professional accomplishments but also by how well we address the country’s deepest inequities, how well we treat people whose only commonality with us is their humanity.

Think about the measure by which your life will judge yourself. For success should be measured where it truly counts

I end with an attempt to answer the fundamental questions I posed at the the beginning of this keynote. What does it mean to be a Filipino physician today? To be a PCP Physician today?

The Filipino physician stands at the forefront of a transformation era in healthcare, embodying compassion and patient-centered expertise while eagerly incorporating innovative practices. The Filipino physician is not just a healer but a pivotal agent of change in Philippine society, advocating for the well being of the community beyond the confines of the clinic. Called upon to teach, to heal, to lead, they embody the essence of heroism where it truly counts. Grounded in profound humanity, their success is measured not by accolades, but by how they inspire, mentor, and care for patients and colleagues, fostering a culture of heroism. Envision a college of physicians comprised entirely of such heroes; Now imagine a nation transformed by their influence.

Mabuhay kayong mga new vanguards of internal medicine. Mabuhay ang Filipino INTERNIST. Mabuhay ang PCP. Mabuhay ang Pilipnas. Maraming Salamat po.