Oyg Animal Care Clinic Taytay Rizal

DR. RAFAEL CRUZ, a well-rounded Family Medicine practitioner epitomizes the comprehensive, continuing care for patients and their families. He is a Fellow of the Philippine Academy of Family Physicians and the Philippine Society of Diabetologists.

The ever growing number of patients with diabetes in Rizal Province in 2004 caught the interest of Dr. Cruz to attend a 2-week Diabetes Care team Education program at the Philippine Center for Diabetes Education Foundation headed by Dr. Litonjua at Makati Medical center. During the training, he was awarded as Best Diabetes Educator. Still not completely satisfied, he pursued a more intensive training which was a 2-year Diploma course at Institute for Diabetes Foundation, UERMMMC  through a Scholarship grant. Despite his busy schedules in clinical practice, he gave more time in this new career path. He believed that completing the training is really worth it making him more confident in dealing with his patients.

After his graduation, his patients increased and 70% of which have diabetes. In 2007, he established Diabetes Club S amahan T aga-Taytay in O rganisa P alaban sa Diabetes or STOP-DIABETES Club in Taytay, Rizal which has a membership of more than 4,000 patients with diabetes. As Chair of the Department of Family Medicine at Unciano Medical center in Antipolo, he also set up a Diabetes Clinic in 2008, as a venue for learning for Family Medicine Residents.

In 2010, he introduced an innovative program for Family Medicine Residents in Rizal Provincial Hospital Angono Annex called "Practical Diabetology ". He believed that dealing with diabetics requires a lot of skills, knowledge, patience, dedication, compassion and enthusiasm. It is a life-long learning experience because diabetes is a very dynamic field that has to be updated always for new trends in management and current medications. He was blessed to receive travel grants abroad to attend conferences in Europe, Asia and the United States for the past 25 years to augment his clinical practice.

According to Dr. Cruz, "for the past years, routine diabetes care has been carried out in the secondary and tertiary healthcare setting in Rizal province that entails a lot of money for ordinary patients for routine check-ups , laboratories and high consultation fees of specialists. It's about time that ideal primary care diabetes schemes be set up locally to sustain the comprehensive needs of our community. Programs involving diabetes are only limited to small clinic and dependent most of the time from pharmaceutical companies." The right time came in 2016, when he was invited by Dr. Jason Sierra, incoming Medical Director of One Cainta Municipal Hospital, a 100 –bed Primary local government hospital in Cainta, Rizal to join Mayor Nieto's pet project to establish Diabetes Center for indigent patients. Without a second thought he accepted to join the project. He was given a free hand to formulate the programs. He prepared the Consultation Schemes, educational materials, free Insulin pens, training modules for doctors and nursing staff. With the support of Mayor Keith Nieto, who provided adequate logistics for the Cainta Diabetes Center such as 2 clinic staff, free antidiabetic drugs, laboratory workups for senior citizens, hospitalizations, insulins and glucometers for selected patients, they were able to cater to  more than 2,000 patients. They handled 30-40 diabetic patients daily, receiving 4-5 referrals from specialists – like  management of pediatric patients with Type 1 DM, opthalmologists'  referrals  for patients' clearance for cataract surgery, OB consultants referring patients with gestational diabetes mellitus and pregnant diabetics, general surgeon for clearance on  abdominal  surgery, nephrologist's referral for patients with chronic kidney disease and undergoing dialysis, neurologist asking for co-management with stroke patients, dental clearance prior to tooth extractions, and Internal Medicine referrals for co-management of elderly patients with co-morbidities – daunting tasks they have to face daily. This made him realized that Family Medicine Specialist is the most appropriate person to handle all cases in this setting since we cover all ages from pediatrics to elderly, all body systems and care from prevention to palliative. He believe that it is still our moral and personal obligations not to leave our patients at any stage of treatment – from consultation to Intensive Care and even in the last minute of their breath.

Experiences in handling different cases of diabetic patients helped him organize and learn new practical approaches to meet the complex needs of diabetic patients and be able to improve the process of diabetes care which later lead to better outcomes. Some of the strategies he has done to improve the lives of his patients were as follows;

1. 2- minute Modified Plate method for dietary counseling
2. A worksheet for 2 –day dietary history
3. Outpatient insulin therapy for severe hyperglycemia
4. Educational materials for hypoglycemia awareness
5. Screening for diabetic patients with depression
6. Practical Diabetology – innovative program for Family Medicine Residents
7. Importance of Diabetes Club as a support group- structured diabetes group education program
8. ABC of diabetes Care – a comprehensive program ranging from routine laboratory work ups, lay education, vaccination,  foot screening, BP determination, wound care, eye screening, exercise  for weight reduction program and screening for microvascular and macrovascular complications
9. Diabetes Team – referral to other specialists regarding management of diabetes complications. Networking and team-approach was established among all members of hospital staff.

At present, they plan to propose a Residency Program in Family Medicine in Cainta Municipal Hospital since it has a lot of clinical materials, good complement of trainors, supportive administration and good venue for learning.

Aside from being a Family Physician and Diabetologist, he was also a Certified Hypertension Specialist. He also took courses on Animal Bites leading to the establishment of Animal bite center in his hometown in Rizal.

As far as leadership and professional activities are concerned, he has been a Regional director of PAFP, President of PAFP Rizal chapter, a Board member of Philippine Wound Care Society, Foundation of Family Medicine Educators and Philippine Association of Diabetes Educators. He is also a member of the Philippine College of Occupational Medicine, Philippine Thyroid Association and American Academy of Family Physicians.

What is interesting apart from being a clinician, lay educator, researcher and social mobilizer, he studied Martial arts and became the President of Aikido Dojo of Rizal 1st dan blackbelt Aikijujitsu Martial Arts from 1997 to present.

Oyg Animal Care Clinic Taytay Rizal

Source: https://thepafp.org/2019/02/15/dr-rafael-cruz/

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