Originally Posted by Unregistered

U student writing essays ah.

Aiyah. APN , care managers exist liao. Doesn't work, still a doctor centric care model. Anything complicated they ask me still, Medicine I got to prescribed also, MC also I write. I explained the decision logic to them, next time asked me still. End up i see the patient better and faster. Anything wrong also my own fault. When they see , sometimes they tell u a half f picture , u ok their plan but actually they screw up but just cos they put discuss with Dr xzzz, it becomes Ur responsibilities.
They are useful for a very small subset of stable patient, like hyperlipidemia stable for the last 10 years that kind, htn on amlodipine 2.5mg that kind.
Sometime I slot in stable chronic for myself so I can take a breather. Whole day see double digits hba1c cases very headache. APN thst can prescribe are few. Most dun want to take up that license also , do doctor work dun get doctor pay..why bother.

So no Ur thesis is useless.

Polyclinic work is actually challenging and a hospital trained m.med fp can actually treat and manage a lot of things. I can manage female incontinence all the way short of operating on them for example , I can even do a pipelle if needed if a women comes in with post menopausal bleeding. Deliver babies also no problem. Toe nail avulsion, joint injection , plaster and cast etc all no problem..perhaps a bit rusty nia. I even learned how to do a cystoscopy so if u give me access to CT urogram, I can actually clear asymptomatic microscopic haematuria myself.
Referral occurs usually due to patienrt request or becuase some useless RP has no ****ing idea what to do...or simply doesn't care. Unfortunately back when poly wasn't a posting of choice, they took in a fair bit of pinoy , Malaysian and India doc that aren't exactly v good. Now can't fire them and the system has to live with their inadequacies.