Quote:
Originally Posted by Unregistered
You can try to train to be fantastic Family Physician capable of working in rural out of city area. Manage virtually everything including colored obstetrics and deliver anaesthesia and even surgery like appendectomy and ORIF.
But in Singapore realistically how is that relevant? Who is going to pay you big bucks for doing those things?
If you want to make money and have lots of patients you will realize that it is the patients that pay you. And many patients have no idea what is a good doctor.
More often it is the doctor they like. Like. The guy who listens and is on same wavelength. Agrees. Says what they want to hear. Assuring. "See him or her already feel better liao"
That kind of rubbish.
EBM? joke lah.
How many Sg patients when having a cold or flu will ask for antibiotics?
I will say that the wonderful description of the super well trained MMED FAM MED is over qualified to be a family physician in Sg. In fact quite likely if that person were to work in pre setting will be damn frustrated because the patients will want him or her to do the wrong non EBM stuff. Will disagree with his or her EBM advice. Argue that natural alternative better than pharmaceutical. TCM better than Western Medicine. And oh yes....insurance plans tying your hands. Limit caps in bill per patient including meds and consult.
You realize your extreme knowledge and training is only worth $30 or less.
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This oft quoted example of patient wanting abx for flu and cold a bit cliché lei.
Only the china patient wants those reduce inflammation meds now a days. Everyone understand when I say abx kill bacteria, u have a virus, abx doesn't kill it. Only the ah tiong still go 消炎药 and when u ask them to translate or show pic..it turn out to be some penicillin. Got time I try to educate them, dun have time I take the chance they will complain and don't give them.
Come on la, private world , they give abx to earn money, really patient request meh. Hardly any during my locum and private gp stint. Sometimes they even say dun give me abx hor, last time the augmentin u give me cost 40 dollars.
Practice ebm is not about forcing the patient to do what u like. A lot of it is understanding their perspective. The ah ma who forever believe her cough is due to heatiness of cos don't like it when u tell her her belief is wrong. Same like Christians who hear Jesus talking to them..medically they have hallucinations lei. U go tell them that lor, see get complain or not for not respecting religious views.
Emb is about u as a doctor understanding the basis for Ur medical decision and advice and tailor it to the patient needs. If got chance, educate and explain instead of expecting the patient to 100 percent follow u blindly.
If u lend a ear and patient trust u, they will follow what u say.
Your standard as a doctor is lacking la. That's the problem. An inadequately trained fp adpots attitude like yours.