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10-06-2021, 09:43 PM
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Quote:
Originally Posted by Unregistered
Thank you for your answer.
I asked because 30 hours seem crazy, I can't even stay awake 20 hours. And I am not the smartest out there... no awards, no nothing. How do I know I can survive medicine before entering medicine. If the school selects you, does that mean you are good enough? That you probably can make it?
I wanted to do medicine because i want to work for doctors without borders. But people tell me its too idealistic and that to do medicine it is more than wanting to help people
I should be a therapist or a psychologist instead
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Make yourself a billionaire first. Then you are free to do many things including working for doctors without borders.
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10-06-2021, 09:55 PM
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Quote:
Originally Posted by Unregistered
Patients dont know the difference between GP and FP. Especially when it comes to paying for consult fees.
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Ha. U apply evidence based medicine u go home eat porridge.
Take eye stye for example. U go gp, it will be lubricating eye drops, antibiotic eye drops and even oral antibiotics. Easily 60 bucks per consult.
The patient then come to me 1 week later complaing why not better, I tell them the treatment is to press your eye with a warm towel 3 times a day. Then they ask me why the gp give so many eye drops not working and u telling me warm towel can liao?
I tell them , to make money la! Tell u warm towel only can charge u 18 bucks Nia. Give u meds can earn more! But the gp should at least tell them some right things..(or maybe the gp himself dunno)
Many fly by night gp out there la. I understand no choice need to make money. But u have pple with mrcs going to setup gp clinic...duh. Some diabetic patient come to me and say they cannot pay for their empoglofozin cos it's 120 dollars per mth. Wah Rao. Haven't give Metformin already go second line, use some brains la, now u permantly lose a patient to polyclinic Liao. We more busy, u less business.
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10-06-2021, 10:48 PM
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Quote:
Originally Posted by Unregistered
Ha. U apply evidence based medicine u go home eat porridge.
Take eye stye for example. U go gp, it will be lubricating eye drops, antibiotic eye drops and even oral antibiotics. Easily 60 bucks per consult.
The patient then come to me 1 week later complaing why not better, I tell them the treatment is to press your eye with a warm towel 3 times a day. Then they ask me why the gp give so many eye drops not working and u telling me warm towel can liao?
I tell them , to make money la! Tell u warm towel only can charge u 18 bucks Nia. Give u meds can earn more! But the gp should at least tell them some right things..(or maybe the gp himself dunno)
Many fly by night gp out there la. I understand no choice need to make money. But u have pple with mrcs going to setup gp clinic...duh. Some diabetic patient come to me and say they cannot pay for their empoglofozin cos it's 120 dollars per mth. Wah Rao. Haven't give Metformin already go second line, use some brains la, now u permantly lose a patient to polyclinic Liao. We more busy, u less business.
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You are correct. But it is also what the patient's expectations are. Many medicines. Go see Dr only get advice pay $18 is not worth it. Go see doctor get a bag of medicines pay $60 is worth it.
As long as Singapore still allows anyone with MBBS to open GP clinic you will continue to have this kind of standard. Also patients dont really know what good medicine is. What EBM is. They go based on "how nice" the doctor is. How well the dr meets their expectations. Nothing to do with EBM.
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10-06-2021, 10:56 PM
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Quote:
Originally Posted by Unregistered
Thank you for your answer.
I asked because 30 hours seem crazy, I can't even stay awake 20 hours. And I am not the smartest out there... no awards, no nothing. How do I know I can survive medicine before entering medicine. If the school selects you, does that mean you are good enough? That you probably can make it?
I wanted to do medicine because i want to work for doctors without borders. But people tell me its too idealistic and that to do medicine it is more than wanting to help people
I should be a therapist or a psychologist instead
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Sounds like you just wanna experience the life working with doctors without borders.
You dont have to be a doctor to work with them
s://.doctorswithoutborders.ca/content/who-we-need
s://.doctorswithoutborders.ca/application-process
Why not do some work with them first. Then decide if you still want to be a doctor. Certainly the experience on your resume will help you in your application to medical school.
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10-06-2021, 10:59 PM
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Quote:
Originally Posted by Unregistered
Ha. U apply evidence based medicine u go home eat porridge.
Take eye stye for example. U go gp, it will be lubricating eye drops, antibiotic eye drops and even oral antibiotics. Easily 60 bucks per consult.
The patient then come to me 1 week later complaing why not better, I tell them the treatment is to press your eye with a warm towel 3 times a day. Then they ask me why the gp give so many eye drops not working and u telling me warm towel can liao?
I tell them , to make money la! Tell u warm towel only can charge u 18 bucks Nia. Give u meds can earn more! But the gp should at least tell them some right things..(or maybe the gp himself dunno)
Many fly by night gp out there la. I understand no choice need to make money. But u have pple with mrcs going to setup gp clinic...duh. Some diabetic patient come to me and say they cannot pay for their empoglofozin cos it's 120 dollars per mth. Wah Rao. Haven't give Metformin already go second line, use some brains la, now u permantly lose a patient to polyclinic Liao. We more busy, u less business.
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It is not just to make money. It is the patient's expectations. Most people in Singapore expect to go to see Dr and get some medicine. If they go and pay $18 and go home and tell family dr just said apply warm compress no medicine they will say wah lau $18!!! for that!!!! Give some eye drops also lah. You can also earn more money. Actually Singapore should do away with allowing GPs to dispense medicine. Maybe sure you can allow dispensing but maybe make it totally not-for-profit. Conflict of interest really. This is serious stuff that impacts negatively on the quality of medicine service provided.
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10-06-2021, 11:27 PM
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Quote:
Originally Posted by Unregistered
Ha. U apply evidence based medicine u go home eat porridge.
Take eye stye for example. U go gp, it will be lubricating eye drops, antibiotic eye drops and even oral antibiotics. Easily 60 bucks per consult.
The patient then come to me 1 week later complaing why not better, I tell them the treatment is to press your eye with a warm towel 3 times a day. Then they ask me why the gp give so many eye drops not working and u telling me warm towel can liao?
I tell them , to make money la! Tell u warm towel only can charge u 18 bucks Nia. Give u meds can earn more! But the gp should at least tell them some right things..(or maybe the gp himself dunno)
Many fly by night gp out there la. I understand no choice need to make money. But u have pple with mrcs going to setup gp clinic...duh. Some diabetic patient come to me and say they cannot pay for their empoglofozin cos it's 120 dollars per mth. Wah Rao. Haven't give Metformin already go second line, use some brains la, now u permantly lose a patient to polyclinic Liao. We more busy, u less business.
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Btw empagliflozin can be first line.
Since 2019, ESC/EASD can be first line for empa for patients with high cv risk.
Sglt2i is critical.
Some of the ops rp not sure whether fm or not.
Seem to by pass sglt2i. Then go straight to sulphonylurea, not good.
Dude that guy so fat already, insulin resistance ++ , su and insulin will worsen the weight.
They shld keep up to date with the literature.
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10-06-2021, 11:35 PM
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Quote:
Originally Posted by Unregistered
Btw empagliflozin can be first line.
Since 2019, ESC/EASD can be first line for empa for patients with high cv risk.
Sglt2i is critical.
Some of the ops rp not sure whether fm or not.
Seem to by pass sglt2i. Then go straight to sulphonylurea, not good.
Dude that guy so fat already, insulin resistance ++ , su and insulin will worsen the weight.
They shld keep up to date with the literature.
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Agree there are many ops docs who cmi, similarly there are many pte gps who cmi.
There are good docs in ops, there are good docs in gp land
It is important for doc to devote an afternoon of reading time per week to maintain currency, to attend college online education events .
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11-06-2021, 12:02 AM
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Quote:
Originally Posted by Unregistered
Btw empagliflozin can be first line.
Since 2019, ESC/EASD can be first line for empa for patients with high cv risk.
Sglt2i is critical.
Some of the ops rp not sure whether fm or not.
Seem to by pass sglt2i. Then go straight to sulphonylurea, not good.
Dude that guy so fat already, insulin resistance ++ , su and insulin will worsen the weight.
They shld keep up to date with the literature.
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Cost is a big factor when it comes to prescribing- both in OPS and private. Hence this EBM stuff doesn't really work in practice. Especially so when you will have a lot of differing advice depending who you talk to. Obviously the patients who are not rich and cannot afford expensive medicines will go with the doctor who offers Metformin first. And they will also believe when they are told the Dr who suggested Sglt2i as first line "only wants to make money".
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11-06-2021, 12:14 AM
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Actually how long after MMED (FM) can one start pursuing FCFPS to work towards consultant position ah
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11-06-2021, 12:32 AM
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Quote:
Originally Posted by Unregistered
Actually how long after MMED (FM) can one start pursuing FCFPS to work towards consultant position ah
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Who here will know which famous HOD will say "Don't say "actually" when presenting.
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