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How is life as a doctor in Singapore?

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  #2601 (permalink)  
Old 22-08-2021, 11:18 AM
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That is just one example of patient asking for MRI back.
How about all the other instances where patient does not outrightly ask for MRI back.
Reading the guidelines is not just for MMed doctors.
Please have some pride in being GP. You are not a referrologist.
If you just anyhow manage, you are no better than a fresh graduate medical student.
(In fact they will probably be better because they would have prepared hard for MBBS)
One thing you never do especially in pte practice is to deny a patient an investigation they want and are willing to pay for.

You term this being a referrologist?

There is a reason why guidelines are called guidelines. Because that's what they are. They are no law or rules. Dont believe me?

If a patient insists on an MRI and you deny them thay saying by guidelines they do not deserve one and later on they find another dr who does it an they find a rhabdomyosarcoma in the psoas miscle and they decide to complain to SMC ans sue the first doctor who denied the MRI see what happens when you try to quote guidelines.

Hindsight is 20/20.

There is no medal for saving the "healthcare system" cost and waste. No bonus either. But you run the risk or missing things. How likely? Probably not. But when it is not a common ground you have reached with a patient who wants the test you will be disciplined accordingly as per the hindsight 20/20 guideline.

Wait till you kena. You will change your tune.

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  #2602 (permalink)  
Old 22-08-2021, 11:23 AM
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Originally Posted by Unregistered View Post
One thing you never do especially in pte practice is to deny a patient an investigation they want and are willing to pay for.

You term this being a referrologist?

There is a reason why guidelines are called guidelines. Because that's what they are. They are no law or rules. Dont believe me?

If a patient insists on an MRI and you deny them thay saying by guidelines they do not deserve one and later on they find another dr who does it an they find a rhabdomyosarcoma in the psoas miscle and they decide to complain to SMC ans sue the first doctor who denied the MRI see what happens when you try to quote guidelines.

Hindsight is 20/20.

There is no medal for saving the "healthcare system" cost and waste. No bonus either. But you run the risk or missing things. How likely? Probably not. But when it is not a common ground you have reached with a patient who wants the test you will be disciplined accordingly as per the hindsight 20/20 guideline.

Wait till you kena. You will change your tune.
Bro. Read properly.
I said that is just one instance of patient requesting for MRI.
What about OTHER instances.
I didnít say refuse patient who request for MRI.



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  #2603 (permalink)  
Old 22-08-2021, 11:25 AM
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Originally Posted by Unregistered View Post
One thing you never do especially in pte practice is to deny a patient an investigation they want and are willing to pay for.

You term this being a referrologist?

There is a reason why guidelines are called guidelines. Because that's what they are. They are no law or rules. Dont believe me?

If a patient insists on an MRI and you deny them thay saying by guidelines they do not deserve one and later on they find another dr who does it an they find a rhabdomyosarcoma in the psoas miscle and they decide to complain to SMC ans sue the first doctor who denied the MRI see what happens when you try to quote guidelines.

Hindsight is 20/20.

There is no medal for saving the "healthcare system" cost and waste. No bonus either. But you run the risk or missing things. How likely? Probably not. But when it is not a common ground you have reached with a patient who wants the test you will be disciplined accordingly as per the hindsight 20/20 guideline.

Wait till you kena. You will change your tune.
And just FYI I practise in multiple FM settings so I am well familiar with the type of patients encountered in various settings.

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  #2604 (permalink)  
Old 22-08-2021, 12:26 PM
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And just FYI I practise in multiple FM settings so I am well familiar with the type of patients encountered in various settings.
You kena before? Not yet? I hope you never ever kena. But the odds are against us all.
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  #2605 (permalink)  
Old 22-08-2021, 12:34 PM
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Quote:
Originally Posted by Unregistered View Post
One thing you never do especially in pte practice is to deny a patient an investigation they want and are willing to pay for.

You term this being a referrologist?

There is a reason why guidelines are called guidelines. Because that's what they are. They are no law or rules. Dont believe me?

If a patient insists on an MRI and you deny them thay saying by guidelines they do not deserve one and later on they find another dr who does it an they find a rhabdomyosarcoma in the psoas miscle and they decide to complain to SMC ans sue the first doctor who denied the MRI see what happens when you try to quote guidelines.

Hindsight is 20/20.

There is no medal for saving the "healthcare system" cost and waste. No bonus either. But you run the risk or missing things. How likely? Probably not. But when it is not a common ground you have reached with a patient who wants the test you will be disciplined accordingly as per the hindsight 20/20 guideline.

Wait till you kena. You will change your tune.
From the way u write, I can already say u are one of the lousy gp. And really one of the reason why I think untrained gp like you should not be allowed to continue practicing independently and tainting patient expectation of doctors.

Your MRI example is a lousy one. Even if the pat complain and finds that u deny a patient a MRI for a 3 day hx of back pain but eventually turn out to be a rare tumour , u will not be medically neligent unless there are other signs that points to something sinister. Because u lack training , you have no idea what is going on and all you can do safely is transfer the burden of care to someone else. So lousy medically that you don't even dare to standby your own assessment . You don't even deserve a MBBS. My apn can probably do a better job than you. If u had been properly trained, u would have know that such pat often have thier own ideas and expectations, most of them dun really want the MRI, they just want reassurancre. U really think even with insurance,any of them want to take time off work, go visit a specialist , sit inside a machine for few hours, visit specialist again, then deal with the insurance agent to claim money? Pls la.


If you give a patient just what he wants, u are essentially not doing your job. Your backpain example is not uncommon, many Indian and PRC patient request for it. If u just sit at your desk and try to reassure the pat he is ok, of cse he don't believe. Do a full physical, teach them some back self physio, give proper safety netting advice. 90 percent of such patient all understands and no one pushes u for a MRI. The remaining 10 percent no choice, they have their agenda and u refer and confirm all come back normal.
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  #2606 (permalink)  
Old 22-08-2021, 12:48 PM
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Originally Posted by Unregistered View Post
From the way u write, I can already say u are one of the lousy gp. And really one of the reason why I think untrained gp like you should not be allowed to continue practicing independently and tainting patient expectation of doctors.

Your MRI example is a lousy one. Even if the pat complain and finds that u deny a patient a MRI for a 3 day hx of back pain but eventually turn out to be a rare tumour , u will not be medically neligent unless there are other signs that points to something sinister. Because u lack training , you have no idea what is going on and all you can do safely is transfer the burden of care to someone else. So lousy medically that you don't even dare to standby your own assessment . You don't even deserve a MBBS. My apn can probably do a better job than you. If u had been properly trained, u would have know that such pat often have thier own ideas and expectations, most of them dun really want the MRI, they just want reassurancre. U really think even with insurance,any of them want to take time off work, go visit a specialist , sit inside a machine for few hours, visit specialist again, then deal with the insurance agent to claim money? Pls la.


If you give a patient just what he wants, u are essentially not doing your job. Your backpain example is not uncommon, many Indian and PRC patient request for it. If u just sit at your desk and try to reassure the pat he is ok, of cse he don't believe. Do a full physical, teach them some back self physio, give proper safety netting advice. 90 percent of such patient all understands and no one pushes u for a MRI. The remaining 10 percent no choice, they have their agenda and u refer and confirm all come back normal.
I said insists on MRI. To assume that as a dr I didnt bother to examine and explain and advise as per normal protocol before rhe patient insists on MRI....

You are one of those doctors that thinks so highly of themselves and every othe dr is ****.

Yup thats the profession for you. Yes you are the bestest dr around.
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  #2607 (permalink)  
Old 22-08-2021, 05:05 PM
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Why all the GPS only posting here? Letís listen to the specialists.

Is orthopedic training hard to get?
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  #2608 (permalink)  
Old 22-08-2021, 05:52 PM
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And just FYI I practise in multiple FM settings so I am well familiar with the type of patients encountered in various settings.
On a completely separate note, how do you get to practice in multiple FM settings? (I am just thinking, you can locum in gp land, then ops, or CH/NH?)
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  #2609 (permalink)  
Old 22-08-2021, 06:25 PM
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What's wrong with ordering mri as long as they pay out of own pocket.
I never stopped anybody from driving Toyota bmw or merc as long as they pay out of own pocket
I never stopped anybody from eating at restaurant as long as they can pay for themselves even though they should be cooking at home to save money.

However if they are susidized, then mri needs to have a valid indication.
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  #2610 (permalink)  
Old 22-08-2021, 10:18 PM
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Question to mopex mos, how do you guys cope if you are posted to a posting that you hate or not your choice?
Is there still any point of trying your best given that you know you are not going to stay there beyond 6mths? (Or you should adopt the army Chao keng attitude?)
Depends on your career goals, if you wish to do residency (but in a different specialty) still need to put in effort as words can spread (even across different SI). But if you already planning to leave the system (i.e just waiting for bond to end before going locum/private then just Chao keng lol)
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