How is life as a doctor in Singapore?

Originally Posted by Unregistered

Im in public. But my patients number are restricted due to specialty clinic.
I feel lucky to able to spend good 20-25min per patient.
I can really optimize my arb/statin/sglt2i dose
Even glp1 is available to me
I start my long acting insulin in quite a number of patients
I have good nursing support.
I even can counsel patients on diet, teach them saturated fat and read food product label

I asked them open their handphone app to show me the steps they taking teach day
And keep on drilling them the three pronged approach

Diet
Exercise
Medicine

I worked in polyclinic before as a baby MO.
And locum quite extensively in my early days
Impossible to do above.

The fp clinic in polyclinic can.
15 minutes per patient and I keep seeing the same patients
Fine tune until swee swee. Many issues this visit cannot sort out next visit I work on it
Till some brilliant guy came up with teamlet model.
Work well on paper la. Useless in real life. The teamlet keep changing doctor, this visit I start something the next doctor go do stupid things . Other times I don't even know what the hell was going thru the previous rp mind. It's easy for the useless pinoy , Malaysian and Indian rp to just cont med , patient decline titration and see 3 months. Sometimes see liao very disgusted. Anaemia keep repeating fbc and throw to next doctor to settle.

U endocrinologist really just see diabetes? U sound very fam med lei
Or u work at the diabetes clinic in admiralty ?

Originally Posted by Unregistered

The fp clinic in polyclinic can.
15 minutes per patient and I keep seeing the same patients
Fine tune until swee swee. Many issues this visit cannot sort out next visit I work on it
Till some brilliant guy came up with teamlet model.
Work well on paper la. Useless in real life. The teamlet keep changing doctor, this visit I start something the next doctor go do stupid things . Other times I don't even know what the hell was going thru the previous rp mind. It's easy for the useless pinoy , Malaysian and Indian rp to just cont med , patient decline titration and see 3 months. Sometimes see liao very disgusted. Anaemia keep repeating fbc and throw to next doctor to settle.

U endocrinologist really just see diabetes? U sound very fam med lei
Or u work at the diabetes clinic in admiralty ?

But why u must sort out all the pts issues or even do FPC
See chronic just see chronic la , dont go dig dig
And pt refuse is patient own problem, we can only advise
In the end their decision. 5 mins extra i spend on one to convince is 5 mins less for the
Next patient - is that fair then

Originally Posted by Unregistered

Not sure if there are any senior colleagues or faculty members on this forum. Just wondering how does the faculty feel in general if a resident says they want to quit the program? Do they get angry, disappointed or they just don't care (quit then quit lo)

I am thinking of leaving the system after completing IM junior residency next year, i.e (not apply for senior residency positions), just not sure how to broach that topic to PD or my supervisor.

u have to think leave the system then do what ok.
GPs a lot . Some make it , some don't. You spend 3 years doing hospital medicine, are u sure u can do GP work? GP work damn siong one. Very long hours, you trading hours for money. 15K to a MO sound like a lot but as a GP but u burn ur life away in a small room for the rest of your life. Consultant 8am stand there like a boss, pple tell u what is going on , 9:30 am drink coffee liao. Run some clinic, do some QI , participate in some research , teach some resident, everyone loves you and u song song become elder in department, top of food chain, untouchable.

try apply for some gen med, geriatrics or renal medicine, maybe heng heng get in. Tong 3 years then exit liao and guaranteed rice bowl for life. Any specialist work in hospital while cannot huat , at least safely can bring home bacon for the kids and work long enough hit senior con can slack liao. Don't go invest in bitcoin or fall prey to love scams, you should be able to retire in style.

PD dont care one la. If you think they care, that means they are doing a good job pretending. Ahaha.. they also like u and me.. You think really deep down they care for each and every one of the IM resident? superficial only.

hard truths
every man for himself.

Focus on what is important in life. Find a good partner. Marry , have kids. Love your parents.
Everything else, life is a stage. Perform there for show.

Originally Posted by Unregistered

Cannot say like that la.
Still need to do your job to control the chronic disease
Patient don't want to listen is one thing (imho, it's usually a lack of trying. I usually
Convince them to start diabetes or statin.
U dun try very hard no one can blame you, but end of the day
Some altruism is needed.
Dun be like my rps, every one is con med, tcu 3 months

The endocrine and FP already say is impossible

The F FP even got cheek to criticize RPs when ownself say the system is wrong

You go try fight a court case with a rotating team of lawyers each time is only work on case for 15 min. Or be a bank relationship manager each time assign different banker.

Or even help people buy flat each time assign different agent

Is impossible is cannot. Try or dont try got difference? Maybe difference to conscience only. The other way of saying it is "trying to be the hero". Hero will burn out and kena more complaint of being slow and dont clear Q. These metrics are monitored and factored more than peasants got seen and get same meds decline change and tcu.

Dont give bad advice to poly drs on how to survive there. FP will know the problems.

Those RPs are there to be the scapegoats.

I’m convinced Polyclinic is not for people who want to actually practise fam med
There’s not enough time for each patient, and yes, even with this rubbish Teamlet model the doctors keep changing and rotating.
There is no actual continuity of care.

Policy makers have the illusion that by continuously upskilling FPs the situation in Polyclinic is going to improve. But no - not possible to have a Polyclinic that is cheap, fast and good all at the same time.
OPS Shld just be run by one boss MMed and above, the rest just RPs and MOPEX to clear queue and see 5 min per patient as per the allocated time given by MOH.

Originally Posted by Unregistered

The endocrine and FP already say is impossible

The F FP even got cheek to criticize RPs when ownself say the system is wrong

You go try fight a court case with a rotating team of lawyers each time is only work on case for 15 min. Or be a bank relationship manager each time assign different banker.

Or even help people buy flat each time assign different agent

Is impossible is cannot. Try or dont try got difference? Maybe difference to conscience only. The other way of saying it is "trying to be the hero". Hero will burn out and kena more complaint of being slow and dont clear Q. These metrics are monitored and factored more than peasants got seen and get same meds decline change and tcu.

Dont give bad advice to poly drs on how to survive there. FP will know the problems.

Those RPs are there to be the scapegoats.

Originally Posted by Unregistered

I’m convinced Polyclinic is not for people who want to actually practise fam med
There’s not enough time for each patient, and yes, even with this rubbish Teamlet model the doctors keep changing and rotating.
There is no actual continuity of care.

Policy makers have the illusion that by continuously upskilling FPs the situation in Polyclinic is going to improve. But no - not possible to have a Polyclinic that is cheap, fast and good all at the same time.
OPS Shld just be run by one boss MMed and above, the rest just RPs and MOPEX to clear queue and see 5 min per patient as per the allocated time given by MOH.

No one at OPS except the dr seeing you will say that each patient only gets 5 min.

That's the problem. The system is built on lies and false promises to EVERYONE.

Patients are lied how much time and care the system has for them
The drs have to keep up this lie knowing they dont have enough time to care
the HODs perpetuate the myth and front
the politicians tell themselves they are doing their best and maximizing what they get from the tax payer money
the tax payer thinks they are paying too much taxes already

all lies.

What do the experienced folks here think of healthier SG or the new capitation model of funding? Do you guys think anything will change and whether it's good or bad for the polyclinic doctors or gps out there, or it is just another wayang scheme?

Originally Posted by Unregistered

No one at OPS except the dr seeing you will say that each patient only gets 5 min.

That's the problem. The system is built on lies and false promises to EVERYONE.

Patients are lied how much time and care the system has for them
The drs have to keep up this lie knowing they dont have enough time to care
the HODs perpetuate the myth and front
the politicians tell themselves they are doing their best and maximizing what they get from the tax payer money
the tax payer thinks they are paying too much taxes already

all lies.

Everyone want cheap , want good , want fast. Where got? only paper talk time got.
Yes, import doctors from overseas lo.
They come initially very gilat. But as with all humans, after a while do the minimum.
Esp when u pressure them.
each patient 10 minutes
- have to find out reason for encounter. Sometimes many many reasons. Other times reason not clear.
- examine
- explain results
- explain management
- answer every other by the way questions
- order medication request
- arrange next TCU / blood test
- type notes

all in 10 minutes. 45 times a day.
while some patients really can finish in 10 minutes, a lot cannot
some cases super complex, other times patient also need time to digest what you are telling them.

End up lower skillset doctors cope by chin chye do
' decline titiration, cont meds, see 3/12 with bloods'

leaving it to the next doctor to stare at a Hba1c of 10%, HB 10, rotting foot wound and depression.
healthier SG?
pls la, equip the workforce with the ability to do their job first.
Fire all the useless RPs from whatever 3rd world countries.
Give each properly trained M.med level FP 15 minutes each patient and let the patient seen the same doctor most of the time.

other countries FP is all 3 years training. GP in australia and UK is the m.med FP in singapore. Singapore GP is just a MO level doctor in other countries, they are not even allow to practice independently.

Originally Posted by Unregistered

Everyone want cheap , want good , want fast. Where got? only paper talk time got.
Yes, import doctors from overseas lo.
They come initially very gilat. But as with all humans, after a while do the minimum.
Esp when u pressure them.
each patient 10 minutes
- have to find out reason for encounter. Sometimes many many reasons. Other times reason not clear.
- examine
- explain results
- explain management
- answer every other by the way questions
- order medication request
- arrange next TCU / blood test
- type notes

all in 10 minutes. 45 times a day.
while some patients really can finish in 10 minutes, a lot cannot
some cases super complex, other times patient also need time to digest what you are telling them.

End up lower skillset doctors cope by chin chye do
' decline titiration, cont meds, see 3/12 with bloods'

leaving it to the next doctor to stare at a Hba1c of 10%, HB 10, rotting foot wound and depression.
healthier SG?
pls la, equip the workforce with the ability to do their job first.
Fire all the useless RPs from whatever 3rd world countries.
Give each properly trained M.med level FP 15 minutes each patient and let the patient seen the same doctor most of the time.

other countries FP is all 3 years training. GP in australia and UK is the m.med FP in singapore. Singapore GP is just a MO level doctor in other countries, they are not even allow to practice independently.

Too expensive. For me is ok. But I dont want to pay for someone else
Maybe all healthcare private pay. Govt just give people maybe $500 a yeat for healthcare. You save up if you healthy. You can use it for visits and meds. Extra needs you pay out of pocket

See who wins. GP vs polyclinic. And pls dont fund polyclinic and make it unfair playing field.

I feel issue here is not whether you have MmEd or not
But rather time per patient

If there is 15 mins per patient at least , then proper care will be given, can discuss
Preventative measures as well eg) screening / immunizations
There are basic things you dont need an mmed to do
All u need is time