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How is life as a doctor in Singapore?

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  #5621 (permalink)  
Old 06-07-2023, 03:31 AM
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Pales in comparison to psychiatric drugs. A monthís prescription of anti-depressants easily cost over $200 in private clinics.

Many people also try to avoid going to IMH for treatment because of the fear of having a public mental health record.

So they would rather pay the higher fees incurred by going to a private psychiatrist
Looks like it isn't the patients that "would rather pay the higher fees with the psychiatrist" but rather the GPs that do not want to help them.

It takes too much time for a GP to see a mental health patient and charge $30 for a 30 min consult.

Not to mention SMC has strict rules restricting GPs from prescribing (>7 days supply) BDZs, which is a very common drug used for patients with anxiety, panic attacks and insomnia.

Business wise makes no sense plus their hands are tied anyway.

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  #5622 (permalink)  
Old 07-07-2023, 05:43 PM
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Looks like it isn't the patients that "would rather pay the higher fees with the psychiatrist" but rather the GPs that do not want to help them.

It takes too much time for a GP to see a mental health patient and charge $30 for a 30 min consult.

Not to mention SMC has strict rules restricting GPs from prescribing (>7 days supply) BDZs, which is a very common drug used for patients with anxiety, panic attacks and insomnia.

Business wise makes no sense plus their hands are tied anyway.
I thought it's max 2-4 weeks for benzo?

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  #5623 (permalink)  
Old 07-07-2023, 10:23 PM
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I thought it's max 2-4 weeks for benzo?
Donít do benzo
Be a good boy

Donít do cough syrup
Be a good boy

Good boy = no drug addicts at ur clinic = no temptation = no smc

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  #5624 (permalink)  
Old 09-07-2023, 05:36 AM
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://.healthprofessionals.gov.sg/docs/librariesprovider2/publications-newsroom/smc-newsletters/nov-2022/smc-newsletter-2022_20th-ed_nov.pdf

see page 17

A short course of 2 to 4 weeks of a BZD/hypnotic may be considered in acute
insomnia (less than 4 weeks) if it is severe, distressing and disabling. It should
be prescribed for intermittent use and only when necessary.

Similarly, BZDs are indicated for short-term relief (2 to 4 weeks only) of
anxiety that is severe, disabling or subjecting an individual to unacceptable
distress, occurring alone or in association with insomnia or short-term
psychosomatic, organic or psychotic illness.

BZDs may also be added to anti-depressants in the short term to offset their
initial excitatory effects in the treatment of depression and anxiety disorders
and should be tapered and withdrawn by 4 weeks. BZDs should not be used
as monotherapy in the treatment of depression.

Extended and long-term use of BZDs/hypnotics beyond 2 to 4 weeks is not
recommended even when used at therapeutic doses, because efficacy is not
clearly established.
There must be appropriate clinical review, clear indications and adequate
documentation for any continued or repeat BZD/hypnotic prescription.
The concurrent use of two or more BZDs/hypnotics should be avoided.
BZD/hypnotic use should be limited to short term symptomatic relief, at the
lowest effective dose and taken intermittently, to minimise the side-effects
and risks of dependence.

Specialist Referrals
The following patients should not be further prescribed with BZDs/hypnotics,
but referred to the appropriate specialist for further management:
Patients who require or have been prescribed BZDs/hypnotics beyond a
cumulative period of 8 weeks.
Patients who are already on high-dose and/or long-term BZDs from their
specialists or general hospitals; where possible, these patients should be
referred back to their respective specialists for further management until
they are weaned off BZDs/hypnotics.
Patients who are non-compliant with professional advice or warnings to
reduce intake of BZDs/hypnotics.
Patients who refuse to be referred to a specialist should be counselled
appropriately. Such refusal should be documented in the patientsí medical
records. Patients who refuse and turn aggressive should be reported to the
police.

Sounds like SMC only wants GPs to manage patients with Adjustment disorder.
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  #5625 (permalink)  
Old 12-07-2023, 09:53 PM
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Poly is very frustrating at times, anyone else wanna quit but deciding?
Am a gdfm RP and not sure if i shld just locum
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  #5626 (permalink)  
Old 13-07-2023, 07:13 AM
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Does anyone else in poly ever feel their boss is not interested in hearing feedback that they do not wish to act on ?
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  #5627 (permalink)  
Old 13-07-2023, 10:22 AM
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Does anyone else in poly ever feel their boss is not interested in hearing feedback that they do not wish to act on ?
This "asking for feedback" thing is not to be taken literally.

They have to say it and make it official.

But you think your Head really wants to hear all the problems
And bad stuff going on in the poly?

Is like bringing out dirt from under the rug and then what?
You expect the Head to clean?

Dont be dumb.

At meetings keep quiet if nothing positive to say.

Better to be a cheerleader. Boss come up with ideas for project
Say yeah that's a good idea. I think it will help a lot.

Only time you can bring up problems is when you say
Poly had this and that problem but I already fixed or resolved it
By doing this.
Then head will know wah this fella good identified problem
And took initiative to solve it meaning I dont have to solve it.
Good!

Those like to "feedback" until machiam like kpkb at meeting
You think the head like?

You dont heed this advice you can learn the hard way.
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  #5628 (permalink)  
Old 13-07-2023, 11:36 AM
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Default dumb

Humans are dumb. Indeed
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  #5629 (permalink)  
Old 13-07-2023, 04:50 PM
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Poly is very frustrating at times, anyone else wanna quit but deciding?
Am a gdfm RP and not sure if i shld just locum
Just quit lo.
Work so demanding nowadays.
KPI this kpi that.
Healthier sg.
Depending on Ur cluster...obesity kpi, ptec, Teleconsult recuritment

Outside locum otot.
Hourly rate better.
No need be very responsible.
Patient also less question. All want MC and go and not trying to take advantage of the system by asking for vitamin c. , Vitamin d , vitamin b , Gingko, glucosaminr , ketopeofen , cetirizine steriod cream, aqueous cream, emulsifying ointment
I once told off a patient all he needs is vitamin m la.

Ops a lot of entittled patient.
Somehow they think whatever they ask we must acceede.
Bloody hell.

Private GP patient where got so demanding.
Infact more they ask ..more money they spend.
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  #5630 (permalink)  
Old 13-07-2023, 05:42 PM
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Does anyone else in poly ever feel their boss is not interested in hearing feedback that they do not wish to act on ?
u must see your boss pattern.
some really not bad and put there for change and bigger things
others just some politically correct idiot who yes their way up and class 95 ( hear only the good things)

anyway, dun get too involved la. Heads actually not v powerful. what they do clinical services, quality , FMD etc all involved. they also tied. u want them to let u see lesser patients not possible because this is MOH directive for example.

end of the day. Just farm built ur fortune to have a recurring stream of income and have the flexibility to get out of the system.
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