How is life as a doctor in Singapore?

Originally Posted by Unregistered

They are building more
But who is manning them?
U need to build a core group of 10 to 15 good FP to anchor the clinic
Cannot be reward those few that have potential to be head
or directors only and then ignore the rest
U train generals but all your foot soilders leave or morale low how u fight a war
Hire mecenaries u ok for a while but long term u gg.
10 years we took in temp reg doctor from unrecognised uni from India, Philippines and now we still suffering the consequence of it. They remain a big drag on the system.

All that talk about importance of primary care being the backbone
Hello this backbone now is osteoporotic
The quality of private land gp dun say, all your well trained m.meder in ops jaded and sian liao
I believe in my skillset to manage multi-morbid patient
But very chuan lei
Some patient got fatty liver, got poor DM, got CKD and obese
Yes management like to say just focus on 1 or 2 and leave the rest to next consult
Hello...my peenoy rp or low quality gdfmers can't do sheet tbh.
Continue medicine see 12 weeks is all they do...no wonder can see fast
Anaemia in 70 year old male start iron tablet, CKD no workup, transaminitis repeat lft
Sigh.
Everytime I see such cases my heart sank a bit for my patient who have the bad luck.
I also want to stay and help patient
But system not rewarding me and infact penalising me becuase I'm slower but thorough
Now still throw healthier sg on me
Tell me got increment, wait 2 months no sound no colour

Aiya. Sua la. Go private better.
Pay higher if I work for it. If want slack also got 10k easily.
Patient nicer
Cases simpler
My own patient I own them and not inherit shoddy work from inept juniors

Pay is the same whether you chup these jia lat chronics
Chuan or no chuan.
So chuan for what?

Originally Posted by Unregistered

They are building more
But who is manning them?
U need to build a core group of 10 to 15 good FP to anchor the clinic
Cannot be reward those few that have potential to be head
or directors only and then ignore the rest
U train generals but all your foot soilders leave or morale low how u fight a war
Hire mecenaries u ok for a while but long term u gg.
10 years we took in temp reg doctor from unrecognised uni from India, Philippines and now we still suffering the consequence of it. They remain a big drag on the system.

All that talk about importance of primary care being the backbone
Hello this backbone now is osteoporotic
The quality of private land gp dun say, all your well trained m.meder in ops jaded and sian liao
I believe in my skillset to manage multi-morbid patient
But very chuan lei
Some patient got fatty liver, got poor DM, got CKD and obese
Yes management like to say just focus on 1 or 2 and leave the rest to next consult
Hello...my peenoy rp or low quality gdfmers can't do sheet tbh.
Continue medicine see 12 weeks is all they do...no wonder can see fast
Anaemia in 70 year old male start iron tablet, CKD no workup, transaminitis repeat lft
Sigh.
Everytime I see such cases my heart sank a bit for my patient who have the bad luck.
I also want to stay and help patient
But system not rewarding me and infact penalising me becuase I'm slower but thorough
Now still throw healthier sg on me
Tell me got increment, wait 2 months no sound no colour

Aiya. Sua la. Go private better.
Pay higher if I work for it. If want slack also got 10k easily.
Patient nicer
Cases simpler
My own patient I own them and not inherit shoddy work from inept juniors

With only 5 min per patient, management of the patient by M5, GDFM, MMed, FCFP, MBBS (India) will all be the same - continue all meds, TCU 3/12
Hence no need to train any FPs, just anyhow anybody with an MBBS will do

Originally Posted by Unregistered

They are building more
But who is manning them?
U need to build a core group of 10 to 15 good FP to anchor the clinic
Cannot be reward those few that have potential to be head
or directors only and then ignore the rest
U train generals but all your foot soilders leave or morale low how u fight a war
Hire mecenaries u ok for a while but long term u gg.
10 years we took in temp reg doctor from unrecognised uni from India, Philippines and now we still suffering the consequence of it. They remain a big drag on the system.

All that talk about importance of primary care being the backbone
Hello this backbone now is osteoporotic
The quality of private land gp dun say, all your well trained m.meder in ops jaded and sian liao
I believe in my skillset to manage multi-morbid patient
But very chuan lei
Some patient got fatty liver, got poor DM, got CKD and obese
Yes management like to say just focus on 1 or 2 and leave the rest to next consult
Hello...my peenoy rp or low quality gdfmers can't do sheet tbh.
Continue medicine see 12 weeks is all they do...no wonder can see fast
Anaemia in 70 year old male start iron tablet, CKD no workup, transaminitis repeat lft
Sigh.
Everytime I see such cases my heart sank a bit for my patient who have the bad luck.
I also want to stay and help patient
But system not rewarding me and infact penalising me becuase I'm slower but thorough
Now still throw healthier sg on me
Tell me got increment, wait 2 months no sound no colour

Aiya. Sua la. Go private better.
Pay higher if I work for it. If want slack also got 10k easily.
Patient nicer
Cases simpler
My own patient I own them and not inherit shoddy work from inept juniors

With only 3-5 min per patient, the management of each patient is the same regardless of whether M5, MBBS Singapore, MBBS India, GDFM MMed FCFP… just continue meds and TCU 3/12

Originally Posted by Unregistered

OPS will not reward you for seeing patients properly.
Which is why everyone just does a **** job at it and passes the buck around leaving the patients clueless.
As I said, no point launching all the fancy programmes and infrastructure what not when the basics can’t even be gotten right.

If the management truly wants OPS to continue in this current state, then they should just let it fully be run by MOPEX, with one MMeder as head.
Everybody just anyhow see patients, 3-5 min per patient to clear KPI.

Those who see the light should just leave ASAP and let OPS devolve back into the 1980s when it’s run by crappy doctors and MOPEX.

It's not just OPS.
It is across all medicine.
The objective is to do what the CPG recommends.
As long as all the boxes ticked. Patient no bad outcome can already.
There is ABSOLUTELY ZERO reward for producing results.
But ALL THE RISK if things go badly. Sometimes it is just bad luck.
Like that 3 year old who kena Acute necrotizing encephalopathy after flu shot.
As a doctor you must learn this. Your role is to do safe things that is JUST ENOUGH.
Those bonus is more for doing higher volume work - bring in more revenue and money (again by doing JUST ENOUGH you have more time to see more patients so more money) or in institution is writing papers, admin etc.
NOBODY cares about you helping that lady with HBA1c 10 drop down to 6.5. Your effort is just lumped into the whole clinic DM KPI numbers.
Work smart otherwise you will burn out and for what?
Medicine is a long game. No FIRE.

Originally Posted by Unregistered

It's not just OPS.
It is across all medicine.
The objective is to do what the CPG recommends.
As long as all the boxes ticked. Patient no bad outcome can already.
There is ABSOLUTELY ZERO reward for producing results.
But ALL THE RISK if things go badly. Sometimes it is just bad luck.
Like that 3 year old who kena Acute necrotizing encephalopathy after flu shot.
As a doctor you must learn this. Your role is to do safe things that is JUST ENOUGH.
Those bonus is more for doing higher volume work - bring in more revenue and money (again by doing JUST ENOUGH you have more time to see more patients so more money) or in institution is writing papers, admin etc.
NOBODY cares about you helping that lady with HBA1c 10 drop down to 6.5. Your effort is just lumped into the whole clinic DM KPI numbers.
Work smart otherwise you will burn out and for what?
Medicine is a long game. No FIRE.

Actually the indians taught me a lot
Nowadays i spend 3min per patient for chronic
I just go to the medication tab and reorder exactly same
Beat them at their own game

guys dont worry.

We have the Resident Pipeline to train doctors who do the right thing

Just wait for them to pass MMED and the quality of docs will increase!

I am actually curious, how can a doctor make himself more highly valued and indispensible? (Meaning if he say he wants to quit, people will actually try their best to keep him- either through higher pay or other perks)

From the way I see it, it seems that family medicine (GP/FPS) are very replaceable. (Not that they are useless/unimportant, just that it's very easy to find someone to replace them)-maybe it's just the sheer volume of GP/FP nowadays.

Not sure if specialist are the same? I personally think GM and Geri or even gs is pretty much the same. Not sure about the more specialized fields, esp the procedural ones (like neurosurgery/cardio thoracic surgery/spine surgery, or like cardio interventionist) are more indispensable (as there are fewer trainees each year)

And for those who already entered into a generic field (like FM/AIM), how can they make themselves more valuable or indispensable to the institution (Can be public/private) so that they can't be replaced so easily ...

Originally Posted by Unregistered

You are wrong , average working person has some kinda corporate benefits and will just go to panel clinic nearby , most willing to top up cost

Yah good point. Forgot about corporate folks having insurance and panel.

Yeah then they’ll prolly just top up. But so big difference?

The shop house clinic was so ex, I’d rather drive to the heartlands to get my MC

The heartlands clinic’s owned by the GP himself and he’s so nice

Originally Posted by Unregistered

I am actually curious, how can a doctor make himself more highly valued and indispensible? (Meaning if he say he wants to quit, people will actually try their best to keep him- either through higher pay or other perks)

From the way I see it, it seems that family medicine (GP/FPS) are very replaceable. (Not that they are useless/unimportant, just that it's very easy to find someone to replace them)-maybe it's just the sheer volume of GP/FP nowadays.

Not sure if specialist are the same? I personally think GM and Geri or even gs is pretty much the same. Not sure about the more specialized fields, esp the procedural ones (like neurosurgery/cardio thoracic surgery/spine surgery, or like cardio interventionist) are more indispensable (as there are fewer trainees each year)

And for those who already entered into a generic field (like FM/AIM), how can they make themselves more valuable or indispensable to the institution (Can be public/private) so that they can't be replaced so easily ...

I see 20patients in 1hr
You see 10 in 1hr

I twice as valuable as you

Originally Posted by Unregistered

I see 20patients in 1hr
You see 10 in 1hr

I twice as valuable as you

I round two full wards in a morning
You round half ward in a morning

I four times as valuable as you