How is life as a doctor in Singapore?

Originally Posted by Unregistered

Many of the telecons were for less than 1 minute.

And they got mc and meds as well.

You can read all about it in the news.

There are many doctors in GP/polyclinic who see patients with urti in 2 minutes. (Esp with documentation and order templates now on most IT system)
I have also done it before.
Ask relevant history, red flags, check temp and listen to lungs
- can be done in 2 min, esp for those young pts (e.g nsf)
- 1 min for pt to verify name and IC number, and history
- 30 sec to check temp, throat, lungs
- 30 sec to document and order med (with help of templates)
(And btw I am one of the slower drs in my polyclinic)

My personal concern is what is deemed an appropriate time ( in moh eyes) for a usual teleconsult with a simple condition like urti?
Also moh has also mentioned that teleconsult must have the same quality of care as a physical consult. It is not possible for examination in teleconsult. Hence, even for urti, will the absence of lung auscultation be considered as suboptimal care in the eyes of MOH?

Yes manadr was terrible and rightly sanctioned but I am more concerned about the legal implications for telemed moving forward.

Originally Posted by Unregistered

There are many doctors in GP/polyclinic who see patients with urti in 2 minutes. (Esp with documentation and order templates now on most IT system)
I have also done it before.
Ask relevant history, red flags, check temp and listen to lungs
- can be done in 2 min, esp for those young pts (e.g nsf)
- 1 min for pt to verify name and IC number, and history
- 30 sec to check temp, throat, lungs
- 30 sec to document and order med (with help of templates)
(And btw I am one of the slower drs in my polyclinic)

My personal concern is what is deemed an appropriate time ( in moh eyes) for a usual teleconsult with a simple condition like urti?
Also moh has also mentioned that teleconsult must have the same quality of care as a physical consult. It is not possible for examination in teleconsult. Hence, even for urti, will the absence of lung auscultation be considered as suboptimal care in the eyes of MOH?

Yes manadr was terrible and rightly sanctioned but I am more concerned about the legal implications for telemed moving forward.

Also just to add on, it is very possible also because polyclinic has urti zone, where you see nothing but urti
Also GP land-sometimes my ca write "ari" under comments
So I can already key in my documentation and order template after I call PT and when he is walking in,
So can even be less than 2 min sometimes the actual consult.

Originally Posted by Unregistered

Also just to add on, it is very possible also because polyclinic has urti zone, where you see nothing but urti
Also GP land-sometimes my ca write "ari" under comments
So I can already key in my documentation and order template after I call PT and when he is walking in,
So can even be less than 2 min sometimes the actual consult.

sorry... what is ari?

Originally Posted by Unregistered

sorry... what is ari?

acute respiratory infection

Consultation fee needs to increase
Easy to just crack the whip
But to tackle the underlying issue ... if GPs were well paid per consult why would they resort to such things

Consultation fee is cheaper than haircut.

Originally Posted by Unregistered

There are many doctors in GP/polyclinic who see patients with urti in 2 minutes. (Esp with documentation and order templates now on most IT system)
I have also done it before.
Ask relevant history, red flags, check temp and listen to lungs
- can be done in 2 min, esp for those young pts (e.g nsf)
- 1 min for pt to verify name and IC number, and history
- 30 sec to check temp, throat, lungs
- 30 sec to document and order med (with help of templates)
(And btw I am one of the slower drs in my polyclinic)

My personal concern is what is deemed an appropriate time ( in moh eyes) for a usual teleconsult with a simple condition like urti?
Also moh has also mentioned that teleconsult must have the same quality of care as a physical consult. It is not possible for examination in teleconsult. Hence, even for urti, will the absence of lung auscultation be considered as suboptimal care in the eyes of MOH?

Yes manadr was terrible and rightly sanctioned but I am more concerned about the legal implications for telemed moving forward.

In my opinion, telemed is only appropriate for certain types of consults.

Eg reviewing lab results. Imaging reports. Conveying plan of management.

It is inappropriate care for undifferentiated diagnostic problems. Anything that requires physical examination.

It can be appropriate maybe for mental health.

Business people and politicians pushed for telemed. And the medical community caved in.

can I as anchor doc see only work permit checks then leave locum to see all acute cases monday and friday?

Originally Posted by Unregistered

can I as anchor doc see only work permit checks then leave locum to see all acute cases monday and friday?

can... helps if you are the boss also

btw, polyclinic got patients with multiple medical issues , and each doctor see >60 patients per day

guess how much time they really have?
reading the long list of problems itself already takes a few minutes.. ordering meds properly at least 1 minute.

im not sure if manadr patients are as complicated as polyclinic follow up patients. plus the fact that physical exam cant be done shaves off a lot of time.

Originally Posted by Unregistered

btw, polyclinic got patients with multiple medical issues , and each doctor see >60 patients per day

guess how much time they really have?
reading the long list of problems itself already takes a few minutes.. ordering meds properly at least 1 minute.

im not sure if manadr patients are as complicated as polyclinic follow up patients. plus the fact that physical exam cant be done shaves off a lot of time.

I mean physical exam apart from inspection.