How is life as a doctor in Singapore?

Originally Posted by Unregistered

Average FFS visit is ~$33/visit in BC and Ontario.

In Capitation model, physicians are paid by the number of patients that they enroll onto their roster. The physician is paid a certain amount per month that the patient remains on their roster (fee varies according to age and co-morbidities). However, if that same patient visits another family MD (e.g. walk in clinic), then the cost of that visit (e.g. $33) gets deducted from your capitation. Hence there is incentive for the physician to make themself available for the patient and trying to keep their patients as healthy as possible.

There are also bonus incentives for meeting certain metrics (e.g. % of patients who received age-appropriate cancer screening, vaccinations etc) which can add up to several tens of thousands per annum.

Are you a family physician in Canada? Previously from Singapore?

Originally Posted by Unregistered

Average FFS visit is ~$33/visit in BC and Ontario.

In Capitation model, physicians are paid by the number of patients that they enroll onto their roster. The physician is paid a certain amount per month that the patient remains on their roster (fee varies according to age and co-morbidities). However, if that same patient visits another family MD (e.g. walk in clinic), then the cost of that visit (e.g. $33) gets deducted from your capitation. Hence there is incentive for the physician to make themself available for the patient and trying to keep their patients as healthy as possible.

There are also bonus incentives for meeting certain metrics (e.g. % of patients who received age-appropriate cancer screening, vaccinations etc) which can add up to several tens of thousands per annum.

What about profits from the sale of medicine? $33 is only consult right?

Originally Posted by Unregistered

What about profits from the sale of medicine? $33 is only consult right?

GPs don't sell medicine in Canada. They write a prescription and you go to the pharmacy to collect your medicine. Pharmacy earns the medicine fee.

Originally Posted by Unregistered

GPs don't sell medicine in Canada. They write a prescription and you go to the pharmacy to collect your medicine. Pharmacy earns the medicine fee.

Yes so the physician's prescribing pattern is minimally influenced by the profit from the sale of medications.

Originally Posted by Unregistered

What about profits from the sale of medicine? $33 is only consult right?

Physicians get reimbursed for performing vaccinations, tray fee for biopsies etc.

Originally Posted by Unregistered

Physicians get reimbursed for performing vaccinations, tray fee for biopsies etc.

How would you compare Canada vs Singapore? Pros and cons? Overall?

Originally Posted by Unregistered

I graduated from NUS Medical School 1998. MBBS. Back before it was the Yong Loo Lin School of Medicine. (Aside....all the medical schools and hospitals are being named after businessmen who had nothing to do with medicine. It is sad. But that's the reality. Money talks)

You can search up "Migrate to Canada CIC" and find all the information you need. I applied for PR back in 2004. Under skilled migrant category. I got my PR in 2008 and did my landing. Family and I only moved in 2010.

I took the exams - MCCEE, MCCQE1, NAC-OSCE, MMI. Took me 2 years to finish the exams. Applied for residency at the University of Calgary. I was living in Edmonton at the time but I wasn't too keen to go back to medicine really. So I only applied to U of C because their program is the most slack. Only 1 month of hospital rotation (Internal medicine). 2 year program. So only in 1 month out of 24 is there a call schedule. Shiok right?

Life as a physician here is way better. I speak from a general as well as family physician perspective.

Some things are the same. Demanding patients. Patient complaints when they dont get what they want. Patient dissatisfaction if you dont do what they want even if you follow the guidelines. Hey all round the world patient is KING now. Spineless College (sinkieland calls it council), if patient complains and makes false accusations they will believe the patient.

Ok but that aside here are the big differences in Canada:

1) No talk about $$$$. One thing I hated in sinkieland is the $$$ talk. Especially as a private GP. You prescribe medication, the patient will ask how much? Then all the back and forth as to why you wont prescribe a better drug because they cant afford it. And also tests. HBA1c costs about $35 during my time. Patients wont pay for it. So not only do you have to convince the patient to have the test done, you have to convince them to PAY FOR IT. That's sinkieland. Not in Canada. Order the test and the province pays for it. Certain tests eg MRI are triaged by someone else eg radiologist. If they think it isn't necessary they will send you a letter saying so. Then just pass the blame to the radiologist. blood work? Just order. Of course only if the patient wants it. Many PRC patients take this as a buffet. But it is such a relief not to have the sell the monetary aspect of tests and medications. Oh with medications, I dont sell them. They go to the pharmacy to fill their prescriptions. So they haggle with the pharmacy.

2) You are paid for consultation and examination. Paid for the visit. No inventory to worry about (maybe just the drug samples which you can give out free to needy patients or patients you want to give them to). In Alberta a 15 min visit will pay $55.62. If you spend a total of 15 minutes total seeing the patient AND

Writing a referral letter.
Charting.
Reviewing the chart.
Reviewing but not waiting for lab/DI results.
Talking with and examining the patient.
Anything else the physician does in relation to the patient's care.

then you can add a modifier CMGP01 which will give you the $55.62. The base rate for as standard visit regardless of time is $38.03. So it isnt face to face time of 15 min.

So easily if you see 6 patients an hour (and spend some extra time doing your charting after hours) you will be making $300-$400 an hour.

There is also a code you can bill annually for a complete physical exam. Pays $104.60. Think of it as the fee for doing one of those health screening visits/packages in the private clinics and OPS in sinkieland.

3) Family Medicine is a true specialty. If you havent done family med residency you CANNOT be a family doctor. There are ENT surgeons who cannot get a job position at hospitals and CANNOT work as a family doctor and they also cannot get into fam med residency either. So you feel good man. Protected.

4) The only way a patient can see a specialist is if they got a referral letter from their family doctor. No such thing like sinkieland google and call to make appointment with specialist directly. Sorry.

5) Few clinics open at night. Hours are usually 8-5, sometimes less. I personally only work Tuesdays 9 to 5 and Wed to Fr 10-3

I made over 400k my first year and have been consistently pulling in 300-400k per year since. 4-5 day work week.

Life is good man. Weekends we go to the Rocky Mountains to hike, fish, kayak, ski

What made me want to migrate? Actually I got very disillusioned with sinkieland after my SAF MO days. The trigger though was SARS. I was an MO at SGH at the time. Team 1 with Chng Siew Ping and Alex Chao. We all know what happened. What maybe not everyone knows is that we did voice our concerns about how close the TTSH transfer patients were put next to normal wards. I remember Dennis Lim told us at the meeting with Minister and CMB they told everyone this "There are not enough N95 masks to go around. You wear one, then the nurses will wear. Then the clerk will want one. Then the porter. Then the cleaner."

In the end Alex paid with his life. Chng Siew Ping got full blown SARS. I was warded in the room next to hers at TTSH but I did not get SARS.

After that I made up my mind I was getting out of the **** hole (by the way I don't blame the PAP. It is the sinkies themselves. Sinkies are selfish, money minded, kiasi , kiasu, self righteous, maid dependent) I applied for PR 2004 and left my Surgical BST. Went out to be GP and learned a lot as well (that's another story)

I think these days the Provinces in Canada are quite open to Singapore doctors especially if you have completed MMed Fam Med. If you want to be a specialist here it is almost impossible. But family medicine is very do-able.

I'll just quote this poster in response to your question on Medicine in SG vs Canada

Originally Posted by Unregistered

I'll just quote this poster in response to your question on Medicine in SG vs Canada

That is one view. I find it hard to believe. Can share your own experience?

wtf why so many canada posts

Originally Posted by Unregistered

wtf why so many canada posts

To contrast life as a doctor in SG vs Canada