How is life as a doctor in Singapore?

Originally Posted by Unregistered

Hi! Thanks for the insight. Can you also explain the difference between surgeon and proceduralists?

Roles are slightly different. Cardio and Gastro physicians undergo training in the real of internal medicine before specialising in their respective procedural-based specialities (stenting, scoping, EP). So they have the capacity and the skill set to manage common conditions that a surgeon would be very rusty at practicing (since they dedicate so many hours to surgical training and don't have the official internal medicine training). however surgeons can be good at internal medicine, especially the bright ones (like A.Kow).

However this does make a difference especially in private practice. For example, a cardiologist can manage hypertension, HLD, basic diabetes and so can a gastroenterologist. They essentially are more confident in GP work. So the base revenue of a private clinic would be clinical practice, anything on top of that like scoping, stenting, are bonuses. (esp. for stenting, most are non-emergency)

But for surgeons they have much fewer "clinical" patients and much lesser "GP" work. Of course there are those specialties like ENT, Plastics that have a "clinical" side to it- ENT has management of common ENT conditions like OSA, AR, and OM and a whole lot of nasoendoscopes, and plastics has the 'aesthetics' side to it.

Originally Posted by Unregistered

Nitrates are a concern for patients taking PDE2 inhibitors. Hypotensive crisis. As it is I dont see many drs warning their patients about informing the A&E dr or paramedics about recent use of PDE2 inhibitor in the event they suffer a heart attack and are brought into hospital for treatment. How many Drs do that? Onus is on the A&E dr to ask before giving nitrates.
These things can be put on the product information or the box labels. Not a big problem. Same with other medications with potential drug interactions.
Another one would be Tamsulosin causing mydriasis and leading to Floppy Iris Syndrome after cataract surgery. How many drs discuss this with their elderly male patients with BPH going for cataract surgery?
I would argue that putting information out there to empower patients is more important because many drs do not know enough. It is not entirely the Drs fault because the breadth of knowledge is just too huge for one person to cover much less go in depth.
Whereas with patients they will google everything about ONE condition or ONE medication because it is relevant to them.

I used to think like you until I realised how important and difficult improving my clinical acumen was. Way less straightforward than you think.

Originally Posted by Unregistered

Roles are slightly different. Cardio and Gastro physicians undergo training in the real of internal medicine before specialising in their respective procedural-based specialities (stenting, scoping, EP). So they have the capacity and the skill set to manage common conditions that a surgeon would be very rusty at practicing (since they dedicate so many hours to surgical training and don't have the official internal medicine training). however surgeons can be good at internal medicine, especially the bright ones (like A.Kow).

However this does make a difference especially in private practice. For example, a cardiologist can manage hypertension, HLD, basic diabetes and so can a gastroenterologist. They essentially are more confident in GP work. So the base revenue of a private clinic would be clinical practice, anything on top of that like scoping, stenting, are bonuses. (esp. for stenting, most are non-emergency)

But for surgeons they have much fewer "clinical" patients and much lesser "GP" work. Of course there are those specialties like ENT, Plastics that have a "clinical" side to it- ENT has management of common ENT conditions like OSA, AR, and OM and a whole lot of nasoendoscopes, and plastics has the 'aesthetics' side to it.

Thanks for the clarification. Can i enquire, what about specialist intensive care. How does it work for them? How does it work for ICU doctors in private practice. I understand that ICU doctors can come from respiratory medicine, anaesthesia and internal medicne.

Originally Posted by Unregistered

I used to think like you until I realised how important and difficult improving my clinical acumen was. Way less straightforward than you think.

The money in medicine is not in diagnosis and clinical acumen unfortunately. You should know. Drs aren't really paid to think. It is all volume based. Best to find high volume of high paying work that is brainless and low risk. Or a variation of those 4 factors.

Originally Posted by Unregistered

Why is a dumb idea? I supposed the OP always wanted to be gp and not specialist (i.e he not giving up his ambition)
I think this is a good loophole to exploit..

He's dumb for assuming that this is something novel or something that other people haven't tried before.

://mothership.sg/2018/10/tax-avoidance-medical-practioners/

://.straitstimes.com/singapore/iras-recovers-10m-from-high-earning-tax-avoiders-doctors-lawyers-property-agents

Originally Posted by Unregistered

The money in medicine is not in diagnosis and clinical acumen unfortunately. You should know. Drs aren't really paid to think. It is all volume based. Best to find high volume of high paying work that is brainless and low risk. Or a variation of those 4 factors.

Absolutely
This person who is commenting is a real doctor.
High volume high paying that is brainless and low risk.
Not low volume, low paying that requires alot of brain power and high risk
Any example?

Originally Posted by Unregistered

Absolutely
This person who is commenting is a real doctor.
High volume high paying that is brainless and low risk.
Not low volume, low paying that requires alot of brain power and high risk
Any example?

Eg of the former category would be cataract surgery lasik surgery and health screening clinics
Of course the eye stuff pays much more and has more risk

Ortho work too. Like TKR THR.

Originally Posted by Unregistered

Eg of the former category would be cataract surgery lasik surgery and health screening clinics
Of course the eye stuff pays much more and has more risk

Ortho work too. Like TKR THR.

there are diff kind of risk

tkr really isn't a a low risk procedure.
u havent meet chronically infected tkr coming back to hunt u for 10 years.

cardiac surgery is high risk but patient Die, that's it.
patient seldom sue becuase they know going in is high risk.
those who live grateful to you forever.



u know what is high volume, high pay and brainless?
sell cough mixture or sleeping tablets
only problem is MOH keeping an eye on you. your soap notes better write Sui sui

Hi! Can someone shed some light about the salary/income as a specialist in private practice? I heard of a private practice specialist (age 60+) with 150mil net worth which is totally mindblowing...

Do you guys select a specialty based on the ability to make good money? That is if you guys even specialise at all (perhaps you may think starting own chain of clinic can make even more)..

Thanks in advance!

Originally Posted by Unregistered

Hi! Can someone shed some light about the salary/income as a specialist in private practice? I heard of a private practice specialist (age 60+) with 150mil net worth which is totally mindblowing...

Do you guys select a specialty based on the ability to make good money? That is if you guys even specialise at all (perhaps you may think starting own chain of clinic can make even more)..

Thanks in advance!

I think those are the older days
I dont think the newer boys will make that much
I will suggest that to go down the GP route.