How is life as a doctor in Singapore?

Originally Posted by Unregistered

hi wall of text,
so what are u doing ah

I decided to venture into some healthcare business consulting and set up a business.

Dr pay is quite high.

$5k whereas most degree holder start at $4k.
They shld be appreciative

Originally Posted by Unregistered

Wait wait wait what is IV biphosphanates. Are you sure you're a doctor? You're talking about teriparatide or denosumab I presume? Teriparatide and denosumab is indeed better for patients, with better improvements in bone density and less hassle. Not cheap both for the clinic and the patient. Must compare apples to apples.

Bro….
R u some Junior HO or Baby MO?
Have you not heard of IV bisphosphonates??? Lol??
You haven’t heard of IV Zoledronic acid?

This is for the sotong who has never heard of IV bisphosphonates in his life:
s://.ace-hta.gov.sg/docs/default-source/acgs/supplementary-guide-on-available-treatment-options-(nov-2018)ecd01456d0bc4c3581d805b12a46c143.pdf

Pls read the Osteoporosis ACE guidelines

Originally Posted by Unregistered

Happens frequently in private.
GPs and specialists over charging or choosing more expensive treatments to line their wallets.
Just saw another patient yesterday who was following up with a specialist (not Ortho / endocrine) for an unrelated issue, who has been on IV bisphosphonates costing 1000+ dollars a year, and she had no idea there was an oral alternative which prolly cost 10% of the cost. And she has no contraindication to oral bisphosphonates.

Another patient I had was given a customised combination steroid / moisturizer / antibiotic cream from private derm which was $300+, when the same individual creams can prolly be bought at $50 tops.

Most of the time it’s willing buyer, willing seller.
But the problem is that many patients are not even made aware of the alternatives.

What about this dr who accuses specialists of profiteering giving IV bisphosphonatez? Sotong or satki?

Originally Posted by Unregistered

What about this dr who accuses specialists of profiteering giving IV bisphosphonatez? Sotong or satki?

Patient with osteoporosis do you offer an old auntie IV bisphosphonates straight up or discuss management options like PO bisphosphonates costing 10% of the cost?
The poor auntie didn’t even know what the medicine is for until I explained it to her.

Originally Posted by Unregistered

Patient with osteoporosis do you offer an old auntie IV bisphosphonates straight up or discuss management options like PO bisphosphonates costing 10% of the cost?
The poor auntie didn’t even know what the medicine is for until I explained it to her.

maybe she has IDA/gerd/gastritis? so cannot take oral bisphosphonates have to use IV

Originally Posted by Unregistered

Patient with osteoporosis do you offer an old auntie IV bisphosphonates straight up or discuss management options like PO bisphosphonates costing 10% of the cost?
The poor auntie didn’t even know what the medicine is for until I explained it to her.

Clear problem of conflict of interest because Drs can profit from actual sale and dispensing of the medication they prescribe.
Polyclinic drs see poor patients. But not all patients are poor. I agree drs shouldnt take advantage of ignorant patients. But would you have looked at it differently if "poor auntie" was instead some rich tai tai?
I think both ways it is wrong.
Question why is a "poor auntie" going to expensive pte specialist for treatment?
It is like accusing expensive high end restaurants of overcharging for crab steak lobster.
Poor auntie should not go to high end specialist clinics and expect cheap treatment.
But overall should ban drs from profiteering from prescribing and dispensing medicines

Originally Posted by Unregistered

maybe she has IDA/gerd/gastritis? so cannot take oral bisphosphonates have to use IV

Erm, I did mention she did not have contraindications to PO bisphosphonates.

If y’all see enough patients, there is a lot of information asymmetry out there.
You will see even poor patients going to private specialists simply because they do not know any better.
Some think only certain meds can be found at certain specialists, or wrongly assume that there’s only one management option available.

Of course it’s not in the private doctor’s interest to right site the patient because it is not in his own interest.

Originally Posted by Unregistered

Erm, I did mention she did not have contraindications to PO bisphosphonates.

If y’all see enough patients, there is a lot of information asymmetry out there.
You will see even poor patients going to private specialists simply because they do not know any better.
Some think only certain meds can be found at certain specialists, or wrongly assume that there’s only one management option available.

Of course it’s not in the private doctor’s interest to right site the patient because it is not in his own interest.

Your logic is absurd when you are applying it to businesses.

It is akin to saying the BMW sales people should explain to customers that there really isn't all that much difference between a BMW and a Lexus.

Or expecting the Apple Store to tell people they JUDGE to be poor to go buy Xiaomi phones instead.

You might be surprised that some of these "poor aunties" you speak of could be quite financially well off.

Leave the subsidies and determination of whether a patient meets criteria as needy to the social worker and the finance people.

The other option is to nationalize healthcare. All healthcare falls under MOH then.