How is life as a doctor in Singapore?

Originally Posted by Unregistered

you seemed to be extremely motivated by money.
Every post is about the low rate of return where doctors do things one to one.
Anyway, your perspective la.
Very funny, comparing CEOs or the mythical property agent who made millions.
Very easy to talk about them, to become one, you dunno the sweat they go through.
CEO 1 company only got 1. Takes luck, charm and capabilities to get there
Millionare property agent ? Haha, many scrapping by nia. Its a super low barrier of entry job. You really think every agent every month sell a few million dollar properties?

by and large the most bey gan of doctors who become GP is at least 12-15k. Steady job u can do until old, part time or take long break and come back.
Your CPA, CFA, software engineer or whatever you recommend might be scrapping by with a 3-4k salary if they are at the bottom of their food chain. Those making 8K usually middle management and stress as hell. Sell insurance you think so easy? Pilots ? not every makes captains hor. Some stay as senior first officer forever, plus the disruption to sleep cycle, radiation exposure u have to decide if worth it or not.

You probably think of doctors like GP as bey gan.

I think drs would disagree. They all high flyers in school. Not bey gan.

So if they had done something else maybe they will be somewhere.

There are many very successful finance pros that were medical school rejects. At that time so sad rhey didnt make it to medicine. But looking back say heng ar never necome doctor! And they tell kids study law economics finance. Not medicine anymore.

Now all the ones going go med school are the children of fhose bey gan parents. Still believe be doctor is good.
Sure la if you not very clever stidy very very hard get good results then get into med school wah so good.

Thise jin satki parents all laugh shake head.

Originally Posted by Unregistered

you seemed to be extremely motivated by money.
Every post is about the low rate of return where doctors do things one to one.
Anyway, your perspective la.
Very funny, comparing CEOs or the mythical property agent who made millions.
Very easy to talk about them, to become one, you dunno the sweat they go through.
CEO 1 company only got 1. Takes luck, charm and capabilities to get there
Millionare property agent ? Haha, many scrapping by nia. Its a super low barrier of entry job. You really think every agent every month sell a few million dollar properties?

by and large the most bey gan of doctors who become GP is at least 12-15k. Steady job u can do until old, part time or take long break and come back.
Your CPA, CFA, software engineer or whatever you recommend might be scrapping by with a 3-4k salary if they are at the bottom of their food chain. Those making 8K usually middle management and stress as hell. Sell insurance you think so easy? Pilots ? not every makes captains hor. Some stay as senior first officer forever, plus the disruption to sleep cycle, radiation exposure u have to decide if worth it or not.

Honestly what kind of doctors are these right. money minded only.
Back in the good old days its all about caring for patients
No wonder cant pass mmed/fcfps these days.

Originally Posted by Unregistered

Once u get invited means f reg coming
Congrats!

Anyone got called for pledge but subsequently submitted testimonial and got rejected?

Originally Posted by Unregistered

Honestly what kind of doctors are these right. money minded only.
Back in the good old days its all about caring for patients
No wonder cant pass mmed/fcfps these days.

Last time patients all just guai guai listen to dr. Parental medicine
Simpler less complicated less to know
Times change. People change.
Houses were less than 200k.

Hi guys, would like to hear the opinion of some of the seniors in this chat, particularly those involved in medicolegal work.

Is it true nowadays that what you document on the consult note or rounding note is actually more important than what you actually tell the patient?

A bit of context: currently a junior MO mopexing, currently rotating through surgical posting, also done medical last posting (still undecided on my career).

For example, nowadays, when we are asked to consent someone for a procedure (e.g tkr/wound debridement), our consent is 2 pages long, explaining all the risks, benefits, alternatives. It is easy as all these is templated. (I.e if you type .tkr and everything comes out). I can assure you that when we mos consent or even when the consultant themselves consent in clinic, not all the info is explained to the patient. Is it true that as long as we document, even if it is not said to the patient or the patient can't understand it's also ok if issues arise in the future?

I have highlighted to my consultant before, that for some of my patients (esp the older ones) they actually don't fully understand what I say, they have no known dementia, but can't really remember, retain and repeat the info that I have given them (which I believe it is part of determining mental capacity), but my consultant just say as I long as I document in detail (i.e the template with all the info) and patient sign the consent form then it is ok, don't worry.

Similarly, if pt refuse a particular investigation/specialist referral, we will also document a whole long essay about the potential serious things that can be missed, without actually telling the patient all these things (sometimes we just say a bit, but document a lot more). This is true for both surgical and medical postings; sometimes the reg/con themselves will actually even overwrite our note after rounds and add in even more stuff that we didn't really tell the pt, or stuff that I feel the pt don't really understand.
They will also sometimes change the wording/phrasing of our documentation, even though that is not what we said.
- A typical example will be, e.g the cxr for a old uncle shows a small lung nodule, we will physically tell the uncle, don't worry, the nodule is small, don't need CT, don't need investigate further.

However when we document, they will change it to "cxr shows lung nodule, discussed CT thorax for further evaluation, patient not keen, understand risks of missing malignancy. " ; Which is kind of not what we tell the patient?

I guess I am still very junior and will never understand the naunces of these kind of things. Just wondering if that is the way going forward, (i.e documentation more important than the actual communication), but I don't know, it just feels wierd that we are twisting our words and documenting things that are not really said or done...

Would appreciate genuine advice/opinion thanks

Originally Posted by Unregistered

Hi guys, would like to hear the opinion of some of the seniors in this chat, particularly those involved in medicolegal work.

Is it true nowadays that what you document on the consult note or rounding note is actually more important than what you actually tell the patient?

A bit of context: currently a junior MO mopexing, currently rotating through surgical posting, also done medical last posting (still undecided on my career).

For example, nowadays, when we are asked to consent someone for a procedure (e.g tkr/wound debridement), our consent is 2 pages long, explaining all the risks, benefits, alternatives. It is easy as all these is templated. (I.e if you type .tkr and everything comes out). I can assure you that when we mos consent or even when the consultant themselves consent in clinic, not all the info is explained to the patient. Is it true that as long as we document, even if it is not said to the patient or the patient can't understand it's also ok if issues arise in the future?

I have highlighted to my consultant before, that for some of my patients (esp the older ones) they actually don't fully understand what I say, they have no known dementia, but can't really remember, retain and repeat the info that I have given them (which I believe it is part of determining mental capacity), but my consultant just say as I long as I document in detail (i.e the template with all the info) and patient sign the consent form then it is ok, don't worry.

Similarly, if pt refuse a particular investigation/specialist referral, we will also document a whole long essay about the potential serious things that can be missed, without actually telling the patient all these things (sometimes we just say a bit, but document a lot more). This is true for both surgical and medical postings; sometimes the reg/con themselves will actually even overwrite our note after rounds and add in even more stuff that we didn't really tell the pt, or stuff that I feel the pt don't really understand.
They will also sometimes change the wording/phrasing of our documentation, even though that is not what we said.
- A typical example will be, e.g the cxr for a old uncle shows a small lung nodule, we will physically tell the uncle, don't worry, the nodule is small, don't need CT, don't need investigate further.

However when we document, they will change it to "cxr shows lung nodule, discussed CT thorax for further evaluation, patient not keen, understand risks of missing malignancy. " ; Which is kind of not what we tell the patient?

I guess I am still very junior and will never understand the naunces of these kind of things. Just wondering if that is the way going forward, (i.e documentation more important than the actual communication), but I don't know, it just feels wierd that we are twisting our words and documenting things that are not really said or done...

Would appreciate genuine advice/opinion thanks

please highlight this consultant to SMC and CMB
it is true that in the eyes of the law whatever we document goes because nobody else can verify what we say.
but obviously we should document and counsel with a clear conscience instead of just writing template consent for everyone

Originally Posted by Unregistered

Hi guys, would like to hear the opinion of some of the seniors in this chat, particularly those involved in medicolegal work.

Is it true nowadays that what you document on the consult note or rounding note is actually more important than what you actually tell the patient?

A bit of context: currently a junior MO mopexing, currently rotating through surgical posting, also done medical last posting (still undecided on my career).

For example, nowadays, when we are asked to consent someone for a procedure (e.g tkr/wound debridement), our consent is 2 pages long, explaining all the risks, benefits, alternatives. It is easy as all these is templated. (I.e if you type .tkr and everything comes out). I can assure you that when we mos consent or even when the consultant themselves consent in clinic, not all the info is explained to the patient. Is it true that as long as we document, even if it is not said to the patient or the patient can't understand it's also ok if issues arise in the future?

I have highlighted to my consultant before, that for some of my patients (esp the older ones) they actually don't fully understand what I say, they have no known dementia, but can't really remember, retain and repeat the info that I have given them (which I believe it is part of determining mental capacity), but my consultant just say as I long as I document in detail (i.e the template with all the info) and patient sign the consent form then it is ok, don't worry.

Similarly, if pt refuse a particular investigation/specialist referral, we will also document a whole long essay about the potential serious things that can be missed, without actually telling the patient all these things (sometimes we just say a bit, but document a lot more). This is true for both surgical and medical postings; sometimes the reg/con themselves will actually even overwrite our note after rounds and add in even more stuff that we didn't really tell the pt, or stuff that I feel the pt don't really understand.
They will also sometimes change the wording/phrasing of our documentation, even though that is not what we said.
- A typical example will be, e.g the cxr for a old uncle shows a small lung nodule, we will physically tell the uncle, don't worry, the nodule is small, don't need CT, don't need investigate further.

However when we document, they will change it to "cxr shows lung nodule, discussed CT thorax for further evaluation, patient not keen, understand risks of missing malignancy. " ; Which is kind of not what we tell the patient?

I guess I am still very junior and will never understand the naunces of these kind of things. Just wondering if that is the way going forward, (i.e documentation more important than the actual communication), but I don't know, it just feels wierd that we are twisting our words and documenting things that are not really said or done...

Would appreciate genuine advice/opinion thanks

cxr lung nodule. Must go for CT.

Ur con damn unethical, counsel don’t go for CT yet document ask patient go for CT?
I suppose this is a troll post or need to report to ur dept head


It is untrue what u document down means 100% safe.
In lawsuit, if what u document conflicts with what the plaintiff say, during cross examination they will ask.

Basically, their angle of attack is inadequate consent.

Originally Posted by Unregistered

Anyone got called for pledge but subsequently submitted testimonial and got rejected?

If the testimonial is bad, I guess it will be rejected

Originally Posted by Unregistered

cxr lung nodule. Must go for CT.

Ur con damn unethical, counsel don’t go for CT yet document ask patient go for CT?
I suppose this is a troll post or need to report to ur dept head


It is untrue what u document down means 100% safe.
In lawsuit, if what u document conflicts with what the plaintiff say, during cross examination they will ask.

Basically, their angle of attack is inadequate consent.

The cxr example quoted (not sure real or not) is a little extreme. But I do agree that patient may not always understand what we document down onto our consult note. Come on la, you think a 80 year old uncle will understand 2 pages worth of consent, all the risks and benefits and alternative available?

[QUOTE=Unregistered;228585]Hi guys, would like to hear the opinion of some of the seniors in this chat, particularly those involved in medicolegal work.

Is it true nowadays that what you document on the consult note or rounding note is actually more important than what you actually tell the patient?

A bit of context: currently a junior MO mopexing, currently rotating through surgical posting, also done medical last posting (still undecided on my career).

For example, nowadays, when we are asked to consent someone for a procedure (e.g tkr/wound debridement), our consent is 2 pages long, explaining all the risks, benefits, alternatives. It is easy as all these is templated. (I.e if you type .tkr and everything comes out). I can assure you that when we mos consent or even when the consultant themselves consent in clinic, not all the info is explained to the patient. Is it true that as long as we document, even if it is not said to the patient or the patient can't understand it's also ok if issues arise in the future?

I have highlighted to my consultant before, that for some of my patients (esp the older ones) they actually don't fully understand what I say, they have no known dementia, but can't really remember, retain and repeat the info that I have given them (which I believe it is part of determining mental capacity), but my consultant just say as I long as I document in detail (i.e the template with all the info) and patient sign the consent form then it is ok, don't worry.

Similarly, if pt refuse a particular investigation/specialist referral, we will also document a whole long essay about the potential serious things that can be missed, without actually telling the patient all these things (sometimes we just say a bit, but document a lot more). This is true for both surgical and medical postings; sometimes the reg/con themselves will actually even overwrite our note after rounds and add in even more stuff that we didn't really tell the pt, or stuff that I feel the pt don't really understand.
They will also sometimes change the wording/phrasing of our documentation, even though that is not what we said.
- A typical example will be, e.g the cxr for a old uncle shows a small lung nodule, we will physically tell the uncle, don't worry, the nodule is small, don't need CT, don't need investigate further.

However when we document, they will change it to "cxr shows lung nodule, discussed CT thorax for further evaluation, patient not keen, understand risks of missing malignancy. " ; Which is kind of not what we tell the patient?

I guess I am still very junior and will never understand the naunces of these kind of things. Just wondering if that is the way going forward, (i.e documentation more important than the actual communication), but I don't know, it just feels wierd that we are twisting our words and documenting things that are not really said or done...

Would appreciate genuine advice/opinion thanks[/QUOTE

Rule of thumb is if it isnt documented then it never happened. Not done. Nothing.

When it is documented then can argue if it was done etc

So it is better to over document than under.

They should just video record all encounters. Body cam. No need to write notes. Send the video to medical transcribers to create a typed written summary for easy reference for past notes.

This would save drs time plus have a 100% accurate record for medico legal purposes . Save on trial times who said he said she said. Save costs.