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29-07-2020 12:54 AM
Unregistered Forget cost. Forget saving one's butt. Forget defensive medicine.

The most important is patient's safety and well being. What's best for the patient.

And if anyone scrimps on cost that will not go well in court.
29-07-2020 12:17 AM
Unregistered
Quote:
Originally Posted by Unregistered View Post
Didn't you also learn that anaphylaxis is a type 1 hypersensitivity, whereas systemic contact dermatitis / metal allergies is type 4 (delayed) hypersensitivity? You don't get respiratory symptoms with the latter...

Practising defensive medicine may save your butt, but it will not make you a good physician and you will end up ordering a lot of unnecessary tests and create waste in the system.
That's what they teach in medical school of course. And the administrators and politicians love to have cost savings.

But really there is no medal for saving cost.

And when it comes to a medicolegal case you are on your own.

Everything is fine until you face one.

Saving one's butt is important. If you don't believe me you can go ask Dr Lim Lian Arn.
28-07-2020 09:03 AM
Unregistered
Quote:
Originally Posted by Unregistered View Post
We all learnt this in medical school. There is no NEVER. MCQs correct? Always and never are no no words.

So even if it is very rare.......this could happen and it WILL bite you in the butt. Always assume the worst in medicine and you will be the safest doctor on earth.

If a patient dies of anaphylaxis and you used the phrase "but it is very rare" it will still not protect you much.
Didn't you also learn that anaphylaxis is a type 1 hypersensitivity, whereas systemic contact dermatitis / metal allergies is type 4 (delayed) hypersensitivity? You don't get respiratory symptoms with the latter...

Practising defensive medicine may save your butt, but it will not make you a good physician and you will end up ordering a lot of unnecessary tests and create waste in the system.
24-07-2020 11:36 PM
Unregistered
Quote:
Originally Posted by Unregistered View Post
What type of hypersensitivity and to which metal/alloy?

If it is allergic contact dermatitis, it does not usually cause any systemic/neurologic/respiratory symptoms. Nickel is the most common metal allergy, followed by chrome. In this case, from what you have described above, then I don't think you have anything to worry about from the medical point of view.

I doubt that this person has systemic contact dermatitis, which is very rare.
We all learnt this in medical school. There is no NEVER. MCQs correct? Always and never are no no words.

So even if it is very rare.......this could happen and it WILL bite you in the butt. Always assume the worst in medicine and you will be the safest doctor on earth.

If a patient dies of anaphylaxis and you used the phrase "but it is very rare" it will still not protect you much.
23-07-2020 08:12 AM
Unregistered
Quote:
Originally Posted by Unregistered View Post
Without divulging in explicit details.

The TLDR story: initial screen, patient claims to be hypersensitive to a certain alloy. Nothing shows up in the medical records, I scheduled the patient for referral nevertheless and sent him back to his unit. As much as I want to just Attn C the dude, there was no symptoms that warrants it.

Fast forward a couple hours, patient exhibits severe fibromyalgia during a certain military exercise.
What type of hypersensitivity and to which metal/alloy?

If it is allergic contact dermatitis, it does not usually cause any systemic/neurologic/respiratory symptoms. Nickel is the most common metal allergy, followed by chrome. In this case, from what you have described above, then I don't think you have anything to worry about from the medical point of view.

I doubt that this person has systemic contact dermatitis, which is very rare.
18-07-2020 05:00 AM
Unregistered
Quote:
Originally Posted by Unregistered View Post
oh yes, it just reminded me that when you come back from USA to Singapore, because you are young, it is likely that the SAF may call you up to do MOCC so you can convert to become a SAF MO.

So be prepared to do field training again. This time it is setting up BCS.
Maybe it is because I have not been back for reservist in a long while, but looking back, I actually kind of enjoyed my time in BMT and OCS.

I did not enjoy my time in unit though, since I had an incapable farmer as a supervisor that kept tekan-ing me for the sake of flexing.
18-07-2020 12:40 AM
Unregistered
Quote:
Originally Posted by Unregistered View Post
Omg I wish I could buy you a round for sharing this: "I not doctor I dunno. I let doctor make medical decisions"

Me and my batch mates from my MOCC all had this theory that non-regular MOs are cannon fodders whenever sh!t hits the fan. It always irks me how sometimes regulars who are not even medically-trained throw condescending remarks like "u last time study well doesn't mean u can disrupt my unit ops".
The safest are those guys in HQAMS and in staff non combat position where they dont see any patients at all. They will never get any complaints or medicolegal problems. The irony is also that these SAF MOs are the highest ranked as well. Proof that SAF value clinical work poorly.
17-07-2020 11:44 PM
Unregistered
Quote:
Originally Posted by Unregistered View Post
I responded to this, but for some reason it states that a moderator has to approve the post?
oh yes, it just reminded me that when you come back from USA to Singapore, because you are young, it is likely that the SAF may call you up to do MOCC so you can convert to become a SAF MO.

So be prepared to do field training again. This time it is setting up BCS.
17-07-2020 11:41 PM
Unregistered
Quote:
Originally Posted by Unregistered View Post
Omg I wish I could buy you a round for sharing this: "I not doctor I dunno. I let doctor make medical decisions"

Me and my batch mates from my MOCC all had this theory that non-regular MOs are cannon fodders whenever sh!t hits the fan. It always irks me how sometimes regulars who are not even medically-trained throw condescending remarks like "u last time study well doesn't mean u can disrupt my unit ops".
You are spot on!

The SAF is absolute rubbish. You should know by now. The exercises and what not is nothing for defending Singapore it is all for show so someone can get a good appraisal and promotion.

I don't know if you or your cohort have experienced things like this:

When I was MO I had a serviceman come in to see me. When I asked how I could help him he said he did not know. His encik told him to go see me. I called the encik and he said that this storeman is full of problems. AWOL. Lazy. Wont do work. He asked me to certify him unfit for storeman vocation so that he can post him out.

And all kinds of rubbish men are sent to the MO for. The MO is the "last line of defence" when it comes to people serving NS. There are literally thousands everyday trying to worm their way out of NS by saying they have some medical problem. Many are real. And many are also not real.

There is absolutely ZERO training in medical school all around the world to determine who is faking their illness. ZERO. We are all trained to listen to our patients and believe everything they say when we take history. Not suspect them of lying all the time.

But yet in the stupid SAF this is what the commanders expect MOs to do. Think of the men as liars. Cheaters. Geng.

I appeal to all SAF MOs currently serving and future, please be careful and do not fall for these tricks. It is smart that the SAF gets young inexperienced doctors for these roles. Because when you are about 5 to 10 years into practice you will have realized there is no one to protect you or back you when it comes to medicolegal mishap. You are on your own. And in medicine anything can happen. In a dangerous environment like training for war the risks are even greater. Protect your men your soldiers give them the ATT C you profession demands that you do.
17-07-2020 11:25 PM
Unregistered
Quote:
Originally Posted by Unregistered View Post
I think your complaint will be resolved with mediation.

No negligence that I can see.

You should be ok.

I was an SAF MO myself before. I did learn that there is no one who is going to support you at the SAF. All the commanders who keep saying training is important and all will say "I not doctor I dunno. I let doctor make medical decisions"

And as you know there are no definites in medicine. Better to err on side of caution and be an advocate for your patients.

While your army record may not be good and the commanders hate you it is only for 2 years.

Whereas if you were found negligent or a complaint goes to SMC it is FOREVER.


There is no medal for helping SAF conduct their training. Little gain everything to lose.
Omg I wish I could buy you a round for sharing this: "I not doctor I dunno. I let doctor make medical decisions"

Me and my batch mates from my MOCC all had this theory that non-regular MOs are cannon fodders whenever sh!t hits the fan. It always irks me how sometimes regulars who are not even medically-trained throw condescending remarks like "u last time study well doesn't mean u can disrupt my unit ops".
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