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Today 12:11 AM
Unregistered It's about money, but during the interview stage who would say that they enter medicine for the money
Yesterday 06:43 PM
Unregistered
Quote:
Originally Posted by Unregistered View Post
and then how many specialist u meet are genuinely interested in their field ?
I meet many cardio and oncologist who are v money focused. same as opthamologist.
others choose a speciality based on prestige.
your Geri , gen med , renal doc more often than not after Im residency dunno what to apply, then ok let's put Geri as second choice as backup becuase dermatology I likely cannot get in anyway.
Psy trainees many many is I dun want be gp but I need a speciality.

I be frank la.
I choose FM because I don't like hospital calls. I like my pat to walk in to see me and walk out after seeing me. sometimes at work I dun feel respected by patient becuase I'm like a referralogist. come on la, mild acne u want derm referral? ok lo.
Its all about money.
Leave the real doctoring to the pple who want to doctor and earn less money.
Yesterday 09:27 AM
Unregistered
Quote:
Originally Posted by Unregistered View Post
How much of the GP/FM cohort actually made up of doctors who are genuinely interested in general practice and outpatient management of chronic diseases?

Most of the doctors I’ve met who have chosen such a route have done so not out of genuine interest (eg lifestyle, disenchAnted with hospital work, can’t get specialty training etc)
and then how many specialist u meet are genuinely interested in their field ?
I meet many cardio and oncologist who are v money focused. same as opthamologist.
others choose a speciality based on prestige.
your Geri , gen med , renal doc more often than not after Im residency dunno what to apply, then ok let's put Geri as second choice as backup becuase dermatology I likely cannot get in anyway.
Psy trainees many many is I dun want be gp but I need a speciality.

I be frank la.
I choose FM because I don't like hospital calls. I like my pat to walk in to see me and walk out after seeing me. sometimes at work I dun feel respected by patient becuase I'm like a referralogist. come on la, mild acne u want derm referral? ok lo.
Yesterday 01:25 AM
Unregistered How much of the GP/FM cohort actually made up of doctors who are genuinely interested in general practice and outpatient management of chronic diseases?

Most of the doctors I’ve met who have chosen such a route have done so not out of genuine interest (eg lifestyle, disenchAnted with hospital work, can’t get specialty training etc)
03-12-2021 11:18 PM
Unregistered
Quote:
Originally Posted by Unregistered View Post
there will be the hawker who become so good can guai lan and people will still come back for more. ideally become the cancer surgeon or that interventional radiologist, pple come to your for ur skill to remove the tumour, u how guai lan, they also lan lan. not happy bye lor, good luck with your cancer!

ahaha.
anyway. good news ey for fam med. next month likely to get in approval to be recognised as speciliast liao. yes, I. can set up my chain of family medicine specialis clinict and charge pple 100 bucks per visit. huat ah!
i confirm go the neighbouring GP for mc. spend $100 for ?? ideas concern and expectation???

or $12 ops good enough.


no lah. even surgeon in pte need to be polite. confirm got complication eventually one.
03-12-2021 10:11 PM
Unregistered SO, what are the admin jobs available? anyone knows
eg) pharma companies, what is the title to look for
03-12-2021 08:48 PM
Unregistered
Quote:
Originally Posted by Unregistered View Post
U guys are totally spot on.

To summarise

Kpi is clear crowd
If got benefit, ur own teamlet patient counsel more.
Documentation is key.
Do counsel for worse case scenario “ return advice given/go ed if condition worsen”

Ops principle is Same as hawker.
The best hawker isnt the one that use the best ingredients and serve the best dish
But some one who knows how to cook fast for the masses, use average ingredients and ensure no food poisoning, without causing long queues.

Hawker = cook fast, good enuff ingredients, avoid queue, no food poisoning
Ops = see fast, basic care, avoid queue, return advice
there will be the hawker who become so good can guai lan and people will still come back for more. ideally become the cancer surgeon or that interventional radiologist, pple come to your for ur skill to remove the tumour, u how guai lan, they also lan lan. not happy bye lor, good luck with your cancer!

ahaha.
anyway. good news ey for fam med. next month likely to get in approval to be recognised as speciliast liao. yes, I. can set up my chain of family medicine specialis clinict and charge pple 100 bucks per visit. huat ah!
03-12-2021 07:31 PM
Unregistered U guys are totally spot on.

To summarise

Kpi is clear crowd
If got benefit, ur own teamlet patient counsel more.
Documentation is key.
Do counsel for worse case scenario “ return advice given/go ed if condition worsen”

Ops principle is Same as hawker.
The best hawker isnt the one that use the best ingredients and serve the best dish
But some one who knows how to cook fast for the masses, use average ingredients and ensure no food poisoning, without causing long queues.

Hawker = cook fast, good enuff ingredients, avoid queue, no food poisoning
Ops = see fast, basic care, avoid queue, return advice
03-12-2021 05:27 PM
Unregistered
Quote:
Originally Posted by Unregistered View Post
You are hard to please. Probably think of yourself very highly best dr at OPS best HOD.
The OPS game is to meet the KPI for volume of patients. Clear the crowd more than contribute to crowd bottle neck. Patient in patient out faster than slower while staying out of trouble. No complaints. No medicolegal issues. If good get some complimentary letters.
As you should know information discrepancy very common. Patients dunno what is good medicine vs good PR skills butter up auntie uncle.

I have never heard of OPS dr get bonus cos he or she got the highest % of patients with HBA1c <7 or BP on target.

Case in point in the general pool, patients dont see back the SAME dr. Not allowed to choose even if they wanted. If want must go FP clinic pay more.
So as an MO in OPS you want that A grade play the game. And do some projects for the OPS. Research project etc.

Your ideals are well meaning and good. But the pragmatic reality is it doesnt pay lah.

Spending time and effort to counsel lifestyle mod? Dont waste time lah. Thankless work. And kena many many ignorant patient say and say till vomit blood nobody appreciates really.
you sound v jaded leh and yes I agree it doesn't pay. but ok la, hopefully I amass some good karma for my mother and my child. there are days I super Sian also don't want talk and there are days I want to quit too.
u are paid if KPI metrics for hba1c and BP is met. not a lot but can pay for annual car tax and a good staycation. at least for me la. I drive a 2.5l car btw.

u think it's thankless becuase , ahem, u dun know how to counsel. I agree some is hopeless gone case u don't need talk more but a lot will listen if u can speak their frequency

I actually do counsel the full range of stuff for osteoporosis before I start lei. u need skill to bring all the information across succinctly, but yes, including mechanism of action as well.
03-12-2021 01:27 PM
Unregistered
Quote:
Originally Posted by Unregistered View Post
But nowadays documentation more important than counselling.
E.g your chest pain guy, if you document "return advice/red flags given". You are safe even you didn't actually do it and pt dies.
Conversely, if you did tell him Abt the red flags/return advice but didn't document, he dies of mi, you can still be sued.

I just left the system but when I was mopexing in ops/Ed/im, my seniors/consultants always say documentation is king.
Osteoporosis counselling and bisphosphonate initiation when I was in gm, our documentation is 2 pages (talk Abt all risks, benefits, side effects, alternative, mechanism of action, follow up, failure of treatment etc) but the actual conversation with pt is less than 1 min ("we give you med to strengthen the bone ah, sometimes can cause stomach problem but will give you med also, don't worry")

. We can write so much simply because there is a smart text/template specially designed for such purposes (I guess is to protect us from lawsuits lol)

In Ed there is even a special tutorial for all mopex on "documentation to protect oneself as in what sort of thing we MUST write for certain presenting complaint, but no tutorial on comms skills lol.
Exactly. Documentation is king. If you document it is done. If not documented means not done. There is no video recording or audio recording (not allowed due to privacy issues).

Templates is the way to go. Nobody got time to spend 15 minutes talk to patient say many things then spend another 15 min writing long journal entry write like dear diary what the patient and I talked about like scribe. Btw nobody pays for all the time spent on documentation.
So have template. Standard all the things supposed to say all there. Never say also documented. Ass covered. Play the game. The practice is medicine is now dictated by what the lawyers say we should do.

All this stuff theough is never really taught in med school because it would be scandalous. All those idealistic academia are the worst. I pity young drs as they have to learn from their own mistakes and getting into trouble or see their colleagues get in trouble.

There is another pearl. A patient who is happy because you listened to him and did what he wanted he got what he wanted will never complain even if you never followed guidelines and what not. But a patient who is unhappy cos he didnt get what he want even if you follow guidelines CPG protocol whatever will complain and probably cook up things say you rude you arrogant you incompetent stupid etc. Complaint is always bad no matter even if you are right. No complaint is best. But everyone knows if the way you practice is all patient happy one and no complaint means you probably not following guidelines lah

Do be careful. Make sure what you do for patient to make them happy is not illegal. And also not one of those clear cut violate SMC rules one. Also dont cause harm to patient. Otherwise try to keep patients happy as a rule.
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