It's Christmas time, there's no need to be afraid. At Christmas time, we let in light and we banish shade. It's the end of the year. So this is Christmas and what have you done? Another year over, and a new one just begun. Well, not yet. Not before we make our resolutions for 2019. It is a good thing to have a direction, be it having life goals, or a moral compass, or our Singapore Medical Council Ethical Code and Ethical Guidelines.
What would you like to see in the coming year? Let us gaze into the magical crystal ball.
A good future
Good succession planning is important so that there will be good doctors to look after us. Artificial intelligence (AI) will not do.
Our patients need a human touch, a caring face, a nod of approval, a smile of understanding and a twinkle in the eye.
During our many kopi sessions, my friends have often raised their worries on more than one occasion. One of their worries is who will take care of their medical illnesses when they grow old?
Will we be able to find a doctor that is very skilled in medicine, upright and ethical with the right ethos and compassion, and at the same time street-smart?
Zooming on to the subject of subsidies. We have first the Community Health Assist Scheme (CHAS), then Pioneer Generation Package, then Merdeka Generation Package and then CHAS for all citizens of Singapore.
Currently, we have blunt instruments; we need to tweak the current subsidies so that they can be used in the right way. These should be given to those who truly deserve it – not only those who are financially challenged, but also those whose disease burden is so great that they will need the additional funding.
I find that those who are truly in need often do not bargain or haggle. Those who do often include those who feel the pinch as they want to continue to smoke their packet of cigarettes and indulge in their nightly beer-drinking sessions with their buddies. Pouring subsidies to invoke a change in behaviour is the desired outcome instead of just a populist measure.
I have mentored medical students in their clinical groups and one common question that surfaces is how I met my wife. I am glad that they have such thoughts of wanting to build a career as medical doctors and also plan to start their families. The quota on female students has been lifted for years and that should encourage our students to start their families.
I believe that building up great caring holistic family units is only possible by setting good role models and providing quality upbringing of our children. Such closely knitted family units should aid the caring for the elderly for generations to come.
Government that takes care of its people big and small
The Regional Health System has been tasked to look after the people in their assigned sector. No longer do they only provide incidental care or chronic care, the restructured hospitals will track the healthcare journey of all their assigned citizens wherever they seek healthcare, be it at the GPs, outpatient services, private hospitals, community hospitals, etc, including foreign healthcare facilities.
On the road to achieving one family doctor for every citizen of Singapore, patients may be recruited or assigned to primary care doctors for better familiarity and continuity of care, instead of the current fragmented care of patients having several GPs and many subspecialists for different conditions (eg, one for skin, one for chest/cough and one specialist for each joint pain).
There are so many science fiction and science fantasy stories and movies, including one that I read many years ago – Isaac Asimov's Foundation series about psychohistorians who can predict the future and manage the future based on the learned historical response of the human mind.
Will the flavour of the season – AI with deep thoughts – be able to run our lives and predict the future? Will AI be what we think it will be like in the movies of the Terminator series, or will it be something else that we had never imagined it to be?
The National Electronic Health Record (NEHR) is a tool. Whether it is good or bad depends on how you use it and the powers to be implementing it. I believe that the NEHR will provide invaluable assistance in revealing the healthcare journey of our patients that will aid us in managing our patients better. We have conducted studies to generate valuable data to boost our feedback. Will the implementers get it right this time?
Back to basics
With all the enabling information technology, Internet of things and telemedicine, I still believe in the basics of everything. Be it medicine or human nature.
If you do not know by now, everything will have its glorious moment and timing is of utmost importance.
Do not rush and pressure ourselves too much. Some things cannot be rushed. Because when the time comes, when the stars are aligned, when the trajectory is correct, things will happen.
That does not mean that we should just sit and wait and not try at all. Master Yoda in Stars Wars once said, "Do. Or do not. There is no try".
But I say, "Keep on trying and you will get there one day."
In moving from healthcare to health, we need to focus on prevention.
So as the saying goes, "Prevention is better than cure".
It is about how we can give such preventive advice, make these measures palatable and inculcate habit-forming for the public at large.
I have been a gamer for ten to 20 years now. Gaming is part of my daily routine, with adjustments only when it comes to public holidays when I do not work.
I have a friend who does not play games but loves to travel. So I told him we can apply gamification to his interest in travels. With some explanations and after a short while, he understood the power of gamification.
Wishing all SMA Members (Ordinary, Honorary, Life, Spouse and Student) and friends of SMA, a very Happy New Year!
It is SMA's 60th Birthday next year, what would you like to see?
Note
- Song lyrics at the beginning of the article are from "Do They Know It's Christmas" by Band Aid and "Happy Xmas (War is Over)" by John Lennon.