It's difficult to make a decision to go into private practice; leaving a salaried job for one where pay is not guaranteed is a huge leap. The pay-off includes greater flexibility and agency, but the uncertainty, especially for younger consultants, can be overwhelming. For the rest of us who continue in the public sector, there's a support group for that – it's called joining your friends for a beer at the pub. Dr Desmond Wai offers some important finance-related advice for doctors who are thinking of joining the private sector either as an employee or partner. I would also add that doctors should think about the factors that might push them back into the public sector: burnout, regulations, control by medical insurance companies, unhappy patients and possible isolation.
Speaking of isolation, it is an effective strategy in the fight against healthcare-associated transmission of infectious agents. Dr Wong Sin Yew and Dr Jean Sim remind us of the importance of standard precautions in the clinic, which include first- contact triage, strict hand hygiene, use of personal protective equipment, environmental cleaning, appropriate cleaning of equipment if they are not single-use, proper biohazard waste management, respiratory hygiene, and staph (oops, I mean staff) immunisation. From now on, it's gloves when giving sponge baths to the turkey or chicken roast (that is, marinating them).
Speaking of poultry, chickens are as loquacious as the local drunk, and just as incomprehensible. Yet, a machine-learning programme managed to understand the murmuring of sleep-deprived chickens and the rales of chickens suffering from heat stress.1 Imagine what doctors could do with artificial intelligence (AI) – Prof Henk Schmidt explores the possibilities and hurdles. AI could revive the art of medicine – relieving doctors from administrative tasks and giving us more time for patient care. I am looking forward to an AI system that can listen to a patient-doctor interaction and create a clinical note.
In this issue, there is some reminiscing going on - Dr Foo Gen Lin whose housemanship memories are jogged by magnificent sunrises and beautiful birdsongs; Dr Anantham Devanand about his first day on-call as a houseman; Dr Lee Pheng Soon about his 1982 to 1983 housemanship in Toa Payoh Hospital, Kandang Kerbau Hospital and Singapore General Hospital; Dr Ivan Low whose bad luck houseman calls were ameliorated by good nurses, caring colleagues and a responsive IT helpdesk; and Dr Sunder Balasubramaniam about exiting residency. Other doctors who have become new parents might wish to reminisce about the time when all they had to concentrate on was what went on at the workplace, where there was only one butt to wipe. While it is good to indulge and think about the past, medical students Jedd Chiaw and Caitlin Choo envision a future where education, understanding and respect will help to reduce the stigma of mental illness.
Elsewhere in this issue, Dr Tan Su-Ming apprises us of an amazing Amazon adventure, and Dr Tan Yia Swam takes a fourth dimension journey to write a letter to her younger self about starting housemanship.