This column in the May 2020 edition marks the first time I write for SMA News as President of SMA. I am the first woman president of SMA, and I am acutely aware of the responsibilities, expectations and challenges. I am positive about the great potential I see, everywhere. Being elected to be SMA President is a privilege and an honour. I will do my utmost for doctors and for patients.
COVID-19: a time of change
This marks the fourth month that COVID-19 is present in Singapore. COVID-19 has impacted the world and brought unprecedented changes to our lives. International travel came to a halt; there's confusion, worry, and fear over falling sick and dying. Struggles over resources threaten healthcare in every country – personal protective devices, ventilators and healthcare workers. The World Food Project warns of famine in some countries. Economies move into recession. Harder times are coming. We see a surge in the abuse of social media: fake news, keyboard warriors and armchair experts are everywhere. Some countries have increased incidents of racism. The COVID-19 pandemic is a threat to us all: to life and personal safety, to livelihoods in all walks of life.
But, not all is lost.
There is much greater connectivity today. Colleagues reach out across continents to share scientific information and updates, to better enable each other to heal their patients. Friends continue to catch up remotely. In Singapore, we see people setting up groups to help those in need. We have so many volunteer groups springing up everywhere.
In our own profession, Facebook, WhatsApp and Telegram chat groups have allowed doctors (especially those in private practice) to keep in touch. Hardworking moderators have managed the groups – to allow for fruitful discussion, sharing of good information, some humour to de-stress and the occasional venting. This level of support is amazing.
I have made many new friends in these groups, and we have shared anecdotes, complained together and reassured each other. I was especially touched by the individuals who reached out to me privately to offer personal assistance, and to volunteer for the various small projects I wanted to start. Funnily enough, I realise that we have never met in person, nor even video-chatted yet. If the profile photo is a childhood photo, or covered in personal protective equipment (PPE), or of a pet, I don't even have a face that I can visualise. In fact, if your name is a nickname or initials, I'm sorry, you'll always be "FluffyBunny92" in my mind. (This is a fictional example. Any coincidence to anyone alive/dead is sheer coincidence!)
Thank you all, for your friendship. I am very glad to know you. I look forward to meeting you in person one day, soon.
SMA now: current changes
There are changes within SMA. The Council has been planning to take SMA up yet another notch, to keep abreast with changes in the way we practise medicine. Broadly, I see three key areas:
- Changes in medical advances
How can any doctor know the whole breadth and depth of all the different specialties? As training programmes change, and residency has a shorter training time compared to the old basic specialty training/advanced specialty training system, how do we better prepare our young doctors? How do we better utilise telemedicine? How do we integrate artificial intelligence into our future practice safely and meaningfully? The SMA Doctors-in-Training Committee and Telemedicine Workgroup serve to provide some guidance on these matters.
- Changing medico-legal landscape
Medical practice is getting more complex. Treatment options are more varied. Patients have more access to information, whether or not the information is accurate or appropriate. A lot more communication is needed to address a patient's concerns and deliver satisfactory care. Doing the right thing may not be enough anymore. We have to do the right thing, the right way. The SMA Centre for Medical Ethics and Professionalism is further developing new modules to augment the programmes that individual residency programmes provide. Some of these will be suitable, even essential, for doctors who are many years past graduation to be up-to-date with changes in medical law, in applications of the Singapore Medical Council Ethical Code and Ethical Guidelines.
- Changes in people
We have four Council doctors who have stepped down, and four new doctors who have come forth to serve on the SMA Council. The current Chief Administrator who has been with us for a decade, has decided to change his area of work. The SMA Secretariat has had many more people joining to better serve our Members. I am actively looking out for more doctor volunteers to join our various committees.
Giving thanks
I want to register my thanks to Dr Noorul Fatha As'art; immediate past President, Dr Lee Yik Voon; and past Presidents Dr Chong Yeh Woei and A/Prof Chin Jing Jih for their years of service and leadership on the SMA Council. Special thanks and gratitude to Mr Martin Ho, Chief Administrator of the SMA Secretariat for the past ten years. He has brought structure and improved the workflow of the organisation – and this provides a solid foundation for the changes I hope to bring about.
I want to thank the many friends and colleagues who have shared your struggles with me. I hear you; I feel for you. Wherever you are.
Solo GPs trying to keep your practice going...
Locum doctors wondering about PPE support, locum slots...
Sandwich generation having to look after young and old...
Junior doctors in restructured hospitals following rosters and leave restrictions...
Senior doctors being burdened by tough decisions...
I know how frustrating it is. I feel your resentment. I feel the hopelessness. And yet –
Whatever we do, whether in word or deed, let us do it for the right reason and give thanks.
We were called to this profession. It is hard, it has always been hard. The personal sacrifices we had to make, and will continue to be asked to make. You are not alone. Far from it. These are difficult and challenging times for everyone. Let's keep our eyes and heart focused on WHY we are doing this.
SMA future: being female, being "young" (relatively)
I've been fascinated by research articles on the strengths and weaknesses of female leadership. People's perception of my relative youth is a double-edged sword.
I used to always think of myself as a young doctor. I joined Council at age 26. I'm not 26 anymore. While some doctors (ahem, you know who you are) still call me "xiao mei mei" (translate: little girl), I have now crossed over to an age where some other xiao mei mei will say, "you were my tutor when I was in M3". And of course, she's not a little girl either, she is a consultant!
The age divide is real. Young people think that the old are slow and unchanging. The old think that the young are hasty and fickle. The "strawberries" are pampered. The "boomers" are over the hill.
We should not and must not subscribe to the same biases.
I respect and honour the seniors who have taught me so much, and done so much for our profession. I will heed your words.
As for the doctors younger than me and the medical students whom I have interacted with, thank you for trusting me, and sharing your passionate hopes and dreams.
So what lies ahead?
The SMA serves as a rallying point for all doctors, and maybe even all healthcare workers. With these many ongoing changes, there are great opportunities for growth. I ask for your support. Join the SMA, and join me in performing more works of service.
"I alone cannot change the world, but I can cast a stone across the waters to create many ripples." – Unknown