Digital adoption has taken a quantum leap in almost all facets of our lives, brought about by the pandemic. Without these technological advances, this past year under the shadow of COVID-19 would have been even more stressful.
Looking back, how fortunate are we to be able to order food and groceries online and have them delivered to us? My friends who are not in customer-facing roles were able to work from home during Singapore's circuit breaker and in the months after, instead of having to risk exposure during commutes. Students were able to continue some form of education online. Entertainment and emotional support continued through various forms of social media, online games, streaming of movies, etc.
Bettering healthcare through technology
In healthcare, webinars have helped us all to continue medical education, and even allowed for mass broadcast events like the telemedicine and COVID-19 vaccine webinars held jointly with the Ministry of Health (MOH) and professional bodies, each attended by almost 1,000 participants. In fact, the SMA held its very first virtual Annual General Meeting via Zoom in April 2020 and subsequently, monthly Council meetings have also been virtual. International meetings were possible with some accommodation for time zone differences. I found it really convenient and enriching, without the hassle of air travel. It is also environmentally friendly!1
With the aid of technology, the SMA Doctors-in-Training committee has also been able to connect with our student members from the National University of Singapore's Yong Loo Lin School of Medicine, Duke-NUS Medical School and Lee Kong Chian School of Medicine, as well as overseas universities. Close to 500 overseas medical students who came back to Singapore amid the pandemic are stranded here due to COVID-19, and have not been able to resume their clinical lessons. Informal support in the form of the various Telegram and WhatsApp groups flourished, with fast responses to queries and fairly quick rectifications of fake news.
Once again, I thank new friends made over the past year – even though I am busier and not able to be online as much now, I am warmed by your lovely messages.
A double-edged sword
Some hospitals and medical practitioners have implemented telemedicine effectively. Upgrading of electronic medical record systems are in the works, to better integrate technology in the delivery of treatments.
The portable ultrasound can serve as an extension of our hand and help to pick up abnormalities that fingers are not able to perceive. While some may lament the loss of clinical acumen, I would say that we should make use of technology as it becomes available, and use it to guide and augment clinical decision-making rather than replace clinical judgement. In my breast surgical practice, the bedside ultrasound is invaluable in differentiating a prominent ridge of lumpy breast tissue from a real lump, and in giving immediate confirmation of a suspicious solid lump versus a clearly benign simple cyst!
However, as with everything, technology has its downsides.
Cybersecurity is a real concern, with frequent reports of various database breaches and leaked personal data. We have to do our due diligence by keeping up to date with basic safety measures. These include using passwords of adequate complexity, changing them regularly, using different passwords for different systems, etc.2 The professionals will also need to do their part in ensuring that hardware and software are kept up to date to minimise risks.
The rise of electronic platforms offering “medical concierge” services, “free medical advice” and “convenient specialist consultations” have also been worrying. There is currently no regulation over such services. It cheapens the doctor-patient relationship, and lacks accountability. The SMA is in discussions with MOH regulatory services to better define the scope and boundaries, and see how best we can protect patients.3
Doing good by others
I spoke in Parliament about cyber-bullying, and it saddens me to see this happen to doctors. Personal posts are taken out of context and amplified, and anonymous emails are set up to criticise and insult with no accountability or personal responsibility. I am still studying to see how to protect myself and others from such attacks.4 I can only remind myself to think before I speak/type, and to simply be kind – to see things from the other person's point of view. I don't have to like or agree with them, but I don't have to put them down.
What does being professional mean? One should be consistent and competent, in work and in behaviour. One should be ethical and have a strong moral compass – be honest, honourable and reliable. Finally, one should support others. Be an enabler, to empower others to achieve more than what they can alone. Teaching and maintaining professionalism is a lifelong journey.
It has been a really difficult 15 months co-existing with COVID-19. Chronic stresses are building up, and I am aware that some doctors are facing financial difficulties. Some are not coping well emotionally. Some might have taken to potentially self-destructive habits. I urge everyone to stay united and to reach out to us at SMA (sma@sma.org.sg) for help when needed.
The SMA Council doctors are volunteers – though we might be slow in response, we hear you and we care. “Emerging Stronger, Together” is not just a fancy tagline. Let's actualise this!