February, the month to celebrate Valentine’s Day (or Friendship Day) and the Lunar New Year always reminds me that it is a good time to be thankful for our loved ones, both friends and family!
Invaluable support from “family”
“Good friends are like stars. You don’t always see them, but you know they are always there.”
The past year has brought about much personal and professional growth. My private practice has somewhat stabilised into a comfortable pace, with an invaluable network of like-minded colleagues. I have also learnt the importance of having good support – a kind word, a thoughtful text, and help given when asked (and when not asked!). Meeting new friends and colleagues with similar values, and working to achieve a greater good together have also been encouraging.
However, the year has also exposed me to a new kind of problem. It was brought to my attention that there were insidious and potentially libellous comments from anonymous people or acquaintances on social media. It was something I had not encountered before. Moreover, such actions are foreign to my nature – I believe that criticism and feedback should be above board, and honest. If one should have a problem with me, tell it to my face. Planting seeds of discord and mistrust on social media is a cowardly and underhanded way to engage. And this is when I have to rely on my friends to have my back – to inform me of such situations, or to speak up for the truth on those platforms.
It is also in such situations that I feel the warmth of “familial” support best. For professional matters, fellow colleagues provided that support. In advocacy matters, the SMA Council is just like my other family. Everyone who has been on the council, especially past Presidents, understands the stress and scrutiny involved. Despite the sacrifices in giving up personal and family time, we keep on going because we believe in the cause of SMA – “For Doctors, For Patients”.
Part of a greater whole
“I destroy my enemies by making them my friends.”
This is an old saying which has been attributed to many historical people in the past. It is also one of my best friend’s favourite quotes. I laughed when I first heard it from him, because it reminded me of Sheldon from The Big Bang Theory. Over the years however, I have come to appreciate it more and more.
Have you ever encountered a situation where you and your colleague had differing opinions on what should be done for your mutual patient? I recall several such scenarios when I was doing my general surgery training. It could be with an intensivist, a fellow surgeon, an oncologist, or anyone else. Yet, above it all, we all had the patient’s best interests at heart. There were no wrong sides. There were no enemies. We hold a multi-disciplinary discussion, weigh in on the pros and cons, and present our considered options to the patient and his family – we have thus done our best, and the right thing.
In my work with the SMA, I sometimes see similar tensions playing out at various meetings as there are bound to be differing opinions and approaches on tackling issues that concern the profession; and it does not help that many of these issues are not straightforward.
Indeed, it’s incredible how complex our local healthcare system is. Think about it. Starting from the selection of medical students, to housemanship, advanced specialist training and consultancy opportunities, there are multiple hoops which doctors have to jump through, each with its challenges. For those who go into private practice, there are considerations on how to run a viable and ethical business, the costs, charges and taxes. With the latest medico-legal changes, there is a need to keep pace with the wide spectrum of patient needs and wants. Rapid
advances in technology also require us to consider benefits of online platforms versus security risks.
Aside from these, public education, prevention and screening are also important components. What is the role of complementary medicine? And what about alternative medicine? There is also healthcare economics to consider: MediShield, Community Health Assist Scheme, how exactly do subsidies work? What are Integrated Shield Plans? How about all the nursing, paramedical and allied health professionals who also make up the system? Not forgetting ambulance services, nursing homes, hospices, home care teams, pharmaceutical companies, medical
record services, couriers, laboratories, kitchen, cleaning, building maintenance, and the list goes on.
As doctors, we have to realise this: although we are the “prominent” face of healthcare, all the above are also
essential components of the healthcare system. Just as we cannot treat a single organ in isolation and should
manage the patient as a whole, I urge everyone to think of global solutions to healthcare problems.
Continued journey ahead
To have effective change, the various stakeholders have to be willing to communicate – exchange feedback, criticisms and ideas openly – and work together. One such example in the works is the collaboration between Academy of Medicine, Singapore (AMS), Life Insurance Association and SMA, with support from the Ministry of Health, in the review of Integrated Shield Plans. Several meetings have been held in the past year, riding on the earlier work of the Health Insurance Task Force set up in 2016 and its recommendations (https://bit.ly/2G8GYWP). Such a massive undertaking may be months in the making, and the professional bodies shall update our members when ready. I can already foresee that there is no way to please everyone, but I remain hopeful that there will be a mutual understanding from all parties, with changes that will better serve the people of Singapore.
In the meantime, please keep yourself abreast of the healthcare landscape, including changes to the Medical
Registration Act and the Singapore Medical Council (SMC) disciplinary process. Take part in the forthcoming
online feedback on SMC Ethical Codes and Ethical Guidelines and sign up for relevant courses by the SMA Centre for Medical Ethics and Professionalism. And if you face issues in your clinical practice that need to be looked into, reach out to us via sma@sma.org.sg.
“I may not always be there with you, but I will always be there for you.”
As much as I enjoy making new friends, there is distinct pleasure in reaching out to old friends and acquaintances – people whom I find inspiring, and whom I really enjoy spending time with! Even a small random text (or meme or funny GIF) to touch base again renews the friendship. Disclaimer: just because you have not received a text from me personally, does not mean that I’ve “unfriended” you, okay?
As I take on the additional role of a Nominated Member of Parliament for the next two-and-a-half years, I admit
that I am concerned if it’ll be too much to handle! However, I must register my thanks to the doctors in the SMA Council, the AMS leadership, and the staff of both professional bodies (especially Mr Lee Sze Yong, Ms Krysania Tan and Mr Roland Lim) for their support. I’ll do my best to continue representing doctors and patients on this platform.
My friends, we all have our own lives to lead, and the daily bustle may make us drift apart. But if ever help is needed, get in touch and I’ll do my best. Let us all nurture and support each other, to be the best we can be.
Illustration: Dr Justinian Zai