A few months ago, I received a hand-written card from the son of my long-time patient, Mr C. He thanked me for caring for his father over the years. The last few years were difficult, as Mr C became increasingly frail with multiple chronic conditions. Together, we managed to keep most of his care within the polyclinic, reducing repeated hospital visits and minimising stress for the family. This simple gesture encapsulated what family medicine (FM) is truly about: the privilege of journeying alongside patients through life's complexities.
To me, the relationship with the patient is at the core of FM. Relationship- based care anchors care within NHG Polyclinics, with its teamlet care model encompassing trust, continuity and holistic support for the patient. It is this alignment with my personal values and conviction that motivated me to serve in public primary healthcare, joining NHG Polyclinics as a young medical officer in year 2000.
When I first chose FM as my career path nearly 25 years ago, I remember the raised eyebrows. "You're not specialising?" friends asked with genuine surprise. Yet I never saw it as a lesser choice. What drew me to FM was the aspect of humanity it offered – the privilege of caring for patients and their families, building trust over time through life's ups and downs.
The strategic imperative
Primary care forms the cornerstone of Singapore's healthcare system. With our rapidly ageing population, we are faced with a corresponding increase in healthcare demand and multi-morbidity. By 2026, Singapore will become a super- aged nation. This demographic reality has driven strategic shifts towards strengthening primary care, emphasising preventive care and anchoring treatment in the community. Our goal is clear: enable our seniors to remain active and independent for as long as possible, visiting hospitals only when necessary.
FM has always responded to the healthcare needs of our society. Today, as we see our healthcare landscape move to one that caters to a super-aged society challenged with ageing, frailty and end-of-life care needs, FM is ready to respond.
The Ministry of Health's formal recognition of FM as Singapore's 36th specialty with effect from 1 November 2025 reflects both the rising importance and proven impact of FM. This recognition acknowledges what we have long known – that family physicians with advanced training possess both the breadth to manage diverse clinical conditions and the depth of expertise to care for patients with multiple medical conditions and complex needs.
The growth of FM in Singapore
Since the 1990s when the Master of Medicine (Family Medicine) and fellowship programmes were established, and 2011 when the FM residency programme began, generations of family physicians have been trained and equipped to care for patients with a wide spectrum of clinical conditions, multi-morbidity and complex needs. These family physicians combine clinical excellence with the relational skills essential for comprehensive patient care. We can all do our part to further the field of FM. In addition to my roles at NHG Health and NHG Polyclinics, I serve as adjunct associate professor at the NTU Lee Kong Chian School of Medicine, advocating for and mentoring the next generation of healthcare professionals in FM research and education.
FM leadership in transforming care
Our family physicians practise in the communities they serve. Enriched with this perspective, family physicians lead many of the advances to transform primary care, including areas of patient-centred care, evidence-based practice, quality of care, patient safety, competency-based training, clinical practice guidelines and research.
Clinical leadership in complex care
An ageing population presents increasingly complex care needs, including psychosocial challenges that require coordinated, multidisciplinary care. Family physicians serve as clinical leaders, managing complex problems while coordinating care across hospitals and community partners. In NHG Polyclinics, the teamlet care model – comprising family physicians, nurses and care coordinators – forms the foundation of comprehensive care. When needed, teamlets can also tap on our broader multidisciplinary team, including allied health professionals and care coaches. Similarly, through NHG Health's role as a regional health manager, we support more than 200 GP clinics in the Central-North Primary Care Network, connecting GPs with community health teams for enhanced multidisciplinary support.
Care consolidation and coordination
Patients benefit significantly from having one trusted doctor and/or team manage their conditions, which results in fewer hospital visits and reduced healthcare fragmentation. Family physicians can order hospital investigations and, through shared protocols, consolidate care pathways and continue managing patients within their clinics. This approach delivers care that is comprehensive, coordinated and accessible close to home for the patients.
Community connection and social prescribing
Family physicians also serve as vital connectors between clinical care and community resources. Through NHG Polyclinics' social prescribing initiatives like ENRICH (ENgaging and empoweRIng our Community for better Health), our care teams have linked patients with community support systems that address social determinants of health. This upstream approach recognises that health extends beyond clinical interventions to encompass social, economic and environmental factors that influence well-being. It also supports the national Age Well SG initiative to enable our seniors to age actively, stay socially connected and be cared for within their communities.
Preventive health advocacy
Family physicians are ideally placed to drive personalised preventive care initiatives. From health screening programmes to genomics-based family health assessments, family physicians are well-positioned to champion proactive health management. For vulnerable populations, programmes like NHG Polyclinics' EMBRACE+ (Enhanced Maternal Baby ToddleR And Child SurvEillance) provide targeted interventions for both mother and child. In NHG Polyclinics, family physicians lead proactive care for elderly patients through frailty and dementia screening, while integrating mental health support with accessible primary care. This aligns with the Healthier SG initiative, the national shift towards preventive care.
Innovation and evidence-based practice
Family physicians drive quality improvement through enhanced data utilisation, expanded primary care research, and educational innovation. NHG Polyclinics co-developed PRIME-CXR, an artificial-intelligence (AI)-powered chest X-ray (CXR) triage solution leveraging AI for prioritisation of CXR reporting. By leveraging advanced digital health technologies and remote monitoring capabilities, care delivery can be improved while maintaining the personal touch that defines FM.
FM in primary care: delivering value to the system
International evidence consistently demonstrates that health systems with robust primary care achieve better outcomes at lower costs, with less hospital burden and more integrated patient experiences. Health systems with a strong FM as the cornerstone of care delivery facilitate timely access to care and enable a wider range of services and treatments to be delivered in primary care, thus reducing hospital utilisation.
Capability building for the future
The recognition of FM as a specialty necessitates continued investment in capability building. Medical schools are already devoting increased time to FM education, while FM residency programmes will expand into advanced specialty training pathways.
Equally important is the strategic pivot towards funding models that support proactive, preventive care. Under capitation funding models, public healthcare clusters have strong incentives to invest in primary and preventive care, strengthening community-based services to maintain population health.
A personal reflection
When I first embarked on FM postgraduate training, I was drawn to its humanity-driven focus and breadth. Today, I remain proud to be a family physician. The formal recognition of FM as a specialty in 2025 demonstrates that family physicians play a pivotal role in the care of the population with increasingly complex health and social needs, and it affirms the importance of FM in both primary care and the Singapore healthcare system.
I encourage more doctors to pursue advanced FM training. As our population ages and health needs grow increasingly complex, family physicians are uniquely positioned to lead care transformation. We stand ready for this future – grounded in relationships, guided by evidence and inspired by purpose.
The handwritten card from Mr C's son reminds me daily why this recognition matters profoundly. It represents not just professional acknowledgement, but the validation of a care philosophy that places patients and families at the heart of our work. FM has always been about more than treating diseases – it is about caring for residents and their families in the communities we serve.
Acknowledgement
The author acknowledges the assistance of Pair, an AI assistant created by Open Government Products, in refining and editing this article.