Polyclinic : Most God Damned excuse I Have ever heard!!!
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[quote]Originally posted by CM06:
[b]Actually one solution to alleviate the shortage is to bring in the nurses and/or pharmacists to be the front line of medical diagnostics. Most countries face a shortage of doctors hence the change of this system.[b]
Pharmacists at Guardian pharmacy etc are currently able to give medical advice and sell you medicine for minor ailments as they do in western countries. The reason why patients don't use them often is because they want MCs and the cost of medication is much higher at private pharmacises.
If doctors do not sell medication and all patients are required to get their drugs from the pharmacy, it will not affect doctors much but the adverse effect on patients will be great. GPs will still keep their fees at the current level but patients will have to pay more at the private pharmacies. On weekends and at night, patients may have to travel far to find a pharmacy that's open and complains will increase.
You have to think carefully about the implications. Unlike you, I am in the medical profession although I do not have a personal interest in this since I am not a GP.
One solution to the problem is to require patients to make appointments to see the doctor at polyclinic. Whether it is the UK or Australia, you have to make an appointment to see your doctor. Singapore has been too kind to patients to allow our patients to just walk in. As a result, the morning is overcrowded whilst the clinic is usually rather empty at about 2pm (I have worked in a polyclinc for a year and that's my experience). A strictly appointment system will regulate the patient load and allow the administration to deploy doctors more efficiently. If you want to just walk in to see a doctor, go to a private GP.
In addition, we can bring in more foreign doctors. They are cheap and can be sent back when we do not need them anymore. Patients complain about language problems in communication, perhaps more doctors from PRC will do. Their qualifications may not be recognized but they can handle minor medical conditions since many forumners think that nurses will do anyway. -
Just because you wait 3 hours the doctor must give you antibiotics? Why don't you wait 5 hours and ask for morphine?Originally posted by ShutterBug:Wait 3 hours, and then not prescribed Antibiotics for sore throat???
Bluddy hell! The gov might as well not bother with providing this kind of Half-assed Healthcare!!!!
Wake up your idea! Medicine is given based on your medical condition...this is a clinic, not a bloody grocery shop! Why should the doctor prescribe antibiotics for a viral pharyngitis? -
In all the top Universities, only the best students are accepted for Medicine and Law....that's a fact. The medical course is trying and we are focring students to acquire a lot of information within a short time (the medical course used to be a 6-year syllabus but has been reduced to 5 years by cutting out the long holidays other NUS students enjoy).Originally posted by BillyBong:There is a definite shortage of doctors in all areas of the govt service.
What could possibly be the reason for that? Perhaps the overly stringent requirements, coupled by multiple interviews and character assessment is beginning to show its limitations?
How many 'experts' sitting in front of the panel can truly assess whether an interviewee will indeed follow up on his/her promise and take the hypocritical oath with soleumn sincerity? What is the percentage of bond-breakers within the medical profession?
And for those that break bond, how many others are denied a place in their desired profession? It's a simple demand and supply. Singapore youths are not devoid of talent; it's merely the limitation of the system in place that denies them a chance.
The system must be tweaked to best meet the current constraints. We have people who join the medical industry because of peer pressure, because of parental pressure, because of namesake, because of string-pulling and because of behind-the-scene 'players' who dictate who gets the slots and who doesn't.
While i agree we need considerable character to meet the demands of being a doctor, shouldn't we also review the entry criteria for those aspiring to be doctors?
Not every problem has a solution but this one does. Why are the powers-that-be ignoring the obvious?
Selection of medical students may be flawed in some individual cases (selectors are only human...they cannot tell what the future is) but to suggest it is based on connections is ridiculous. Where's your evidence for that? I am the son of an uneducated vegetable seller who has nothing to donate to the powers that be... plenty of people like me who got through the selection. -
Why so defensive? Did i say people bribe their way into the medical profession? If so we have a serious problem.Originally posted by oxford mushroom:In all the top Universities, only the best students are accepted for Medicine and Law....that's a fact. The medical course is trying and we are focring students to acquire a lot of information within a short time (the medical course used to be a 6-year syllabus but has been reduced to 5 years by cutting out the long holidays other NUS students enjoy).
Selection of medical students may be flawed in some individual cases (selectors are only human...they cannot tell what the future is) but to suggest it is based on connections is ridiculous. Where's your evidence for that? I am the son of an uneducated vegetable seller who has nothing to donate to the powers that be... plenty of people like me who got through the selection.
I reiterate that the selection process is flawed. Yes, humans cannot necessary predict the future of potential hopefuls, nor can they assume that their candidate is the right person. But being human also means having the tendency to favour one over the other. We are still swayed by outward appearances, by the manner one presents themselves and many other factors which are intangible.
Why is the pool of entrants not expanded? Is that so hard or is the criteria unrealistically stringent?
In SG context, i'm fully aware that hopefuls require good grades. But i am also aware that many who are not straight 'As' also get in. That clearly indicates that your statement of only the best students are accepted for Medicine is completely unfounded: the BEST do not get in, and more often than not, the BEST do not want to join the medical industry.
So you are stuck with 2nd tier candidates. Should we strike them off too solely on account of grades?
As a doctor, you of all people know that passion and love for the work is what drives a doctor each day. For the hours worked and the treatment dished out by unreasonable patients, the pay is a pittance.
In that regard, grades alone do not define whether a person is ready to accept his/her role as a doctor. The pool of candidates should be enlarged to include such 2nd tier hopefuls. We already have a shortage; by fixing the number of candidates each year, we are only heaping enormous and unrealistic pressure on the existing talent, and doing nothing to solve the shortfall. -
Originally posted by BillyBong:
Every year there are about 100-200 places for medical students and each year we have more than that number of students with perfect scores (3 As for 3 A level subjects) applying to Medicine. NUS can easily take in all these top students, but instead it is the government's policy to spread talent beyond Medicine and Law, allowing deserving students with lower grades to enter, as long as they are judged to be able to complete the course. Your statements in this respect are self-contraditory: first saying that that the criteria are overly stringent and yet accepting that not all medical students have straight 'A's. The medical school takes in the best of each cohort, but not all these top students have straight 'A's, although they are close to it.
Why so defensive? Did i say people bribe their way into the medical profession? If so we have a serious problem.
I reiterate that the selection process is flawed. Yes, humans cannot necessary predict the future of potential hopefuls, nor can they assume that their candidate is the right person. But being human also means having the tendency to favour one over the other. We are still swayed by outward appearances, by the manner one presents themselves and many other factors which are intangible.
Why is the pool of entrants not expanded? Is that so hard or is the criteria unrealistically stringent?
In SG context, i'm fully aware that hopefuls require good grades. But i am also aware that many who are not straight 'As' also get in. That clearly indicates that your statement of [b]only the best students are accepted for Medicine is completely unfounded: the BEST do not get in, and more often than not, the BEST do not want to join the medical industry.
So you are stuck with 2nd tier candidates. Should we strike them off too solely on account of grades?
As a doctor, you of all people know that passion and love for the work is what drives a doctor each day. For the hours worked and the treatment dished out by unreasonable patients, the pay is a pittance.
In that regard, grades alone do not define whether a person is ready to accept his/her role as a doctor. The pool of candidates should be enlarged to include such 2nd tier hopefuls. We already have a shortage; by fixing the number of candidates each year, we are only heaping enormous and unrealistic pressure on the existing talent, and doing nothing to solve the shortfall. [/b]
We do not have a shortage of doctors. We have a shortage of doctors in the PUBLIC sector. The ratio of doctors to the population in Singapore compares very favourably with many western nations. The problem we have is that the private sector pays 3 times as much as the public sector and more. We have two-thirds of the doctors in Singapore serving one-third of the patients in the private sector, leaving public sector doctors with the bulk of the workload at less than half the pay.
The polyclinic charges are too low as it is. It is heavily subsidised and because it is cheap, attracts far too many patients. If a GP gets 50 patients a day, he will be grinning from ear to ear. Yet the polyclinic doctor gets paid less than half the GP's salary and sees 100 patients a day. Of course he is going to leave if he can...that's just human nature.
I can just see what the Minister is going to do next. He is not allowed to charge patients more and he cannot pay polyclinic doctors more. But he has to solve the problem of the long queues and the high patient:doctor ratio in polyclinics. He will introduce means testing to polyclinic services. Only the poor who cannot afford a private GP will be allowed to use polyclinic services at the subsidized rate. All other patients will be charged higher rates closer to average GP charges. This will push more patients to the private sector whilst not penalizing the poor. With fewer patients in the polyclinics, they will also lose less money. He will not have to increase charges to break even and he won't have to worry about doctors leaving the service everyday because they are overworked and underpaid.
The result of all this grumbling about long queues at polyclinics may be that the better off will no longer be able to access subsidized polyclinic services in future. -
One solution to the problem is to require patients to make appointments to see the doctor at polyclinic. Whether it is the UK or Australia, you have to make an appointment to see your doctor. Singapore has been too kind to patients to allow our patients to just walk in. As a result, the morning is overcrowded whilst the clinic is usually rather empty at about 2pm (I have worked in a polyclinc for a year and that's my experience). A strictly appointment system will regulate the patient load and allow the administration to deploy doctors more efficiently. If you want to just walk in to see a doctor, go to a private GP.
Ya, if i know i will be sick on that particular day then ^this would work. -
Lots of forumners want to emulate western nations....that's what people have to live with. Singaporeans complain about waiting 2 hours to see a doctor for a cold. In the UK, you may have to wait 2 days to see your GP. During the festive season, you may have to wait 2 weeks if he is away on holiday.Originally posted by Boy Stratus:Ya, if i know i will be sick on that particular day then ^this would work.
shen zai fu zhong bu zhi fu -
Means testing was a flop at the last election. While the MIW will not admit it, their suggestion and proposal to conduct means testing was shot to pieces by the WP. There was no basis to their formula and Khaw Boon Wan was shrewd enough to deflect further discussion on this topic by putting the whole idea on ice.Originally posted by oxford mushroom:Every year there are about 100-200 places for medical students and each year we have more than that number of students with perfect scores (3 As for 3 A level subjects) applying to Medicine. NUS can easily take in all these top students, but instead it is the government's policy to spread talent beyond Medicine and Law, allowing deserving students with lower grades to enter, as long as they are judged to be able to complete the course. Your statements in this respect are self-contraditory: first saying that that the criteria are overly stringent and yet accepting that not all medical students have straight 'A's. The medical school takes in the best of each cohort, but not all these top students have straight 'A's, although they are close to it.
We do not have a shortage of doctors. We have a shortage of doctors in the PUBLIC sector. The ratio of doctors to the population in Singapore compares very favourably with many western nations. The problem we have is that the private sector pays 3 times as much as the public sector and more. We have two-thirds of the doctors in Singapore serving one-third of the patients in the private sector, leaving public sector doctors with the bulk of the workload at less than half the pay.
The polyclinic charges are too low as it is. It is heavily subsidised and because it is cheap, attracts far too many patients. If a GP gets 50 patients a day, he will be grinning from ear to ear. Yet the polyclinic doctor gets paid less than half the GP's salary and sees 100 patients a day. Of course he is going to leave if he can...that's just human nature.
I can just see what the Minister is going to do next. He is not allowed to charge patients more and he cannot pay polyclinic doctors more. But he has to solve the problem of the long queues and the high patient:doctor ratio in polyclinics. He will introduce means testing to polyclinic services. Only the poor who cannot afford a private GP will be allowed to use polyclinic services at the subsidized rate. All other patients will be charged higher rates closer to average GP charges. This will push more patients to the private sector whilst not penalizing the poor. With fewer patients in the polyclinics, they will also lose less money. He will not have to increase charges to break even and he won't have to worry about doctors leaving the service everyday because they are overworked and underpaid.
The result of all this grumbling about long queues at polyclinics may be that the better off will no longer be able to access subsidized polyclinic services in future.
My earlier suggestion regarding 2nd tier students getting into doctoring was based on the fact that straight 'As' get knocked out at the interview phase while those with worse off grades get through because they can TALK. They can sell themselves and 'convince' the panel they deserve that slot.
The govt wants the best but are still selective about who they pick. So ultimately, the pool of talent is deliberately shrunk. Your claim that the govt is spreading the talent between law and medicine makes no sense. They have a glaring shortage of doctors, but they insist on fixing the intake.
If the system fails to entice existing doctors to stay after their 5-year bond, then why not expand the intake? This question has not been addressed. An increase in the initial intake will surely compensate the inevitable loss later. Yet the govt comtinues to ignore the obvious and maintains strict CONTROL on the barriers to entry. -
Actually, it's kind atrue leh. I went to Pasir Ris Clinic today for MC and the lao ah ma before me took 1 hr inside while I was in and out in 15 mins. IT's the age and diseases related to the age la.Originally posted by red_amoeba:its partially true. when this news came up at last night's news. I was amazed that they credited Pasir Ris polyclinic for their good work in "managing patients". Its total rubbish. The only reason is because of age and not due to their "management".
Firstly, Pasir Ris is a new town, the concentration of older folks are low and obviously the patients aren't going to comprise of old folks. Secondly when most of the younger folks fall ill, they will go company doctors, and not polyclinics. Hence the polyclinic naturally have lesser patients with long-term illness and not because they manage the patients, don't give wrong credit
And the report goes to say about 75% of the patients felt polyclinic gives value for money. Of course lah, when medical expenses is so high, polyclinic see doctor is still the only means to afford some medical attention. That simply mean, a common folk has no other choice but to go polyclinic because they are the cheapest compared to other medical alternatives, in absolute terms, they are not.
I really dun understand how they can claim credit like this...
I went at 12 plus for my queue and registration. The bloody registrar said the data was full and that i had to wait for 1 hr more before I could re queue for my turn to see doc. I dont think liddat management very gd lor. -
Basically, I see a lot of C&B stories being told over this entire issue, and a lot of political egos being thrown around by the MIW, but NO REAL improvements or solutions being produced by our ever-wise gov.
I guess for this matter as well, they have to wait till crap hits the fan before they pick up their asses and get real work done. -
waiting time depends on where you live in the UK. For central London, depending on where you live, it can be as quick as 30mins. NHS waiting time can be just as short. Somehow NHS seems to have more doctors in London.
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I think people should not box all doctors into their own ideal picture - in reality there are many different kinds of doctors. Any interview or selection process is flawed because people sitting on panels tend to choose the same kind of people.Originally posted by BillyBong:Means testing was a flop at the last election. While the MIW will not admit it, their suggestion and proposal to conduct means testing was shot to pieces by the WP. There was no basis to their formula and Khaw Boon Wan was shrewd enough to deflect further discussion on this topic by putting the whole idea on ice.
My earlier suggestion regarding 2nd tier students getting into doctoring was based on the fact that straight 'As' get knocked out at the interview phase while those with worse off grades get through because they can TALK. They can sell themselves and 'convince' the panel they deserve that slot.
The govt wants the best but are still selective about who they pick. So ultimately, the pool of talent is deliberately shrunk. Your claim that the govt is spreading the talent between law and medicine makes no sense. They have a glaring shortage of doctors, but they insist on fixing the intake.
If the system fails to entice existing doctors to stay after their 5-year bond, then why not expand the intake? This question has not been addressed. An increase in the initial intake will surely compensate the inevitable loss later. Yet the govt comtinues to ignore the obvious and maintains strict CONTROL on the barriers to entry.
I prefer a more liberal system. Most applicants should be accepted if they are keen and dropouts should be re-directed to other courses if they find that the course of study is not suitable.
This way you would have passionate people doing the things they are interested in.
Some doctors write, some see patients, others see patients occasionally, some teach, some research, some do other things completely unrelated to medicine.
When you have doctors with other interests and personal development other than being just focused on seeing a few patients a day, then real advances in science, medicine, delivery of medicine improves.
If you have to sweat each day to just see the 100 patients in the polyclinic and end up exhausted - then that's it, your contribution to society is only one hundred patients seen, and even then probably just patched up crudely and go, not world-class service.
Unfortunately, anything world-class would be expensive. -
If the bosses or teachers dont need MCs right away, i dont even care if i have to wait for 2 days. Cause we still have leftover pills, actually dont see docs wont hurt. & you should know some schools & workplace insist people to see the docs in the morning, & will check the time of departure etc.Originally posted by oxford mushroom:Lots of forumners want to emulate western nations....that's what people have to live with. Singaporeans complain about waiting 2 hours to see a doctor for a cold. In the UK, you may have to wait 2 days to see your GP. During the festive season, you may have to wait 2 weeks if he is away on holiday.
shen zai fu zhong bu zhi fu -
Originally posted by BillyBong:
The WP has no solutions of its own but use the opportunity to play on voters' fears. That's the problem of opposition parties who dare not make unpopular but essential decisions. Now that the election is over, the ruling party may use the uproar about waiting time to bring about this change. Means testing is a big change in policy and must not be rushed through. But come about it must, and when that happens, means testing will be applied to more than just medical subsidies but other benefits like the Progress Package etc.
Means testing was a flop at the last election. While the MIW will not admit it, their suggestion and proposal to conduct means testing was shot to pieces by the WP.My earlier suggestion regarding 2nd tier students getting into doctoring was based on the fact that straight 'As' get knocked out at the interview phase while those with worse off grades get through because they can TALK. They can sell themselves and 'convince' the panel they deserve that slot.
Your ideas of the selection system is far too simplistic. It takes alot more than just talking...many medical students are selected because they are down to earth and can do the job. We take a dim view of those who can just talk..Those with straight 'A's and speak well are more likely redirected to the law faculty.They have a glaring shortage of doctors, but they insist on fixing the intake.
You obviously haven't read my post. I contend that there is no shortage of doctors in Singapore. Whilst polyclinic doctors may see 100 patients a day, not many GPs are fortunate enough to have 50 patients a day. We have a severe shortage of doctors in the public sector because the salary differential between the public and private sectors is too high. Increasing the intake will not stop the migration towards the private sector. The solution is to increase doctors in the public sector by increasing their pay (which is not popular) or by hiring foreign doctors who are then given a limited license to practise only in the public sector. -
Basically, I see alot of hot air from people who rant about everything without thinking about the implications and constraints. You should live in the UK and try to get an appointment to see your GP or hospital consultant.Originally posted by ShutterBug:Basically, I see a lot of C&B stories being told over this entire issue, and a lot of political egos being thrown around by the MIW, but NO REAL improvements or solutions being produced by our ever-wise gov.
I guess for this matter as well, they have to wait till crap hits the fan before they pick up their asses and get real work done.
Singaporeans are getting a terribly good deal....You get to just walk in and see a doctor for just a few dollars in the polyclinic. The message Singaporeans must wake up to is: medical care is not cheap. Someone (and in many cases the government and taxpayers) is paying for it. -
No wonder you are in the UK.Originally posted by oxford mushroom:Basically, I see alot of hot air from people who rant about everything without thinking about the implications and constraints. You should live in the UK and try to get an appointment to see your GP or hospital consultant.
Singaporeans are getting a terribly good deal....You get to just walk in and see a doctor for just a few dollars in the polyclinic. The message Singaporeans must wake up to is: medical care is not cheap. Someone (and in many cases the government and taxpayers) is paying for it.
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The MC system does not work. You give workers 7 days of MC a year, they will want to make use of it even if they are not sick, otherwise they lugi...Originally posted by Boy Stratus:If the bosses or teachers dont need MCs right away, i dont even care if i have to wait for 2 days. Cause we still have leftover pills, actually dont see docs wont hurt. & you should know some schools & workplace insist people to see the docs in the morning, & will check the time of departure etc.
The alternative I proposed to some bosses of surrounding companies and factories when I was working in the polyclinic was to give their workers a variable bonus depending on how many days they do not take MC. A worker who does not take any MC at all will get an extra 7 days' pay as bonus per year. Those who used up all their MC entitlement taht year will get nothing.