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49 comments:
MOHH has outdone themselves once again. after a crazy year spent fighting H1N1 and pulling 70 hr work weeks, they are "pleased to inform" us junior doctors that we're given a 1% pay rise.
it's not that we're money minded, but we do have to pay our study loans and feed our family too. and besides, that's just downright insulting when we find out what the other stat board and civil servants get.
where is my 8 months bonus?
when the good times comes will we be subjucted to such excess that some of the civil servants enjoy?
oh i forgot MOHH is actually a private entity..... do you know that? I guess we wont get anything besides meagre pay rise. Gone are the days where under Singhealth / NHG you get at least $300 x 12 months pay increament on yearly basis.
now we get pay market rate for fresh graduate and get nonsense pay increament. I guess if you're gonna be an MO it will take you a lifetime to hit their pay cap.
The other way of looking at this is that they can hire more Drs with the same pool of money..... why dont make us work for free? Tie us down with longer bonds/conditional registration etc....
Doctors doctors doctors.....you guys have to accept that becoming a doctor is not the way to get rich anymore.
If you are truly serious about making money and making your life better it is best to leave medicine as soon as possible.
There are only a few options left these days
1) Executive banking jobs
2) Be a businessman
That's about it.
I would even say that what Ministers earn is pittance compared to the above two.
Doctors just have to tell themselves that there is more to being a doctor than earning money. I think this is the new "catch phrase".
Sorry but this is the reality like it or not.
"Doctors just have to tell themselves that there is more to being a doctor than earning money."
That's what people want doctors to tell themselves because they are unwilling to pay for healthcare.
The reality is - and will always be - that he who can supply what is in demand will make money; and healthcare is always in demand.
Supply and demand.
There are so many people willing to become doctors. Fact is many of these young folks don't understand pay notice to this supply and demand problem.
MOH is finally realizing (after experimenting) that there is no need to restrict the supply of doctors in Singapore in any way.
"that he who can supply what is in demand will make money"
Well how MUCH money?
I'd rather be the guy who leverages on others to make exponential sums of returns on my investments be it time, effort or money. You can't win.
"I'd rather be the guy who leverages on others to make exponential sums of returns on my investments be it time, effort or money."
So would everyone.
Being a doctor is still a good way of making capital that allows you to do that.
Not really. The best is to leverage off OPM. And that's where bankers and businessmen excel.
As a 26 year old doctor what capital can you have working as a doctor?
The best way would be just to inherit a fortune or strike the lottery, but we are not talking about the best way - just good ways.
How long will one stay a 26 year-old doctor? By the time a doctor completes his bond his salary would have more than doubled, and he can command more than that on the open market.
Even if being a doctor is not the BEST way of getting rich, it does not follow that doctors should not expect to make moeny from their practice.
To my junior colleagues: you offer a valuable service and you deserve to be paid a fair wage for it. The subsidised healthcare system and the bond system distort that, but while it is the reality for you now, it does not have to be nor will it be always.
Don't let people tell you that being a doctors should be all about caring and compassionate and not about making money - those people can keep their money and see how far care and compassion go towards curing cancer or healing a fracture.
Don't let people make you feel guilty for wanting to make more money, as long as what you are practising is neither criminal nor fraudulent.
In fact, as long as you are trading your knowledge, skills and experience in an honest fashion, be proud that people value what you have to offer and give something they value in return.
You doctors make too much money. MOH is right to bring in more FT doctors to lower the cost of healthcare. It is high time overpaid doctors get a fair wage! Healthcare is a necessity. We need to keep costs low. Like HDB. If young doctors are complaining about money now, it is frightening to think what kind of doctors they will be when they grow up. No wonder doctors fleece their patients! SMC must come down hard on such profiteering.
Is MOH bringing in FT doctors "to lower the cost of healthcare"?
I thought it's always been MOH's stand that FT doctors help alleviate our manpower shortage in the public sector.
Everyone knows MOH keeps healthcare costs low through other methods - e.g. making Singaporeans pay with their own money instead of using government funds; not subsidizing GPs enough to manage chronic illnesses, etc.
Sure, Anon. Healthcare should be cheap when you require it, just as HDB flats should be cheap when you want to buy one.
But not when you want to sell one.
(And I will assume that low-priced FT doctors are OK for other people, but not when your grandmother is sick, because she can only speak dialect, right?)
People who provide what you call a "necessity" shouldn't be paid fairly for their services, but should provide it to you out of the goodness of their hearts? Whatever gave you that inflated sense of entitlement?
This is the kind of topsy-turvy mentality that people have had for too long, the result of which are a populace with unrealistic expectations and a subservient medical profession.
Unfortunately, the medical profession is now rejecting that ethos and 'acting out', either in an overtly criminal manner like selling sleeping pills, in a professionally dubious manner by selling unproven therapy, or by simply following market forces and giving up general practice for aesthetics.
Your kind of mentality, Anon, is the reason why doctors in the public sector become demoralised and choose to go into the private sector.
Techincally speaking (by which I mean I am guessing here...) you cannot lower healthcare cost by making people pay more - it just alters your subsidy:out-of-pocket ratio - the nation's healthcare spending remains the same, regardless of who pays.
But I agree with you - bringing in foreign doctors, regardless of how much they are paid relative to local doctors, does not decrease givernment spending; in fact, it increases government spending. The only way to reduce government spending is to sack doctors, not hire more.
The cost to hire one Singaporean doctor with 5 years of experience is about the cost of TWO NTS doctors with the same amount of experience.
I have visited polyclinics and seen NTS doctors. While there are differences between the two, I would say the lower cost of hiring them is worth it. I can also see that they see just as many patients as the Singaporean doctors.
So in productivity terms this is 2 for one. If that isn't lower manpower costs for the same productivity then tell me what is?
Perhaps you guys are all specialists still mollycoddled by the hospitals. But your colleagues in the polyclinics have already been hit hard. From what I have heard there are many many foreign trained registrars in the hospitals these days. MOH is simply pushing out their ideas slowly and gradually across the board.
The private GP market will also be hit hard soon.
GPs earn a decent wage, but it is no longer extravagant.
Hopefully one day, the same can be said of specialists. It's all a matter of supply and demand. If you flood supply, the price will come down. And there are so many gullible young people who want to study medicine for various reasons. So why not? Flood it. Also invite the foreigners in as well. Flood the market.
The market will take care of prices.
You are trying to scare us by talking about how doctors resort to frowned upon means to gather their riches. Well thankfully our government is strong enough to put forth measures to control this.
Why should the market give in to unscrupulous methods by reducing supply? That is illogical economically.
Enjoy it while it lasts. Doctors do not control the healthcare industry. We the people do.
I have to say: I'm not sure why becoming a doctor shouldn't be a way to get rich. Doctors study for years of their lives, absorbing massive amounts of information and training, incurring huge debts and live an arduous lifestyle.
All that, for the "good of it"? Compensation is commensurate with effort and training. Many of the people complaining here wouldn't accept that for any of their jobs.
And I'm wondering: is this premise of doctors controlling everything (through their now-lost moral authority, or their almost omnipotent command over the healthcare industry) correct? Isn't the Ministry of Health controlled by bureaucrats?
I won't discuss the point about NTS doctors and their registration, except to say that I stand by my earlier observations that quality and country of origin do not always correlate. They may cost less than local doctors to hire, but if the government just wanted to save money they would just not employ more doctors, local or foreign.
"But your colleagues in the polyclinics have already been hit hard."
Really? Perhaps you would like to tell us how much wages for local polyclinic doctors have decreased over the past few years since they started employing foreign-trained doctors?
"If you flood supply, the price will come down."
Sure. But as long as aesthetics still pays better than general practice, doctors will still go for the former rather than to provide the "necessity".
"Doctors do not control the healthcare industry. We the people do."
You determine the healthcare industry, but your interests are too diversed to control it (and the same can be said of doctors). You the people determined that aesthetics will be more lucrative than chronic disease care, but you the people could not prevent GPs from moving from the latter to the former - you have an inflated sense of your powers.
At the end of the day none of these measure to seek to 'control' the medical profession will work because it ignores the fundamental economic reality - people with something of value to provide will demand something of value in return. If you begin from the start point that you do not want to pay for something you value, then your end point can only be that you do not receive value.
Wasn't there a survey recently on earnings of GPs over the past 10 years? It was in 2006.
http://news.sma.org.sg/3911/Survey.pdf
"GP’s income per
month was $10,524 (mean) and $13,758 (median).
Compared to the 1996 Survey, the average
GP worked longer hours in 2006, and saw fewer
patients. Income has largely stagnated in the 10-
year period: in 1996, the average income of a GP
was $10,271 per month, while the figure in 2006
was $10,524."
See those results? Income has largely STAGNATED in the 10 year period. Actually it has DECREASED over the 10 year period, but the doctors couldn't bring themselves to write that could they? Imagine, in 10 years the average income of a GP has decreased. From 1996 to 2006 how much have property prices gone up?
Your former SMA president has also addressed such issues before regarding polyclinics.
http://news.sma.org.sg/4004/Forum.pdf
It's ok. There are always several stages when confronted with stress. Consternation and denial is usually first stages.
Strange. My pay has been going up steadily.
You're probably not a GP. Neither is spacefan.
As I mentioned earlier. It has started with the broader market. The so called "doctor on the street". The GP. Slowly it will filter down.
The recent move to have a residency program that churns out specialists is just another step in the right direction.
Are you honestly convinced that GP who do aesthetics make just over $10,000 a month?
I've just commented on the later post, before seeing this big discussion.
just a simple question to the non-medical readers: which would you rather have?
a) good quality healthcare
b) cheap healthcare
the reality of ANY professional service is about balancing the above 2 factors. pay a lawyer crap, and he's not going to bother to do good work for you. or an accountant. or any other professional service provider. he'll cut corners and you won't even realise it, simply because you're not knowledgeable enough to know that he hasn't given you his best.
~medicalgrounds~
to anon @ 23:26
do you honestly think a residency program that churns out specialists is going to produce GOOD specialists?
we'll find out in 6-8 yrs once they start popping out.
angrydoc, you are trying to misdirect here. We are not talking about aesthetic beauticians with an MBBS. To me they aren't even doctors.
GPs. General practitioners. Aka Family Doctors. That's the group I am talking about. The ones who work in majority of GP clinics and polyclinics. Doctors who in the past gave great value for money. They manage everything. But of course society wants other things but that is not the focus of discussion.
How did those earnings figures stagnate for 10 years? Think about it.
What is good or bad is also subjective. What we do have in Singapore is a good system of checks on accountability. SMC. The courts.
So doctors can't cut corners at the risk of patient's well being. That we can be assured. As it is you can see the people are more suspicious these days. Legal suits are on teh rise.
If anything the job is more difficult for doctors today.
I don't envy you guys. I'm just stating what is happening.
"We are not talking about aesthetic beauticians with an MBBS."
I see. Doctors who make more money are not doctors so your point that doctors do not make a lot of money is still valid. Of course.
"So doctors can't cut corners at the risk of patient's well being. That we can be assured."
I'm just going to plead the 5th here.
That's not my point. You are trying to direct the discussion into the "why do GPs go into aesthetics?" area which is not what we were discussing.
We were discussing the reality that the government's policies have caused salaries of GPs to stagnate. Related yes. Different focus yes.
That itself can be easily fixed by having MOH and SMC decree that GPs should not practice aesthetic medicine. It should be done by dermatologists and plastic surgeons. This is good for the people. After all aesthetics is not a necessity so why should costs be kept low for them? Safety is the main issue and having well trained proper trained specialists is the way to go.
Doctors cutting corners. Of course the adage is "do anything you want, just don't get caught".
Well the public is getting more suspicious and more learned. So cutting corners can be caught more often these days.
It's an ethical issue. The medical profession wants us to trust them, but they threaten us that they will cut corners here and there? This isn't acceptable even among your peers. What do you call it....self regulation. Well now we are starting to scrutinize that self regulation a lot more.
All these moves are good for the people.
Over the past 10 years, has healthcare gotten worse or better?
You are trying to make the point that doctors now earn less and should accept that they earn less.
I am making the point that doctors may not really be earning less and do not accept earning less, and provision of healthcare may suffer as a result.
You yourself recongise that fact when you stated that MOH should ban GPs from doing aesthetics and that self-regulation is not enough. Your solution to doctors veering from their core work to try to make more money is 'anything but paying them more'.
I think we understand each other perfectly; we just don't agree.
You're right. We don't agree.
However, we have set things in motion already. And we can see from what is going on around us not only in Singapore but all over the world where things are going as far as healthcare is concerned.
As I have said before. This isn't personal. I sympathize with doctors. I understand both sides. What I say though is just what unfortunately is the majority speaking.
In any case, it might surprise you that I am a doctor myself.
So are you earning less?
Do you think you should earn less?
My answer to both questions is a 'no'.
From a doctor's perspective of course the answer to the 2nd quesstion is a no. for the first I take the 5th :)
But the point is we are looking at this from the perspective of a doctor and OUR earnings.
Is it possible to have a good healthcare system with good doctors paid lower wages?
It isn't difficult to lower wages gradually over a period of time. Just limit the increases slowly so that it does not keep in line with inflation.
Is it possible? I think it is possible. The problem is a political one. However in Singapore the political power is firmly with the government. Hence this will be the way of the future.
It has happened in many industries. The IT industry for example. Are our IT services worse off for the large number of foreign IT consultants we employ? I don't think so. But our costs are lower.
Same with engineering.
Same with even radiology. We still live with the X-ray services we outsource. yes there are problems but are they so bad we have to stop the service? No. Why do we have the services? Cheaper, faster, better.
SBS bus drivers in Singapore are paid much less than Aussie counterparts. Bad for driver. Good for commuters. Who wins in Singapore? Why do they win?
I used to feel very upset about these things. But I have come to realize this is the way Singapore is. It is actually what makes Singapore successful.
Our main focus is economy. Bring money into Singapore. Keep costs low or lower costs. More profits. I am sure hospitals are also run in the same way. Of course quality must not suffer. But that is the challenge for CEOs and what they are paid to do.
If you can drive a bus, you don't necessarily have to drive for SBS and take the wages they offer you, do you? :)
I want to encourage our colleagues to not take the defeatist attitude and accept that we will be paid low wages.
I know what you mean AD. But there is no effective doctor union in Singapore.
So what can you do if you don't accept? Go on strike?
Go do aesthetic medicine?
Like the first two posters here. They are not happy with their pay. So what can they do?
Go private and be a GP? Well in the past this was the way. Then MOH solved that problem.
Now working on the specialists....
Strike is not a viable option in Singapore, but going into private practice and doing aesthetics are. Flip to the back of the SMA newsletter and look at all the job offers there.
The idea is to offer skills that are in demand, just as it is with any other job.
Even those who are still under bond have had their bonds paid off by their new employers, who deem them a worthwhile investment to do so.
If the local market isn't attractive enough, there are overseas opportunities too - local groups are opening new markets in the region. On that note, do ask the NTS doctors from the Philippines about work conditions and their healthcare system at home.
Don't curse the darkness, don't think it is the way it has to be - go find a candle and light it.
You're right AD.
But then you are digressing. As I mentioned the idea is lower healthcare costs same quality. Possible? I think so.
Doctors are smart people. Those who want to earn more money will figure out ways to do so. They may not even stay in medicine.
But so often we hear doctors complain and talk as if it is their right to earn high wages. That's not the way to go politically or economically.
Having said that I do think the way forward for most doctors is out of medicine or overseas. We all know that pay in pte sector is heavily influenced by pay in public sector. If the public sector keeps wages low, then private will not be so crazy as to pay so much higher for a start. Also the govt restructured hospitals compete with the pte ones too. All good for the consumer.
Different but related issues - doctor's pay is but one component of healthcare costs. I can't control the other factors, but I think doctors should have a stand on their pay.
I think 'right' is an irrelevant issue - a person is paid what he can get. So yes, we should stop thinking it is our right to earn a high wage, but we shouldn't think it is a wrong to do so either.
The question is whether MOH bothers with what doctors think?
I'm not talking about taking feedback and all. But actual listening and implementing policies for the benefit of doctors.
Doesn't seem to be the case. They take action according to what is good for society. Which isn't a bad thing.
As I said before this isn't an attack on doctors. But what we do that doesn't seem favourable to you/us, is actually good for the majority of people in Singapore.
The reason why doctors often get attacked and yet keep silent is because for so long doctors were the elite and aristocrats and talked about being noble and charitable etc. They did because they could.
Now thigns have changed. But the profession clings to these ideals.
Frankly speaking, for the benefit of the people....why shouldn't we have cheaper consult fees? Or surgical fees? Instead of paying lots of it to let surgeons drive fancy sports cars?
The same can be said of other fields. But then medicine is one of the few that espounds idealogical noblehood.
For the benefit of the people, we should work for free.
Thank goodness I am not doing this for the benefit of the people.
If I could perhaps offer a justification as to why doctors deserve more money: the training involved and the responsibility taken.
Compensation is commensurate to training, effort, and responsibility. Doctors have all three in the bucket loads.
I think if we want to hold doctors accountable, they deserve fair compensation for the amount of work they have to do to be good at what they do.
lftekhar, I totally echo your sentiments as a fellow doctor. Our job ain't easy. Especially balancing the responsibility part vs pleasing customers.
The trouble is that the vast majority of us are employees working for someone. In fact the biggest employer of doctors is the government.
And you know how these employee/employer relationships work right?
We can argue all we want. In the end, the one with power wins. So who holds the power?
Specifically to this accountability issue, I thought about it before. Why is it pilots are paid so much? Well in their hands, if they screw up its a multi million dollar airplane and hundreds of lives at stake.
With a chemical engineer monitoring hygiene standards at a pharmaceutical plant, if he screws up, millions could be poisoned.
With a surgeon who screws up, he can kill ONE person at a time.
So you see, the accountability argument is only as good as how many people you can kill with one screw up.
I have to disagree, Iftekhar. People shouldn't be (and aren't)paid for their training, effort, or responsibilities - they are paid for what value they can offer.
Doctors shouldn't assume that they should be paid highly just because of their training, effort, and responsibilities, they should look at whether their training, effort, and the responsiblities they take on are actually what is valued by the people who pay them.
I'm not saying how much they are paid should be the only determinant of how they should practise - I am saying that it is foolish to imagine that putting in hours and effort in training and taking on responsibilities automatically mean you get a good pay. Once you appreciate that, you can better decide how you want to practice.
Angry Doc: Isn't "value" just another word for "training, effort, and responsibilities"?
If someone has to be trained for many years (higher than the average) to be good at whatever they do, they have to get paid an amount for it to be worth their while.
The counterargument to that is something like government/public service (something not enacted in Singapore, which is unique). Talented people go to government service, even though the pay is low, because they're working for something they believe is bigger than themselves.
If that is the argument, there is some merit in it.
But in all fairness: taking on all of that debt, slogging off all those late nights... the sacrifice involved, it's not fair to ask them for a bargain at the end of that.
The government might rig it however they like "for the greater good," and people might sign up to it willingly (because it's their passion) but I feel the fact remains: it's unfair.
Anonymous:
From what I read, I think you agree in principle, but are resigned to the fact that the government has ultimate control to impose "the greater good."
Your counterexample with the Chemical Engineer is good. I think the thing that we're going for is achieving equity and fairness. The system is not ideal, but we want to get as close to ideal as possible.
A doctor may affect one person at a time, but the procedures he/she undertakes are very complex and require lots of training and experience, and the number of mistakes he can make are huge.
Manning the QA line, not so much.
Like a technician servicing a plane engine can affect hundreds of lives. But I'll bet you he gets paid less than an IT consultant who optimized warehouses processes.
Lives at risk is only an element in the equation. There's an economic element: the opportunity cost of all those years of training and sacrifice, the expenses incurred, etc.
I'm not a doctor, btw. :) But this is an interesting discussion nonetheless.
No, Iftekhar. The amount of training and effort you put into something does not determine the value it has to the consumer.
It takes an enormous amount of training and effort to learn how to treat diabetes properly and to keep current with the latest developments, compared to say giving Botox. Which one gets a doctor more pay? Why?
Effort has no meaning if the outcome is not something you want.
Angry Doc, I recognize that: market forces play a role. What you're talking about is demand and supply.
The demand for botox is more than that of diabetes, sure. Thus, market forces cause botox injections to command a higher price than the more complex procedure of treating diabetes.
But those same market forces that say administering Botox pays more, also dictate that someone who incurs thousands of dollars worth of debt, and immeasurable personal sacrifice, over many years needs to get paid so he/she can repay those debts in a timely manner while maintaining his/her lifestyle.
Again, the system isn't ideal, and there are confounding parameters. But it's really just a question of degrees.
Treating diabetes is already paid handsomely, compared to, say, the simpler task of laying brick, because of the complexity of the task involved. This is where training plays more of a role.
But relatively speaking, the simple procedure of administering botox commands higher pay (because of its massive demand) as opposed to treating diabetes. This is where market forces play more of a role.
So it's really just a question of degrees in different scenarios.
So, I'm gonna go out on a limb and ask, Angry Doc: what are you saying? Doctors don't deserve higher pay? From your previous posts it seemed you agreed that they did.
If so/not, then why?
Like the word 'right', I don't think the word 'deserve' has very much meaning in a discussion about pay.
I guess my point is that we should all take a step back and acknowledge market forces rather than to say if doctors are paid too much or too little - they are paid what the market will bear. As healthcare providers and consumers we all influence market forces and are influenced by it.
My advice to my colleagues is to be proactive and not cry foul when the market doesn't value what we have to offer. We must either generate the demand for what we can supply, or else supply what is demanded.
wah AD, are you from TTSH?
Sounds very much like Value System Analysis. VSA, TPS.
Absolutely right. What is value to the process may not be value to the customer at all.
The question always asked is, what is the customer willing to pay for? Usually they want to pay for things they WANT.
So why is it botox injections cost more? Because the only time people get botox injections is when they WANT to have it.
Whereas for diabetes, the treatment is sometimes because they NEED it.
I think both of you have got it all wrong.
In any business, you must know your customer.
What does your customer want? What is he willing to pay for?
Give the customer what he wants and he will give you what you want.
The problem with healthcare is that people see it as a need. Not a want. Hence they are not willing to pay too much for something they need.
so in summary, the main argument quite a few pple are arguing for is that medicine should follow market forces of supply/demand.
in that case, there's no longer any necessity in insisting on good quality medicine all the time, since the 'customer' may not always want that.
if they're not willing to pay for consultation and good counseling, and optimising their medications, then it's their choice ... should I be held liable that the patient does not want to pay for treatment to lower his blood pressure from 160/100 to 135/80? or his HbA1c from 10.5 to 7? he'll only lose a few years of his life... and he won't even know it coz it's all aggregate statistical results.
anyway, it's not like we've got the time to optimise everyone's medical therapy in the real world even if we wanted to... we let so many things slip by just because we haven't got the time and/or training to keep on top of things.
Anon 25/1/10 14:50. That's a very interesting comment you made. I have never thought about it this way. But this sheds a new light.
On a separate note, having read the interesting comments here, I am just writing to ponder aloud, "why do people think that doctors owe them a living?" If patients want to be treated like customers, I could treat them like one - "Sorry Mr Tan, you are one of the most annoying customers I have had. Get out of my shop (i.e. clinic) and don't ever come back again. I hate to do business with people like you.". :-D
Hi anons,
I see where you guys are coming from. But seriously you're all just in denial.
1) Medicine is a special type of industry. Especially the doctor-patient/customer service relationship.
2) Doctors are meant to serve patient unreservedly. SMC demands and maintains this. And so does society.
3) You cannot reject patients full stop. If you do, you will be persecuted. It is just the way it is. It is expected.
4) You are always liable for anything that happens to a patient once he sees you. His well being is your responsibility. If he chooses not to follow advice, you have to document it. You also have to document everything you have advised him or else it is as good as saying you did not.
5) Patients/customers are really like ignorant children who know nothing and not expected to know anything about the service/product/condition/anything. They are allowed to claim ignorance as they are laymen and need to be protected by the law and rules. Doctors have the tough job of having to parent these ignorant children. This works to the advantage of the patients/customer and not to the doctor who can be sued off his pants.
6) Try whatever you want but in the end the doctor must be the subservient, messiah like god who is loving nad can do no wrong. Deviate from that and always risk the wrath of man.
7) I cannot for the love of man understand why these things are the way they are and why doctors tolerate all this. One part of me thinks it is because the job used to pay exceptionally well. However in today's world it is illogical to even try.
A few points :
1) Patients are special type of customers. They do not know what they want. What they need is also more important than what they want.
2) Customer satisfaction is always based on whether customers get what they want or get what they think they need. Onus is on the doctor to fulfill these.
3) Patient are ignorant and know little about medical issues. But the customer is never wrong. Onus is on the doctor to educate the patient who knows nothing.
4) If a patient has been given advice, doctor must document it or there was no advice given. If patient does not follow advice, doctor must document and get patient to sign or the patient can plead that they did not understand.
5) healthcare is a service industry. Except the demands are a lot greater on the service providers.
6) Every customer visiting a clinic or hospital is not well and is not happy to go to have services. This is the challenge for healthcare service providers to make the customers visit an enjoyable and pleasant one which will make them "want to come back" but you cannot tell customers "see you again" as it will offend them
To anon 26 January, 2010 08:41,
I think doctors in the past did what they did, not mainly for pay, but for some simple non-monetary things called respect and gratitude. Perhaps both are something that are in scarce supply nowadays (probably replaced by money). Why do you think people do missionary work for free?
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