I am no longer surprised that laymen tend to judge doctors based more on style than substance; nevertheless, I am amused by how justified they feel they are in doing so, as exemplified in no fewer than 3 letters in the ST Forum today.
Mr Lee Seck Kay believes that
"... doctors need to care about their looks; never mind if they are not handsome, but at least they should not give the impression that they are lackadaisical. It is a moral responsibility that many doctors tend to neglect, much to their detriment."(emphasis mine)
Mr Anthony Goh's contribution is:
"The doctor's personality and the way he conducts himself speak better than looks."
Mr Javern Sim shares his experience and wisdom thus:
"I have occasionally come across doctors who are more interested in getting the
diagnosis and prescription of medicine over and done with, rather than
communicating properly with their patients.It is imperative for doctors to be skilful not only on the treatment table, but also in terms of patient management and communication."
(emphasis mine)
Curious. I would have thought that making the correct diagnosis and prescribing the appropriate medicine and letting the patient know the two constituted patient management and communication.Why do the writers seem more hung up on how the doctors look or conduct themselves than on the quality of the medical care or advice, as if the clinical encounter was more a date than a consultation? My suspicion is that lacking the means or inclination to assess the quality of care, patients instead base their judgement of a doctor on things they can assess. It's a natural thing to do - it makes us feel we have control over the situation - but then how a doctor looks or behaves towards you may have very little correlation with the quality of care he provides. If patients choose to judge doctors on style than substance, then perhaps that is what they will get.
The irony, of course, is that doctors too sometimes judge patients by their appearances...
59 comments:
Finally a doctor who get what we administrators have been emphasizing!
Service quality is as important as clinical quality.
Most complaints are doctors never greet me, doctors never smile at me.
Make patients feel happy and they are less likely to complain and sue the hospitals.
Make patients angry and even if your care is perfect, you will still receive complaint letters and sometimes sued. It also makes things difficult for us administrators to answer complaint letters.
I hope doctors will now realize that how u say is as important if not more important than what you say.
"Service quality is as important as clinical quality."
I don't think so, but then "important" here is subjective.
"Make patients feel happy and they are less likely to complain and sue the hospitals."
Every doctor knows that, Anon, but a doctor's first duty* is to provide good care, not make people happy.
* - "Do no harm" is not a first duty - my pet goldfish swimming in its bowl at home is also doing no harm to my patients.
In fact, come to think of it my goldfish is better at doing no harm than I am...
Everyone is placing alot of emphasis on appearances and style now. There is this new hospital which looks like a.....erm...shopping mall.
I'm just saying....
Speaking from patient perspective. If a doctor is competent AND also show that s/he can differentiate you as a person from the rest of her/is patients, then it gives confidence that your doctor is treating you, as opposed to a condition/illness/sickness/disability/procedure. Case in point, a personal experience: my surgeon once referred to me as the "xxx operation last Friday", right in front of me. It's that surreal to be reduced to a procedure simply because I have an illness.
The advantage for the doctors and nurses to treat the patients as individuals instead of just a case/procedure is that it inevitable reminds them to be more sensitive in their communications, and reduce unnecessary miscommunications and conflicts.
"It's that surreal to be reduced to a procedure simply because I have an illness."
Well, Suzanne, you wouldn't even have needed a surgeon if you didn't have an illness now, would you?
angrydoc - maybe someone needs a witch doctor for a consult ... LOL ..
in western countries like australia, abuse of health care staff is never tolerated unlike in our system where admin has time and time again let down health care staff whereas a FON client/family are allowed to act with impunity, ie raise their voices in the wards/using vulgar language and even demonstrating threatening gestures towards junior staff, HCAs/nurses/junior docs/front line admin staff while most of the time, hospital security just stand by doing NOTHING ... SIR- VICE quality!
in the end actions like these (as an example) just increase the turnover rate of our health care personnel
Not sure how many of you remember the fake doctor who was doing his housemanship in SGH.
He received a commendation letter from the hospital for his warm and kind manner in dealing with a grieving family while he actually knew nothing about medicine!
I routinely ask people - would they rather have a caring but incompetent doctor or a rude doctor who could save their life. None of them have picked the caring doc when questioned...admittedly not a proper sampling frame but then....
The turnover rate of healthcare personnel is high because we cant afford to pay high salaries as we want to keep medical costs low for Singaporeans.
Even though healthcare is heavily subsidised, there are the poor and needy which still cant afford.
I think healthcare personnel should be more patient centered.
Who wants to be sick?
Who wants their loved ones to be sick?
Hospital security will step in if family members cross the line but we must be more tolerant of others.
It is hard to recruit healthcare staffs locally and we have to travel overseas frequently to ensure we replace those who quit.
Let us work hand in hand to ensure that patients are treated with respect and make their stays with us as comfortable as possible to minimise the need to reply complaint letters :)
"Even though healthcare is heavily subsidised, there are the poor and needy which still cant afford."
How many? Should we continue to have a public-funded healthcare system that subsidises all reagrdless of whether they can afford just for these poor and needy, or should we make subsidy the exception rather than the norm?
"Who wants to be sick?
Who wants their loved ones to be sick?"
Who wants to be treated rudely while doing their job?
Who wants their loved ones to be bullied when they are doing their jobs?
Everyone falls sick, and everyone dies. Get over it. Being sick or having a loved one who is sick is no excuse to act in a way to another person you wouldn't normally do, or wouldn't want yourself to be treated.
The subsidised heatlthcare system is failing because of your kind of thinking: that people 'deserve' subsidy, and that they can abuse the subsidy and healthcare workers because they 'don't want to be sick'.
Go watch "The Doctor" starring William Hurt
Go watch "Broadcast News" starring William Hurt.
anonymous in 21 July, 2010 02:15
be tolerant?? LOL
does it mean that nurses/junior docs/HCAs/front line admin staff have to be abused?
you should have never allowed such acts of impunity to even take place in the first place.
in western health care systems, verbal abuse by patients/families is NEVER tolerated unlike in Singapore where they are allowed to ACT WITH IMPUNITY, ie shout/raise their voices/raise their arms in threatning gestures/storm into consult rooms without regard for the sick patients who is already in the room. How do you explain that Mr/Miss SIR VICE?
health care costs should be kept to a MINIMAL for everybody and who pays? The 'national kitty bank' who pays for your Father Superior and your senior admin colleague (and you know who - no names mentioned ) who edited the leave/ and pay policies of all health care personnel in the last 5 years.
well those 2 guys can be paid more than SIA pilots! wow sia! so why can't nurses be paid similar to SIA trolley dollies esp if we want to retain them? is the Hong Kong system unsustainable?
I don't believe that we are poorer than HK in any sense esp when our higher mortals are paid a lot more than the HK senior civil servants.
I think someone should forward angry doc post to SMC.
In general, a doctor is expected to
Be dedicated to providing competent, compassionate and appropriate medical care to patients.
No compassion for middle class patients who come to public hospitals since he/she thinks they are abusing the system :(
• Provide access to and treat patients without prejudice of race, religion, creed, social standing, disability or financial status. A doctor shall also be prepared to treat patients on an emergency or humanitarian basis when circumstances permit.
He discriminates the middle income patients who come to public hospitals thinking they are abusing the public system!
• Treat patients with honesty, dignity, respect and consideration, upholding their right to be adequately informed and their right to self determination.
He constantly condemn those who can afford private healthcare services but choose to go public hospitals.
Is this treating patients with respect?
"I think someone should forward angry doc post to SMC."
Someone? Why don't you do it youself if you feel it is so important?
If you disagree with my views and what I advocate, feel free to point out why you think I am wrong.
Trying to shut me up by appealing to a code of conduct without addressing the issues I raise just shows that you don't have any logical arguments against me.
You imply that I have acted against the SMC Code of Ethics, so I challenege you to provide any incidence where I have denied a named patient treatment on account of his or her "race, religion, creed, social standing, disability or financial status", or where I have not treated a named patient "with honesty, dignity, respect and consideration, upholding their right to be adequately informed and their right to self determination" based on their paying status.
Go ahead.
If calling your patient a rude bastard is not violating SMC code of ethics, I dont know what is.
I have no personal feud with you but as a doctor, there is a need to be professional at all times even though you are annoymous.
I belong to the old school and it is a shame to see the profession losing its prestige with gay doctor, houseman taking photos of nurse bathing, doctor blackmailing doctor with sex video, doctor molesting clinic assistant and doctor scolding patients caught on stomp.
Five Ages of Man
To the rude bastard who came into my room before his number was called yesterday asking to be seen before his turn,
I am sorry I was unable to see you first because of your specific combination of age and gender. While you might think that your ‘type’ is unique and deserves to be seen first, I would like to inform you to the fact that each age group has a reason too as to why they think they should have priority.
......
angry doc
Wow, you actually cared enough to find the reference! Thank you.
Now you can go ahead and file a complaint to SMC.
"I belong to the old school and it is a shame to see the profession losing its prestige with gay doctor..."
Wow. That's professional.
dearest anonymous from "old school "
angrydoc has not written anything which has gone against his/her professional ethics (sorry angrydoc i do not know your gender - not that i am interested.. LOL). what he/she has stated that
"To the rude bastard who came into my room before his number was called yesterday asking to be seen before his turn"
my question to you is, is it right for someone to barge into a consult room while another poor SICK patient who is really unwell who really needs the attention of a health care provider (be it a NURSE or a doctor) and make unreasonable demands to be seen first just because he or she needs to rush off to a social appointment? this guy/lady is indeed a kurang ajar, as he/she doesn't understand that the geninuely SICK patient (i am sorry, but i do not mince my words as time and time again, people are just simply SELFISH and they only look after their own self interests and have no regards to other more needy humans) needs to be attended to first.
So as an old school doc, who should be attended first? the sick one or the unreasonable demanding one?
"I belong to the old school and it is a shame to see the profession losing its prestige with gay doctor, houseman taking photos of nurse bathing, doctor blackmailing doctor with sex video, doctor molesting clinic assistant and doctor scolding patients caught on stomp"
wow, you have the cheek to call yourself 'old school' .....
well i would like to ask 'WHERE WERE YOU" during the days of the 'panty raid parties", ie students who target those nurses homes at KE Hall.
and don't tell me that those doctors were from the new school!
doctors from the old school have no respect for nurses and often treat nurses as their handmaids.
I think it's despicable for Anon to dress his homophobia up as 'old school' values.
And as always, to the troll:
http://i660.photobucket.com/albums/uu330/cthulhu19887/forum/facepalm/Facepalm-2.jpg
A statement by Anon : "No compassion for middle class patients who come to public hospitals since he/she thinks they are abusing the system"
Are you implying none are abusing the system? Ask yourself honestly and you will know that there are several middle class patients who DO abuse the system. We aren't saying everyone is....but there definitely are ..and MANY!!
Also broadly classifying the profession as going to the dumps due to a few incidents is really juvenile and just shows lack of thought and consideration. Basically you are saying ALL professions are crap. Does being gay make you a lesser lawyer/doctor/nurse/administrator/teacher/infinity list??? Does molesting, sexual harrassment incidents not happen anywhere else?
You point figures at people labelling them bigots..aren't you a big one as well?
There are people out there who hate doctors.
Why? I don't know. Maybe it is a sense that they feel jealous that doctors know more about information intimately related to their lives/well being? Doctors make more money than them?
I don't know seriously.
But here's what I do know about many Singaporeans having been a doctor in Singapore for more than a decade.
Many Singaporeans think they know a lot about medical stuff. They go to see a doctor not so much to ask the doctor for his opinion, but for the doctor to VALIDATE their own opinions.
For example, if a patient goes to see a doctor after twisting her ankle and has already decided that she needs an X-ray as it might be a fracture, then the doctor attending to her SHOULD say that she needs an X-ray after examining her. If he does not, then he is WRONG and a lousy doctor.
Basically if the doctor doesn't do what the patient thinks the doctor ought to do, then he's not a good doctor.
This is the first requirement. If you don't meet this first one, even if got the second one below it's also no use.
The second requirement is that the doctor must do it in a caring, sensitive, concerned and empathetic manner. This would complete the requisites for a GOOD DOCTOR.
As long as it does no harm to the patient, I usually try to find out what the patient thinks she/he has and what he/she has in mind as to what should be done and do it. The best is when you make the right guess and bingo that's what they thought too.
A problem does arise when you get a patient who has a condition you know is not what she thinks it is. And if you just do what she wants then you are really not helping. In essence being too smart and too medically competent sometimes makes the job a bit more complicated because of something called conscience.
Ideally I would have preferred to be a totally incompetent doctor just guessing and doing what the patients want.
I'll give you a couple of examples.
Patient comes to you saying she has been having "tummy ache" for many days. Got some "diarrhoea" and "gastric". Seen a couple of doctors, taken diarrhoea and gastric meds but not better. She wants a referral for an OGD. As a good doctor you bother to ask about menstrual and urinary symptoms and turns out she's got symptoms suggestive of UTI. You ask for her to do a urine FEME or dipstix and it turns out WBC +++ but she insists she has gastritis and needs a referral for an OGD. Wouldn't it have been easier to just have termed it chronic gastritis/IBS and refer her to a gastroenterologist? Do it in a super caring, friendly, charming , good looking way? Affirm that it is gastritis and that she needs the OGD cos the doctors have all failed her?
The other example is that of chronic cough. Patients seem to think that to treat cough = cough meds and antibiotics. Well common causes of chronic cough = allergic rhinitis, asthma and GERD.
Now the last one is the tricky one. When the patient does indeed have symptoms of GERD and you suggest treating them with gastric and reflux meds for their cough.....well....
Again, easier to just give the more powerful or most powerful antibiotic eh?
Going by the comments from the above....I'd say the basic level would be a simple straightfoward minded doctor who doesn't need to think so much about actually resolving the patient's problem, but to just service their wants with some oomph in service. That's the basic.
If you can do the above AND solve the patient's problems and cure them, then that sets you apart from the rest.
We are following customer service standards. Customer is always right. Well in most service industries, if the customer is truly wrong, it doesn't really hurt them much. But in medicine it can.
Just something laymen should think about.
It's been a long time angry doc, but I have finally moved abroad and walked away from medicine. Looks like things have gotten a lot worse than better from the last time we exchanged views over at my blog eh?
Nice to hear from you again ozbloke (or rather c-bloke...).
I think people who hate doctors do so for the two reasons you listed.
On the whole they hate people who make more money than them - anyone who makes more than them are either overpaid if they are employed, or unscrupulous and profiteering if they are self-employed.
The part about wanting doctors to be nice and conform to a code of values that benefits them is part jealousy, part unwillingness to pay for what they want, and part small-mindedness that makes them want to have control over those who possess more power and knowledge than them.
Problem is they hide all those agenda behind a facade of public spiritedness and moralising, and doctors buy it.
We need to get our colleagues to see through all that and start to say 'no'.
Hey dr ozbloke
It's a pity that u are not practicing anymore.
We need more doctors like you who understand what the patients need and want.
We can sure do with less rude and proud doctors who think they are very smart and calling patients rude bastard.
This make our work easier.
Everyday, we are swarmed with patient complaints and we work so hard for service recovery :)
Anon,
I am proud to say that making your work easier is never my concern when I see patients.
A real-life example of how misguided patients can be:
A certain doctor does not believe in prescribing medication for his patients' acute complaints, e.g. abdominal pain.
Instead, he prefers "psychotherapy", spending a lengthy period "counselling" these people about what he thinks is the root of their problems ( something spiritual perhaps? I haven't had the honour of hearing the details of these conversations. )
So he routinely manages abdominal pain by observing for 2 hours, with no blood investigations done and no medications given. Hands them over a colleague to review when he finishes his shift, and surprise surprise, the patient has not improved. *gasp!*
So instead of excluding something more sinister and alleviating the patient's symptoms, s/he has to stay another 2 hours while we take the bloods and await results, giving the necessary meds for symptomatic relief.
Patient with severe back pain also discharged without any meds. Returned a few days later because, apparently, the "psychotherapy" didn't work its magic.
This doctor consistently gets compliment letters. I guess because he spends up to an hour chatting with each patient, while the rest of his colleagues work themselves into the ground picking up his bloody slack.
The problem when you pay someone like Anon to do a job called "service recovery" and presumably use customer satisfaction as a KPI, you create the idea that customer satisfaction is a worthwhile goal, with no reference to right or wrong.
Ask youreself, Anon, how often do you tell your customer that they are wrong.
I believe that if a doctor doesn't get a single complaint, there is something fishy with his practice.
Many patients nowadays just want you to tell them what they want to hear. According to anon THIS IS A GOOD THING???
Then why consult a doctor for his opinion? I mean, seriously, wouldn't talking to the mirror be the same??
I had the experience of taking over a few cases of "psychotherapy" as well. I mean, the patients are "happy" but they are still in severe pain/fever etcetc. After taking blood work, results come back real bad and the patient gets admitted in the end. Would you honestly want to be pampered and told nice things but horribly mismanaged????
The last one is a rhetorical question btw....
Doctors too can be the nightmare customer they are complaining about here.
I work for a medical supplier and have encountered doctors using the most foul language on me when their equipment don't work the way they expected. Hey, would it kill them to first read the instructions ?? I have also met genius doctors who somehow become structural engineers "advising" me the "best" way to hang heavy items from the ceiling.
Yes, I would prefer a doctor who knows his job well, but is it too much to ask that he don't behave like an asshole ?
I think there is a problem in Singapore.
People might have become just too full of themselves over there.
Everyone thinks they are the smartest and most important.
Actually it is rather simple. People are inherently lazy.
I've always felt that service recovery people don't realize that if all doctors were really excellent in communicating and made all their patients super happy, then there would be absolutely no service recovery to do at all. And guess what. All these service recovery guys would be out of a job!
Everyone would love to sit around do nothing at the desk except surf the net and get paid big bucks for it. Ideal job eh?
That's how it seems in Singapore. Which is where I feel the attitude is all wrong.
We all need each other. We all have our various roles to fulfill. The patient has a role to fulfill when s/he is seeing the doctor just as the doctor has his/her role to fulfill.
Administrators have their roles as well but the primary business of healthcare lies on the foundation that you need to have doctors.
No doctors and you have no hospital, no clinics, no patients and absolutely no need for all those admin staff. Well maybe you can open a hotel and keep those admin staff on a payroll. But then you'll still be working hard but just answering different types of complaints.
Problem is that the people in power are all the administrators. So in reality doctors work for the administrators. Like it or not, accept it or not, that is the reality. Administrators are the bosses. And their ideal is to sit around and have everything running smoothly so they can spend time coming up with new ideas and plans to "improve". Which is what would really get them promoted.
Wrong focus.
In my view the ideal place where service recovery people should be.....is right next to the doctor everyday. Sit in the consult room. And if there is a problem fix it right there and there. See the situation unfold for yourselves and then talk to the patient. No point sitting up in some office, reading and hearing one sided stories from patients who twist and turn the facts and then always doubt the doctor. It isn't fair that way.
But hey.....well....the world isn't fair at all. That's another reality.
Bottomline....if you want something you got to fight for it
"Bottomline....if you want something you got to fight for it"
Gee, wouldn't that make you... "greedy"?
don't forget that these admin people are also the ones who control the nurses. Nurses r also subjected to the mercy of those trigger happy complaint clients.
Isn't it wrong for HR to have the passports of foreign nurses 'confiscated' as 'safe keeping'?
Public Healthcare systems of western countries, ie Australia or NZ do not impound the passports of foreign nurses?
I beg to gain some insight from these admin why is it necessary to stoop down to such unsavory practices.
angrydoc: everybody is 'greedy' lah .. let's face it. from the top to the bottom of the hierachy.
by the way, there are many ways to deal with complaint letters ;)... and i am not scared of complaint letters.
One should not be scared to confront shameful lies.
Lies will be defeated by the Truth!
Yes, anonymous above is correct in that they are promoted according to new ideas and plans, whether it is really necessary or feasible or cost effective for patients, that's another story altogether. After all, during appraisal time, they will have to list all the major initiatives and ideas they have put forward so that their bigger bosses can justify their promotion.
And to quote angrydoc above
"The problem when you pay someone like Anon to do a job called "service recovery" and presumably use customer satisfaction as a KPI, you create the idea that customer satisfaction is a worthwhile goal, with no reference to right or wrong.
Ask youreself, Anon, how often do you tell your customer that they are wrong."
Unfortunately for administrators even if a customer turns out to be wrong or invalid, they can never tell their customers that. The aggrieved healthcare worker who was complained against and investigated had take personal time to go through the case notes and then write a thorough report on the events that occurred. And if end of the day the complaint was not justified, it just ends there. The healthcare worker gets the short end of the stick, the administrator goes to say sorry to the customer regardless (maybe not a direct apology but a regret of some sort, definitely cannot say that the customer was wrong or expectations not justified, otherwise the customer will get even more angry!). Customer satisfaction is necessary I agree, but there must be a reference point, if customers are always treated like they are right no matter what, then the service provider(health care worker) inevitably will feel aggrieved if the event in question is not justified.
While there are complaints that are genuine or justified, on the other hand, there are also many complaints that are frivolous or just simply that expectations of customers were too high to begin with. I'm sure there are "bad doctors" around but there are also "bad administrators" and "bad patients" to complete the picture.
Yes, bersama, everyone is greedy, and there is nothing wrong with it.
The problem arises not from greed itself, but from how one seeks to meet those greeds. If a GP wants to make more money, he can choose to work longer hours, or to sell sleeping pills - the former is at his own expense, and the latter at his clients'. Some people fail to see this distinction and think all forms of greed are bad, and that those who are rich and/or successful are greedy and therefore morally inferior. I guess it's a way for them to feel better about being less successful/rich/driven.
I don't think the administrators think so much about who is right or wrong lah.
In the end they just want less work that's all. And if there are no complaints...means less work....and more time for them to think of some new project to make them more visible.
Which is why it is much easier to just apologize to the patient and give them what they want to resolve the issue ASAP and move on. Who cares about the doctor? Whether the doctor was right or wrong, did the right thing...it's not going to get the service recovery person promoted by siding with the doctor even if the doctor was the victim and not the patient.
Ask any hospital CEO whether they are "patient centric".
Patient centric. The new buzz word. Which in simple terms means....patient is KING.
well, if you were the patients, would you want to seen by rude and uncaring healthcare professionals?
We complain so that the bad sheep of the medical/nursing professional can be removed and we will be cared by courteous, competent and caring staffs.
Another benefit is that only if you complain, you get a chance for a fee waiver.
It's like threatening to cancel your credit card to get a annual fee waiver, or doctors threatening to quit unless they are allowed to go for HMDP.
I don't like dealing with rude people, be they doctors, patients, sales-persons, or waiters.
But you are making a couple of wrong assumptions there.
The first is that not showing a caring attitude = rude, courteous = competent. One can be nice but incompetent (as show by examples given above by other posters), and one can be polite and professional without displaying a "caring" demeanor.
The second is that rude = uncaring. A rude doctor can care a lot about your condition and care.
I see two specialists for my condition (non-subsidised, in case you are wondering), and one is friendly and chatty and asks about my hobbies and tells me about stuff in the clinic, while the other is curt and to-the-point. I prefer the second one.
"Another benefit is that only if you complain, you get a chance for a fee waiver."
You yourself have said it.
Can I add that the hospital bottomline is affected by complaint cases.
We have to hire lawyers to help advise us, draft replies to patients and their families.
Some patients even cc MP, Mr Khaw and even Mr Lee Kuan Kew!
It is ironically cheaper to just give them a waiver and end the case, rather than to investigate further opening a larger cans of worms.
If only doctors and nurses understand how difficult and expensive our work is and strive to provide better service and dont piss patients off.
The blacklist system does not work since if you blacklist the doc, nurse, they can simply join a different hospital and we are not allowed to release their info to our rivals.
The doctors in the past have less complaint cases but the doctors nowadays are so rude and think highly of themselves.
Guess why they are still with public hospitals?
They will starve if they move private since they will offend all their patients!
I suppose what bugs doctors nowadays is that "service quality" seems to have taken priority over "professionalism", both of which mean different things.
Patients pay for professionalism and accurate advice (whether they realise it or not), and service quality is "icing on the cake", so to speak.
The problem is that there's so much fanfare about the icing, and no one seems to be making any noise about the actual cake aka professionalism.
Patients also need to remember that icing only looks nice, but it's substance that counts. Perhaps patients should remain as Patients, and not Customers or Clients.
"Some patients even cc MP, Mr Khaw and even Mr Lee Kuan Kew!"
Wow. I am sure Mr Lee gives every single of those letters his personal attention.
"It is ironically cheaper to just give them a waiver and end the case, rather than to investigate further..."
Just as it would be easier to agree with patients when they are wrong and give them what they want and not what they need. Some of us choose to do the right thing, not the easy thing.
Anon who posted after you makes the important point: medicine is about giving patients the correct advice and not about 'delighting customers'.
Your priorities are wrong.
The cake is a lie....and with admins thinking the way hospadmin does, everyone gets the same very very short end of the stick.
The cake is all a lie...it's a lie......
That's the sad state of medicine now. I didn't join this profession to be the b*tch of every single patient who threatens to complain, I joined this profession to make a difference, to make medically sound decisions and to treat their illnesses
I hate how nowadays, when someone makes a request for a frivolous scan or procedure, the consultant is so quick to cave in to avoid complaints. What happened to saving hospital resources for the patients who REALLY need them? Or cost-effective medicine?
I used to love coming in to work to see my patients, talk to them, and arrive at a consensus of management with them after thorough discussion (naive I know). But with more and more patients making such unreasonable demands, it really kills what motivation I have for work.
I'm seriously contemplating moving somewhere else to practise, where doctors are still respected for their professional medical opinion, and not judged on how fast one can service the patients' wants. The impending flood of new patients (Population of 6 million by 2020 anyone?) and generally crappy work life balance just pushes me away.
I love this country, and it will always be home in my heart, but I just can't bear thinking of practising medicine here for the next 20 years, or even retiring here.
I am reminded here of an A&E junior doctor who had a knack of making patients feel at ease, even garnering compliments like "you are the best doctor i've ever met!". But he nearly missed a diagnosis of bowel obstruction, and would have if not for the medical students in his clinic.
I used to think that if my heart were in the right place, I would very naturally become a "good doctor". But every stakeholder in the value chain seems to have different standards of what a good doctor is - our patients, colleagues, the hospital admin, the govt, and our students too - and now I really have no idea what I want to be like when I graduate.
"I hate how nowadays, when someone makes a request for a frivolous scan or procedure, the consultant is so quick to cave in to avoid complaints. What happened to saving hospital resources for the patients who REALLY need them? Or cost-effective medicine?"
Good. You are learning a very important truth: a subsidised healthcare system that does not demand accountability from its users is doomed to fail. By giving in your consultants are accelerating the process. It's a classic case of the tragedy of the commons.
"... now I really have no idea what I want to be like when I graduate."
You don't have to decide now. Spend the next few years observing your seniors and colleagues. Eventually you will find your own style and reason.
wow hospitaladmin, now you are coming out into the open.
there we go.
by the way, you have failed to answer my queries.
"If only doctors and nurses understand how difficult and expensive our work is and strive to provide better service and dont piss patients off. "
do nurses and doctors deliberately piss patients or clients off?
so u are here saying it is VERY OK for a patient to come storming into a resuscitation bay where doctors and nurses are trying to save lives of patients who are really critically ill so that they can piss off for their 'social' events? and then they lodge a complaint when they are told off?
please answer this one ...
and why is it not ok for you to make it a policy to get security to step in when patients/relatives start abusing front line health care providers? in western countries abuse even at a verbal level is not appropriate unlike in Singapore where hopital admins like you choose to turn a blind eye to such unacceptable practices.
just another slave MO
"I love this country, and it will always be home in my heart, but I just can't bear thinking of practising medicine here for the next 20 years, or even retiring here"
you will have to make the call on this. do it when you are younger.
don't delay till you are past 40 years old as it gets harder to emigrate when you are older.
It is not okay for patient to come storming into resuscitation bay but it is equally not okay for doctors and nurses to be rude to patients.
Please greet and smile at your patients to avoid complaint cases.
Patients and relatives abuse front line healthcare providers because they are frustruated so stop adding oil to fire.
Make them happy, appologise for the long waiting time and identify those patients who are likely to complaint and see them first.
This way, there will be less complaint cases and hosp administrators wont be overworked with answering complaint cases and can actually spend time in quality improvement projects to help improve the health of our patients :)
I allowed the comment above but I suspect it is a parody and not by the same hospadmin who posted earlier.
I hope.
OK this isn't exactly on topic, but I just thought everyone here should read this.
http://www.newyorker.com/online/blogs/newsdesk/2010/06/gawande-stanford-speech.html
our Dear hospadmin said
"Make them happy, appologise for the long waiting time and identify those patients who are likely to complaint and see them first. "
Patients and relatives abuse front line healthcare providers because they are frustruated so stop adding oil to fire.
wow, u are encouraging everybody to be complaint kings and queens.
make them happy? allow them to abuse front line staff?
who is adding oil to fire?
i can confidently concur that you are the one , as you encourage and give the relatives/patients the licence to abuse front line staff while they are busy saving lives of needy patients.
so it is our fault that there is a quene.
it is absolutely disgusting of you to suggest that it is ok to be flippant with patient care so that patients can be processed quickly like a factory production line.
no wonder lots of my experienced Fillipino colleagues are looking for greener pastures in the western world health system after their contract have ended. in the end, we can only get those lousy ones who can hardly form a decent sentence in English.
Re : hospadmin
I see hospadmin still doesn't get the point we're trying to bring across. Your aim, and ours are completely different
Yours is to avoid complaints at all costs, be it sucking up to patients, or letting them throw their weight around and act like kings and queens
Ours is to treat the patients' medical problems, and to prioritise care according to who needs it the most, not who is going to complain
The fact that you can suggest prioritising cases to see based on who is going to complain, already shows your mismatch in priorities. MY priorities are to see the sickest patients first, so that they get appropriate medical care ASAP
If someone who is medically well, but is just being an a**hole about the queue wants to complain, then go ahead. I'm not going to let them cut queue ahead of someone who truly needs medical care just to appease them. I am a doctor, not a customer service agent for g*d's sake.
Do you have a problem with being patient-centeric?
If you can identify those who are likely to complain and see them first, you reduce the number of complaint cases and reduce our workload.
How can this encourage people to complain?
If the patients are happy, why would they abuse front line staff?
Think b4 u comment.
We aim to be fast, safe, cheap and good.
People leave because they are greedy and self centred without thinking how much our hospitals spend to train them.
Stop demoralising your poor colleagues. English can be improved.
What is more impt is that we can actively recruiting people to help solve the shortage in medical manpower.
Stop encouraging them to leave Singapore!
Where is your patrotism?
Quitter!
I think we are dealing with a troll here. I wouldn't bother to reply to the troll's comment, and I suggest you refrain from doing so too.
"Good. You are learning a very important truth: a subsidised healthcare system that does not demand accountability from its users is doomed to fail."
I hope you don't mind if I want to know more about this 'truth'.
1. What do you define as failure of a subsidized healthcare system?
2. Please give examples of failed subsidized healthcare systems.
a clown just commented :
"We aim to be fast, safe, cheap and good.
People leave because they are greedy and self centred without thinking how much our hospitals spend to train them"
best better betterest!!! LOL .. sounds like u are trying hard to copy someone famous huh ;)
wow, i am "greedy" for more work life balance (something that is advocated by our Leader Lee Hsien Loong - how dare you put that in a negative light?
i want more free time with my family , wow i am 'greedy' ... can lor, you and me can be greedy then ;)
we are not customer service agents. we are health care providers, ie doctors, nurses, physios,
english (? Englandd) can be improved within 3 months of training? hahahah ....
this clown just wants to make me crack up with laughter!!!
quitter? quitter for work life balance lah (jangan main main huh - our tuan besar cakap so ok) ! LOL
A failed subsidized system is when staffs discriminate patients.
From the point of view of staffs, they want to see as few patients as possible so if u are rich, u are abusing the system.
If u can borrow money to go private hospitals, u are abusing the system.
It's simple.
Hospadmin just doesn't want more work. That's all it is.
If the system was such that if he could show that the patient was wrong and the doctor is right then the somehow he gets a bonus or higher salary or some rewards maybe an extra week off....well then he would.
Problem is that the ball is in the patient's court. Not the doctors'.
Don't blame hospadmin. Who is he/she anyway? Is he/she a boss? A CEO? A Minister of Health?
C'mon. Hospadmin is just an employee administrator doing his/her job just like us.
We all have to play the game according to the rules. And sorry guys....but we DO NOT make the rules.
There are people who do. And we never ever ever see them at the clinics, at the wards, at the A&E with real patients day in day out.
They sit up in their offices thinking of new projects all the time.
I have a simple suggestion. Very simple one. In every bad customer experience, sometimes the best time to address and rectify the problem is to do it on the spot.
Can we station customer service officers like Hospadmin at clinics and A&Es and wards to come and do customer recover straight away on site? Have them do calls. Shift work perhaps.
Every ward should have one customer service officer to help bring down the number of complaints. I doubt hiring these admin people costs more than the lawyers.
Admin and doctors and nurses should work together at the same place seeing what goes on through the same eyes, feel the heat, hear the noise, smell the animosity.
TOGETHER. Not play good cop bad cop.
Please consider it. I don't try to tell hospadmin how to do his/her job so that it makes mine easier.
But you do see hospadmin telling doctors how to do their jobs so that it makes his/her's easier.
Somethings not so right here.
PS: is anyone out there keen to migrate? The way people treat each other is kind of different in other countries.
dr oz bloke in 30 jul 1547
"PS: is anyone out there keen to migrate? The way people treat each other is kind of different in other countries."
of course lah, it is very different.
one good example, as bersama had stated, it is not acceptable for relatives to abuse front line staff in these countries whereas in sgp, admin has given them the license to do so.
these junior drs and nurses will make the call. we can't stop them if they want to leave and admin will heck care afterall.
australian medical council exams are already conducted in singapore suntech city!
kiwi/uk/aussie nursing recruitment drive are happening in sgp too and they do give out flyers outside the hospitals too!
these admin can continue to tidur or sleep and they won't give a damn and you know why?
they can get cheap, cheaper, cheaperesttt nurses and doctors from india and china
but admin will continue to pay themselves handsome wages and work in their aircon units and it is none of their concern about things happening at ground level. anyway their bonuses are tied down to the number of new projects that they can come up with.
I do agree with dr ozbloke that we should station duty admin personnel at every level to do recovery work on the spot and they should be on call too, to attend to complaints instead of sitting intheir ivory towels
i would like to hear from admin
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