Obesity - a KPI? How silly can you get?

Mr Liak Teng Lit, CEO of Alexandra Hospital and the coming Khoo Teck Puat Hospital was reported as saying "....All things being equal, if you are grossly obese, we won't promote you."

Perhaps Mr Liak should also penalize those who can't pass their IPPT (Individual Physical Proficiency Test). Not to mention the elderly, myopes, diabetics and hypertensives as well.

More at Gigamole Diaries.

Teaching a new ball old tricks...

I was reading this interesting account about the new Adidas ball they've been using for the 2010 World Cup. The Jabulani ball.

Not very well received so far. Many complaints. But for intents and purposes, a technologically superior ball compared to previous versions of the football.

I found it quite interesting.

So here's a question to ponder.... is everything better always...better?

I can think of the software upgrades we keep getting. Each versions gets better and more powerful ...but invariably bigger, messier and more difficult to use. In many ways they become less intuitive and we need more keystrokes to get to the same point. Is better, better?

Our work 'software' has the same problem. Office and management 'improvements' keep destabilizing the work process , and I often wonder if productivity is improved.... or actually degraded through these frequent changes.

Seems like there is a certain efficiency in familiarity, and a certain loss in efficiency when we operate on the learning curve. If changes occur frequently, even though they may ideologically be 'improvements', a certain inefficiency is introduced by moving workers from a position of familiarity (and its associated efficiency) to an unfamiliar uncomfortable position on the learning curve.

Not everything that is better, is actually better.

Closer to home....I think our health care system as well as medical education environments need a period of stability so that we can all start mastering the processes rather than keep chasing endless series of changes.

Ignoring the Elephant

I read this news article with no small degree of amusement:


MTI says no to excluding doctors' Guideline on Fees from Competition Act

SINGAPORE: The government has thrown out the Singapore Medical Association's (SMA) request for its guidelines on fees to be excluded from the Competition Act.

After consulting the Ministry of Health (MOH), the Ministry of Trade and Industry (MTI) has determined that the guidelines could create anti-competitive behaviour, and cannot be excluded from the Competition Act.

The guidelines were introduced in 1987 by SMA and the Association of Private Medical Practitioners of Singapore (APMPS), following the MOH's calls for a guide on medical charges.

This was to equip patients with pricing information on consultation and surgical fees, and to prevent private doctors from overcharging.

In April 2007, the SMA removed the guidelines voluntarily on legal advice that they could contravene the Competition Act.

It then sought to have the guidelines excluded from the Act.

The MTI said in a statement that in the absence of other information, the guidelines would have been useful in providing information to patients on medical fees.

But the MOH is already publishing actual medical fees at hospitals on its website.

In May this year, the government announced that all hospitals making Medisave claims will have to submit basic billing information from early next year.

Public hospitals have been doing so for the last seven years and this is part of the government's plans to make pricing more competitive and realistic in the private sector.

Dr Chong Yeh Woei, president of SMA said: "We hope that the mechanisms to protect the patients will be sufficient, but the downside of this is that there will be a risk that there'll be an erosion of trust between the public and the profession.

"Now, it doesn't matter whether it's the private sector or public sector, the public will perceive it to be an industry-wide sort of situation."

While he admits that there are black sheep in the industry, Dr Chong pointed out that most doctors still charge reasonable fees.

SMA said it will continue to publish data on specialists' fees to give patients some information on pricing in the private medical sector.

It had filed a separate notification with the Competition Commission of Singapore in February last year, and the commission said it hopes to conclude its evaluation shortly.


Now it seems to me that if the government was truly anti-anti-competition, then perhaps we shouldn't just be looking at the competition between the private sector and non-subsidised healthcare in the public sector, but at the more unequal competition between subsidised and non-subsidised healthcare, shouldn't we?

More importantly, why would the Ministry of Health want healthcare costs in the private sector to be lower?*

* - Those of you who know the answer, please do not reply - it will be our little secret...