Does anyone agree that the SMA's appeal to restore the guidelines on medical fees was a huge waste of time?
And correct me if I'm wrong, but wasn't this triggered by a certain medical professor's editorial in the Straits Times, criticizing the removal of these guidelines?
I wonder how much the SMA spent on legal fees.
And what's become of the lawsuit involving a prominent liver transplant surgeon, who charged a foreign patient a gazillion dollars, only to have him die in the end?
It seems every time I read a newspaper article about Alexandra Hospital - now Khoo Teck Puat - it mentions waiting time and all the terrific measures being taken to shorten it.
Here's something for its CEO and journalists to chew on - its Emergency Department does not have round-the-clock senior coverage. And when I say "senior", I mean registrars and consultants.
I.e. senior medical officers and resident physicians run the show on a regular basis, night shifts included.
Apparently, this is because the number of senior ER physicians is lacking, reasons for which I am not privy to. Compare this to the newly established Jurong General - now parked at the old AH premises - that is practically overflowing with consultants.
As patient attendances at KTPH continue to rise - it's already hitting 200+ per day - the powers that be should pay less attention to waiting time, and be more pro-active in attracting specialist talent to the ER.
Being the only local restructured hospital without 24-hour senior supervision in the ER is a step in the wrong direction. Patients should be aware of this, and the administrators should find a solution as soon as possible.
I had the pleasure of reading Atul Gawande's latest essay on National Day. Written in his typical eloquent style, "Letting Go" tackles the issue of dying and how modern medical care is ill equipped to deal with it. Much of the writing revolves around patients with terminal cancer, a particularly difficult subpopulation in the sense that there are so many new therapeutic agents now available (with far more to appear over the horizon), yet these patients remain in a situation where death seems "more inevitable" compared to patients with end-stage heart failure or obstructive lung disease.
Most of the new (and old) therapeutic agents for metastatic cancer offer more hype than hope, and the symptoms they ameliorate at remarkable financial costs (in Singapore, few chemotherapy drugs are subsidized in the public sector) are sometimes replaced by the toxicities of the drugs. I am sure virtually all oncologists understand that with most chemotherapy, they are providing symptomatic relief and prolonging life by several months on average, but the patients and their families generally do not truly understand this at the start, wishing against hope for a miracle that almost never appears. And in some patients, this hope can go too far when they search desperately for ever more experimental drugs and miracle cures on the internet that less scrupulous practitioners may be willing to provide.
From the latest issue of the SMA News.
Comments, please. But keep it civil. :)
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