Angry Doctor

Friday, February 24, 2006

... afflict the comfortable...

I envy the editor of the ST Forum.

You publish one-sided, sometime unsubstantiated complaints of 'aggrieved parties' without checking the facts behind their allegations, publish the replies to them, then sit back and watch the discussion develope, and when you are finally tired of the topic you issue a statement closing the topic, and then wait for the next hot topic to come up. All the while you do no (or little) writing yourself, and are relatively immune from the repercussions since you don't actually make any allegations yourself.

I'd like a job like that.

Well, I don't have that job, but I nonetheless enjoy watching the ongoing saga, now continued in this letter 'published' on the online forum. The author covers many points, so I will interspace my take in the main text.


Doctors at fault? That's not always the case

CUSTOMER service is a two-way traffic. I refer to a clinic in Holland Road's vicinity which closes at midnight. Apparently, late patients were turned away and they complained.

Put yourself in the clinic assistants' shoes. If the patients come at the last minute and each patient takes 15-20 minutes from registration to dispensing and issuing receipts, the clinic's staff and doctor will go home very late every day. It is not as if patients suddenly became sick at midnight. More often, it's because Singaporeans like to put off doing things until the last minute.

Regardless of whether the patient had been procrastinating, or that she was there to see a doctor for a toothache when she should have gone to the dentist, I think it is not unreasonable to expect that if a clinic posts its opening hours as 'to midnight', one should still be served if one stepped in at 11:59pm. I could not find any legal regulation requiring a clinic to adhere to its opening hours, but would not be surprised if such a regulation exists.

The issue rather is the expectations of the clinic staff and the doctor. If you expected to leave the clinic on the stroke of midnight, perhaps it would be more realistic to close registration at 11:30pm and post the operating hours as such. Or if the employer expected the employees to stop registration only at midnight, then perhaps they should be paid for an extra half-an-hour thereafter?


One reader complained that her father was turned away at a clinic in Serangoon because its rules stipulate that only regular patients, and no new patients unless brought in by a regular, will be attended to on holidays.

From the clinic's view, opening the clinic on public holidays is a service to loyal patients of the doctor. They are loath to accept patients who see their competitor doctors but take advantage of their clinic's services only when their regular clinics are closed.

I remember the complaint letter vaguely, but do not recall reading a reply. In any case I think the law is pretty clear on doctors having to see urgent cases. But then again, to determine if it were urgent, you will need to see the patient first... so I guess, it's a no-win situation for doctors here.


Another reader complained she was charged $80 for simple flu medicine. The doctor had prescribed Klacid MR, which is very expensive.

The patient can always tell the clinic that he cannot afford such branded, expensive medicine. A face-saving way is to pay the consultation fee and ask for a prescription to buy the drugs at a pharmacy instead.

There are doctors who charge a premium for using branded, expensive drugs and not generics, so the mark-up and consultation fees go up stratospherically.

The message is: If you want good, strong medicine to cure you at one go without having to go back two or three times to the doctor, be prepared to pay for premium drugs.

The range of fees for simple flu medicines can be from $17 in a common HDB clinic to $80 in 'high-class' GP outfits. It always pays to ask first. It's like this: You can have your hair cut at $8 by the neighbourhood's Indian barber or pay $100 at a high brow hair saloon.

Lim Boon Hee


Leaving aside the question of whether 'good, strong medicine' that cure patients at one go without him or her having to go back to the doctor two or three times exist for all (or indeed a majority of ) conditions, I really like the hair-cut analogy.

I was thinking about the food analogy of a clinic being like a restaurant, but realised that the food analogy may not be apt because the chef directly adds value to the raw material that is the meat or vegetable, but a doctor does not necessarily add value directly to the drugs, which are manufactured elsewhere.

The hair salon analogy is more apt, because one would expect an upmarket salon to use more expensive shampoo and conditioner, for example.

Do more expensive shampoo and conditioner really make a difference? I don't know, but I suspect David Gan doesn't use any of the expensive stuff on himself...

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5 Comments:

  • Lim Boon Hee's letter was published in the print edition of Straits Times as well.

    I think the hairdresser/barber analogy is not that apt actually.

    You don't die or suffer badly if you don't cut your today vs tomorrow. It also seems that medical services are essential. I doubt people would term barber servcices essential in the same way.

    I think the restaurant analogy is still good.

    Mother brings starving child to Loy Kee Chicken Rice restaurant. Asks to buy chicken rice to feed her hungry suffering starving child. The bill : $4

    Mother brings starving child to Chatterbox restaurant at Mandarin Hotel because her hawker centre chicken rice seller has closed. Asks to buy chicken rice to feed her hungry suffering starving child. The bill : $20.

    Note that both Loy Kee and Chatterbox serve up great Chicken Rice of comparable quality. The only difference is the brand, ambience and opening hours. What you would call "window dressing".

    By Blogger Dr Oz bloke, At February 24, 2006 6:24 pm  

  • "Do more expensive shampoo and conditioner really make a difference? I don't know, but I suspect David Gan doesn't use any of the expensive stuff on himself... "

    haha you never know right? Maybe he was given 1 year free supply of expensive shampoo for endorsing the products ;)

    By Anonymous Anonymous, At February 24, 2006 6:48 pm  

  • If you guys do not know yet, yes, there is a difference to doctors who add value. It may be the same medicine but the skill of the doctor counts in how he/she use them. The restaurant with better chef cooks a better dish according to local standards BUT may not suit your taste.

    So, to you there is no difference between the Italian cars, Japanese cars, Korean Cars, Russian cars?

    By Anonymous dryvlee, At February 25, 2006 12:14 am  

  • http://www.straitstimes.asia1.com.sg/
    forum/story/0,5562,373632,00.html?

    The reply from Street 11 Clinic is out.

    By Blogger Dr Oz bloke, At February 25, 2006 12:20 pm  

  • "All the while you do no (or little) writing yourself, and are relatively immune from the repercussions since you don't actually make any allegations yourself."

    Not true. The role of the editor is also to vet whether anything written by readers are defamatory. If it is, and the newspaper publishes that letter, the writer AND the publication will be cojoined in an action for defamation. Most times, the papers rely on the defence of "fair comment" and "comments of public interests" to take the risk of publishing those letters. That's why some letters are never printed in the Forum pages.

    "The message is: If you want good, strong medicine to cure you at one go without having to go back two or three times to the doctor, be prepared to pay for premium drugs."

    What a hare brain solution coming from a presumably medical doc. It is common knowledge even amongst laymen that you don't prescribe the medicine of last resort unless and until it is absolutely necessary. You don't use a sledgehammer to kill a fly. See the reply from Street 11 clinic. We now know that the child did not respond to previous antibiotics, that's why Klacid was prescribed in the hope that this strong designer drug will solve the problem. Apparently, its prescription thereof has caused more problems! :-)

    By Blogger uglybaldie, At February 25, 2006 1:51 pm  

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