Angry Doctor

Tuesday, February 28, 2006

Well, you may be damned if you do it...

The issue patient-doctor confidentiality came up in the discussions over doctors revealing information regarding their patients in their replies to complaint letters in the ST Forum.

I had not planned on discussing the issue here as it was covered on Mr Wang's blog, but phelan's comment set me on a google search, which yielded this article.

Now the article covers specifically Disciplinary Proceedings by the Singapore Medical Council, and it can be (and was) argued that in such cases the complainant's consent for the pertinent facts of the case to be revealed is implied, since it would not be possible for a full and fair investigation to be conducted otherwise. In any case, the party privilege to the information will be small and on a 'need to know' basis.

As for whether a 'trial by media' on the ST Forum qualifies as an exception to the duty of patient-doctor confidentiality, I guess the jury is still out.

38 Comments:

  • just took a cusory glance on the article you posted

    ‘respect the secrets that are confided in [him], even after the patient has died’

    What secret is there to keep by describing the person has been having flu for the last week, taken a course of antibiotics and still hasn't recovered. I find nothing incriminating even if these information were revealed. Do all doctors interpret every thing during the consultation as secret? I am sure most doctors discuss their 'cases' with one another. Wouldn't that be considered a breach of doctor patient confidentiality. I say some of those talks are more embarassing than just a mere flu for 5 days taken first line antibiotics not working.

    'Where a patient has raised a complaint against the doctor, doctor-patient confidentiality should not be in issue as the patient has arguably waived his right to confidentiality'

    Since madam gan raised the complain doesn't that remove her right for confidentiality. I mean who is going to repair the damaged image if the doctor hasn't chosen self defense. Or is he going for a defamation suit?

    By Anonymous Anonymous, At March 01, 2006 12:27 am  

  • Doctor-patient confidentiality is one species of the law of confidentiality. The law of confidentiality is itself a "common law" concept, which in turn means that the principles are not actually laid down by a legislative-making body like Parliament, but by the courts, through their decisions in actual cases, over the years. (Of course there are also situations where a duty of confidentiality arises out of specific statues, eg Official Secrets Act concerning civil servants; Securities and Futures Act concerning persons with insider information on listed companies).

    The common-law duty of confidentiality may arise in quite a number of different variety of contexts - for example, doctor & patient; employer & ex-employee; priest & confessor; counsellor & counsellee; banker-customer or even two business parties.

    It's important to note that there are always exceptions to the duty of confidentiality. Firstly, you have to think about what part of the info is to be treated as confidential. Secondly, there is the question of who you disclose that info to. Thirdly there is the question of why.

    One of the key exceptions is where the discloser's own interest is being attacked by the other party and the discloser needs to defend his own reputation / business / interests by disclosing the info. It is not necessarily confined to the kind of "disciplinary proceeding" example that you have mentioned. The example you have spelled out may only be one example - it could well be a procedural rule rather than a substantive one; in other words, it guides the disciplinary committee on how to conduct its own proceedings in cases where such information is to be disclosed.

    By Blogger Mr Wang Says So, At March 01, 2006 7:15 am  

  • I just clicked on your link (after posting my comment above). As you can see, Francis Xavier mentions another exception to the general rule - "implied waiver".

    The idea, in our present case, goes like this - the woman (a) wrote to a newspaper, (b) mentioned the doctor's clinic, (c) revealed details of her child's illness and treatment, and raised (d) raised issues about fees and charges and efficacy of the prescribed drugs.;

    and from this, it can be argued that she has waived her right to confidentiality; that is, by her conduct she has shown that she does not insist on having her case treated as confidential. Or at least, she does not insist on having certain aspects of the case being treated as confidential.

    By Blogger Mr Wang Says So, At March 01, 2006 8:59 am  

  • Thanks, Mr Wang.

    I don't think the letter-writers will be filing a suit on breach of confidentiality this time round, so I suppose we won't know for sure until a case makes it to the courts or SMC to become the test case?

    By Blogger angry doc, At March 01, 2006 9:13 am  

  • anon,

    when it comes to the 'ethics' of confidentiality, I don't think the 'seriousness' of a piece of information makes a difference to its 'secretness', so yes, everything is supposed to be confidential. This refers to the SMC dealing with the doctor, not civil or criminal court. I don't believe the patient needs to prove damage was done.

    There are exceptions when discussing cases with other people involved in the treatment of the case (implied consent on the part of the patient), but you would still be guilty of a breach if you talked to your colleague from another department not involved in the case during lunchtime, if you disclosed the name of the patient.

    As for the doctor filing a defamation suit, it might be difficult as the patient can claim "special privilege"; in the Elidel case, the complainant justified her actions as trying to "protect other babies and parents who may be none the wiser about this". Of course the difference between her account and that of the doctor may be taken as evidence of 'malice' if she is proven to be lying, but I guess that's all speculation now. We won't be sure until a test case goes to court.

    By Blogger angry doc, At March 01, 2006 9:24 am  

  • I wonder how things will turn out if all of us doctors took a collective stand and replied to all complaint letters written to the press in a standard manner.

    "Due to patient-doctor confidentiality issues, we are unable to respond to the complaint via the press. We have contacted the complainant and explained the isse with him/her personally"

    That would probably make more people suspicious, but would protect doctors from legal persecution.

    Looking at it from all sides, it's a no-win situation for doctors essentially.

    Once you become a doctor and you took that Hippocratic oath, you essentially sold away your freedom. It seems to me that angry patients see doctors as their slaves and punching bags.

    The law protects patients but it does not protect doctors.

    I guess the balancing factor is that doctors are still paid premium salaries.

    Cheers!

    By Blogger Dr Oz bloke, At March 01, 2006 9:54 am  

  • Why is law paid more than medicine when they are 4 yr we are 5 yr
    They have 6months internship, we have 1 yr internship?
    1 yr 6000 for them and us 18000
    Total 24k us 90k.

    Moral of story: Give yr child a book in law rather than a book in medicine.
    Lawyers add value, doctors don't.
    Lawyers work for the rich, doctors don't always work for the rich.
    People don't complain about lawyer's fees, but people complain over doctor's fees.
    With all the bad press, we will soon be as respectable as a used car salesman.

    Regards.

    Other NUS graduates are also earning higher salaries - on average, about $125 a month more than those the year before.

    Bachelor in Law graduates commanded the highest mean gross monthly salary of $4,083, followed by medical graduates, at $3,911.

    On the whole, professional degree holders earned an average of $2,750, an increase of 3% compared to 2004.

    Non-professional degree holders earned $2,300, an increase of 4% compared to 2004.

    By Anonymous AnG Yee Gary, At March 01, 2006 11:53 am  

  • Dear Gary,

    It's sad to see that you are already despondent about medicine as a profession.

    All this even before you graduate! I must say I'm worried for you because it will only get worse after graduation! Much more so when you are serving your housemanship!

    I can see why you have decided that you want to be an administrator. Are you going to do your housemanship? You could choose not to and not be registered as a medical professional.

    I remember during my time in med school, there was a senior who quit med school when he was in year 4. He went back to serve his remainder NS liability (he had disrupted originally) then went back to NUS to study something else. I wonder where he is now.

    I guess you could do the same. It would be pointless to complete med school and never be a doctor. You are far better off with another degree if you want to be an administrator.

    Good Luck!

    By Blogger Dr Oz bloke, At March 01, 2006 12:13 pm  

  • Hopefully I can afford to get a MBA after med school

    DR DRIVEN
    New NMP Dr Tan Sze Wee leads no cushy doctor's life, but travels worldwide in a fast-paced job as a biotech firm's boss

    By Ng Wan Ching
    wanching@spn.com.sg

    WHEN you pick up the phone to call Dr Tan Sze Wee, you never know where in the world he is.

    He spends at least half his time out of Singapore, working to establish a new fungal infection diagnostic kit called Candia5, and to raise money for other products in the pipeline.

    His handphone is on all hours to suit international investors from all time zones.

    'I work 24/7, 365 days a year,' said Dr Tan, 36. 'If I had wanted an easy lifestyle, I would have been a full-time doctor and played golf in my spare time.'

    Now, his hectic pace of life is set to go up a notch: He is one of the nine new nominated Members of Parliament (NMP), who will start their term of service on Jan 2.

    This is on top of continuing to practise as a doctor during weekends at the two clinics he has set up with a partner.

    But this is just what you'd expect from someone who chooses to live life in the fast and unpredictable lane of entrepreneurship.

    His main job, as the managing director of a biotech company, is high-risk.

    WILL POWER

    'It's the will of a people that has made Singapore what it is today. Similarly, it's the will that keeps entrepreneurs like me going,' he said.

    He believes his personal experience over the last four years will put him in good stead to speak up for biotechnopreneurs.

    'We need to reduce the unnecessary adversity and obstacles that entrepreneurs face in Singapore, especially in little-understood industries like biotechnology,' he said.

    There are other challenges: He thinks there are many youths who believe the best days are gone and the worst is to come. He wants to encourage them to step beyond their comfort zone.

    'I grew up in the '70s and '80s in a three-room HDB flat, in a Mandarin- and Hokkien-speaking family. Even in my humble surroundings, I experienced a time of great growth, hope and optimism in Singapore. My family went through the recession of the mid-'80s with esprit and verve intact,' he said.

    He was the top boy at Anglo-Chinese School in Secondary 4 and then went into medicine because it was what his parents wanted.

    After his medical degree, he picked up an MBA as he was also interested in administrative work.

    Next came an offer to work for US-based pharmaceutical company Bristol-Myers Squibb.

    He travelled extensively as its associate medical director. It paid well and satisfied his restless drive for a while.

    Four years ago, he met Australian scientist Dr John Warmington, who had been working on commercialising his PhD research on fungal infection diagnoses.

    Such a diagnosis used to take a week because it had to be confirmed with microscopic or laboratory tests.

    With Candia5, it takes five minutes, and you can do it at home.

    'I quit a well-paying job and put in more than $100,000 of my savings to fund the business,' he said.

    Rockeby Biomed Corporation was born. The company almost didn't make it when its application to list on Sesdaq was rejected by the Singapore Exchange in 2002.

    It was incurring losses then, and did not meet the bourse's requirement that a listing prospect should be commercially viable within a reasonable time frame.

    Dr Tan, Rockeby's managing director and chief executive, said: 'Things were very difficult.'

    In January last year, he turned to the Action Community for Entrepreneurship (Ace) for help.

    'We obtained our interim funding, about half a million dollars, just as we were preparing to roll out the product (Candia5) in Singapore last July. This was crucial to our success.'

    Rockeby went on to list on the Australian Stock Exchange late last year.

    Dr Tan has since raised a total of A$13 million ($15.6m) with another A$5.4m to come by next March.

    Candia5 has hit the market in Australia, New Zealand, Malaysia, Hong Kong, Macau, Singapore, Japan and Vietnam.

    Registers have rung in A$30,000 for the first six months of this year.

    He's now set his sights firmly on the US market.

    'We know that annually about 10 million women see doctors for fungal infections, and the treatment market last year was valued at US$165m ($280m),' he said.

    THRIVES ON STRESS

    Even if Candia5 garners just 1 per cent of that market, it would mean sales of 100,000 Candia5 test kits a year.

    It sells here at $16 per kit.

    It has the potential to bring in millions, said Dr Tan, who is now waiting for the US Food and Drug Administration approval. He is also aiming to get Candia5 into European markets by the end of next year.

    With all his current commitments (spokesman for the Singapore Medical Association and council member of the Advertising Standards Authority of Singapore), he says it is 'a matter of prioritising my time' in order to be an effective NMP.

    'I thrive on stress,' said Dr Tan, who is married with no children. His wife declined to be interviewed.

    Targeting women's health market

    THE Rockeby Group aims to be a global fungal research and development biotechnology group, specialising in the diagnosis and treatment of thrush infections.

    Thrush is candida, a type of fungus. Several species of candida are naturally present in everybody, but it's also commonly the cause of many infections.

    Once infection sets in, it's a contagious disease that occurs most often in infants and children. It's characterised by small whitish eruptions on the mouth, throat and tongue, and usually accompanied by fever, colic, and diarrhoea.

    In women, it commonly manifests itself as a yeast infection of the vulva and vagina.

    Candida also multiplies uncontrollably in people with weakened immune systems, and may cause complications such as meningitis, pneumonia and even death.

    It can affect people with suppressed immune systems due to conditions such as HIV and cancer, as well as organ transplant recipients and premature babies.

    One in five infected babies die.

    This high mortality rate could be due to the condition not being diagnosed or diagnosed only when it's too late, said Rockeby's managing director, Dr Tan Sze Wee.

    He said: 'When the baby starts having a fever, you can't start treatment against fungal infection until you can confirm the diagnosis because the treatment itself is quite toxic. Early diagnosis results in early accurate treatment.'

    Rockeby owns core technology for diagnostic testing of thrush, which forms the basis of Candia5 and its SysCan3 hospital test kit.

    Candia5 is aimed exclusively at the women's health market, while SysCan3 is for premature babies.

    The latter is being tested in a major American study to see how effective it is on premature babies. It is being compared against three other tests to see which offers the quickest and most accurate diagnosis.

    The tests are coordinated by Duke University, in a two-year study sponsored by the National Institute of Child Health and Human Development, part of the National Institutes of Health, the biomedical research arm of the US Department of Health and Human Services.

    Dr Tan hopes to get SysCan3 on the market by 2007.

    By Anonymous Ang Yee, Gary, At March 01, 2006 1:40 pm  

  • "Hopefully I can afford to get a MBA after med school"

    It's not up to hope as far as affordability is concerned. You should be working out the sums now. You mentioned having to pay back the study loan for med school being a problem already. How does getting another loan for an MBA fit into your plans? Work it out and you'll know what you need to do. Don't leave it to hope.

    The other option is to apply for some form of scholarship or study grant via MOH. It sounds to me that Dr Tan was given something like that by MOH. But I guess there would be a bond.

    Perhaps that's what you were "hoping" for? But you did write specifically "hopefull I can afford" which to me doesn't apply to hoping for scholarships.

    But I am quite sure that if you do follow Dr Tan's path and gain success it would be far more rewarding for you personally than being a doctor.

    Good Luck!

    By Blogger Dr Oz bloke, At March 01, 2006 1:46 pm  

  • why settle for administrator?
    health minister lah! =)

    By Anonymous Anonymous, At March 01, 2006 3:10 pm  

  • Health Minister is never a doctor lah.

    So by default cannot liao!

    By Blogger Dr Oz bloke, At March 01, 2006 3:39 pm  

  • MBA is no a big deal in terms of costs... just a matter of efficient time mgt and you may just pay <$20k. unless u are looking at studying full-time in those ivy league biz schools.
    It's not uncommon to see MBBS folks in MBA classes. :)

    Complaint Letters:
    I've always thot that it would be more effective to send your complaint letter to SMC, than to the newspapers..

    Agree with the comments on the letters published that pple tend to only paint one side of the story. But sometimes, the doctors also one kind... got attitude problem, and lack of EQ.

    Eg: the 1st letter on the late nite visit rejected coz near closing hours. Instead of just waving and pointing at the clock.. opened the door and explain the situation, informing that those patients inside had waiting 30 mins already... then suggest alternative like visit the nearby 24hr clinic, etc. I'm sure the 2 patients would not be unreasonable and upset.

    I think you folks should start a knowledge sharing session on how to handle the different types of difficult, obnoxious, bitchy patients... heehee.. :P

    By Anonymous pretzel, At March 01, 2006 11:38 pm  

  • I don't think difficult bitchy obnoxious customers/patients are confined to clinics and hospitals.

    It's a national problem it seems. Just look at the programs put forth by the Singapore government to try to help improve service. GEMS. The customers have a part to play.

    So as far as service is concerned, the entire service industry (doctors included) are trying their best. It's the customers that are the problem judging by the direction the government has identified and taken.

    By Blogger Dr Oz bloke, At March 02, 2006 9:30 am  

  • "It's the customers that are the problem judging by the direction the government has identified and taken."

    What bullshit!

    We the consumers pay for a service. So start smiling, be gracious, be helpful, BE KNOWLEDGEABLE and we will reciprocate.

    By Blogger uglybaldie, At March 02, 2006 10:44 am  

  • "I don't think the letter-writers will be filing a suit on breach of confidentiality this time round, so I suppose we won't know for sure until a case makes it to the courts or SMC to become the test case?"

    Right. I am fishing around with me as the bait. See whether can haul some quack to court to prove a case.

    Get a top law firm to convince the judge to make it a landmark decision

    By Blogger uglybaldie, At March 02, 2006 10:47 am  

  • ""Hopefully I can afford to get a MBA after med school""

    Be reminded that MBAs are now as common as ITE grads.

    By Blogger uglybaldie, At March 02, 2006 10:49 am  

  • "Right. I am fishing around with me as the bait. See whether can haul some quack to court to prove a case.

    Get a top law firm to convince the judge to make it a landmark decision"

    I wish you every success. It's high time someone gave us doctors a wake up call!

    By Blogger Dr Oz bloke, At March 02, 2006 11:23 am  

  • "Be reminded that MBAs are now as common as ITE grads."

    And MBBS holders will working as taxi drivers in the future right?

    I think it's time to switch to becoming a stock broker. :)

    By Blogger Dr Oz bloke, At March 02, 2006 11:24 am  

  • Become the next Warren Buffett.

    By Anonymous Ang Yee, Gary, At March 02, 2006 11:39 am  

  • "And MBBS holders will working as taxi drivers in the future right?"

    Wa, you are very visionary leh!

    In future, Local MBBS will price themselves off the employment market because the Foreign talent Indian and Chinese doctors will be willing to work at quarter price.

    So OZ, better start applying for your taxi driver vocational licence.

    Hee Hee.

    By Blogger uglybaldie, At March 02, 2006 11:55 am  

  • Aiyah I am not so silly lah.

    I already got my MLM golden egg laying goose hatched liao loh!

    By Blogger Dr Oz bloke, At March 02, 2006 12:05 pm  

  • OZ,

    What are you or your wife selling through MLM?

    I want to participate just for a laugh!

    How can you be a good doc. if you are selling some rubbish through MLM on the side?

    By Blogger uglybaldie, At March 02, 2006 12:25 pm  

  • It's not rubbish mind you.

    You want to participate for a laugh?

    No lah you don't need to. You already get enough laughs slagging people in the blogsphere!

    Don't want you to die from laughter you know!

    LMAO!

    By Blogger Dr Oz bloke, At March 02, 2006 12:30 pm  

  • A good MLM product must be something that needs to be renewed frequently, skin creams, vitamins, health supplements.

    By Anonymous Ang Yee, Gary, At March 02, 2006 1:08 pm  

  • repeat after me: Healthcare/Medicine is NOT a service industry.
    Most patients are subsidized, hence most are NOT paying for their own healthcare (and I emphasize: not a service).
    The "foreign talent" that a small place like Singapore attracts tend to be foreign, yes, but for MOST that I've worked with, "talent" is a misnomer. Sure they may work for less pay, but the output often is proportional as well. Of course once in a while we get outstanding ones, but often they use Singapore as a stepping stone on the way to Western countries like the US.

    By Anonymous Dr Quack, At March 02, 2006 7:21 pm  

  • Never mind lah. About the FTs using Singapore as a stepping stone to somewhere.

    So many of them. Endless supply. Endless queue stepping to somewhere but in the meantime, singapore can benefit from low cost health service (oops, sorry,) healthcare from foreign docs.,pharmacists, nurses, radiologists, pathologists etc.

    Don't need no big talent to tell me I've got the flu or gastritis lah. Just gimme the medicine and charge me next to nothing.

    Americans driven by crushing medical costs are rushing across the border into Canada seeking relieve. In the same vein, Singaporeans are also queueing bumper to bumper for cheaper medicine (without a script even) and specialist medical care if needed. No secret that a lot of specialists are malaysians working in Singapore. So malaysians are not inferior as far as doctoring is concerned. So go across the causeway and pay half the price.

    By Blogger uglybaldie, At March 02, 2006 7:43 pm  

  • "Why is law paid more than medicine when they are 4 yr we are 5 yr
    They have 6months internship, we have 1 yr internship?"

    -------
    Errr, we lawyers also have to do an extra 6 months postgrad law course to qualify, in addition to the 6-month pupillage
    -------

    "1 yr 6000 for them and us 18000
    Total 24k us 90k."

    -------
    Errrr, because we lawyers don't use labs and laboratory equipment and cadavers etc, and just rely on books, pen & paper?
    ---------

    "People don't complain about lawyer's fees, but people complain over doctor's fees."

    ---------
    Oh, you are very mistaken. Clients regularly bargain with lawyers over the fees to be charged; but I don't think patients do that with doctors.

    By Blogger Mr Wang Says So, At March 03, 2006 12:49 am  

  • Errrr, because we lawyers don't use labs and laboratory equipment and cadavers etc, and just rely on books, pen & paper?

    Do Science Students use lab??
    Anyway no more dissection because of Sars, so we get money back??
    Dissection in first year only, so where is the money???

    Oh, you are very mistaken. Clients regularly bargain with lawyers over the fees to be charged; but I don't think patients do that with doctors.

    Try rejecting a patient because he can't pay. See what happen to u.
    If yr client don't pay, just write a letter to him.

    Lawyers are better than doctors.
    As Warren Buffett told Charlie Munger, "Law is a good hobby, but u can do better" That was b4 lawyers fees became obscene in US.

    By Anonymous Ang Yee, Gary, At March 03, 2006 2:12 am  

  • When will doctors earn a million?

    TOP LAWYERS LURED WITH $1 MILLION CARROT
    By Tay Shi'an

    HERE'S how much some Singapore companies are willing to pay to entice top lawyers to join them:

    Upto $1 million dollars a year in pay and incentive bonuses.

    So eager are these commercial companies and legal firms to poach these lawyers that several head-hunting firms have been unleashed to look for them.


    What can be included in the package? Salary, sign-on and guaranteed bonuses, profit-sharing, stock options and even club memberships.

    But before you go green with envy, million-dollar cases are quite hard to find. Most such lawyers are established in their own practice and would be quite reluctant to make a career switch.

    Also, they involve only the truly exceptional, experienced and commercially-savvy lawyers, said legal recruitment consultancy and head-hunting companies.

    'These are lawyers who can contribute to the business, not just give legal advice. They have the ability to sit with the general management team... and to use legal knowledge to find solutions for the business,' said a legal recruiter with 10 years experience.

    'For exceptional people, clients will push the limits to get them on board.'

    Deploying head-hunters or recruit consultancies to scout for lawyers is a relatively new trend in the legal profession here, though it is quite common in other countries.

    Unlike big companies, law firms' recruitment exercises have traditionally been quite conservative - either through advertisements in legal magazines or by word of mouth.

    But more and more companies are starting to make use of legal recruiters to find the right lawyers for the job, said several such agencies.

    Legal firms are always willing to pay big bucks for top lawyers as they are seen as money churners. And this happens even as some lawyers face a pay crunch and are sometimes let go by their firms.

    The New Paper understands that, on average, a senior lawyer with about eight years post-qualifying experience (PQE) can draw a salary of $10,000 to $17,000 a month, or about $120,000 to $200,000 a year.

    PQE is measured from the time a lawyer is called to the bar.

    A mid-range lawyer with three to five years PQE can earn between $65,000 and $100,000 a year. That's about $5,500 to $8,000 a month. These exclude perks like bonuses.

    A spokesman for Hudson Global Resources (Singapore) said that salaries and bonuses have improved since the second half of last year, when the economy started to recover.

    She said: 'Premiums over last-drawn salary have increased. Sign-on or guaranteed bonuses are also more common.'

    The spokesman added that the largest sign-on bonus that Hudson has seen recently was one year's salary.

    'It should be noted that this is an exception rather than the norm.'

    Ms Lesley Simmons, country manager for Legal Futures (Singapore), said packages have become 'fairly standard' in recent years.

    She said: 'Gone are the heady days of full expat packages. In these days of corporate governance, one can't be seen treating staff other than fairly from the rest of the company.'

    So, recruitment scenes like that in the book and movie, The Firm - where a fresh law school graduate is baited with a huge salary, a car and a house - are just a 'Hollywood fantasy' she said.

    And what do the legal recruitment companies get for helping make a successful match? Tens of thousands of dollars, it seems.

    Ms Simmons said that, typically, recruitment companies are paid about a quarter of a successful candidate's first-year salary, depending on the type of search.

    This means that even for a mid-range lawyer who earns, say, $80,000 a year, the recruitment company can earn $20,000.



    --------------------------------------------------------------------------------
    Hottest lawyers

    LAWYERS specialising in banking and financial institutions are very much in demand in Singapore.

    That's according to four recruitment companies - Hudson, Legal Futures, Law Alliance and Michael Page International.

    Two of the recruiters made special mention of those with knowledge of derivatives.

    Said Ms Lesley Simmons of Legal Futures: 'Derivatives lawyers are more difficult to find in this region. Financial products are getting more sophisticated here.'

    Debacles like Enron have also made an impact on the legal industry. Legal recruiters Hughes-Castell Singapore and Legal Futures said that there has been increased focus on regulatory compliance.

    A Hughes-Castell spokesman said that the increase in demand for compliance lawyers also stems from 'calls for tighter controls on financial services institutions'.

    Specialisations like corporate finance and intellectual property were also mentioned.

    Most of the recruitment companies said that mid-range lawyers with three to six years' post-qualifying experience are most in demand.

    By Anonymous Ang Yee, Gary, At March 03, 2006 2:19 am  

  • LHL was asked how much PAP ministers are paid. He declined to answer by explains how their pay is worked out. "The benchmark is pegged to two-thirds of the income of the 24th highest earner (median) among a group comprising the top eight earners from six professions (bankers, accountants, engineers, lawyers, MNCs amd local manufacturers)," Mr Lee said.

    I certainly don't see doctors among the top eight earners in that list!

    So the conclusion to the debate is that the top lawyers make MORE money than top doctors.

    I think that settles this whole discussion.

    By Blogger Dr Oz bloke, At March 03, 2006 10:32 am  

  • I never said that lawyers make more or less money than doctors. I was just correcting you on some factual matters.

    Since you are a doctor, it may interest you to know that lawyers are much more prone to depression than the general population. There are various studies on this - here's one that says male lawyers are two times likelier to commit suicide than the general male population.

    Btw, the truth is that most Singapore lawyers are not paid like what the article would suggest. Oh, and I know all those headhunters that the article mentioned - Lesley Simmons headhunts for me about once a year. :)

    Only the investment banking lawyers make that kind of money lah. And what the investment banking lawyers make pales in comparison to what the investment bankers make. Ever heard of 36 months' bonus? :)

    Not kidding you.

    This paragraph:

    "The New Paper understands that, on average, a senior lawyer with about eight years post-qualifying experience (PQE) can draw a salary of $10,000 to $17,000 a month, or about $120,000 to $200,000 a year.

    ... correctly represents my own position but I also have to tell you that I have peers earning no better than $5,000 to $6,000 monthly.

    In the legal profession, a lot depends on your qualifications, and whether you made the right strategic career moves at the right time. For example, within the investment banking world, I managed to muscle in on a hot area - derivatives, and look what the article says:

    "Two of the recruiters made special mention of those with knowledge of derivatives.

    Said Ms Lesley Simmons of Legal Futures: 'Derivatives lawyers are more difficult to find in this region. Financial products are getting more sophisticated here.""

    I could be wrong but I don't think the medical profession really works like that ......?

    By Blogger Mr Wang Says So, At March 03, 2006 5:45 pm  

  • "I never said that lawyers make more or less money than doctors. I was just correcting you on some factual matters."

    Yes Mr Wang, you never said that.

    But here's what our PM said "The benchmark is pegged to two-thirds of the income of the 24th highest earner (median) among a group comprising the top eight earners from six professions (bankers, accountants, engineers, lawyers, MNCs amd local manufacturers),"

    It seems to me from what the PM says, that those six professions are the top earning professions in Singapore. And that is why I concluded that generally the top lawyers earn more than top doctors.

    Which doesn't make the articles Gary quoted so unbelievable frankly.

    By Blogger Dr Oz bloke, At March 04, 2006 4:06 am  

  • That's why Warren Buffett told Charlie Munger law is a good hobby but he can do better.

    Wall street is the only place when people drive in to take advice from people who take the subway.

    Whatever can be sold will be sold by wall street.

    Zero Coupon bonds: u can't default on a promise to pay nothing.

    Want to be finanically independent.
    Learn from the mastet Warren Buffett. His letter is coming up soon.

    By Anonymous Ang Yee, Gary, At March 04, 2006 12:54 pm  

  • Read is books carefully.

    You'll find that Warren Buffet is more of a businessman in his thoughts and investment philosophies.

    He is not a technical stock picker.

    One of the keys in his approach is "predicting future earnings" of companies. Frankly, you can't be good at that if you aren't a bussinesman and know how to run businesses.

    A lot of peole all wish they could be Warren Buffet : self made billionair by picking stocks. The fact is, they are going up the wrong ladder.

    Try reading Peter Lynch's books. You'll get a similar philosophy but a different execution.

    I haven't heard of guys who are consistently successful OVER THE LONG TERM (like Buffet or Lynch) in the market based solely on technical indicators. In fact if it's anything, technical indicators are all hogwash.

    By Blogger Dr Oz bloke, At March 05, 2006 7:51 am  

  • There is still one guy in charge of Windsor who believe in low p.e. Is it John Bogle??

    Warren Buffett recent letter condemn the use of options. Regards.

    I am a better investor because I am a businessman
    I am a better businessman because I am a better investor.

    I love psychology because it helps to understand how the market work like a bipolar patient.

    People will always be fearful and greedy. What is difficult is in which order.

    By Anonymous Ang Yee, Gary, At March 05, 2006 10:47 pm  

  • Peter Lynch:
    One up on wall street
    Learn to earn

    Benjamin Graham:
    The intelligent investor
    Security analysis

    Warren Buffett:
    annual letter
    Of permanent value
    Warren Buffett wealth
    Buffetlogy

    Charlie Munger:
    Damm Right

    John Train:
    The new money master

    Sebastien Chong:
    Value Investing

    Teh Hoii Ling??
    Show me the money 1 and 2

    By Anonymous AnG Yee, Gary, At March 06, 2006 12:55 am  

  • So Gary, any success in stocks?

    I wish you all the best in your future endeavours. At least you have the passion and desire :)

    By Blogger Dr Oz bloke, At March 06, 2006 10:44 am  

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