Angry Doctor

Wednesday, March 19, 2008

Take my rights... please! 2

Well, well. Here's a letter to make angry doc stir from his stupor:


Keep S'poreans small, ban char kway teow?
Letter from GOH KIAN HUAT

I REFER to the report "Beware! Super-sized S'poreans on way" (March 17).

My nine-year-old daughter, classified as severely overweight, has been attending counselling sessions with food nutritionists at the Health Promotion Board for the past two years.

However, her attempts at losing weight have not been successful. It is easy to list the types of healthy foods one should eat, but difficult to find and eat only these healthy items.

I applaud the initiative in asking fast-food outlets to put healthier options on their menus. They should also provide healthy choices for adults.

McDonald's could offer vegetables, fruits or desserts with their set meals and Kentucky Fried Chicken could remove the skin before frying the chicken.

Customers should also be able to choose between soft drinks and ones that contain less sugar.

Health Minister Khaw Boon Wan said he eats char kway teow only three to four times a year, and that if we eat this frequently — five to 10 times a month — there will be trouble. I find this is no different from smoking. Should such unhealthy food be allowed to be sold in the first place?

I suggest that the National Environment Agency ensures that its licencees sell healthy, nutritious food.


The fact is every place that sells soft drinks also sell a drink that tastes exactly like a regular soft drink, but contains only half the sugar and therefore only half the calories.

It's called half a soft drink.

angry doc believes that there are no unhealthy food, only unhealthy meals. (Unless you are talking about poisonous food, and some may include food which contain trans-fat in this category...)

Conversely, there is no healthy food that does not become unhealthy if one consumes too much of it.

A calorie from slice of whole-meal bread is the same as a calorie from a slice of patoto chip, and it is not only what you put inside you that matters, but also how much of it you put inside you.

We may legislate against sale of so-called unhealthy food or their advertising, but as long as oil, starch and sugar remain cheap and available, Singaporeans will continue to have access to cheap calories.

At the end of the day, what and how much we eat is a personal choice and thus personal responsibility, except in the case of children, where it becomes the responsibility of the parents ot guardians. angry doc finds it sad that Mr Goh would rather those choices and responsibilities to be taken away.

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12 Comments:

  • Conversely, there is no healthy food that does not become unhealthy if one consumes too much of it.

    Paracelsus! lol

    By Blogger Lim Leng Hiong, At March 19, 2008 5:48 pm  

  • quite a typically Singaporean request, isn't it? Asking the government to take care of things when it should be the parents' prerogative to do so in the first place?

    By Blogger aliendoc, At March 20, 2008 8:38 am  

  • The saddest thing about this is not that such a letter was written, but that Today saw fit to publish it.

    By Blogger testtube, At March 20, 2008 1:24 pm  

  • And, seriously, what is so difficult about buying fruits and veggies from the supermarket? She speaks as thought the only food available comes from fast food outlets and hawker centres.

    By Blogger testtube, At March 20, 2008 1:27 pm  

  • baaa baaa baaa

    If that reader is not a stoopid sheep, then I don't know what is!

    Everything the government must do and decide for us...haven't he exercise independent judgement and choice?

    No one is forcing him and his daughter to eat at Macdonald or KFC for heaven's sake...

    Neither are there people forcing him NOT to eat well or exercise a little common sense!

    By Blogger Xtrocious, At March 20, 2008 3:12 pm  

  • Totally irrelevant. Are you married, angry doc?

    By Anonymous Anonymous, At March 20, 2008 9:10 pm  

  • Ban this ban that.

    Actually in some sense the government themselves are also like this letter writer.

    Banning aesthetic medicine? Is anyone forcing patients to undergo aesthetic treatments?

    If indeed these "unproven" treatments are so ineffective and dangerous then I doubt these doctors will have flourishing practices now would they?

    Sometimes from such actions you can see how the government views Singaporeans in general. They think Singaporeans are babies who know nothing, are helpless, totally dependent and need nannying.

    Letters written by this letter writer support that theory.

    By Anonymous Anonymous, At March 23, 2008 12:17 am  

  • "If indeed these "unproven" treatments are so ineffective and dangerous then I doubt these doctors will have flourishing practices now would they?"

    Vanity, vanity, all is vanity.... GDoc is always amazed at the number of people who complain about the cost of medical care, and yet would not blink an eyelid while paying literally thousands on aesthetic procedures. To place such an emphasis on physical appearance, perhaps it is a symptom of some malady in modern society?


    "Banning aesthetic medicine? Is anyone forcing patients to undergo aesthetic treatments?"

    Excellent question indeed.

    To be exact, it is not "banning aesthetic medicine" in general. Rather, the controversy is centered on procedures deemed lacking in evidence.

    Now, everybody has an opinion. Each of us has a personal definition of what "evidence" implies. What follows is but GDoc's personal attempt in response to your question. Your milage may vary.

    Generally speaking, "evidence" in mordern medicine ususally means a trial based on a well constructed double blind study.

    Again, broadly speaking, modern medicine usually deals in "pharmaceuticals". The pharmaceutical industry spends millions upon millions to run these clinical trials in order to prove the efficacy of their wares. Medications we consume on a daily basis (e.g. Cholesterol, Hypertension, Diabetic, Analgesics, etc...) are required to produce such evidence.

    The cosmetic industry deals in, well, "cosmetics". Such items are exempted by the American FDA from proving efficacy via clinical trials. This translates to much savings for cosmetic companies, and also serves to protect the cosmetic company's trade secrets, as no data need be published. Thus, by declaring themselves as cosmetics, and not medications, these compounds and procedures fall outside the regulatory perview of medical watch-dog associations.

    Aesthetic medicine is a cross between Cosmetics and Medicine. The term "Cosmo-ceuticals" (cosmetic & pharmaceuticals) has been bandied around for some time.

    Now, as long as "aesthetics" was practiced by beauticians, and "medicine" by doctors, life would have been much simpler.

    Unfortunately, life as we know it, is sadly, complicated. Plastic surgeons have been doing reconstructive work for ages. As society became more affluent, different, and newer demands began to surface. Basic economics dictate that when there is demand, enterprising individuals will step in to oblige. Beauticians, and doctors alike began to exploit a lucrative, and growing market.

    Different standards are expected from beauticians and doctors. Beauticians are held to lower standards, and can promote all sorts of procedures within reason, caveat emptor. Understandably, doctors are held to higher standards, and are expected to adhere to "best practice procedures" (i.e. evidence based medicine). It is this practice of evidence, and non-evidence based medicine that lead to many unknowns and hence the controversy surrounding the current ban.

    In retrospect, many in the medical community were expecting action of some sort. The way things were progressing in aesthetic medicine, it was like watching an accident about to happen.

    Most people agree that some form of regulation was required to protect consumers (read: patients) from unproven products and procedures. However, aesthetic medicine was a "grey zone" that nobody knew how to approach.

    Again, please allow GDoc to reiterate that he is NOT, in any way, passing judgement on aesthetic medicine, but merely stating his personal observations of the industry over many years.

    Different people will, of course, have differing opinions. This is a minefield of controversy. In this spirit, please allow GDoc to answer your question by proposing more questions. It is GDoc's hope that the reader may reach his or her own conclusion after mulling over GDoc's questions.

    Since doctors are generally trusted by the public, should they be promoting procedures that have not undergone exhaustive clinical testing?

    Is the current ban a "turf war" between plastic surgeons, dermatologists and GPs?

    Does the medical watch-dog have a duty to ensure the well-being of the consumer?

    Is it even the medical watch-dog's business to step in?

    Should doctors even be practicing aesthetic medicine?

    Is the growing demand for aesthetic procedures a sign of a healthy, or sick society?

    Would the reputation of the medical community be tarnished by practitioners of aesthetic medicine?

    Many of the qualifications displayed (but not recognized by the medical council) by aesthetic practitioners (e.g.: laser, mesotherapy, aesthetic associations, etc...) require only a few days to a couple of weeks of talks and lectures to attain. Should the consumer be advised accordingly?

    Given the long hours, huge responsibility, and poor compensation in the practice of medicine (generally speaking), can we blame doctors for dabbling in the lucrative field of aesthetic medicine?

    With this, GDoc wishes the gentle reader a good night.


    Disclosure: GDoc does not practice aesthetic medicine.

    By Blogger GuinnessDoc, At March 23, 2008 1:44 am  

  • Hi GDoc

    Excellent post....
    It should be said that as more and more 'heartland' doctors appear to be heading towards asthetic procedures, less will be 'available' to treat actual medical conditions.
    Perhaps this is the reason MOH is clamping down so that health services ie Polyclinics and hospitals will not be overloading due to diversion of patients from the GPs who now prefer asthetic medicine to treating coughs and colds.

    By Anonymous EDoc, At March 23, 2008 7:30 am  

  • It should be said that as more and more 'heartland' doctors appear to be heading towards asthetic procedures, less will be 'available' to treat actual medical conditions.
    "Perhaps this is the reason MOH is clamping down so that health services ie Polyclinics and hospitals will not be overloading due to diversion of patients from the GPs who now prefer asthetic medicine to treating coughs and colds."


    Your guess is as good as mine.

    However, please note that not only GPs are piling into the aesthetics fray. Even specialists in fields that have no relevance to aesthetic medicine whatsoever, have succumbed to the siren call of asethetic medicine.

    This is a phenomenon not unique to Singapore. There are ER physicians who dabble in aesthetic medicine in the US.


    It is GDoc's guess that when given an opportunity to make much more money, doing a lot less work, in a loosly or largely unregulated industry.... who in their right minds could refuse?

    By Blogger GuinnessDoc, At March 23, 2008 9:41 am  

  • P.S. Readers are also reminded to keep in mind that certain government establishments in Singapore have their own aesthetic centres.

    By Blogger GuinnessDoc, At March 23, 2008 9:45 am  

  • Ha!
    MOH has just changed it's stand.
    Guess if they want to regulate doctors, then they will have to check on beauty salon, spas, slimming centres and the like!.. and they are not even regulated!.. So how, doctors cannot do, but others can, and they don't even have malpractice insurance!
    MOH seems to have fallen on its face!

    By Anonymous EDoc, At March 23, 2008 10:30 pm  

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