Tuesday, February 28, 2006

Hear, hear!

Some quotes from letters in today's newspaper in reply to a recent complaints from patients regarding doctors not seeing patients if they go to the clinic close to closing time, & high prices charged etc...

"I believe that doctors have a duty to attend to medical emergencies at all times but I'm afraid I will have to disagree with the assertion that I'm obliged to deal with any patient with any kind of complaint at anytime." Dr Sim Sze Keen

Well said, Dr Sim!

"There is currently no strain of pathogen causing the influenza or common cold that's acutely present just a few minutes before midnight. Most of the patients would have been experiencing symptoms in the preceding hours and there is no reason for them to be attended to when they decide to turn up at the clinic at closing time." ">Tan Shian Ming

I wish more patients had the consideration & common sense shown by Mr Tan.

" Let us not publicly complain or accuse without a clear understanding of doctors and the constraints they face. We should also refrain from giving comments to the media on certain medications and their prices without clarification." Miss Adeline Ng Su Mei

Thank you, Miss Ng, for voicing your support & understanding. Your sentiments echo what many doctors feel, and goes to the heart of the cause of many complaints - lack of communication or misguided reluctance of patients to speak directly to their doctors/nurses regarding their concerns. For some reason, they think that writing to the newspaper, or even their MPs & Ministers will solve their problems.

Thursday, February 23, 2006

An Open Letter

Dear I.M. Sik:

First, let me say that I understand you are not feeling too well, & can empathise with your feelings of anxiety over your medical condition. I hope that you will be able to take the sentiments expressed in this letter with an open mind, and hopefully be able to appreciate that practising Medicine in the modern world is not as easy as you may think.

Doctors go to work everyday with the hope of making their patients feel better. I don't think anyone of us have intentions of killing/maiming/injuring their patients. In a perfect world, everything would come up rosy & everyone would live happily ever after. However, as you know, this is not a perfect world, & unfortunate things do happen, often beyond the control of us mere humans (yes, even doctors are human & not gods!). Whenever possible, safeguards & contigency plans are in place to try to minimise or rectify these unfortunate incidences, but not everyone can be saved due to factors like age, concurrent medical conditions & just sheer bad luck.

In this material world, the question of cost often comes up. Everyone expects excellent medical care with minimal cost. But surely you must understand that logically speaking, that is not possible. There will always be trainee doctors, who will eventually take over the role of their senior & more experienced consultants & professors. If they are not given the chance to learn (under the supervision of their teachers) how will they ever achieve the expertise needed in the future?

It is also not possible for everyone to be under the direct care of a consultant otherwise these poor doctors would not even have time to take a meal let alone do ward rounds, or surgery or spend time with their own families!

Ultimately, there needs to be a relatively fair way of distributing the healthcare needs without compromising on healthcare standards nor on the morale of the healthcare workers. And one way which the institutions have done so is to allow the subsidised patients to be seen by Medical Officers with supervision from their superiors. You have to admit that the amount of subsidy given by the government is not small, and the amount that each subsidised patient has to pay for consultation, drugs, investigations, surgery etc. is a small fraction of the actual cost! It is hard to fathom that many people don't blink an eye about spending hundreds & sometimes, thousands of dollars on slimming treatments, massages, facials etc at the spa & yet gripe about the cost of seeing a doctor when they have a health problem. I sometimes wonder if they have their priorities right.

I hope that you will also understand that doctors have personal lives outside the hospitals and clinics. They have spouses, children, and even hobbies to even out the balance of an otherwise stressful life. So please do not begrudge a doctor for closing his/her clinic on time if it's not a dire emergency or urgent condition. Do take note that locally, we are, indeed, extremely fortunate that there are clinics open 24 hours even on Saturdays & Sundays & public holidays. (Doctors often spend their evenings & weekends with their patients instead of with their own children.) Not so in some of the developed countries. They open from 9 to 5, Mondays to Fridays. If you catch a cold or a flu outside office hours, you can jolly well get your own medicine from the local supermarket. Urgent cases & emergencies would go to the ER. Locally, we are actually spoilt for choice; unfortunately, this is largely unappreciated.

Finally, a humble word of advice - take charge of your own health. Know your medical history & the drugs that you are taking or allergic to, so that when you next see a doctor, he doesn't have to guess or trace records which would take time away from the consultation. Don't be shy to ask questions about your management, your condition, and your treatment. If in doubt, get a second opinion. Most of us wouldn't mind (this is not a matter of losing face; it is your health we are talking about). Remember that risks are inherent in everything we do, including crossing the street! Same thing with medical procedures - do not take for granted that risks are non-existent. Risks vary depending on the treatment/procedure/surgery. Ask your doctor what they are & what are the chances of developing complications; know what the possible complications are. Success rates are also variable depending on the medical condition; and although we would like to be, we are in no way, miracle workers! Discuss all this with your doctor. In this way, you would be able to make an informed decision on how you want to be treated & managed.

Wishing you all the best,


Doc MD

Thursday, February 16, 2006

Boys are ALSO from Mars & Girls from Venus

My 14 year old son recently suffered a bout of viral GE, with fever, nausea, abdominal cramps, vomiting, diarrhea, the works. Threw up all over the bathroom except the toilet bowl (must be a guy thing, trying to will himself not to vomit or suppress the feeling till he couldn't tolerate it anymore, hence, did not make it in time to the aforementioned receptacle).

He went back to school & described his illness to his friends. I believe the words "Projectile Vomiting" were mentioned, probably with a rather graphic description of the state of his bathroom in the aftermath.

The reaction from his female friends : "Eeewww!!!"

And from his best friend (a guy): "Awesome, dude!"

Go figure.

Tuesday, February 14, 2006

Happy Valentine's Day!

Here's a cute poem my son wrote for his Math Valentine's Day assignment:

You are the coordinates of my coordinate plane,
Showing me the way so I don’t go astray.
You are the equal sign of my equation
The exponent of scientific notation
You’re also the parentheses that keep things together
A binomial we shall be forever.
If you were mine,
I’d be just fine,
Will you be my valentine?

Happy V Day, everyone!

Saturday, February 11, 2006

True Colors

Self esteem.

Something that all of us struggle with. From childhood, especially through adolescence & even as mature women, self-doubt & poor self-image affect the decisions we make & how we live our lives.

Watch this.

Thursday, February 09, 2006


Hah! The wonders of medicine...say what you may about the COXIBs but within hours of ingesting the first dose of Celebrex, the pain had reduced by 90%! Hallelujah, I don't have to hobble around the house like an old lady anymore!

One of my pet peeves is the misconception by patients that analgesic drugs (more commonly known as "pain-killers") are bad for you & makes you rely on them (I'm not talking about the opiates even). Some are averse to taking even Panadol, let alone 'stronger' NSAIDS like mefenamic acid, ibuprofen or a COXIB.

More often than not, I have to explain to them that pain is caused by inflammation, & if you make the inflammation go away with the above mentioned drugs, voila! the pain disappears too. So the drug is not PURELY a pain killer, but it acts on the inflammation causing the pain. Of course, at the same time, you would need to elucidate the cause of the inflammation, & address that problem at the same time.

I am not advocating prescribing analgesics or anti-inflammatory left, right & center, but if indicated, the results can be wonderful (as personally experienced recently *GRIN*), & leaves one with a much better quality of life.

Now, back to my softball game......

Monday, February 06, 2006

My Left Foot

Man...I did something to my left foot. Since starting softball 3 weeks ago, my left heel & base of 5th metatarsal has been tender. I know, probably a bad case of plantar fasciitis. But the pain on the lateral part of my foot is a bit worrying...I hope it's not a stress fracture.

I know, I know, I should go see a podiatrist or an orthopod or at least get an X-ray done. But I hate going to see doctors. Yeah, sounds strange, me being one & all.

Maybe it's just me but it feels awkward when I consult a doctor. It's like, I feel like I should be able to diagnose myself already (sic). Even the other way around, if I happen to see a doctor who has come in as my patient for something as simple as an insurance check-up, I feel uncomfortable.

They say doctors make the worst patients & I think I am a classic example. Sigh...if the pain goes on much longer, I'll have to call up one of my orthopaedic colleagues for a consult.