MASTER'S MESSAGE

15 October 2019

Dear Fellow Academicians

The media activities for the month of September, which I had shared recently, underscores the Academy and its Colleges role and commitment to advocate for the profession, and more importantly, for the care and welfare of the patients.

As you are aware, the Academy and its Colleges gave feedback and made contributions to the Fee Benchmarks Committee which published, in November 2018, fee benchmarks for 222 common surgical procedures.  Second phase of the fee benchmark has started.  More procedures are being discussed and consultation and engagement sessions have been scheduled throughout this month.  The Academy has nominated representatives from its various sepcialty-specific Colleges and Chapters to attend and contribute at these sessions.  The main objective is to develop a fair and just pricing for the relevant treatment.  As subject matter experts, we are happy to be consulted on such important health financing matters and to assist the Ministry of Health in the development of fee benchmarks.  Whilst we ensure that prices are not high, we must also ascertain that the prices are not so low that standards of care will be compromised.

I must commend the College of Anaesthesiologists for being very proactive in its recommendation of anaesthesia fees which has been submitted to the Ministry in August as fee benchmark for anaesthesia fees was not scheduled in the first phase.  Recommendations are based on patient safety and high-quality patient care as priority and also cognisant of the pressure of costs and best possible outcomes with the emphasis on value in healthcare delivery. 

Another aspect of patient care which I would like to address is communication through non-traditional modes and channels in today's world of technological advancement.  I have been informed over the past few months that insurance companies have been approaching doctors for patient information via telephone and e-mails.  My advice to colleagues is to ensure there is proof of authorisation by the patient.  When in doubt, you should always communicate through the patient.  We have to be mindful to protect the patient in handling their confidential informaion.

Medicine is a noble profession and a calling.  I would like to reiterate that patients' care and safety remain our utmost priority.  The trust between patients and doctors has to be nurtured and developed.  We must work together to convince the public, especially the patients we face, that they are the most important consideration in everything we do.  After all, this is the crux of the four pillars of medical ethics.

As mentioned by Mr Amrin Amin, Senior Parliamentary Secretary, Ministry of Health and Ministry of Home Affairs in his speech at the recent SMC Physicians' Pledge Affirmation Ceremony: "Trust is a key element in the patient-doctor relationship".

Best Wishes

Dr S R E Sayampanathan
Master
Academy of Medicine, Singapore

'Your Interventional Radiologist and You Series: Women's Health in the New Age', jointly organised by the Academy and College of Radiologists Singapore, was held on 25 August at Lifelong Learning Institute.  The public forum attracted over 200 participants, where experts discussed and shared with the audience the management of uterine fibroids and thyroid nodules.  Patients who had undergone uterine fibroid embolization (UFE) treatment were also at the forum to share their personal perspectives and experiences on the minimally invasive procedure.

The event received media coverage from The Straits Times where Dr Luke Toh, Organising Chair, was interviewed.  Dr Toh said that as patient autonomy increases, they must be made aware of the healthcare options available.  "The choice is ultimately a shared decision between the patient and her healthcare provider," said Dr Celene Hui, another speaker a the forum who spoke on 'What you need to know about fibroids'.

The College of Surgeons, College of Anaesthesiologists and Menarini Foundation International, Italy, organised an inaugural educational seminar entitled 'UTOPIA - Updates on Best Practices in Perioperative Care' on 13-14 September at Carlton Hotel Singapore.  Mr Edwin Tong, Senior Minister of State for Law and Health, graced the event as the Guest-of-Honour.

In his speech, Mr Tong highlighted the importance of building mutual trust which is a core ingredient in a doctor-patient relationship: "As a patient, we must be able to trust that our doctor is doing his best for us, whether in making a diagnosis or in advising on differential options for treatment.  There are rules and standards by which a doctor has to discharge his obligations to a certain standard; and there are also rules which require a doctor to act in the best interest of the patient, unattained and unaffected by his own personal or financial motivations.  There must be professional and civil sanctions should the standards not be met.  That is part of a good functioning regulatory system."

Mr Tong also announced some of the preliminary recommendations from the MOH Workgroup which was tasked to review the taking of informed consent by doctors and the SMC's disciplinary processes.  These include faster processing of complaints lodged against doctors through the SMC and clearer guidelines and codes for the medical profession.

The Congress covered important issues such as medical ethics and defensive medicine, informed consent, preoperative fasting in patients undergoing elective surgery and refresh of the Bolam-Bolitho and the Modified Montgomery Tests, among others.

The College of Physicians held its annual Medicine Review Course on 5-6 October at the Centre for Healthcare Innovation.  Into its 11th year, the Course aims to provide: (a) expert guidelines in the management of commonly encountered problems in the general medicine unit; (b) evidence-based medicine succint update on hot topics in internal medicine and its subspecialties; and (c) concise review of disease conditions that are commonly encountered in clinical practice or examination.

This year's Medicine Review Course was a resounding success with more than 430 local and international delegates and 41 speakers for the two-day Course.

This year's Conference with the theme 'Preventive Health in a Changing World' explores how fast-moving economic, social, demographic and technological landscapes have influenced population health, and the opportunities and challenges they bring.  Held on 15 to 16 October at the Equarius Hotel, the keynote address was delivered by Professor Vivian Lin, Executive Dean, Professor of Practice (Public Health), The University of Hong Kong on 'Sustainable Healtcare in the 21st Century'.

Other topics discussed at the Congress included, 'Mind over Matter: Challenges of the Early-Onset Cognitive Impairment in Work Ability', 'Healthcare Financing: Different Paths to Universal Healthcare' and 'Electronic Cigarettes & Other Tobacco Reduced Harm Products: Godsend or the Devil's Work?'

The pre-conference workshops on 14 October provided hands-on training in health economics, genetics in public health as well as health systems research.

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