Serious PAP accepts dubious foreign doctors in polyclinic

nayr69sg said:

Chootchiew, look from it as a business point of view.

There is HUGE HUGE HUGE HUGE HUGE SUPER DUPER HUGE demand for cough and cold and MC in Singapore. HUGE DEMAND!!!!!

So who is going to do that work? Who? Specialist? No lah of course not lah. So GP lah.

To have the liquid nitrogen stored in the clinic requires cost and maintenance. And the demand for that? LOW. So how? You want to pay costs to provide for a service with low demand for what? Let the specialists do it lah. Also seriously most patients not so generous like you (although I doubt your sincerity given the way you talk about how great you are as a DIY doctor) will pay.

Actually for plantar warts you can do it yourself what. Go to pharmacy see if they have this thing called Compound W or similar. You can freeze your own warts. Why pay?

In Canada patient can also buy OTC and treat themselves but come see me is free mah. Govt pay.

As I said it is the system that creates GPs to do little else but cough and cold and MCs.

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nayr69sg said:

Halsey02. You are contradicting yourself lah. Initially you make it seem like Amoxicillin 250mg vs 125mg is superior for "flu". You even said "Most people don't want to know this...."

Then now you say that there is really no cure for Influenza ( you are correct). What the heck man? Make up your mind.

And lastly, knowing what you know, when you say "Flu...it has so many changing virus, that you get cured from one, you get infected from another new strain...if the basic medication does not work....I head to the doctor." What exactly are you expecting from the GP anyway? Amoxicillin 250mg? If someone is very ill from Influenza, even when they are admitted to the hospital, the treatment is largely supportive only. There is no good treatment for the flu. With most anti-viral drugs you got to take it really early in the disease process to stop the virus from replicating. If you present too late when the virus has replicated so much that the viral load is very high, the use of the anti-viral drug is useless.

Anyway I get the impression that most sinkies see GP as cough and cold , diarrhea doctor. For diabetes and hypertension chronic illness, go polyclinic as medication cheaper. Correct? I also see it that way cos Singapore primary care system is one of the worst in the world.

Over in Canada, family physicians deliver babies, manage chronic pain, give injections for rotator cuff tendonitis, subacromial bursitis, knee steroid or Hyaluronic acid injections, trigger finger, minor surgery for lumps and bumps, acne, eczema, rosacea, liquid nitrogen for plantar warts, seborrheic keratoses, BPH, urinary incontinence, IUD insertion, contraception, hypothyroidism, H Pylori gastritis, migraine, allergic rhinitis, otitis media, otitis externa, pre-natal care, well baby checkups, zoster/shingles, Hepatitis B liver surveillance for liver tumours and viral load, etc (just off my head what I see regularly)

Singapore a lot of these people will not pay the GP to do cos they say GP "rip off" but will go to specialist to do for even higher cost! So naturally GP in Singapore see no point training and learning to do stuff when patients not willing to pay and there is no demand for those services.

Can't blame the GP in Singapore. I was once a GP in Singapore so I know how boring and brainless the work is. Mind you it is not the doctors are brainless. It is the work that patients present to the GP with is brainless. For those more complicated stuff they go specialist.

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gongkia said:

nayr69sg,
I find using cough syrup with codeine for sleeping problem is a much better solution than sleeping pill. The effect is mild and won't knock you out. I heard of people got knock out inside toilet within an hour after taking sleep pill. Sleep pill has too many adverse side effects like zombie state, memory impair, etc.

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gongkia said:

nayr69sg,
I find using cough syrup with codeine for sleeping problem is a much better solution than sleeping pill. The effect is mild and won't knock you out. I heard of people got knock out inside toilet within an hour after taking sleep pill. Sleep pill has too many adverse side effects like zombie state, memory impair, etc.

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nayr69sg said:

I
Proper use of resources and specialists lah. Sinkieland Obs all doing normal deliveries most of the time. And charge specialist rates.

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nayr69sg said:

I give you an example of crap healthcare in Singapore. In Sinkapore pregnant mothers go see Obstetrician. Never go see GP one.

Actually normal pregnancy really almost got nothing to do lah. All those every visit scan is for what? Not like scan find something can do anything about it except perform abortion.

Things that can be done like screening mothers with Glucose Challenge Test at 24 weeks gestation for gestational diabetes, sinkieland obstetrician never do. My guess is patient will not be willing to pay for the test.

And really need Obs to deliver EVERY SINGLE BABY? Seriously? Need specialist EVERY SINGLE BABY?

Canada system is family doctor delivers. (These doctors got extra training of course and can repair perineal tears know how to induce labor, etc) If there is a problem and requires emergency C-section, forceps or vaccuum then Obs is called in. Obs and family doctors work hand in hand. So Obs only see complicated cases. Normal vaginal delivery all done by family doctors. Obs dowan to waste time and resources on normal deliveries.

Proper use of resources and specialists lah. Sinkieland Obs all doing normal deliveries most of the time. And charge specialist rates.

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chootchiew said:

then recently I noticed her blood pressure has been constantly high and never low.

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Leongsam said:

My dad lived till his late 80s and was hale and hearty even though his blood pressure was often in the 170/95 range. The doctor said it was ok for his age and that medication would cause more problems than it was worth.

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halsey02 said:

we all have to be very careful with that...getting "stoned"...I admit, I do, take a light sip of the cough mixture, minding not to get addicted..in times, when the brain is overactive & does not tire to sleep...it usually work.

I don't take or like to take sleeping pills...the "hangover" effect after the pill wears off...is not pleasant..

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nayr69sg said:

In case you did not know, SMC/MOH has very strict guidelines on use of Benzodiazepines and other meds with high risk of tolerance and dependence to treat sleep disorders. Although I would say their reasons for doing so are misguided. They say GP cannot prescribe more than 14 days of BDZs. After which have to refer to psychiatrist. But psychiatrists all just continue prescribing BDZs. Psychiatrists can prescribe BDZs long term. But GP cannot. Idea I guess is that if patient willing to pay specialist psychiatrist fees for sleeping pills not so common and easy can "control" the problem. But it doesn't really address the root cause of the patient's sleep disorder. It could be a mood disorder? Which I hope the psychiatrist will pick up. Or it could be restless legs? OSA?

First and foremost, what is the cause of your "sleeping problem". Insomnia? Waking up in middle of sleep? Difficulty initiating sleep? Sleep apnea? Snoring? Partner snoring and affecting your sleep? Depression? Anxiety?

Knocking you out is not treating the problem. It is merely getting you hooked on drugs. I give you an example guy comes in and says I feel very down and depressed. I prescribe him Fentanyl to help him relax at night and Cocaine to help perk him up in the daytime. Good doctor? Or drug pusher?

Oh well fall on deaf ears in sinkieland lah. LOL!

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Leongsam said:

In NZ most births are performed by a Nurse. Doctors get involved only when there are complications.

In Singapore my CLERK paid $9000 for a specialist package for a pregnancy with no complications whatsoever and this was way back in the 90s. I'm sure it costs a lot more now.

This shows just how rich Singaporeans are thanks to the PAP.

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