Archive for June, 2013

If I am the Minister for Health, I will immediately enforce a mobile medical apps software that can be easily downloaded to every phone for the citizens here effective medical sickness reporting and treatment.

The rationale for this mobile medical apps is due to my observation that doctors are spending too much time taking down (or rather scribbling down data) for common questions that could have been answered while the patients are in the waiting room, idling.  In fact, many doctors are language challenged and not able to converse well in Mandarin or Tamil where most of the foreign workers are from and this takes longer service time.  Likewise for parents with this mobile med apps, they can fill in data for their children and sent to the clinic without needing to take time off or during a emergency.

For this mobile medical apps, which I would term, RSF (Report Sick Form), for simplicity, it will have the followings:

Language Preference:

a.  It comes in different languages like English, Mandarin, Tamil, Hindi, French, German etc to cater to a mulitcultural society that Singapore is aspiring.  This is essential if we want to handle infectious disease fast in times of outbreaks.

General Data Like:

a.  Fever (number, frequency, duration etc)

b.  Cough (dry, wet, whooping etc, frequency, duration etc)

c.  Phlegm (white, yellowish, reddish etc)

d.  Pain (location, frequency, duration, intensity etc)

e.  Rashes (location, frequency, duration)

f.  Headaches (frequency, location, intensity)

g.  Sore throat (when started, describe)

Medication Taken:

a.  Western – describe

b. TCM – describe

Infectious Diseases Suspected

a.  Disease suspected:  Dengue/Malaria/Chikungunya/SARS

b.  Reasons:

c.  Suspected Locality or Cluster:


a.  Food Poisoning suspected

b. Location:

Etc Etc Etc


The above is only a general format that, of course, will be improved with time and usage.  This allow the doctor to focus immediately on other important aspect like helping to derive disease or outbreak clusters like dengue by asking further question to what had been duly filled up at the waiting area. Presently almost all the doctor time is wasted trying to communicate with the patients which can be worsen if there is a language barrier.  This is further complicated by temporary or part-time doctors who have lost the ability to keep up with emerging disease symptoms and cannot ask proper questions while relying on patients to describe. Often the patients are either too sick to remember and perhaps the medical apps with its structured approach can help the incompetent doctors to follow a standard format to derive what is the root cause of the sickness.

Our problem is not that there are not enough doctors but rather the inability to use mobile apps or even pre-filling of forms at the waiting area to reduce doctors workload and move on to more incisive diagnosis, not only to treat the patient properly but to contribute to a national medical database that can effectively derive where the disease clusters are from and will be.

Take Care



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I find that our private medical clinics around the various housing estate can improve their efficiency and effectiveness by providing a checklist for patients to fill while waiting for their turn to see the doctor.  This will shorten the need to overall waiting period as the common questions like “Fever”; “Cough for how many days”; “Yellowish or White Phlegm” can be answered ahead of time.  When we see the doctor the pre-filled form could be scanned or even scanned earlier to save time.

Here I want to recount a bad experience the I had yesterday when I visited a “xxxxxxxxxx” Family Clinic in Marsiling area where the resident doctor Dr Tan was away on holidays.  The temporary doctor seemed to be totally out of touch with reality or in possession of any courtesy or diagnostic ability, when  I visited the clinic on 3 Jun 2013 morning with symptoms of cough and flu.  When I enter his clinic after being called by my Catholic name and which also appear in my IC, this doctor Chong asked what is my name. I replied with my Catholic name “xxxxxxx”.  He asked again “what is your name” and should it not be “Tan Ah Kow” (changed intentionally here).  I told him the nurse already addressed me as in my Catholic name.  He said “no!” you should say your name as “Tan Ah Kow”.

Nevertheless, this is not his main problem.  The PROBLEM IS HIS INCOMPETENCY IN DOING simple diagnosis.

This temporary doctor, Chong, asked me what do I have? I replied I have flu. He then asked me to describe my flu.  I said “runny nose”.  He repeated after me like a school kid and wrote it down on his white card and said somemore. I already feeling very groggy and though why could he ask the questions since he is the doctor and know why questions to ask to come to a conclusive diagnosis.  I then said “cough” and my phlegm was whistish and yellowish.  I remember only seeing he write “white” in the card.  I said I got fever and he checked my temperature which confirmed that I had fever at 37.5 degree.

Then I requested for some ringworm or rashes cream due exercise like badminton when I have to wear the same outfit for a while.  He asked to show him the spot behind my back and I said it was red in colour. He was very sacrastic and asked me how do you know it was red in colour. I looked at him in amazement and say of course my wife told me so.

When I went to collect my medication after leaving his office, I was only given panadol and cough medication.  I then requested the nurse to inform him that I require lozenges as I was having a bad sore throat. I thought I said that to him and wondered why he did not go through a checklist like any normal competent doctor would have done so.

When I reach home I realised that he did not give my any antibiotics for my flu that included fever and yellowish phlegm. I called the nurse and requested that she speak to him.  The nurse then came back to say “yes” you can come now to get your antibiotics.   I have to travel back to his clinic again due to his incompetency, often not looking at the patient to do diagnosis but keep looking at his white card to scribble.

The fact that for a simple diagnosis like flu with yellowish phlegm and fever, I wonder why he could have run through a standard checklist given the patient could be very sick and groggy and not able to think clearly.

In fact just before my turn to see him, an Indian patient went in and everyone can clearly hear him say sacrastically “see I can pronouce you nammmmmeeeeeeeee ………..” in a derogatory manner.  However for the earlier Caucasian lady that  he attended to, he was all smiles sounded so polite that could be overheard in the waiting room and in his  best  submissive configuration.  I wonder why this clinic is not sound proof and let everyone hear what the doctors are saying inside.

Anyway, I sure wonder what is truly wrong with this temporary doctor – was he forced to work overtime in the absence of Dr Tan or was he just simply out of touch with the current practise that require the doctor to be more sensitive and alert to patients’ needs. By going through a proper checklist even before going into clinic maybe it helps to alleviate his or her workload.  I truly wonder how many misdiagnosed cases he seen over the years.  I shuddered at that thought.


To save time for such incompetent doctors, it is best to have a standardized checklist for common diseases like flu, cough and fever etc.  The doctor can thus save time from questioning these symptoms to the patients and instead focus on asking further questions that can better diagnose the disease. In the case above, it showed the lack of knowledge from a temporary doctor who insisted a groggy patient to tell him the symptoms when he should be in a better position to ask the right questions to come up with a proper diagnosis.

Likewise with some many Chinese and Indian national coming to Singapore, it would be good if the checklist can have both Mandarin and Tamil that will facilitate the patient to check the correct boxes in their languages. The doctor can run along the same column that commensurate with the English version and understand the symptoms ticked accordingly.  Likewise, the groups of patients can consult each other or view a demonstration video tape in the waiting area.  This will greatly reduce the treatment time with doctor and allow the doctor to attend to more patients.  Likewise, the patients need not wait to long and can report back for work or return home if necessary.

No wonder he is only a temporary doctor.  I wonder how many of such doctors had been strike off from the medical list. They are not committed and have no interest in treating patients.   Our medical profession should only select those who have the aspiration to serve others and not to make money in this profession.

Take Care


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