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VOLUME 41 NO.06 JUNE 2009 MICA (P) 031/01/2009 SMA 50TH ANNIVERSARY DINNER PRESIDENT’S FORUM The following speech was delivered by Prime Minister Mr Lee The Sum of Hsien Loong at the SMA 50th Anniversary Dinner on 16 May 2009 at All Our Fears Fullerton Hotel. The citation for Prime Minister and dinner report are on page 6 and 7 respectively. The speech by SMA President HOBBIT Dr Chong Yeh Woei was published in the May issue of SMA News. A SADDER and More Distinguished guests, ladies and gentlemen PAINFUL DAY I am glad to be with you tonight at the Singapore Medical Association (SMA) 50th Anniversary dinner. PERSONALLY SPEAKING In the last 50 years, Singapore’s healthcare standards have been totally transformed. Ode to Life expectancy has risen to one of the highest in the world and infant mortality is one of the lowest in the world. Ordinary citizens enjoy high quality medical care, comparable to Polyclinics any OECD country. This reflects the economic and social progress of our country, and REPORT the resources that we have invested into our healthcare system. But a lot of credit must also go to our medical professionals. Your professionalism, dedication and patient labours MASEAN have benefited generations of Singaporeans, all of whom will need medical care at some FEATURE I have learnt the importance of good bedside manners, and found that even when I cannot solve my residents’ problems, lending a patient VOLUME 41 NO.06 JUNE 2009 listening ear will often help them unburden themselves and feel better. EDITORIAL boaRD EDITOR stage of their lives. I thank all our doctors Pandemics are a dangerous threat that we Dr Toh Han Chong for your countless contributions, and must take seriously. Influenza and other DEPUTY EDITOR look forward to your full support to viruses will continue to mutate and evolve, Dr Tan Yia Swam keep up standards and further improve and if not Influenza A(H1N1), then some medical care in Singapore. other new viruses will eventually emerge We have faced some difficult public and reach our shores. We must be fully MEMBERS health problems in the past five decades. prepared when that happens. Prof Chee Yam Cheng Dr Martin Chio Although Singapore maintains good But tonight, let us enjoy a moment’s A/Prof Daniel Fung hygiene and healthcare standards, we break to commemorate this milestone in Dr Hsu Liyang are vulnerable to trans-national diseases, the SMA’s history, and recognise those who Dr Lim Boon Leng because we are so highly connected to the have contributed to the medical profession. Dr Jeremy Lim rest of the world. Six years ago, we were I am honoured and happy to become Dr Tan Poh Kiang Dr Tan Wu Meng struck by SARS. Fortunately, the medical an Honorary Member of the SMA. I am Dr Teo Eng Swee Cuthbert profession rose to the challenge, and led not a doctor, but I know many doctors. Singaporeans to contain and eventually My first wife was a doctor, and so are defeat the disease. Some Singaporeans my sister, cousin and two uncles. I know EX-OFFICIO Dr Chong Yeh Woei tragically perished, including several doctors as colleagues in Cabinet and Dr Abdul Razakjr Omar courageous health workers. But we learnt Parliament, and have also worked with important lessons, especially from our many doctors on our healthcare system. mistakes, and hence were more ready to I have been treated by a succession of EDITORIAL MANAGER tackle the recent outbreak of Influenza doctors at various times, and but for their Ms Krysania Tan A(H1N1). good judgement and conscientious care, I Our response this time has been might not be here tonight. EDITORIAL EXECUTIVE more focused, rapid and coordinated. But the closest I have come to Ms Gracia Ong We reacted aggressively at first, when we practising doctoring is perhaps when I knew very little about the new disease, conduct Meet-The-People sessions for and had to prepare for the worst. As my residents in Teck Ghee. (Indeed, in the outbreak progressed, and we learnt Britain such Meet-The-People sessions The views and opinions expressed in all the articles more about the new virus, we gradually by Members of Parliament are called are those of the authors. These are not the views downgraded our responses. This was the clinics.) The residents come to see me, of the Editorial Board nor the SMA Council unless specifically stated so in writing. The contents of the appropriate strategy – better for us to be their MP. They come one case after Newsletter are not to be printed in whole or in part without prior written approval of the Editor. safe than sorry. another, each problem important to Now the immediate danger has him or her, each one seeking advice, Published by the subsided, but the battle is far from over. assistance, and a solution, preferably Singapore Medical Association, Level 2, Alumni Medical Centre, 2 College Road, We have to remain vigilant as the virus immediately. I am conscious of their Singapore 169850. continues to spread to more countries. high hopes, and of the limits of what I Tel: 6223 1264 Fax: 6224 7827 We must watch closely how this pandemic can do. I have learnt the importance of unfolds, and continually update and good bedside manners, and found that Email: [email protected] URL: http://www.sma.org.sg improve our contingency plans. We will even when I cannot solve my residents’ SMA Reg. No.: ROS 198/59 TAP have to address shortcomings, sharpen our problems, lending a patient listening procedures and restock our medical stores. ear will often help them unburden SMA News june 2009 3 FEATURE themselves and feel better. For MPs, like and protect himself against a bad doctor. own problems always begins with our doctors, must not only try to cure – and So your advice must always be honest, personal efforts. in fact not all cases can be cured – but well-founded, and based on what is in the For doctors advising patients in must always care. There is great wisdom patient’s best interest. their best interests, the most difficult in the ancient medical aphorism – “To Doing what is best for the patient issues are not about money, but about cure sometimes, to relieve often and to often means advising him how not to life and death. As a teenager, I had an comfort always”. So each time I finish a be a repeat customer. Doctors should appendicectomy. My doctor told me Meet-the-People session, I leave with a use their position of authority to that he was happiest treating young greater admiration for doctors, especially counsel and badger patients to tackle patients, because often he could cure GPs or polyclinic doctors who see the problems underlying their medical them completely, and they would go patients in this way every working day. conditions – please stop smoking, home well. But unfortunately that Hence when the Minister for Health exercise more, and lose weight. On their is not the whole human condition. asked me what I proposed to talk about part, patients have to take responsibility Increasingly doctors have to manage tonight, I told him my theme was that for their own good health, and not leave patients who are elderly and declining, doctors have a very difficult job, so please do everything to doctors. Indeed, the most advise patients who are terminally ill, your best. Let me explain the reasons why. give palliative care, and deal with end of First, doctors have to be perpetually life issues. Doctors have to help patients learning and relearning. You have to keep and their families to come to terms abreast of the flood of medical knowledge with bad news, to think through and that is expanding day-by-day, at least Your patient is not make emotionally wrenching choices, in your area of specialty. New research in a position to to decide whether to treat a patient contradicts earlier studies, new treatment aggressively or conservatively, whether protocols supersede old ones, and new judge for himself the to struggle on or to let go. Doctors drugs deliver superior results, but with soundness of your have to exercise judgment and in some different complications and trade-offs. recommendations, and situations say “no”, because doing more As a layman, I find it hard enough to can be counter-productive and cause keep up with constantly-changing fitness protect himself against more suffering and harm to patients. advice – is taking Vitamin C good for a bad doctor. So your These are really more matters for the my body, should I go low-carbo or divine than the physician, yet doctors high-carbo, will eating eggs raise my advice must always be have to deal with them. It calls for not cholesterol levels, etc. Doctors have an honest, well-founded, only knowledge and intelligence, but even harder time keeping up with rapid and based on what is also both empathy and detachment, to medical advancements, but it is crucial put yourself in your patient’s position, that you do so, because as a patient I in the patient’s and recommend what he would want for depend on you to provide me the best best interest. himself, if only he knew what you knew advice, and I will assume that you are of medicine and his condition. current and correct. Third, doctors are expected to Second, doctors must always do what uphold the highest ethical standards. is best for your patient. The patient has Without this, patients cannot trust you the final say, but he relies heavily on you effective way to make our population to advise or treat them in their best for advice.

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