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VO L . 5 0 N O . 1 2 | d e c e m b e r 2 0 1 8 | M C I ( P ) 0 5 0 / 0 1 / 2 0 1 8
MENTORING
Millen n i a l s
Investing in the
Future of Healthcare
news
CON T E N T S
Vol. 50 No. 12 2018
EDITORIAL
BOARD
Editorial
04 The Editor’s Musings
Editor
Dr Jonathan Tan
Dr Tan Yia Swam
Deputy Editors
Dr Tina Tan
Dr Tan Tze Lee
Feature
05 Investing in the Future of Healthcare
Editorial Advisors Sylvia Thay and Jo-Ann Teo
A/Prof Daniel Fung
A/Prof Cuthbert Teo
Dr Toh Han Chong 10 Citation for A/Prof Yeoh Khay Guan
Members A/Prof Chin Jing Jih
Dr Chie Zhi Ying
Dr Jayant V Iyer
Dr Jipson Quah President's Forum
Dr Jonathan Tan 14 Hopes for the New Year
Dr Jimmy Teo Dr Lee Yik Voon
Dr Alex Wong
Opinion
EX-OFFICIOS
Dr Lee Yik Voon Council News 24 Reasons to "Not" Join SMA
Dr Lim Kheng Choon 16 Highlights from the Honorary Dr Tan Yia Swam
Secretary
EDITORIAL
Dr Lim Kheng Choon
OFFICE From the Heart
Senior Manager 26 Living with Disaster
Sarah Lim 17 SMA Supports MOH’s Medical Dr Grace Chew
Assistant Manager Fee Benchmarks
Sylvia Thay
Editorial Executive 18 Letters from Iceland AIC Says
Jo-Ann Teo Dr Anantham Devanand 28 Many Helping Hands to Support
Ageing-In-Place for Your Patients
ADVERTISING AND 19 Empowering Junior Doctors
PARTNERSHIP
Agency for Integrated Care
Dr Benny Loo
Li Li Loy
Tel: (65) 6540 9174
Email: adv@sma.org.sg
Letter
PUBLISHER 20 The Current Problem of
Singapore Medical Association Consent-Taking
2985 Jalan Bukit Merah
Dr Chew Shing Chai
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Singapore 159457
Tel: (65) 6223 1264
Fax: (65) 6252 9693 Event
Email: news@sma.org.sg 21 Finishing Well – The Annual
URL: https://www.sma.org.sg National Medico-Legal
UEN No.: S61SS0168E
Seminar 2018
DESIGN AGENCY M Kayal Pillay Indulge
Oxygen Studio Designs Pte Ltd 30 Beyond Food – Serving Up Change
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PRINTER
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Supplies Pte Ltd Mellissa Ang
Opinions expressed in SMA News reflect the
views of the individual authors, and do not
necessarily represent those of the editorial
board of SMA News or the Singapore Medical
Association (SMA), unless this is clearly
specified. SMA does not, and cannot, accept
any responsibility for the veracity, accuracy
or completeness of any statement, opinion or
advice contained in the text or advertisements
published in SMA News. Advertisements of
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do not imply endorsement for the products
and services by SMA. All material appearing
in SMA News may not be reproduced on any
platform including electronic or in print, or
transmitted by any means, in whole or in part,
without the prior written permission of the
Editor of SMA News. Requests for reproduction
should be directed to the SMA News editorial
office. Written permission must also be
obtained before any part of SMA News is stored
in any retrieval system of any nature.
editorial
The
EDIT R'S
MUSINGS
Season’s greetings to one and all! My favourite part of the holidays
Dr Jonathan Tan
The end-of-year holidays are always is enjoying my brother’s and
a good time to slow down, relax and mother’s cooking. However, if food
take stock of the year that has gone for thought is more your thing, Guest Editor
by. Unless you happen to be one of Dr Tan Yia Swam has contributed a
compelling argument on why you
the lucky ones on call. Dr Tan is currently an orthopaedic
should not join the SMA (I think).
For the SMA, one of our annual Meanwhile, Dr Chew Shing Chai resident at the National University
year-end highlights is the SMA shares his thoughts on consent- Health System. A dwarf in a
Lecture. During this year’s Lecture, taking and the potential need for department of giants, his hobbies
A/Prof Yeoh Khay Guan, Dean of the high-tech recording equipment in include falling asleep while studying,
the modern medical clinic. resubmitting rejected journal articles
National University of Singapore Yong
After some food, it’s always nice and trying to not stutter during
Loo Lin School of Medicine, shared
to watch other people sweat it out morning teachings. He is grateful
his thoughts on the future of medical
on television. Since my son is still for the opportunity to pursue his
education. The 2nd National Medical
too young to play sports, and the dreams, and hopes to become a
Students’ Convention was held on the good orthopaedic surgeon and help
basketball, soccer and rugby teams
same day, with A/Prof Benjamin Ong, I support are in a slump, it’s nice to educate future trainees. He is thankful
Director of Medical Services, speaking know that there is still one team for the love and support of his parents
on the paradigm shifts in medical I can support and live vicariously and wife, without which none of this
training. Both events are the subjects through. The SMA team has done would be possible.
of this edition’s Feature article. us all proud as they emerged
champions in this year’s Inter-
The holidays are also a time to Professional Games, and you can
re-establish connections with others. read all about it in this edition.
As doctors, we may be separated by
The holidays are a time of being
geography, but we are all connected
thankful for what we have. It is also
by the shared desire to do our best a time of giving and putting others
for our patients and the challenges before ourselves. Dr Grace Chew has
we face while doing so. Dr Anantham kindly shared with us her experiences
Devanand and Dr Benny Loo share while volunteering in Okayama,
their experiences at the 2018 Japan, after a massive earthquake.
World Medical Association General Finally, here’s wishing one and
Assembly and the Junior Doctors all a Merry Christmas and a Happy
Network meeting held in Iceland. New Year!
04 DEC 2018 SMA News
FEATURE
Investing in the
Future
of Healthcare Text by Sylvia Thay and Jo-Ann Teo
Is the medical profession future-ready? What are the trends in medicine? How are the doctors of tomorrow
being moulded to meet the needs of the community? These are some of the questions addressed at
this year’s SMA Lecture and National Medical Students’ Convention (NMSC) on 10 November at
Novotel Singapore on Stevens.
Inaugurated in 1963, the SMA Lectureship is Inaugurated in 2017, the SMA National Medical
a prestigious annual lecture delivered by a Students’ Convention provides an opportunity for
distinguished speaker on medical ethics and students of all three local medical schools to come
related topics that are pertinent in the day. together for a day of learning and networking.
Speakers in the 55-year history of the Lecture Through the discussion of important issues
include Dr Gwee Ah Leng (1963), Emeritus pertinent to medical education, the Convention
Professor Wong Hock Boon (1979), Professor seeks to provide clarity on students’ roles as
Arthur Lim (1981), Mr Justice P Coomaraswamy future doctors in an evolving medical training and
(1989), Professor Woo Keng Thye (2007) and practice landscape. In its first run, A/Prof Benjamin
Chief Justice Sundaresh Menon (2012). Over Ong delivered the keynote address "The Future
the years, many respected seniors and young of Singapore Healthcare and What It Means to
doctors alike have set aside time to attend these Medical Students Today".
Lectures, both for the intellectually stimulating
discussions as well as the networking
opportunities at the event.
DEC 2018 SMA News 05
1
SMA Lecture “While we’re here primarily to a glimpse of a helpful tool in medical
learn from the SMA Lecture, we education: the Virtual Interactive
The 2018 Lecture – “The Future of
[participants] can also benefit from Human Anatomy, otherwise known
Medical Education” was delivered the SMA Lecturer’s achievements, as VIHA, which offers a close-up and
by A/Prof Yeoh Khay Guan, Dean of character and values.” With that in
Yong Loo Lin School of Medicine, interactive learning experience of
mind, A/Prof Chin Jing Jih delivered the human anatomy. As he delved
National University of Singapore the citation of A/Prof Yeoh Khay
(NUS Medicine) and Deputy Chief into the role that artificial intelligence
Guan, regaling the audience with (AI) plays in healthcare, A/Prof Yeoh
Executive of National University his many achievements and notable
Health System. The Lecture explored encouraged the audience to think
contributions to the healthcare sector of “AI” as “augmented intelligence”
the implications of shifting trends in – with great admiration and some
Singapore healthcare and its impact instead – one that serves to support
well-injected humour (see page 10).
on medical education. The notable and assist healthcare professionals
event drew an audience of more than Gearing for the future in their practice. Additionally, he
150, comprising doctors, educators, reminded everyone that the human
A/Prof Yeoh began his Lecture with a
medical students, even A-Level touch that doctors offer to their
quick poll to get a better grasp of the
students and their parents. patients cannot be replaced and thus
diversity of his audience. There was a
soft skills and values are especially
In his welcome address, SMA fine mix of aspiring medical students
and medical doctors, both GPs and important in this era.
President Dr Lee Yik Voon highlighted
the heavier emphasis on medical specialists (of which a good portion had That is why being future-ready
ethics and professionalism in the graduated more than 20 years ago). starts as early as the selection of
current medical curriculum, which he In his brief introduction, A/Prof Yeoh students; aside from their academic
believes should be taught in practice listed some of the key challenges performance, students are also
and not merely as a module. After all, that the current healthcare system assessed on other attributes and
he surmised, “learning, understanding faces, as well as the shifts and values precious to the profession.
and incorporating professionalism are transformation of healthcare going These are then further inculcated
different things.” forward, before focusing on these five through incorporating values-driven
key issues: Technology; Changes in actions and community services.
Practice Patterns; Changes in the Role A/Prof Yeoh also echoed the call for
of the Doctor; Medicine, Science and more generalists, especially with the
2 Innovation; and finally, the Future- changing role of the doctor.
Ready Doctor.
Concluding his Lecture, A/Prof
With the use of comic strips Yeoh shared with the audience that
and videos, A/Prof Yeoh aptly “The future is bright and exciting,
demonstrated the two facets of the but it will not be easy”, because
application of technology in today’s there are challenges to overcome.
medical education and healthcare. He then proceeded to sum up the
One of the videos gave the audience ten key skills he believes tomorrow’s
06 DEC 2018 SMA News
doctors will need to overcome the
challenges ahead. Among them 3
included leadership skills, soft
skills, skills for lifelong learning, a
high degree of adaptability and
versatility in the health system and,
most of all, the continued trust and
support from the community.
A vibrant discussion
Panellists:
• A/Prof Yeoh Khay Guan
• Dr Anantham Devanand,
Council Member, SMA; Head,
SingHealth Duke-NUS Lung Centre;
Senior Consultant Physician,
Department of Respiratory &
Critical Care Medicine,
Singapore General Hospital
• Dr Dujeepa Samarasekera,
Director, Centre for Medical
Education, NUS Medicine; President,
College of Clinician Educators, medical students, and even the entering into medical school at the
Academy of Medicine, Singapore panellists themselves posed and right age; and the accuracy of the
addressed many burning questions mini interviews when it comes to
• Dr Chia Li Ann, Faith, assessing attributes in applicants. The
that arose. Unsurprisingly, the
Senior Consultant, Rheumatology, panellists took turns to address each
question of whether AI will eventually
Allergy & Immunology, Tan question with wisdom and foresight,
replace doctors was raised and the
Tock Seng Hospital; Designated sharing their honest opinions
panellists agreed that despite being
Institutional Officer, National and knowledge gained from their
unable to predict the future, it is clear
Healthcare Group Residency respective capacities.
that doctors will always be in demand
Moderator: and are irreplaceable, though After what was an engaging and
what is needed from doctors may thought-provoking panel discussion,
• A/Prof Tan Choon Kiat, Nigel,
change in the future. Other topics of the appreciative participants
Council Member, SMA
concern included whether students, applauded A/Prof Yeoh for the great
The panel discussion was educators and clinicians are being Lecture and the panellists for the lively
ablaze with excitement as doctors, protected considering the growing discussion, before continuing their
educators, current and aspiring expectations; whether students are discussions over drinks and snacks.
5
4
Legend
1. SMA Council Members posing
for a fun shot with A/Prof Yeoh
Khay Guan and the panellists
2. A student raising a question
for discussion
3. Participants listening intently
4. A moment of humour
5. Dr Lee Yik Voon presenting the
token of appreciation to A/Prof Yeoh
6 of the SMA Doctors in Training (DIT) Sharing of experiences
Committee, to reduce confusion and
allay fears of what is to come. Panellists:
• A/Prof Benjamin Ong
Doctors of tomorrow
• A/Prof Denise Goh, Associate
It was all ears when A/Prof Ong took Professor, Department of
to the stage to deliver his keynote Paediatrics, NUS Medicine; Head
address on “Paradigm Shifts in and Senior Consultant, Division
Medical Training and What It Means of Paediatric Genetics and
for Medical Students Today”. He spoke Metabolism, Khoo Teck Puat-
at length on Singapore’s population National University Children’s
and our fight against chronic diseases, Medical Institute, National
transformation of care models University Hospital
and the paralleled importance of • Dr Ng Chew Lip, Council Member,
2nd SMA National Medical nurturing doctors who are fit-for- SMA; Associate Consultant, Ear, Nose
Students’ Convention purpose. He highlighted the main and Throat – Head and Neck Surgery,
upstream strategy of moving from Ng Teng Fong General Hospital
The second edition of the SMA NMSC
treatment focus to health promotion
saw students from the three local Moderator:
and disease prevention.
medical schools converge once again
for a time of learning, mindfulness Assuring the audience of a • Dr Ivan Low, Chairperson of the 1st
high-quality education programme, SMA NMSC
and engagement. Graced by A/Prof
Benjamin Ong, Director of Medical A/Prof Ong shared the MOH’s aim In a bid to better address medical
Services (DMS), Ministry of Health to accredit all three medical schools students’ queries on training and
(MOH), the convention sought to by 2022, as well as to prescribe core specialisation, this segment of the
address hot-button topics relevant to learning outcomes for all graduates programme allowed the sharing
to ensure that they are ready for of first-hand comments and
current medical students.
postgraduate year 1. Specialist training experiences from our esteemed
In his welcome speech, Thurston standards will also be introduced in panellists. On the topic of specialty
Heng, chairperson of the NMSC, 2020 to ensure that specialist and selection, A/Prof Denise Goh shared
explained how the theme of this year’s family medicine training programmes that many students enter medical
convention with its emphasis on health meet common baseline requirements. school with a set pathway for
and the community was selected, and themselves. She opined that as a
In his closing, A/Prof Ong doctor in a vocation of service, one
hoped that the participants would
encouraged students to choose should be intelligent enough to be
benefit from the carefully planned
broad-based specialties that meet adaptable during their journey.
programme. Dr Lee Yik Voon, in his Singapore’s needs, such as family A query was raised on how DITs can
opening speech, let us in on how medicine, internal medicine and ensure that Government policies
medical students and newly minted geriatric medicine, among others. (eg, working hours) are effective,
doctors have been in regular contact Students were also urged to embrace especially in organisations with
with SMA over concerns regarding lifelong learning and to provide strong hierarchical forces. In answer,
upcoming changes in training models seamless, appropriate and cost- students were advised to give
– a testament to the need for continual effective care to patients by working specific feedback and possible
inter-school collaboration and support with fellow healthcare colleagues. solutions to the ministries involved,
7
8
08 DEC 2018 SMA News
9
Showcasing our work
and engage the SMA DIT Committee, On top of the rich content
whose role is to represent junior delivered in the ballroom,
doctors who may feel unfairly SMA also had the opportunity
treated. Also addressed were the
to showcase the many facets
issues of tailoring expectations for
of our work to participants.
competition, paradigm shifts in
Over the tea and lunch breaks,
gender roles, and the need to be the
participants visited specially
best that one can be in their pursuit
set-up booths to find out more
of medicine.
one’s personal expectations. Through about the privileges SMA
Mindful or “mind full”? a short test, students also learnt that Members enjoy, including
multitasking is a myth – there’s only the current SMA eMarket
After a short break, Ms Jennifer
rapid refocusing of the mind! Ms Davis and membership year-end
Davis, Director, Student Personal
shared the science behind mindfulness promotions. Many also tried
and Professional Leadership,
training, and how to “retrain” one’s their hands at a pop quiz
Duke-NUS Medical School; Clinical
brain to be present in the moment at the SMA Academy and
Psychotherapist and Mindfulness
without being overwhelmed. Publication booth, which
Trainer, took to the stage for a sharing
session on mindfulness and its won them small tokens of
A fulfilling experience
application in overcoming challenges, appreciation. Participants even
pressure, information overload and When we spoke with the participants, got a sneak preview of the
distractions. Students were led to it was evident that the main take- courses lined up in 2019, and
perform a simple breathing exercise home message was to change were polled on the courses
to detach from physical distractions one’s perspective to flow with the they wish to attend and the
and “check in” with their body. The current shifts in medicine and, in type of content they wish to
silence in the room was palpable particular, endeavour to specialise in see. At the SMA Charity Fund
and it was evident that this short disciplines that will meet the needs of (SMACF) booth, participants
and simple exercise provided the Singaporeans. Many also acknowledged understood more about the
participants with a much needed the need to serve selflessly for the good charity’s causes, as well as the
reprieve from the flurry of daily life. of the community. importance of supporting
The students were then encouraged In a nutshell, this annual joint needy aspiring doctors and
to share their experience with one effort by student leaders of the three the various means to help.
another – was it a mindful meditation medical schools is commendable to Thanks to the support from
or were their minds full of busy say the least, and we are convinced several participants, SMACF
thoughts and stressors? that there should be more of such reported a total donation
Students then filled out the opportunities for medical students to of $6,000 from that day’s
Perceived Stress Scale questionnaire, a collectively discuss issues that affect outreach efforts!
widely used psychological instrument the way medicine is practised in the
that measures the respondents’ level years to come.
of control over their lives and how It was all around a rewarding and
they think they can manage stress. fruitful day of activities for our more
When asked to share about their than 200 participants for the day and
main sources of stress, many cited SMA looks forward to continuing in
examinations, relationship conflicts our efforts to bring valuable support
and lack of time for oneself; a crowd to our Members and to bring together
favourite was the need to live up to the profession. See you in 2019!
10
Legend
6. A/Prof Benjamin Ong delivering
his keynote address
7. Dr Ivan Low leading the panel
discussion
8. Ms Jennifer Davis sharing on
mindfulness
9. A student clarifying his doubts
10. Posing for a shot amid the
sharing session
dec 2018 SMA News 09
Citation for
FEATURE
A/Prof Yeoh Khay GuaN
Delivered by A/Prof Chin Jing Jih,
Deputy Chairman Medical Board,
Tan Tock Seng Hospital; former SMA
President (2012-2015)
On behalf of SMA, I would like Medicine) in 1992, where he was seven years, he built upon the
to thank you for your support awarded the Seah Cheng Siang Gold strong foundations laid down by his
and welcome you to the SMA Medal for being the most outstanding predecessors and achieved deep,
Lecture 2018. The SMA Lectureship candidate that scored the highest steady progress in the medical
is awarded to eminent and marks in the clinical section of the school through a style of governance
distinguished persons who have examination. He was appointed a that emphasises stability and
made significant contributions to lecturer in 1993 and senior lecturer in sensibility. Internally, he reorganised
medicine and the community. With 1997, in the Department of Medicine the basic science departments into
the programme we have lined up of the then NUS Faculty of Medicine, a medical science cluster that is
today, I am confident that you will which is now the NUS Yong Loo Lin more integrated and synergistic
not regret your decision to spend School of Medicine (NUS Medicine), through sharing of resources and
your Saturday afternoon with us. where he completed his specialty talents. To boost NUS Medicine’s
This afternoon, the SMA will be training in gastroenterology. From ability to attract and retain talents,
presenting the SMA Lectureship 1996 to 1997, he was awarded the Prof Yeoh augmented the clinician-
China Medical Board Fellowship scholar and clinician-scientist tracks.
to A/Prof Yeoh Khay Guan, a highly
for Post-graduate Studies at the Recognising that education is a team
respected leader and appreciated
Digestive Disease Center, Medical effort beyond the boundaries of the
colleague in the profession. While we
University of South Carolina. Upon Kent Ridge campus, and as a team
often invite to the podium luminaries
returning to NUS in 1998, he was player himself, Khay Guan ensured
that are outside the profession,
appointed assistant professor; by that all healthcare institutions and
the pleasure and pride tends to be
the year 2000, he was promoted to clinical faculty contributing to the
augmented when the SMA Lecturer is
associate professor in NUS Medicine; undergraduate teaching of NUS
one of us. It is therefore a true honour
and three years later, he was made Medicine’s students receive due
for me when I was nominated by
senior consultant in the Division of recognition for the part they play.
Prof Yeoh to deliver his citation today.
Gastroenterology and Hepatology He conducted regular engagement
A/Prof Yeoh Khay Guan, or Khay sessions with clinician-educators
at the National University Hospital.
Guan since we are among friends and and teachers in the hospitals and
In 2003, he was admitted as a Fellow
colleagues, hails from Anglo-Chinese solicited feedback to strengthen
by the Glasgow Royal College of
School, where he often claims to have the collaborations. His designated
Physicians and in 2005 by the London
had a mediocre academic record. But successor as dean, A/Prof Chong
Royal College of Physicians.
true to his school motto, “The best is Yap Seng, shared that Khay Guan’s
yet to be”, his CV just got more and logical and common-sense way of
more interesting as I prepared this Deanship thinking through issues, decision-
citation. Khay Guan graduated from In November 2011, Khay Guan making and implementation
the National University of Singapore succeeded Prof John Wong as dean has helped the school to make
(NUS) in 1987, and went on to obtain of NUS Medicine, after serving as tremendous advancement, especially
his Master of Medicine (Internal vice dean since 2002. In the past in remapping the undergraduate
10 DEC 2018 SMA Newsmedical curriculum and improving its systemic enquiries and finally to translation of bench research findings
pedagogy. In his quiet and effective translatable knowledge was already to impactful clinical application is
way, Khay Guan has taken NUS starting to show, hinting strongly a testament to Khay Guan’s talent,
Medicine to a higher level of strength at his future success as a clinician- perseverance and resilience in
and consolidated the school’s scientist. During that period, I believe leading a project through the entire
position as one of the top medical he showed much research interest on research continuum, and sets a
schools in Asia. chilli and its effect on the stomach. standard to emulate for clinician-
Yes, the red hot chilli that we use to scientists in Singapore.
External spice up our meals. But Prof Yeoh
But Khay Guan saw his role in
did not stop with just being curious.
The dedication and influence of Prof Instead, he studied the effects of the academia to be more than
Yeoh’s leadership extends, however, chilli and discovered that contrary to just being a successful and well-
far beyond the boundaries of NUS common belief, chilli and capsaicin published researcher. He is able to
Medicine and National University Health are actually protective to the gastric see the systemic issues and needs,
System (NUHS). He has served, and mucosa, which was a great relief to and made it his calling to change
is still serving, in many committees, the many Singaporeans who love the research mindset and culture
task forces, working groups, panels spicy food. He proceeded to publish across all levels of seniority in NUS
and boards. At NUS, in addition to his several papers and make quite a Medicine and in Singapore. For
deanship, Prof Yeoh also serves on the number of scientific presentations example, one of his notable initiatives
Health Innovation Programme Steering on the topic, culminating in the was to set up the Medical Grand
Committee and the Translational prestigious Young Clinician Award Challenge in NUS Medicine, a medical
Laboratory in Genetic Medicine Steering at the 10th World Congress of students-led innovation programme
Committee. He is also a member of the Gastroenterology in 1994. that encourages them to identify
Governing Board for the Singapore unmet healthcare needs and work
Institute for Neurotechnology. At the The rest, as they say, is history. collaboratively with students from
Ministry of Health (MOH), he chaired Prof Yeoh went on to author or other faculties, like engineering,
the MOH Review Committee for co-author over 170 peer-reviewed to explore creative solutions that
Residency Training, which brought papers over a span of 15 years, will address these challenges. He
about important adjustments to the particularly on gastric cancer – an has also worked hard to source for
resident training programme. He amazing feat, considering the time research funding to support research
is currently a member of the MOH and energy that he has to distribute excellence at the medical school, and
Specialists Accreditation Board, National among his other responsibilities in led by example with his own research
Postgraduate Year 1 Assessment leadership, education and clinical efforts in gastric cancer.
Committee and the MOH Medical service. In 2013, he was lead principal
investigator of the Singapore Gastric In 2013, Prof Yeoh was deservingly
Licensing Examination Steering
Cancer Consortium, a national awarded the National Outstanding
Committee. He has been an appointed
flagship research group, which aims Clinician Scientist Award, one of
member of the Singapore Medical
to redefine the management and the key National Medical Excellence
Council (SMC) since 2011, where he
improve the outcomes of gastric Awards by the MOH. All of these
also serves as vice-chairman of SMC’s
cancer in Singapore through early achievements, ladies and gentlemen,
Complaints Panel. Since 2009, Prof
diagnosis, a project supported were attained while serving as the
Yeoh has also been the chairman of
by a Translational and Clinical dean of Singapore’s largest and oldest
the Health Promotion Board’s Steering
Research Flagship Programme medical school.
Committee on the National Colorectal
grant from NMRC amounting to In 2016, he was conferred the
Cancer Screening Programme. At
$24,999,999.60. Through his work Public Administration Medal (Silver)
A*STAR, he is currently a member of
with Prof Yoshiaki Ito and other in recognition of his multifaceted
the Industry Alignment Fund-Pre-
multicentre collaborators, Prof Yeoh contributions to healthcare and the
Positioning Programme, National
made many important research medical profession in Singapore.
Medical Research Council (NMRC)
findings and produced numerous
Infrastructure Review Panel for RIE2020,
publications impacting the diagnosis NUHS
NMRC Clinician Scientist Award Panel
and management of gastric cancer.
and NMRC Singapore Translational Some of you may be aware that Khay
In early 2018, he and his colleagues
Research Investigator Award Panel. Guan will be stepping down soon as
published a landmark paper in the
journal Cancer Cells, which used the dean of NUS Medicine, but he is
Research DNA sequencing to identify patients definitely not retiring from healthcare
But Khay Guan may even be better with intestinal metaplasia that are and his journey will continue. He will
known for his inspiring achievement associated with subsequent dysplasia be continuing, in a full-time capacity,
as a world-class researcher. Even or gastric cancer, separating them his role as Deputy Chief Executive of
in his early years of doctoring as a from patients that exhibit normal- the NUHS – a responsibility that he
gastroenterology trainee, his potential like epigenomic patterns, who were has held concurrently with all his other
in converting clinical curiosities into associated with regression. The appointments since January 2014. This
DEC 2018 SMA News 11will be the next chapter in his illustrious As a superior officer and leader, As an educator, he has gone
career as he strives to develop NUHS as Khay Guan has earned his respect beyond a mere clinical teacher to
both a regional healthcare cluster and and following not by hierarchy or a leader in medical education who
an academic medical centre. Yet again, authority, but by true leadership will bring benefit to generations of
living up to his school motto “The best qualities. Those who have had the students by enhancing the system and
is yet to be”. privilege of working with and for environment for learning and training.
him are grateful for his unwavering As a researcher, he has gone
Leadership style support and backing, and for his beyond a mere prolific clinician-
readiness to be accountable. He scientist to a research leader who
I must confess that the last time I never shirks from responsibility
presented a citation for the dean of accelerated research at a systemic
and is ready to acknowledge any level, by improving the research
another medical school, he jokingly mistakes, apologising on behalf of culture and infrastructure.
told me later that he thought he was his team – all these done in a quiet
listening to his eulogy. But I have and modest way. As a leader, he has gone beyond
always believed that while we’re a mere administrator to a visionary
here primarily to learn from the SMA One of his staff had this to share: and effective yet empathetic leader
Lecture, we can also benefit from “Khay Guan is the type of boss who would bring about all-round
the SMA Lecturer’s achievements, people gladly go the extra mile for organisational improvement to the
character and values. Which is why I because he gives trust and space as medical school and profession.
have not been economical with my people work and lets them know that And above all, his unassuming,
words nor have I exercised restraint in he has got their backs covered. He humble and approachable personality,
my sharing of Prof Yeoh’s remarkable demands high standards and makes and his scientific curiosity, integrity,
journey. Furthermore, in spite of all it clear when these are not met. But honesty and compassion, have made
his achievements, Prof Yeoh remains in the decade that I have worked with him a much loved and respected role
a humble and unassuming friend and for him, I have never seen him lose model among his medical colleagues,
and colleague. While I respect his his composure or lash out at staff who friends, collaborators, students and
preference to remain low key about his under-delivered.” staff – truly a doctor, scholar, scientist
achievements and virtues, I personally And another had this to say: and gentleman.
feel that the profession today is in I would like to end this citation
“Khay Guan will be remembered by
need of such an excellent role model. with a quote that is generously shared
the administrative and executive staff
Therefore, it is also my obligation this by one of Khay Guan’s colleagues and
as a dean who notices and remembers
afternoon to give you a glimpse of deputies, A/Prof Lau Tang Ching, vice-
the colleagues who beaver away in
Khay Guan’s remarkable emotional dean for Education at NUS Medicine.
quiet corners of the School.”
quotient, which I believe contributed Echoing the views of many other
to his many successes and to the Khay Guan’s collegial and colleagues at NUS Medicine, Prof Lau
positive influence he has had on the approachable style has facilitated shared the following philosophical
medical school and those around him. warmer ties and closer collaboration thoughts on Prof Yeoh:
between NUS Medicine and organisations
I have never personally worked “He is like water. The excellence
like SMA and Lee Kong Chian School of
directly for Khay Guan, except for of water appears in its benefitting
Medicine. His relaxed personality and
serving as his co-chair in the MOH and respecting all things. It is full
his honest and open-minded approach
Residency Review Committee a few of compassion and where it flows,
have catalysed collaborations with
years ago. But it was an experience lives flourish. It is transparent and
other organisations. This has also been exemplifies integrity. With humility, it
where I learnt much from him about a key factor to his highly successful
running a productive meeting – occupies without striving and does not
multicentre, multidisciplinary and mind flowing to low places.”
good active listening, providing collaborative gastric cancer TCR Flagship
good summary of issues, avoiding Programme, which is a refreshing While many of us know that Khay
micromanagement, offering story in today’s highly competitive Guan’s favourite liquid is probably
solutions decisively and achieving world of biomedical research. more than mere H2O, I think Tang
better results from nudging an Ching’s metaphorical use of water
agenda rather than forcing things here to describe Khay Guan is most
Summary
down people’s throats. One of his apt and elegant.
colleagues shared that in the past Prof Yeoh Khay Guan has indeed much
It gives me great honour and
seven years of his deanship, he has to teach us beyond just his Lecture.
pleasure to invite to the podium,
been very effective while remaining Allow me to attempt a summary.
my good friend and fellow doctor,
popular with the students as well As a clinician, Khay Guan has gone dean of NUS Yong Loo Lin School of
as the faculty, which is not an easy beyond a mere healer to a healthcare Medicine, A/Prof Yeoh Khay Guan, to
task. He is both highly respected leader that has and will help many deliver the 2018 SMA Lecture, sharing
and warmly regarded by all, but more patients by improving the with us his wisdom on “The Future of
never feared in the negative sense. system of clinical care. Medical Education”.
12 DEC 2018 SMA NewsSMA SEMINAR
Tax Obligations
on Medical
Practice
DATE 30 March 2019, Saturday
TIME 1 pm to 5 pm (lunch provided)
VENUE Novotel Singapore Clarke Quay
Cinnamon Room, Level 5
CME 2 points
(subject to SMC’s approval)
EVENT HIGHLIGHTS HOW TO REGISTER
■ Tax obligations of a medical practitioner 1. Go to https://www.sma.org.sg/coursesfordoctors
■ Overview of IRAS approach on tax 2. Log in to your membership portal
avoidance arrangements 3. Search for “SMA Seminar: Tax Obligations on Medical
■ Common tax errors (GST and Practice”
income tax) 4. Fill in the form and click on “Submit”
■ Budget 2019 and why it matters to you
WHO SHOULD ATTEND
?
■ Private practitioners
■ Clinic owners
DID YOU You could track the SMA courses you
have attended when you log in to your
■ Clinic staff who manage clinic tax and KNOW membership portal prior to registration.
corporate matters
For more information, please contact
Denise Tan or Jasmine Soo at 6223 1264 or email courses@sma.org.sg.PRESIDENT'S FORUM
Hopes FOR THE
New Year Text by Dr Lee Yik Voon
It’s Christmas time, there’s no need to be A good future Will we be able to find a doctor that
afraid. At Christmas time, we let in light is very skilled in medicine, upright
Good succession planning is important
and we banish shade. It’s the end of the and ethical with the right ethos and
so that there will be good doctors to compassion, and at the same time
year. So this is Christmas and what have
look after us. Artificial intelligence (AI) street-smart?
you done? Another year over, and a new
will not do.
one just begun. Well, not yet. Not before Zooming on to the subject of
we make our resolutions for 2019. It is Our patients need a human touch, a subsidies. We have first the Community
a good thing to have a direction, be it caring face, a nod of approval, a smile of Health Assist Scheme (CHAS), then
having life goals, or a moral compass, or understanding and a twinkle in the eye. Pioneer Generation Package, then
our Singapore Medical Council Ethical During our many kopi sessions, my Merdeka Generation Package and then
Code and Ethical Guidelines. friends have often raised their worries CHAS for all citizens of Singapore.
What would you like to see in the on more than one occasion. One of their Currently, we have blunt instruments;
coming year? Let us gaze into the worries is who will take care of their we need to tweak the current subsidies
magical crystal ball. medical illnesses when they grow old? so that they can be used in the right way.
14 DEC 2018 SMA NewsThese should be given to those who patients having several GPs and many In moving from healthcare to health,
truly deserve it – not only those who are subspecialists for different conditions we need to focus on prevention.
financially challenged, but also those (eg, one for skin, one for chest/cough So as the saying goes, “Prevention is
whose disease burden is so great that and one specialist for each joint pain). better than cure”.
they will need the additional funding. There are so many science fiction
It is about how we can give such
I find that those who are truly in need and science fantasy stories and movies,
preventive advice, make these measures
often do not bargain or haggle. Those including one that I read many years
palatable and inculcate habit-forming
who do often include those who feel the ago – Isaac Asimov’s Foundation series
for the public at large.
pinch as they want to continue to smoke about psychohistorians who can predict
their packet of cigarettes and indulge the future and manage the future based I have been a gamer for ten to 20 years
in their nightly beer-drinking sessions on the learned historical response of the now. Gaming is part of my daily routine,
human mind. with adjustments only when it comes to
with their buddies. Pouring subsidies
public holidays when I do not work.
to invoke a change in behaviour is Will the flavour of the season – AI
the desired outcome instead of just a with deep thoughts – be able to run I have a friend who does not play
populist measure. our lives and predict the future? Will AI games but loves to travel. So I told him
be what we think it will be like in the we can apply gamification to his interest
I have mentored medical students in
movies of the Terminator series, or will in travels. With some explanations and
their clinical groups and one common
it be something else that we had never after a short while, he understood the
question that surfaces is how I met
imagined it to be? power of gamification.
my wife. I am glad that they have such
thoughts of wanting to build a career The National Electronic Health Record Wishing all SMA Members (Ordinary,
as medical doctors and also plan to (NEHR) is a tool. Whether it is good or Honorary, Life, Spouse and Student) and
start their families. The quota on female bad depends on how you use it and the friends of SMA, a very Happy New Year!
students has been lifted for years and powers to be implementing it. I believe It is SMA’s 60th Birthday next year,
that should encourage our students to that the NEHR will provide invaluable what would you like to see?
start their families. assistance in revealing the healthcare
journey of our patients that will aid us in
I believe that building up great Note
managing our patients better. We have
caring holistic family units is only a. Song lyrics at the beginning of the article are
conducted studies to generate valuable
possible by setting good role models from “Do They Know It’s Christmas” by Band Aid
data to boost our feedback. Will the and “Happy Xmas (War is Over)” by John Lennon.
and providing quality upbringing of
implementers get it right this time?
our children. Such closely knitted family
units should aid the caring for the
Back to basics
elderly for generations to come. Dr Lee is a GP
With all the enabling information practising in
technology, Internet of things and Macpherson. He is
Government that takes care of its also a member of
people big and small telemedicine, I still believe in the
the current National
basics of everything. Be it medicine or General Practitioner
The Regional Health System has been human nature. Advisory Panel. He is a
tasked to look after the people in their pet lover at heart who
If you do not know by now,
assigned sector. No longer do they only is the proud owner of
everything will have its glorious moment a dog, and regularly
provide incidental care or chronic care,
and timing is of utmost importance. feeds neighbourhood
the restructured hospitals will track the community cats. He
healthcare journey of all their assigned Do not rush and pressure ourselves also enjoys playing
citizens wherever they seek healthcare, be too much. Some things cannot be online war games and
rushed. Because when the time comes, thinks that playing
it at the GPs, outpatient services, private
when the stars are aligned, when the Pokemon Go is a good
hospitals, community hospitals, etc, form of exercise.
including foreign healthcare facilities. trajectory is correct, things will happen.
On the road to achieving one family That does not mean that we should
doctor for every citizen of Singapore, just sit and wait and not try at all. Master
patients may be recruited or assigned Yoda in Stars Wars once said, “Do. Or do
to primary care doctors for better not. There is no try”.
familiarity and continuity of care, instead But I say, “Keep on trying and you will
of the current fragmented care of get there one day.”
DEC 2018 SMA News 15council news
Report by Dr Lim Kheng Choon
Dr Lim is the
Feedback on MRA for our Members and their patients in
Honorary
Singapore’s healthcare ecosystem.
SMA’s representatives participated
Secretary of
in a consultation conducted by
the 59th SMA Feedback on Fee Benchmarks
the Ministry of Health (MOH) on
Council. He Advisory Committee’s Report
is currently proposed amendments to the Medical
an associate Registration Act (MRA). Apart from SMA representatives participated in a
consultant submitting feedback on other matters, consultation by the MOH on the Fee
at Singapore Benchmarks Advisory Committee’s
General Hospital. we had also proposed for the MRA to be
aligned to Section 85(19) of the Legal Report and recommendations. The fee
Profession Act so as to reduce frivolous benchmarks were subsequently published
complaints and to potentially reduce by MOH on 13 November 2018.
delays in genuine cases. SMA supports the introduction of
the fee benchmarks and sees it as one
Member query on fitness for of the key measures to help control
employment healthcare costs. SMA’s full response
can be found on page 17.
SMA received a member query in
October 2018, seeking advice on follow- The SMA Council wishes to take
up actions for a possible HIV-positive this opportunity to recognise and pay
result conducted as part of a work tribute to the hard work and significant
permit medical examination. time invested by all who contributed to
the development of the fee benchmarks,
Our recommendations included as well as earlier editions of the SMA
contacting the clinical laboratory to Guideline on Fees. We believe the effort
confirm the test results and also to notify will be rewarded as doctors, patients
the MOH as stipulated in the regulations and payors would all benefit from the
under the Infectious Diseases Act. greater clarity of fees and affordability
Members who face practice-related of healthcare.
issues may write to sma@sma.org.sg to
seek the opinions of fellow practitioners Medical student leaders meet
within the SMA Council. with SMA Council
Current student leaders of the three
First SMA Council meeting at local medical schools met up with
new premises representatives of the SMA Council on
15 November 2018 to discuss current
The SMA Council held its first council
and future plans, and to brainstorm
meeting at SMA’s new premises on 25
how SMA can continue to support
October 2018.
the learning and growth of medical
The Council is optimistic that the students in Singapore. SMA also hopes
new location, landlord and neighbours to play a key role in bringing students
will provide the right support for SMA from all three schools together to build
as we continue in our advocacy role collegiality within the profession.
16 DEC 2018 SMA NewsCOUNCIL NEWS
SMA SUPPORTS
MOH’S MEDICAL
FEE BENCHMARKS
On January 21, 2018, the Ministry of Health (MOH) important measures include looking at hospital facility
announced the appointment of a Fee Benchmarks charges, and redesigning insurance products.
Advisory Committee to recommend industry The introduction of fee benchmarks will open the
benchmarks for medical procedures and services. way to several changes in the future that will generate
This afternoon, MOH made a public announcement simplicity and thus help control healthcare costs. First,
of the medical fee benchmarks which it had sought ill patients will no longer need to delay treatment as
participation from the Singapore Medical Association they await prior approval from insurance companies,
(SMA) and also the Academy of Medicine, Singapore in cases where doctors follow the benchmarks.
(AMS) and the College of Family Physicians Second, insurance companies will no longer need
Singapore (CFPS), through our representatives to have appointed insurance panels, thus saving the
on the Fee Benchmarks Advisory Committee. The attendant administrative costs. Third, patients will
benchmark is also a recommendation from the have a wider choice of doctors, if they are allowed
Health Insurance Task Force (HITF). to consult any doctor who charges within the fee
SMA has been an advocate of transparency in benchmarks.
fees and supports the introduction and objectives SMA supports the introduction of the fee
of the fee benchmarks which will facilitate patient benchmarks and hopes that more procedures will be
empowerment and promote trust in the doctor- included over time and with each update.
patient relationship. SMA was involved in the process
of developing the fee benchmarks and is of the
opinion that it was a fair process. The fee benchmarks
will benefit doctors (who will now have a guide Dr Lee Yik Voon
when they set their fees), patients and payers. The President, Singapore Medical Association
fee benchmarks are one of several ways that rising
healthcare costs can be addressed. Other equally Issued at 6pm on November 13, 2018
DEC 2018 SMA News 17Letters from Iceland
council news
Text by Dr Anantham Devanand
The 2018 World Medical Association 2005. Membership in the WMA is information may make these issues
(WMA) General Assembly was launched heterogeneous and includes national largely misunderstood by the general
on 2 October by the organisation’s medical associations, medical regulators public. Therefore, it is imperative
president, Dr Yoshitake Tokokura, in and trade unions, with the critical for the medical profession to show
the futuristic Harpa Concert Hall and requirement of membership being leadership in providing a thoughtful
Convention Centre in Reykjavik, Iceland. independent of any national political and independent voice to advocate on
The world’s northernmost capital city control. Akin to SMA’s core values, the behalf of patients before technology
lived up to expectations with its picture- mission of the WMA is to act on behalf of runs ahead of us. Otherwise, the threat
perfect waterfront and wind-swept both physicians and patients. of unwise misuse of what we can do
autumn weather. The cliche is that if threatens to trap us all in a quagmire
In its years of service, the WMA of moral dilemmas. This assembly also
you don’t like Icelandic weather, just
wait five minutes. This bears testament successfully negotiated the politics of marked the beginning of work on the
to the unpredictability and severity of Nazism, apartheid and voting rights, latest revision of the International
the climate of both the country and to grow and become a platform for Code of Medical Ethics. Perhaps then
the global medical issues. This general developing a global consensus on it is fitting to reflect on a verse from
assembly marked seven eventful medical ethics. Some of the historic W.H. Auden, a man who found deep
decades of work since the WMA’s policies that are used as reference the inspiration in Nordic travel as reflected
founding on 18 September 1947. world over are highlighted in Table 1. in his travelogue, Letters from Iceland.
The WMA was created after This year, experts discussed the
its predecessor, the Association medical fraternity’s response to the
“This passion of our kind
Professionnelle Internationale des looming global challenges of physician-
assisted suicide, artificial intelligence, For the process of finding out
Médecins (APIM), was suspended
during World War II. From a 27-member genetic editing, non-invasive prenatal Is a fact one can hardly doubt,
assembly, WMA’s membership testing and data security. The need to But I would rejoice in it more
has since grown to 113 national separate the facts from the hype was If I knew more clearly what
medical associations, and SMA has obvious before any informed analysis We wanted the knowledge for,
been a constituent member since could be done. The complexity of Felt certain still that the mind
Is free to know or not.”
YEAR POLICY
1948/2017 Declaration of Geneva: Physician’s Pledge
Dr Anantham Devanand
1949/2006 International Code of Medical Ethics
is head of SingHealth
Duke-NUS Lung
1964/2013 Declaration of Helsinki – Ethical Principles for Medical Research
Centre and director
Involving Human Subjects of interventional
1975/2016 Declaration of Tokyo – Guidelines for Physicians Concerning Torture pulmonology. He leads
the medical humanities
and Other Cruel, Inhuman or Degrading Treatment or Punishment in office at the SingHealth
Relation to Detention and Imprisonment Medicine Academic
Clinical Programme and
1981/2005 Declaration of Lisbon on the Rights of the Patient serves as deputy director
of the SMA Centre of
2002/2016 Declaration of Taipei on Ethical Considerations Regarding Health Medical Ethics and
Databases and Biobanks Professionalism.
Table 1: Historic policies of the WMA
18 DEC 2018 SMA NewsEmpoweringJunior Doctors
COUNCIL NEWS
Text by Dr Benny Loo
The Junior Doctors Network (JDN) This JDN meeting, delegates from of the fellow JDN delegates and I also
meeting under the World Medical 16 countries across the globe came received many interesting ideas on how
Association (WMA) was recently held together to discuss the new trends in to better serve my Singaporean junior
in conjunction with the WMA General postgraduate medical education. The doctors. Last but not least, I wish the
Assembly in Reykjavik, Iceland, from IMA shared that until 2015, they have newly elected working committee all the
1 to 2 October 2018 at the Icelandic had a limited postgraduate training best in their future endeavours.
Medical Association (IMA) office. It was structure and that most trainees have to
my privilege to attend the meeting complete their higher specialist training
Legend
on behalf of the SMA Doctors in abroad, and the Canadian Medical
Training (DIT) Committee, for I was Association (CMA) explained their system 1. Group photo with the WMA leaders and
JDN delegates
able to renew the bonds formed of competency-based curriculum. A
during the 2015 JDN meeting held representative from the Foundation for
in Oslo, Norway, and also make new Advancement of International Medical
acquaintances with representatives Education and Research also presented Dr Loo is an associate
from other parts of the world. on a potential collaboration with JDN consultant in paediatric
to offer international exchanges for medicine at KK Women’s
The JDN was formed in Vancouver in and Children’s Hospital.
residents to further their training.
October 2010 to create a platform for He looks forward to a
junior doctors worldwide and to ensure Another topic covered was on morning dose of caffeine
that their voices are heard both within the well-being of junior doctors and and plenty of patients’
combating burnout. The CMA shared smiles every day. He is
the WMA and globally. Its mission is to also the chairperson of
empower young physicians to work survey results on burnout among the SMA DIT Committee.
together towards a healthier world their residents and the approach to
through advocacy, education and recognising the signs and degrees of
international collaboration. This is very burnout. They also highlighted the
much in line with the purpose of SMA’s importance and methods of training
DIT Committee, which is to provide a resilience in the junior doctors. The
meeting concluded with an "ideas cafe"
platform for local junior doctors across
session to improve the JDN, and an
all training institutes to collaborate
election for the next working committee.
towards a better training environment,
both intra-institutional and on a It was a very refreshing experience
national level. as I was greatly inspired by the passion
1THE CURRENT PROBLEM
Letter
OF CONSENT-TAKING
Text by Dr Chew Shing Chai
On Thursday 26 July 2018, I attended a peer review lecture at Mount Elizabeth Novena Hospital. The topic was
“Vaginal Birth after Caesarean Section” or VBAC as we call it.
The lecture was interesting, involving six cases, some of which were pushed through an incredibly long period of
labour, causing awe and astonishment among many of us. But the interest of the entire group was totally ignited when
the discussion came to the question of how to obtain consent for the VBAC, leading to the discussion on the procedure
of taking consent in general.
One member who had been taken to court recounted how his consent form, which was taken by him in the presence
of a staff member, was totally voided when the patient said she did not understand the contents of the document she
had signed.
The discussion was intense and it was concluded that the patient has to be taken through the consent form line by
line, with each line initialled in the presence of a witness. Or else, the patient has to write (in her own handwriting) the
concept of what the procedure entails. Or, the entire session has to be videotaped as is done in the US.
Some of us are old enough to remember that the old consent form had a line which said “and any other procedure
that the surgeon may deem fit”, giving him a carte blanche. This is now obviously obsolete.
When medical negligence cases first appeared in courts, the learned judges felt that they were not able to judge
medical issues regarding competence, so they decided to appoint expert witnesses acting as amicus curiae. Hence
the cases were judged based on sworn testimony of doctors and the precedents were known by their names, eg,
Bolam, Bolitho, etc.
In 1999, a Scottish obstetrician managing a short (150 cm) insulin-dependent diabetic with a macrosomic baby
estimated at 3,600 g at 36 weeks was so unhappy at being asked how large the baby was that she decided to stop doing
measurements. She decided to do caesarean only if the baby was over 4.5 kg (how she would be able to estimate that
after stopping measurements is unfathomable). Labour was induced at 38 weeks (baby guestimated at 3.9 kg) and
when there was no progress, more oxytocics were given. When the os was full and no descent was made, forceps
were applied and only half the head emerged. General anaesthesia was given to allow the head to be repositioned
for caesarean (Zavanelli manoeuvre), but she decided to continue to pull the head out, resulting in extreme
shoulder dystocia.
Failed attempts at symphysiotomy followed by massive accouchement force resulted in the delivery of Sam
Montgomery, a 4.25 kg quadriplegic, hypoxic brain-damaged individual.
Of course, this case went through two courts where obstetric colleagues (“expert witnesses”) swore that it was
unfortunate and unpredictable, and their testimony won the day on the two occasions. But in 2015, the Supreme
Court found that there was no proper advice given and so we now have the Montgomery case that hangs over
our heads.
My conclusion totally unacceptable and that the monumental disaster
1. The obstetrician flagrantly flouted the ethical that crippled little Sam should have been settled with
principles of patient autonomy, beneficence and compensation to the mother.
non-maleficence. Then the law would not have been changed and
2. The learned judges who could not rebut the we could keep to the old Bolam-Bolitho-Whitaker
testimony of the “expert witnesses” changed the law. precedents. We cannot change the law so we have to
live with it. We only need to pray that we do not have
3. Therefore we do not really need “expert witnesses” any mishaps during surgery, and we do need good
any more. videotaping equipment and videos dubbed in the four
official languages, if we do any procedures.
What we needed in 1999 were some truthful
obstetricians to testify that the management was I welcome all comments.
Opinions expressed in all letters published in SMA News reflect the views of the individual authors, and do not necessarily
represent those of the SMA News Editorial Board or SMA, unless this is clearly specified. The contents of letters are not to be printed
in whole or in part without the prior written permission of the Editor (to request for reproduction, email news@sma.org.sg).
20 DEC 2018 SMA NewsYou can also read
