Another doctor in trouble

[Lotr]

1 hour ago, Kb27 said:

So a doctor now has no life ?

He treats a patient and he must be present all the time. Cannot take leave, cannot go overseas.

Private doctors have to be there for their patients and they are compensated handsomely for it.

[Lotr]

Speaking from experience, I see that there are ward doctors in government hospital who will be there round the clock but for private, the specialist will only come in once or twice a day.

Patient care in government can be more holistic as they have allied health care staffs to help patients on diet, physio etc.

 

[Philipkee]

4 hours ago, Kb27 said:

So a doctor now has no life ?

He treats a patient and he must be present all the time. Cannot take leave, cannot go overseas.

To that extent, yes.  

An example i can give is a taxi driver.  As long as you have a passenger in your taxi, you cant go on leave or take mc.  So if the taxi driver wants to earn more money by constantly picking up passengers, he has no life, no time to go to toilet etc

But the flip side is if there happen to be a lot of passengers but he chooses not to pick them up cos he wants his power nap, he needs to be mentally prepared that after he wakes up and looks for passengers he might not find many.

Each private doctor earns a lot from each patient but he also knows that the market is fickle and you cannot be assured of a steady stream of patients all the time unless your reputation is really that good.  Hence they dont like to reject patients.

[Sdf4786k]

12 hours ago, Philipkee said:

My two cents.

In public, no issues handing over.  Cos there is a team.   In private it gets tricky.

The doctors are technically not staff of hospital.  In fact they pay the hospital for the right to work there and rent a clinic and hence they are customers.  Also, let's say Dr A is in the clinic.  The patient comes specifically looking for dr A.  Cos this is private.   You have a choice unlike govt where you get the doctor on call.

Hence, why would dr A hand over the patient to dr b unless absolutely necessary?  Money will be an issue.  Who pays Dr B?  If Dr B makes  mistake, Dr A reputation will go down as well.

If I remember correctly, payments to doctors and hospital are separate in private sector. Patient pays doctor directly or via clinic.  Hospital charges are separate.  Of cos there are many variations so sometimes hospital collects on behalf of doctor or there is a team.  Like one clinic got two doctors who are friends/ husband and wife etc who cross cover but in a nutshell, you cannot compare the practices of a private hospital with that of a public hospital.  

There should be medical officers on duty for emergency cases like code blue or something but in terms of management of patients like in this case where surgery is required, Dr A has be informed and perform the surgery.  If he hands over or asks another doctor to perform it, he loses income and reputation.

I make no comments on the nurses.  Cos i dont know the facts.

And to answer directly.  What if there was an emergency and Dr A is suddenly unavailable like MC and he needs to hand over to Dr B?  Can be done.   But might have loss of income for Dr A and if word spreads that Dr A is always sick and likely to handover the patient to another specialist, Dr A might find less patients looking for him and he earns less or closes shop.

seems like what you describle like a used car sales man on commission ...

So operations and surgery comms based? If so, I no longer have the same respect as I used to if this was the behavior that led to the demised of the woman.

 

 

[Kusje]

13 hours ago, Philipkee said:

My two cents.

In public, no issues handing over.  Cos there is a team.   In private it gets tricky.

The doctors are technically not staff of hospital.  In fact they pay the hospital for the right to work there and rent a clinic and hence they are customers.  Also, let's say Dr A is in the clinic.  The patient comes specifically looking for dr A.  Cos this is private.   You have a choice unlike govt where you get the doctor on call.

Hence, why would dr A hand over the patient to dr b unless absolutely necessary?  Money will be an issue.  Who pays Dr B?  If Dr B makes  mistake, Dr A reputation will go down as well.

If I remember correctly, payments to doctors and hospital are separate in private sector. Patient pays doctor directly or via clinic.  Hospital charges are separate.  Of cos there are many variations so sometimes hospital collects on behalf of doctor or there is a team.  Like one clinic got two doctors who are friends/ husband and wife etc who cross cover but in a nutshell, you cannot compare the practices of a private hospital with that of a public hospital.  

There should be medical officers on duty for emergency cases like code blue or something but in terms of management of patients like in this case where surgery is required, Dr A has be informed and perform the surgery.  If he hands over or asks another doctor to perform it, he loses income and reputation.

I make no comments on the nurses.  Cos i dont know the facts.

And to answer directly.  What if there was an emergency and Dr A is suddenly unavailable like MC and he needs to hand over to Dr B?  Can be done.   But might have loss of income for Dr A and if word spreads that Dr A is always sick and likely to handover the patient to another specialist, Dr A might find less patients looking for him and he earns less or closes shop.

Thanks for sharing. From what you described, it is a systemic problem. 

How can the life and death of a patient be linked to whether their doc is on MC or not?

System is broken and needs to be fixed.

[Watwheels]

To me the question is why was the patient's limb blood vessels found severed? What could have caused it? Did patient had a fall? This was not mentioned. 

[Beregond]

14 hours ago, Philipkee said:

 

 

this is something new,

all private operate this way?? or only a small %?

those private hospital cannot employ their own doctor??

[RogerNg_185295]

9 hours ago, Lotr said:

Private doctors have to be there for their patients and they are compensated handsomely for it.

How handsomely paid are they? Give some hints?

[Galantspeedz]

The coroner noted that Mount Elizabeth Hospital had reviewed its nursing protocols for post-surgery care for total replacement knee procedures, with effect from April 2018.
Read more at https://www.channelnewsasia.com/news/singapore/woman-died-mount-elizabeth-hospital-dr-sean-ng-knee-surgery-11912566

 

Shouldn't review be for all post surgery procedures rather than only total replacement knee prodcedures?

So only when 1 person die for each procedure than review?

[Kusje]

40 minutes ago, RogerNg_185295 said:

How handsomely paid are they? Give some hints?

Google it la.

Google Susan lim can already.

[Ash2017]

Basically, from my reading:

 

1. Gone to private practice too early (too junior)

2. Too little experience with Total knee replacement surgery 

3. After surgery, going off for conference or holiday without medical cover for his patient, in some countries, considered criminal offence. If after all "successful" surgery, why NOT all patients are sent home soon after, but instead they are kept in hospital because complications may occur and emergency treatment may be needed. The curious point is patient is kept in hospital but no proper doctor cover.... it seems like a case of covering backside technique.

 

[Cook123]

Failed ipo 

worry how to make more money

how to operate like that?

[Watwheels]

23 minutes ago, Ash2017 said:

Basically, from my reading:

 

1. Gone to private practice too early (too junior)

2. Too little experience with Total knee replacement surgery 

3. After surgery, going off for conference or holiday without medical cover for his patient, in some countries, considered criminal offence. If after all "successful" surgery, why NOT all patients are sent home soon after, but instead they are kept in hospital because complications may occur and emergency treatment may be needed. The curious point is patient is kept in hospital but no proper doctor cover.... it seems like a case of covering backside technique.

 

You might be partially right. I think this issue isn't new and has been talked about many times. Specialist doctors are specialised in their field but not in other fields as well. And then elderly patients do not have just one health issue bogging them, they are seeing so many specialists. There's no all rounded doctor like in the hospital drama "House". But everyone in the non-medial profession thinks doctors are like the doctor in "House". It already took so much time and hard work for a doctor to become a specialist. How much more time will it take for the doctor to become an "all rounder"? It's also quite ridiculous just thinking about it.

Is it really what they called post surgery "complications". I seriously doubt it. What the doctor is unaware of why the patient's knee is not healing properly after the surgery or what caused the limb's blood vessels to be severed is not "complications". After the successful emergency surgery done on the patient's knee her health deteriorate but what caused it? Her body failed and ultimately she died. Nobody knows the details.

Edited September 19, 2019 by Watwheels

[RogerNg_185295]

9 minutes ago, Watwheels said:

You might be partially right. I think this issue isn't new and has been talked about many times. Specialist doctors are specialised in their field but not in other fields as well. And then elderly patients do not have just one health issue bogging them, they are seeing so many specialists. There's no all rounded doctor like in the hospital drama "House". But everyone in the non-medial profession thinks doctors are like the doctor in "House". It already took so much time and hard work for a doctor to become a specialist. How much more time will it take for the doctor to become an "all rounder"? It's also quite ridiculous just thinking about it.

Is it really what they called post surgery "complications". I seriously doubt it. What the doctor is unaware of why the patient's knee is not healing properly after the surgery or what caused the limb's blood vessels to be severed is not "complications". After the successful emergency surgery done on the patient's knee her health deteriorate but what caused it? Her body failed and ultimately she died. Nobody knows the details.

Any doctors in MCF can shed light on this?

[Lala81]

Based on what my friends say, you can damage the artery during a TKR.
But it's extremely uncommon if u are skilled. And from reputation wise, i don't think he has a skills problem. And he definitely has done enough volume.

Beyond that, can't really comment. 

[Lala81]

25 minutes ago, Watwheels said:

You might be partially right. I think this issue isn't new and has been talked about many times. Specialist doctors are specialised in their field but not in other fields as well. And then elderly patients do not have just one health issue bogging them, they are seeing so many specialists. There's no all rounded doctor like in the hospital drama "House". But everyone in the non-medial profession thinks doctors are like the doctor in "House". It already took so much time and hard work for a doctor to become a specialist. How much more time will it take for the doctor to become an "all rounder"? It's also quite ridiculous just thinking about it.

Is it really what they called post surgery "complications". I seriously doubt it. What the doctor is unaware of why the patient's knee is not healing properly after the surgery or what caused the limb's blood vessels to be severed is not "complications". After the successful emergency surgery done on the patient's knee her health deteriorate but what caused it? Her body failed and ultimately she died. Nobody knows the details.

A major event like a limb with compromised blood supply can lead to shock and organ failure. It's also a combination of luck and how strong your body is inherently, whether you have underlying co-morbidity issues. 
Another patient may have survived it. Usually most TKR patients are able to stand up the next day. If u can mobilise, there's no real need to check for an ischemic limb

[Lotr]

4 hours ago, RogerNg_185295 said:

How handsomely paid are they? Give some hints?

For hospitalization related, everything starts with 4 digits 

[Lotr]

3 hours ago, Ash2017 said:

Basically, from my reading:

 

1. Gone to private practice too early (too junior)

2. Too little experience with Total knee replacement surgery 

3. After surgery, going off for conference or holiday without medical cover for his patient, in some countries, considered criminal offence. If after all "successful" surgery, why NOT all patients are sent home soon after, but instead they are kept in hospital because complications may occur and emergency treatment may be needed. The curious point is patient is kept in hospital but no proper doctor cover.... it seems like a case of covering backside technique.

 

I might be wrong, but I think there are doctors in A&E and special wards like  ICU and HDU