As we celebrate our nation’s 60th birthday, perhaps it is time also to think what may happen in the next 60 years for doctors living on this island. Certainly, the medical profession has come a long way since 1965. The profession’s trajectory has been largely a positive one, both for itself, the country and the community it serves.
We have become bigger and more complex. Each year, thousands of applicants vie for the 500 or so places in our medical schools. Another 200 come from foreign universities. Taking into account retirements and deaths, our ranks have increased by about 600 to 700 a year in recent years. We have grown to 35 specialties and 10 subspecialties.
But do these numbers mean that everything is hunky dory down the road for the next 60 years or even just the next 10 to 20 years?
Let’s ask a few questions (which will NOT be answered in this column):
- What if doctors are no longer trusted by the public and held in high esteem by society?
- What if our medical schools no longer attract the brightest to apply?
- What will happen if only the rich can afford to send their children to our local medical schools?
- What if there are significant numbers of doctors who cannot get a well-paying job after they finish their housemanship or their 5-year government bond and most of our young doctors no longer think Singapore is a good place to work and make a living and go elsewhere to practice medicine and raise their families?
- What if defensive medicine takes root and becomes pervasive in Singapore?
- What if two-thirds of our doctors quit public service and go into private practice? (Presently, the converse is true: roughly two-thirds of the medical profession work in the public sector)
- What if the medical profession loses our professional independence and practice in a way that is dictated by other parties with different priorities, such as insurance companies and third-party administrators?
- What if we are no longer seen to be a country that can offer the most advanced medical services in the region and regional competitors have surpassed us in capability and skills and Singaporeans have to go to a neighbouring country to get access to advanced treatment modalities and highly skilled doctors?
- What if large numbers of doctors no longer believe it pays to be ethical because making a living as an ethical doctor is just too difficult and unrewarding?
- What if the majority of doctors can no longer afford private housing or own a car at even say, 40 to 45 years-old?
These are uncomfortable questions to which we instinctively know the answers to, but which are difficult to say aloud, especially to non-doctors. What is more, many of these 10 questions are actually interlinked or correlated.
While we have every reason to be thankful these 10 questions are really hypothetical in nature now, we also always need to be alert and to guard against the possibility that the answers to these questions becomes reality in Singapore.
Happy SG60!
hobbitsma 