A Doc's Life is a underground Medical Blog about some poor Singapore doctors. They are sibei sian and very buay song. Best practices not observed!
(Warning: Grammar is non existent in this blog. Those obsessively compulsive about good English please go no further and book an appointment to see your psychiatrist in Singapore.)

Friday, May 15, 2015

Why You Don't Want to Be Happy with Your Doctor

Those of us who work in Hospital will know about the all important Patient Satisfaction Survey (PSS) season. This is when the admin staff suddenly appear from their dungeons and start distributing milo drinks and so-ta-piah (soda crackers) to patients. Dr Og always see some of the doctors steal the milo drinks and biscuits. Wah lau, don't so siah suay can or not... patients only get this type of good service once a year, so don't go and steal la.

But hor, this journal from JAMA which has been circulating around facebook for a while liao shows that higher patient satisfaction was associated with less emergency department use but with greater inpatient use, higher overall health care and prescription drug expenditures, and increased mortality.

What this means is: the more you like your doctor, the clinic or the hospital, the worse your outcome will be!!

Dr Og thinks this may not be true everywhere but sometimes, making the patients satisfied means giving them what they want. And one thing that patient always want is to go off medications. If I tell all my patients meng jiak yok liao (no need medications), I'm sure all of them will be sibei happy lor.

And they probably won't be well enough to make it for the next PSS to register their dissatisfaction.

Actually, what Dr Og thinks really will work is if we survey Doctor's Satisfaction! Surely if your doctor is happy, he will be in a better state to treat you and your outcome will likely improve. JAMA should really look into it! Unfortunately, I can't suggest this to hospital management as I have vested interest.

But if they really do the Doctors Satisfaction Survey hor, then at least we don't have to steal Milo and so-ta-piah (which incidentally is my fave snack)!


Sunday, April 26, 2015

Love Bites!

Dr Og last time work in the ward will always try and avoid chatting too much with the patients. It's not like Dr Og don't like you all ok, it's just that lokun must have lokun decorum, which means that we must be distant and mysterious. After some of my fellow colleagues kennah stalked, it affirmed my stance further -- although the staff nurse tell me I not yandao enough to get stalked one....hhhhhmmmmpph!

I remember got one time when I was a MO, the baby MO haolian show me a thank you letter folded into a heart-shape from a patient. This patient was young and chio and he baby MO was very buaya type. The patient was actually quite well but was admitted for low platelets because tiok Dengue (those were good ol' times when there were actually enough beds to admit patients). We were all in the same team and the few younger male MOs including Dr Buaya were fussing all over her. For the first time, they would actually put up their hands to take blood.... for her of course. It was a strange sight. One MO tying the tourniquet, one MO preparing the blood tubes and the lucky one, who won the orh ar peh ar song, performing the venipuncture.

Me? I didn't want to join the the charade, preferring to attend to the ah pek and ah mah. The old folks usually talk talk talk but they don't really mind you not listening. Anyway they either forget who you are soon enough or if their senses are impaired, they may not know who you are in the first place. 

I like my distance.

So this baby MO and the few other MOs who fussed over the girl all received the heart-shaped-thank-you-letters on the day she was discharged. I think I would be lying to say that I was not slightly jealous and wondering if her telephone number was in it. (There was of course no way we would call her as that would be ethically wrong.) After all, all of us do like to be liked but it's really about the amount of effort you are willing to put in.

Few days later, there were some shouting going on at the counter and it was distracting me from writing my blog in the MO room. I walked to the counter and there was the girl and her mother shouting at the poor PSA. They were complaining that there was a big blue black on the area where the blood was taken and refused to accept the explanation that it was quite normal and that the blue black will go away. Soon the buaya MO & et al joined in to explain but it quickly escalated into a heated argument. 

It ended acrimoniously with the girl pointing at the buaya MO shouting, "I want to complain against you!" 

Mother and girl stormed off...... presumably to the Quality Management Office. (Sometimes you get a limited edition teddy bear if you complain hard enough!)

Moral of the story? 

Please press the cotton on the venipuncture site long long and not let go. Otherwise sure kennah haematoma!  

Tuesday, April 21, 2015

Faster and Furiouser!

So Fast and Furious 7 cheong pass $1 Billion liao. Dr Og played a part in that by having watched the show one week ago. Fast and Furious is one of Dr Og's favourite movie franchise (after Star Wars, Harry Potter, Avengers, LOTR, Transformers, Ironman, Superman, Batman, Spiderman, Toy Story, The Hunger Games, X-Men.......) There are bromance, fast cars and the Rock. Really, whats there not to like.

If anything at all to criticise, the screenplay writers got lazy and copied the plot of Avengers (who copied the plot of Transformers). It is basically about some people wanting to take over the world and these dudes with super fast cars stopping them and in between some buildings and cars get blown up. Like the Avengers these dudes have super power. They can jump in, out, down, up vehicles without falling by altering the law of Physics, they have invulnerability and can survive car crashes and falls from height without any substantial injuries, and their cars can even fly from one building to another. Unlike in Transformers (another movie about saving the world while destroying some cities along the way), the cars do not transform and start talking rubbish, which Dr Og feels is a good thing actually.

Dr Og also think Vin Diesel got lazy. This dude won some acting award last time tio boh? Why now he like only got one buay song face and one ya ya papaya expression?

The Rock (sorry dunno his name) was not bad in the show. He fell off a building and managed to hope  the char bor in his arms. After that he went hospital still alert and GC well! Only break a few ribs bones and had a cast over his arm. He later summon super power and break the cast by flexing his arm. So un un un believable, I tiok stunned like vegetable lor. But he redeemed himself immediately in the next scene by driving an ambulance to go help fixed facies Vin Diesel. An ambulance in fast and furious wor!

The Rock say he wants to do a spinoff for his character in Fast and Furious. I think Dr Og can contribute the plot:
The Rock after falling from so high and breaking this and that bone. And also anyhow AOR from hospital without proper treatment, was downgraded to PES C9L9. So he cannot work in the dunno simi government agency liao coz he fail medical board.

He retires to become an ambulance driver and learns to drift ambulance at the hill behind MOH which used to be KEVII. Because of his extraordinary driving skill and speed, unhuman strength to pick up any casualty without a stretcher and ability to bump off all the slow coach cars jamming up the road to SGH A and E, he manage to improve our national ambulance response time single handedly! Complaints such as this totally disappears as the Rock can get you to TTSH and KKH at the same time with his doppelganger super power (how can this be a Fast and Furious movie without some ridiculous right?)!

Also SNEC can sponsor all their doctors' lovely sports cars (which would otherwise be just parked there anyway and never see the real speed they were built for). The name of the movie I also think swee swee liao, call Faster and Furiouser: Ambulance Cheong No Enuff. In line with our Singapore motto of Faster Better Cheaper... for SG50 Swee la!



Wednesday, April 15, 2015

Tips on How to Make Your Doctor Like You (Part 2)

Last week, Dr Og teach you how to make your doctor like you. If you haven't try better quick quick. There are of course lots of research to show that if your lokun like you, he will treat you better. Even the char kway teow uncle will give you more hum if he likes you right?

Here comes some more tips!

4. Listen (After You Talk)

You are after all C-O-N-S-U-L-T-I-N-G your doctor (and paying to do so), so its only right that you L-I-S-T-E-N to the consult (to make your money worth it). Many patients switch off when they are told things they do not want to hear and when sh#t hits the wall, they will claim "Wah, Loctor why you neh tell me don't take meh-cine will be so jialat."

Wah lau... Dr Og told you so and also judiciously documented it down in the case notes ok. But you weren't listening, were you. Not likable at all... humph.

5. Self Diagnosis and Treatment

Being ke kiang and demanding your doctor to give you treatment for the diagnosis you think you have is not likable at all lah. Yes, you can Google about your symptoms but you did not spend 5 years in medical school, one (tortuous) year as a Houseman and another 4-5 years in specialty training. You did not spend thousands of hours seeing and treating thousands of patients with the same problem.

Even if you more clever than the doctor, pretend pretend a bit. Trust me, when the doctor sayang you, the injection also not so painful one.

Anyway if you really so so clever, you don't need to see and doctor or to have him like you. Press Alt-F4.

6. Assuming Responsibility

And if you so clever and you think you can self diagnose and self treat like taking a selfie on your smart phone, please also take responsibility for the risk you put yourself in hor.

Aunty (from last post): "Lokun I ok liao, the medicine I stop liao, can har?""
Dr: No la, best continue la. You choose to stop anything happen not my pasar ok."
Aunty: "Means I can stop la, can har, you say one har!"

One month later...

Aunty Angry: "Wah lokun you say can stop, see now so jialat, you bluff me ar!!!"
Aunty's Son: "Wah lokun, why you tell my mother to stop medicine??? You sabo ar, I port you to hospital!"

Now even the son is unlikable, hai...

7. Maiming or Killing Your Doctors

If your doctor is dead, he really cannot like you. Attacking him will really do no good to your patient doctor relationship because there will be none left. If you really don't like your doctor just change la and maybe the next doctor same pattern as you. 

In China, doctors are frequently attacked and sometimes killed by buay song patients and relatives. Some of you may say orbid good since the doctors there take bribes and angbaos and some of you may laugh it off since Singapore is like the safest place in the world. But low crime  being threatened and even actual physical violence are not so uncommon. Nowadays, doctors kennah thrown hot milk and infected needles and even tiok kicked ar!

Why so liddat? The doctor will be so scared that he will be standing at least ten feet from you during consult liao, the stethoscope where got long enough?

Aiyah, its really easy for your doctors to like you. Just be patient, polite and nice (how hard is that right?). Being liked by your doctor will bring unprecedented privileges and extra KY jelly before the fingers do the walking.....

Sunday, April 12, 2015

Tips on How to Make Your Doctor Like You

So you really want your doctor to like you ar? If not you wouldn't have ended up in this page from Google search right? Don't be shy, you are just one of the many Lokun Worshippers out there. (For stalkers out there, to read the special how to make your doctor LOVE you post, press Alt F4 now!)

And what if you don't like to lick like a doctor? Yes, you will be treated equally whether your doctor like you or not... but you will be treated more equally if your doctor does. After all, as much as you doctor lovers refuse to believe it, we are humans after all.

So if you will like a gentle per rectal examination (with a prostate massage extra service), here are some tips on how to make your doctor really like you:

1. Punctuality

Yes, sometimes you need to wait a bit when you are on time. But you have to know, doctors are egomaniacs and you will damage their egos if you make them wait for you instead. So if you guai guai come early, your doctor will really appreciate la. Even if you need to wait long long, so what? It is all worth it because your doctor will like you! If he ever even offer a hint of apology for making you wait, quickly counter apologize for causing him to apologize. In this way, both of you can quickly get over the "why you always late" and "why need to wait so long" issues and focus on the medical problem at hand.

2. Gifts

Dr Og has received all sorts of weird stuff from patients, including stuff toys, belts (yes belts!) and some suspiciously used objects. Most patients would present normal gifts like fruit hampers or bring us some drinks and food.

Honestly, no need la. 

No Ang Baos please! Singapore doctors cannot be bribed. Do not even try giving us anything more than $10 in value as your doctor then has to waste time to declare this to Human Resource. Most of the time gifts that are of substantial value will be sold off and proceeds donated to hospital endowment funds.

The best stuff Dr Og has received are thank you notes or cards to say tell us that they are better. A simple thank you never fails to melt your doctor's heart, boost his morale and improve your likability!

3. Talk

The patients that Dr Og definitely cannot tahan are those who refuse to talk.

Dr Og: "Aunty, simi tai chee" (Madam, what ails you?)
Aunty sulks: "......"

Dr Og: "Aunty, li si tolo boh ho sei" (Madam, where do you feel unwell?)
Aunty continues to sulk: "......"

Dr Og: "Wah lau, li mai kong wei, mai liao si kang, er bai ka lai la, lua kau lang jin zuay la" (Perhaps you will like to think about what your problem is and come in later?)
Aunty finally squeezes a line: "Wa simi tai chee, li si lokun kuah buay chut meh? Li si simi lokun?" (I got what problem you cannot see with your eyes is it!)

 It is absolutely ok to write down in point form, what you will like to communicate with your doctor. In fact this is an efficient way to let your doctor know your problems. Avoid coming into the consult with pages and pages of prose as your doctor immediately knows you are a kan cheong spider and your likability drops to rock bottom.

To be continued...