5 Steps to Becoming a Truly Patient-Centred Public Hospital

See Ma! Got carps and cigarette butts!

Hospital admins are always talking about missions and visions and senior management is always harping about patient centred care. But honestly, when you go to a hospital, do you feel like the hospital is meant for you the patient? When you want to get admitted, sure tell you not enough beds and kennah stuck in A and E. In fact, you may not even be able to find a car park space for your Mercedes in the first place! 

No scared. Dr Og reveals the 5 secret steps to becoming a truly patient-centred public hospital!!

Step One - Have a Lottery Store
Buying Toto and 4D are undoubtedly the favourite past times of Singaporeans. How can miss buying your lucky numbers just because you are admitted to hospital right? If you miss, the number sure come out one! 

Hospitals should have a lottery store right in 7-11 or Cheers like our HDB estates la. To make things easier, let the ah mahs (cleaners) in the ward help patients collect bets and earn some tips for themselves. In OT last minute before the anaesthesia sets in can also put last order. Its win-win for everyone!

Step Two - Have More Yellow Boxes
Ok, Dr Og knows this is controversial. Yah lah, smoking is no good. But isn't it cruel to make the ah pek with COPD (panting) crawl all the way out of the hospital boundary to smoke? Have a heart, condone off more yellow boxes in the hospital for them to smoke. 

But have our medical social workers station there to provide counselling and nag at all of them about smoking. This will also increase the work scope of our MSWs and stop them from complaining about "everyday only do financial assessments niah..."

Win-win again!

Step Three - Treat Your Doctors Better
Look. The simple fact is that patients go to a hospital to see doctors and to get treatments. You can have the most friendly counter staff around but all the patients really care about are the 15-minute consults where they get to interact with the doctors.

Du Lan (angry) Doctors (DLDs) are not going to be very nice to patients are they? DLDs will spend every waking moment in angst and in opposition to the hospital administration. All there are in their minds are how to siam the next admin meeting / hospital lecture on anything but patient care and how they will really like to trip the CEO as he walks out of his office before giving him a good piece of their mind. 

Yup, DLDs are not effective doctors. Is it really that difficult to make doctors happy? See my next post lah!

Wah Waterfall. Well done CEO!

Step Four - Kill the Water Features
I can understand why all CEOs want a pond or a fountain in their hospital. The official story is that the kois and sound of running water are soothing to our patients. In reality, the CEOs are probably comparing "is your pond bigger than my pond" during MOH meetings! Honestly, how many patients you ever see going to enjoy the water features? They are becoming places for people to throw rubbish and their unwanted neon tetras. Also poses a danger for drowning (don't look down on shallow waters ok)!!! Water features are useless, waste water and waste money. Get rid of them, make better use of the space (like 4D shops, yellow boxes or maybe extra hospital beds) and show that you are committed to patient care.

Otherwise, get rid of the CEO.

Step Five - Change Hospital Name Can??
Last time very easy. Hospital in Changi called Changi Hospital. Or named after Singapore. Or at the very least named after a great historical pioneer and philanthropist. Now suddenly named after people Dr Og has never heard before one. Must google then "ohhhh is the ancestor of some rich family." 

You really think our ah peks and ah mahs can remember all these names?? Now you ask them where they are when you do orientation, they all tell you they are in Tan Tock Seng coz thats the only hospital with a human name that they know.

So change the name back to like Yishun General, Jurong General before even the taxi drivers get confused. 

Especially when its impossible these days to drive to a hospital (even new ones) as there are no carpark one!!!! 

Waste Time

So National Day came and went. This year Dr Og so busy, never even watch the fireworks. In hospital, always so many things to do; like change passwords, forget passwords and reset passwords for the various computer systems in the hospital. Plus if you also go to other hospitals to "visit" (means you kennah prostituted to other hospitals), you need to remember extra sets of passwords!

This is no easy feat especially when we get older and your digit span gets shorter! (BTW, digit span is not the length of your finger or any other parts of your body, so don't worry hor!) Now they more kiasu! Must have alphanumeric and capital letter! Uncle sometimes cannot even remember where I park my car you want me to remember so many difficult passwords?

Talking about car parks, the car parks in our hospital are the most jialat. One particular hospital the ramp into the car park so narrow sure scratch if you drive big car ok! Lucky uncle no money anyway so car small small. But the worst thing about the car parks are that there are no space. So if suay suay traffic jam or go out makan during lunch, come back sure no space. Now you know why your lokun always late for clinics huh!

But most times, we doctors always have to go to hospital very very early. Not to start ward round early, but to attend talks. Most times, the talks are irrelevant to your area of speciality but your Boss need to fulfil KPI for attendance. Its really funny to see Operations people working on their laptops in a clinical presentation. Talk about wasting time. Sometimes, the hospital hold talks during lunch and they tell us that's the only time doctors are free. But why they never provide lunch huh? Then when do we get to eat??? Then again, I must really count my blessings if its not one of those compulsory admin talk I have to attend coz unlike the Ops people, I cannot see my patients while listening to them sprout Greek. Mebbe next time Dr Og write blog during these talks! Anyway they are not during the official office hours. Ha!

Ok, I better get back to my work. Dr Og has cleverly written all his passwords on a piece of name card so that I will never get them wrong again.

Hahahahahahahaha!

Wait..... where did I put the name card huh?

Sometimes They Don't Survive

Statistics is very much part of our training in medicine. The graph above is known as a survival curve and every step signifies a death. Whilst a million death is a statistic, each death is to a doctor a powerful if not sometimes painful reflection.

For we may try our utmost and do whatever we can but sometimes, some will slip through our hands. With each death and with the bias of hindsight, there is always that nudging, albeit transient, feeling of guilt. The feeling that I could have perhaps done things better or that I could have done more, if I can do it all over again.

Or perhaps it is with the knowledge that with each death, we are ourselves one step closer, that is the origin for this wishful thinking of saving our patient's life, such that ours may one day be saved.

But alas, sometimes, and oftentimes, they don't survive.

The Avengers

Those who have not watched the Avengers must go and watch la! Especially lokuns. Not only was it very shiok to see Ironman fly here fly there, Hulk jumping around, Cap American cheonging aimlessly, the Avengers actually delivers a  very important message. Like in our Lokun Choo, Avengers is all about team work!

In a medical / surgical team, you always need the goodie two shoe like Captain America who does not care about pay or fame. A also stands for Altruism and he is always ready to throw the A card in your face. If you tio smack by him, its almost like kennah Cap's shield. Sure faint big time!

You will also always have the maverick like Ironman, narcissistic because his lao pek wu liu and he drives a Porsche to work. But no worries, Cap will keep him in check! Only problem is he will get all the girls la... (just accept it ok.... you drive Chery QQ, he drive Porsche...)

In every team, there will be a Hulk. Forever angry with everything and bashing around. You dunno why he is jumping in anger but he complains incessantly about everything including canteen food no good, weekend rounds too many, pay too low (which is true) and changes too many. Most of the time, Cap has to come in to damage control for him. Others may hate him but Cap will tell you he has a nice side to him known as Bruce Banner and is harmless la.

Thor is my fave character in the Avengers. Who don't like a pretty boy who thinks he is God? Unfortunately narcissism may cause conflicts in the team and Ironman will fight it out with Thor for that one chiobu nurse! Thor will lose as he is actually in love with himself (something only Gods can do) and is too busy playing with his own loin lock. Thor's greatest weakness is his hammer. It behaves like a boomerang; dunno how many times he tio whack by his own hammer liao!

Most teams will have a Hawkeye but some teams may have a lesser version, the Cockeye. Hawkeye is the most hated member of the team. Problem is that he likes to shoot arrows at people. If you tio his rapid fire, good luck. Cockeye abit better, coz he shoot arrows but everytime buay tio!

But hor, the most important member of the team is Black Widow! There must always be a sweet young thing in the team to make all the difficult blue letters to the hum sup senior doctors. Any unwarranted urgent radiology scans that your Consultant ask for, ask her to settle, sure can! However, she must be zhai enough like in the movie so that Ironman, Thor, Cap America and Hulk not matter how horny won't dare to touch her coz she is thorny.

It is important to remember that like the Avengers, we need to work together as a team to repel any possible Alien invasion. Good luck!

打点滴

Ok, if you guys are expecting daily updates, please don't. Just happen that I read this news I buay tahan must share my experience:

Patient: 医生，为什么不帮我打点滴！
Loctor: You have tension headache, iv drip will not help. Your blood counts are normal. No infection, no need for iv antibiotics.
Patient: 不行！我在国内每次头痛都打点滴！打了马上好！
Loctor: I'm telling you there is no indication. You are not dehydrated. No need iv.
Patient: 你是怎么當医生的呀! 我头痛就是要打点滴! 痛死了!
Loctor (in broken Mandarin ((I know, this loctor damn jialat, English Chinese all broken))): Tamade dian di ni de tou!! Chi wang yao ma shang hwei jia! (Google Translate: Madam, you can go home after having your pain killers.)

In some countries, strange as it may be, it is a cultural norm for patient to get an i/v drip for any condition or complaint. In Singapore, we like to do things for a rational reason. 不爽你又能怎样?