Number and quality of doctors in Sin

The statistics given by Amy Khor in Parliament has stirred many emotions among Singaporeans on the number of doctors and the quality of doctors in the island. I did not have the details on how the numbers and ration were arrived. We have now 1 doctor to 520 of the population. Is the population based on 3.3m citizens or 5.4m or should it include the medical tourists? Anyway how the data are collated and computed and the implications are not what I want to comment here.

Our medical services are on par with the best in the West. And we used to have an added competitive edge in pricing lower than the West. It was the equivalent of CBF, cheaper, better and faster or cheap and good. Many medical tourists find it value for money, for equivalent quality to the West but at bargain price. But this is changing.

Other than our infamous case with the royalties in Brunei, our medical fees are catching up with the West for many reasons. One is our cost of living. Higher rental, higher property prices, higher prices of luxury cars, and higher everything, which means that the medical professionals would have to charge higher too to enjoy all the good things in life. And for those who are studying medicine here and aspiring to earn big money, the cost of a medical education is also so much higher, and many times more overseas. All these add to the eventual fees to be charged to the patients.

Everything should be fine when the patients are willing to pay and can afford to pay, and the quality of medical services remains high. What can go wrong is a compromise in the quality with the influx of foreign trained doctors and specialists. Our local doctors are top notch, professionally and in academics. They are the crème al crème of their cohorts in schools. Everyone got more than straight As to be even considered for medical school, and many were rejected. That speaks quality. The very best became doctors.

Are the foreign additions of the same quality? I am prepared to say yes on paper, as these should be the criteria to judge them and their professional resume. Fingers crossed that this is well and the integrity of the medical profession is not compromised.

I think at the top level, the specialists, the problems of fakes and quacks are lesser as many would have proven themselves before attaining their positions and recognitions. The problem is at the lower level. At the GP and junior specialist level, medical professionals are flooding the industry from everywhere, presumably the medical council would have done their due diligence to have their professional qualifications and expertise verified and spelt good and okay, on par with our top notch doctors.

There is no doubt that our first world quality control and checks would be able to keep the quacks and cheats and the not so good out of the system. The third world fraudsters should not get passed the barriers and the scrutiny of our super talents. If these are in, then the quality of our medical services will definitely be affected. By right the cost of medical fees should be lower with medical professionals coming from third world countries. Relatively, the cost of producing a third world doctor, their cost of living, cost of education, etc, etc are much lower compare to the cost of producing a top notch doctor in our system. Their return on investment is pretty high when the cost was low while the returns from fees in a first world city are exceptionally much higher.

How this is working out I dunno and they may be paid exactly the same as our top notch locals who came from a top notch system both in quality and tuition fees. The foreign doctors are getting paid for more than what they are worth. Are the Singapore patients getting value for money? Now this exposes some mismatch and misgivings won’t it?

There are reasons to pay them the same for the same job. But the input in the production of our local doctors and those of foreign doctors, especially from the developing countries will show a vast difference in the cost, and the quality as well. To the foreign doctors, the return is very good. They would be earning their comparative income if they stay at home country, low tuition fees, low medical fees to charge. To the Singapore locals, the return is not so good as it would take something like half a million to train one of our very best local doctors through our system.

We are not comparing apple with apple are we? Some oranges may be as good as apples, but many will likely to be lemons and charging the price of apples. Are we being fair to our top notch locals and also our local patients paying medical fees fit for top notch doctors but not getting top notch doctors to treat them?