Family doctors can train to become specialists
Singapore will continue to invest in and strengthen the primary care sector as it has become imperative especially given an ageing population, said Health Minister Ong Ye Kung.
This will include recognising family physicians who undergo additional training as specialists. They deserve the status to stand alongside other specialists and it also signals the importance of primary care, he told The Straits Times.
Another move, to enable doctors to provide faster and better care, is to make it compulsory for all clinics and hospitals to be part of the National Electronic Health Record (NEHR) which holds the essential health data of patients.
NEHR has been around for many years, but about 10 per cent of private clinics and most private hospitals are still not part of the system. Legislation will be in place by early next year that will force them to input their patient’s medical data.
Explained Mr Ong: “Whether it is a family doctor, specialist or hospital surgeon, when they see a patient for the first time, it helps a great deal when they have the medical history, drug allergies, and recent diagnostic images of the patient.
“With this information, they don’t have to repeat tests; they don’t have to waste time, and they can make better and faster decisions, for the good of the patients.”
Patients who do not want their information in the system may opt out.
Speaking at the World Organisation of Family Doctors Asia Pacific Regional Conference at Raffles City Convention Centre on August 22, Mr Ong said Singapore will continue to invest in the competencies of family doctors.
Medical schools will devote more curriculum time to family medicine and preventive care, while practicing doctors can improve themselves through continuing education and training.
He added - to loud applause from the 1,300-strong audience, including many from overseas - “Given the rising importance and impact of family medicine, MOH will be working with the family medicine fraternity towards recognising Family Physicians with advanced Family Medicine training as specialists.”
He also wants to discourage single-doctor clinics because this is no longer ideal.
“As our population gets older, medical conditions are more complex and the clinic may need more expertise, including doing health screening, rehabilitation or physiotherapy work, etc. Private clinics will need to work with and support each other, and more will need to be brought into the primary care networks.”
To be most effective, family doctors need to form strong partnerships, both upstream and downstream.
“Downstream, with secondary and tertiary care in hospitals, in order to escalate cases. Upstream, to community resources, so that social prescriptions such as better diet and more exercise can be followed up,” he said.
Under Healthier SG, which promotes a one patient one doctor model for more holistic care, the 80 per cent of private clinics already on board can leverage the support various agencies, such as the Health Promotion Board, People’s Association and SportsSG, which have numerous touchpoints on the ground, established over decades, to engage and mobilise residents.
So far, more than 1 million people representing almost half of the target population of those aged 40 and above, have enrolled in Healthier SG. This take up rate, said Mr Ong is “beyond our expectations”.
But good primary care alone is not enough. It needs to be supported by policies that promote healthy lifestyles.
As a result of various measures introduced over the years, fewer people are smoking and more take part in regular exercise.
The introduction of Nutri-Grade which indicates the amount of sugar and saturated fats in drinks has resulted in a gradual but steady decline of sugar consumed here. This is turn has resulted in a drop in people with diabetes from 8.8 per cent to 8.5 per cent over five years.
However, more people now suffer from high blood and cholesterol levels - significant risk factors for heart disease. Food is a major culprit, especially sodium and saturated fat.
Mr Ong said people here are consuming almost twice the recommended level of sodium. So he hopes to introduce nutri-grade showing the amount of sodium in food to help people make better choices.
He added: “The area that needs more urgent investment is preventive care, delivered through primary care and family doctors, which are the foundation of health. Investment in primary care has become an imperative, especially given an ageing population.”
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