Why patients are left with more questions than answers

SINGAPORE - I concur with Dr Andy Ho's views ("Please be patient when patients have questions"; June 13). Patients and their family members often leave the consultation room with more questions than answers. There are many reasons behind this unhealthy phenomenon.

First, clinics are often packed with patients, and doctors face severe time constraints. It would be helpful if patients could prepare a list of questions and present it to the doctor at the start of the consultation. The doctor can then plan the consultation better.

Second, consultation charges in Singapore are relatively low compared to those in other developed countries. With low charges, administrators have to shorten the consultation time and pack more patients into each session. This frustrates both the doctor and the patients. To address this, the public may have to accept higher consultation charges.

Third, our consultation model is evolving too slowly and cannot keep up with the rising expectations of an educated populace and the rapid development of information technology. Arming patients with more knowledge does not remove the need for the physician to sieve through the information gathered and address the patients' concerns and anxieties.

Fourth, our public hospitals play an important role in training the next generation of medical practitioners. But the training is often focused on providing a service and not engaging the patient. If each consultation does not satisfy the patient, he will keep returning to the clinic. This leads to a vicious circle where new patients keep coming in while old patients keep returning.

Fifth, Singapore is a small country with abundant public medical facilities offering highly subsidised care. Patients in tertiary health-care institutions are cared for at prices that are perceived to be lower than those in primary care facilities.

With this distorted perception, there is no perceived price gradient to move patients from the hospitals to the polyclinics, let alone from the public sector to the private sector. Without a gradient, clinics will remain crowded and patients frustrated.

Everyone has a part to play and benefits to reap if we can have effective and efficient medical consultations.

Leong Choon Kit (Dr)

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