One side of the Coin: Value in Underwriting A lot of folks are talking about Value Based Healthcare. It’s the in-thing now. Two public health specialists (Drs Jeremy Lim and Jake Goh Jit Khong) joined in the IP debate recently (25 April 24) and wrote in the Straits Times recently that “Ultimately, every stakeholder wants ‘Value’”. Let’s see if the IP insurers are delivering value. To do that, unfortunately, we have to look at the numbers. This hobbit is not particularly a whiz at numbers but let’s give this a shot. And if the figures given in this post are proven to be very wrong, this hobbit ..read more

There has been some concern over a spate for ophthalmologist resignations from the public sector in the last 12 months or so. But first, some statistics to put things in context. In the latest SMC Annual Report (2022), it was recorded that there are 314 ophthalmologists in Singapore, of which 122 worked in the private sector and the rest (192) worked in the clusters. Therefore, about 39% of all ophthalmologists are from the private sector. From 2018 to 2022, a period of 4 years, the number of ophthalmologists increased by 42, from 272 to 314. That’s about an increase of 10.5 per year in this p ..read more

squib – (noun) A short humorous or satiric writing or speech (Merriam-Webster’s Dictionary) Since my last post, “Letters to Hobbit 2024” (https://hobbitsma.blog/2024/02/15/letters-to-hobbit-2024/), many more alert and mythical readers of this column have stepped forward to give me further examples of stupid questions and requests from high priests of the Insurer Order. While we politely call them high priests, I have been told these chaps have all the charisma, intelligence and persistence of a lice-infested orc. Further examples of stupid questions: • “Why do you follow-up the patient every s ..read more

This month, we continue with the tradition of publishing some completely nonsensical letters from our alert but fictitious readers. For the avoidance of doubt, this column is written in the spirit and form of satire. If anyone is offended by this satire, go and suck your thumb. Trust me, it helps. To at least ingest some germs, if nothing else. Your microbiome needs it, since you are so uptight. <><><><><><><><><><><><><><><><><><><><><><><><><> ..read more

A New Year brings new hopes and aspirations. And new worries and fears, unfortunately. In this new year, the hobbit wants to wish all readers of this nonsensical column a very ungratifying year and may all of you remain as ingrates. This is because in 2024, the scariest word is gratification. Woe be unto you should any of you (especially those in the public sector) be suspected to have received gratification. Gratification can be displayed in many different forms; these include free concert and F1 tickets, or may even be just letting off a loud burp or two after a heavy meal or an upsized cup ..read more

It’s that time of the year when practically everyone you know is on holiday overseas. They are taking full advantage of the almost almighty Singapore dollar and standing up for Singapore by chirping “cheap, cheap” from Tokyo to Tasmania and from Seoul to Sao Paulo. Of course, most people do not realise that there are zero-sum games in this world after all – if we find everywhere else cheap, then everyone else also probably finds us expensive. Which probably explains why Orchard Road is rather quiet nowadays, when compared to other shopping districts in the major cities of Asia. But it’s OK, in ..read more

Life as a GP used to be simple. But it’s not so simple anymore. And this hobbit is not even talking about Healthier SG and the NEHR. We are just talking about signing up as a member of the Royal College of GP in the UK. As expected, you need to fill up a form when you apply to be a member. The link to the form is as given below at the end of this post. You are asked to declare your gender identity and you are given the following choices: Prefer Not To Say Man Woman Transgender Genderqueer Agender Genderless Non-Binary Cis Man Cis Woman Trans Man Trans Woman Third Gender Two-Spirit Bigender Ge ..read more

The Fattest Cats On 9 October, The Economist published an article, “Who profits most from America’s baffling healthcare system”. The sub-heading read: “Hint: it isn’t big pharma”. The article began by saying that on 4 October, 75,000 employees of Kaiser Permanente went on a 3-day strike. Kaiser Permanente is a name that many public sector senior management in Singapore may be familiar with. It was the go-to place for study trips and was touted as a model of care that we could learn from, even before the idea of population health became popular or anyone thought about Healthier SG (HSG). The ar ..read more

It was announced recently that a new common curriculum for incoming NUS dentistry, medicine, nursing and pharmacy students will be introduced (The Straits Times, 16 Aug 23)1. The Straits Times reported that the aim of the common curriculum covering five modules was to “imbue in students a greater awareness of social issues and their impact on health, as well as cultivate teamwork, communication skills and digital literacy. Students will also learn about working and communicating in multidisciplinary teams, as well as the legal and ethical principles underpinning the practice and delivery of he ..read more

Recently I received in my email an EDM about a seminar organised by the SMA, “Taking the Plunge – Going Into Private Practice” which will be held on 26 Aug 2023. That set me on thinking of what it means to go into private practice in the post-Covid world of 2023. Specialists I was just chatting with some young surgeons the other day and was astonished to find out that apparently, at least 12 orthopaedic surgeons have left for the private sector in the first six months of 2023! From anecdotal evidence, this exodus is not just limited to orthopaedics but extends to other specialties as well. The ..read more