Published on 06 June 2022
Family Doctor: What is that?
Professor Joseph Sung
Dean, Lee Kong Chian School of Medicine
Yesterday, I attended the Work Plan Seminar 2022, an annual conference organised by the Ministry of Health in Singapore. Minister for Health Mr Ong Ye Kung said at the conference: “We are Ministry of Health, not Ministry of Sickness”. Following that, he outlined his plan on Healthier SG, a blueprint of how to make Singapore a healthier city for all ages, all ethnic groups and all social classes. In this grand plan, he did not mention genomic studies and precision medicine; he said nothing about CAR T-cell therapy for cancer; he even skipped talking about new vaccines and new drugs. Instead, he said, “We need to mobilise our network of family doctors.”
Healthier SG plans to anchor every Singaporean residents to primary care in the country. Primary care doctors will no longer just see patients with cough-and-cold, but will be taking a pivotal role in caring for patients with chronic illness. They will give advice on healthy lifestyle, prescribing social remedies such as diet, exercise and sleep. They will not be practising in silos, but working as a team with hospital practitioners and specialists. Family doctors will be on the center-stage of healthcare in Singapore. That is a great plan.
His speech reminded me of my family doctor when I was small. His name is Dr Lau Man-hing (I can still remember his name). Dr Lau looked after my grandparents, my father, my mother and me, when I was below 10 years old. He knew everything in my family as we went to see him for every problem about our health. Once, he even paid us a home visit when my grandfather was too ill to go to his clinic. There was an occasion that I ran a fever and went to see him. The lift broke down and I was stuck in it for over an hour. Dr Lau came out from his clinic and watched me while I was inside the lift. Obviously he could not listen to my chest or prescribe his medicine, but his company and comforting words made a difference. In all my memories of him, that is a real doctor, a doctor that knows his/her patients, a doctor that cares about them (physically and emotionally), a doctor that gives advice based on the needs of his/her patients. That is the kind of doctor we long for: a hard-to-find doctor in today’s healthcare system.
This reminds me of an American television series in the 70’s that I loved so much, “The Brian Keith Show”. In this series, father-and-daughter paediatricians Dr Sean Jamison and Dr Anne Jamison run a family clinic in Oahu, Hawaii. But it was not a clinic that we know of today. It was more of a care centre for sick children, filled with laughter, love and lots of hugs. Dr Jamison did not wear a white coat, and was usually seen in his casual Hawaiian shirt. On his shoulder, there was no stethoscope, but a teddy bear. Most importantly, Dr Jamison was a fatherly figure in his clinic, and he cared for the sick kids as well as their parents. When I watched this, I said to myself “This is the doctor I want to be”. Fifty years passed since this show was aired. I still remember why I want to be who I am now.
In this era when most of us are excited about technological advancements and scientific breakthroughs, when electronic medical records have diverted our eyes from patients during consultations, when throughput and cost-effectiveness are two of the most important key performance indexes in health systems, let us not forget that family doctors who provide personal care to patients and their families are what society needs.
“One of the greatest tragedies of the 20th century is that in developing the means of Medicine, we have forgotten the meaning.” Z Neuwirth