SINGAPORE: Two weeks ago, a traditional Chinese medicine (TCM) physician was suspended and fined S$10,000 after one of his patients experienced chest pains and lost consciousness following “blood-letting” therapy.

The Traditional Chinese Medicine Practitioners Board (TCMPB) said the physician had not carried out “appropriate TCM inquiries” on the patient’s medical history and did not inform her about the treatment options for her cough, the risks and complications of the blood-letting therapy.

This has sparked discussion on what must be done to ensure physicians dispense their duty appropriately.

ACCREDITATION TO ENSURE PROPER TRAINING

In Singapore, TCM physicians are required to be licensed by the TCMPB before they are allowed to practise.

This accreditation ensures physicians are trained with the necessary knowledge and skills, and have passed the Singapore TCM Registration Exam administered by the TCMPB. As with most other professionals, there is also an ethical code of conduct that they must adhere to.

The license assures the public of a baseline level of competency when seeking treatment. However, similar to Western medicine, a doctor’s licence to practise cannot eliminate malpractice altogether.  

Malpractice encompasses a wide variety of ways in which a professional may do his job poorly, arising due to information asymmetry, miscommunication, negligence, poor judgment, a failure to exercise due care and diligence, unethical or criminal intent and so on.

It is regrettable when cases of malpractice emerge, for that means a patient has not received the deserved standard of care. Yet, barring cases with unethical or criminal intent, the great majority of physicians act with their patients’ interests in mind.

Physicians are well aware of the high personal costs of malpractice accusations, which can be accompanied by enquiries, lawsuits, compensation and a licence suspension.

What they must bear in mind more seriously, however, is the damage done to the reputation of the TCM industry as a whole. The harm inflicted on a patient one has a duty of care towards, and the negative impression the public may form of TCM cannot be quantified in monetary terms.

As Prime Minister Lee Hsien Loong has noted recently, where TCM institutions will play an increasingly important role as Singapore’s population ages, TCM practitioners must raise their standards.

Continuously improving the quality of TCM services at the industry level is thus of paramount importance.

EXPANDING UNDERSTANDING

These days, patients are tech-savvy and more willing to seek out different ways of maintaining their health, such that many try out an assortment of treatment from Western, TCM and alternative medicine simultaneously.

Thus, physicians must not only know the latest technology and treatment methods within their own fields, they must also constantly brush up their understanding of other medical trends and treatment options.

News reports have illustrated a growing number of doctors trained in Western medicine taking up TCM-related certification, such as acupuncture, to complement their practice, whether in performing such treatments or simply to communicate advice to a more diverse set of patients.

Similarly, TCM physicians must not rest on their laurels but do the same to polish up on their knowledge. This can better help meet patient expectations and reduce mishaps, as have occurred in the past when a patient consuming TCM remedies also underwent Western treatment.

One can acquire such knowledge through self-improvement and professional development courses. Asking the patient about his previous diagnoses and what other medication he’s on should become part of a standard protocol to strengthen the appraisal process.

COMMUNICATION IS KEY

Another area where practice failure frequently occurs is communication.

TCM concepts and theories are abstract and different from Western medicine, especially to the uninitiated. As patients are more exposed to modern science and Western medicine, it can be challenging for physicians to explain TCM’s approach clearly.

To reduce misunderstanding and consequential practice failure, physicians could improve on their communication skills, and use simple and plain language to explain TCM diagnoses and therapies. Customised courses which combine communication with total quality management could be organised as part of the professional development training for TCM physicians.

The increasing number of young TCM physicians with knowledge of both Western and traditional medicine illustrate budding recognition that both schools can complement each other.  

This is an opportunity for TCM physicians and Western healthcare providers to view each other not as competitors but collaborators, working together to formulate the most effective medical approach for patients. To achieve this, medical practitioners must be open-minded and hold fast to the common goal of delivering the best quality healthcare service to patients.

In the training of doctors and physicians, the syllabi already contain both Western medicine and TCM topics to facilitate mutual understanding. To further narrow the gap, more shared seminars and relevant professional development courses can be organised to facilitate learning and networking.

Like most other continuous education programmes, the attendance of these courses should count towards the required number of hours needed for the renewal of practice licences for doctors and physicians alike.

A spirit of continued learning and improvement should contribute towards the creation of a comprehensive healthcare system that benefits all Singaporeans.

Dr Goh Chye Tee is director of the Biomedical Sciences and Chinese Medicine programme at Nanyang Technological University, Singapore. ​​​​​​​

SINGAPORE: Evening rush-hour commuters travelling along the Downtown Line were affected by delays on Tuesday (Dec 12). 

Several commuters tweeted that they experienced delays of 10 to 15 minutes along some stations along the Downtown Line towards Bukit Panjang, including Promenade, Tampines East, MacPherson, Chinatown and Newton stations.

In a notification sent from the Land Transport Authority’s (LTA) MyTransport app at 7.26pm, commuters were told they can expect an “additional travelling time of 10 minutes on Downtown Line due to a signalling fault”.

The fault happened at Tampines station, said train operator SBS Transit in a tweet at about 7.45pm.

At 8.13pm, it tweeted that the train line was back to regular services. 

One commuter reported that an announcement was made when his train stopped at Telok Ayer station: “This train will stop here for a short while. We are sorry for the delay.”

Several commuters said their trains stopped for longer than usual at some stations. When the trains finally moved off, they became “stuck” again at another station, they added.

LTA previously stressed that rail operators are required to inform passengers of any delay exceeding 10 minutes after receiving feedback from commuters on rail operator’s announcements during service delays. 

SINGAPORE: Singapore’s first electric car-sharing service was officially launched on Tuesday (Dec 12), with 80 cars and 32 charging stations available for public use across the island.

The service, which is provided by BlueSG, is part of Singapore’s plans to reduce reliance on private vehicles and encourage the use of public transport. 

To use the cars, drivers need to subscribe to the service online or through the BlueSG app. They can either choose to receive a BlueSG member card or register their existing EZ-Link cards which drivers can use to book vehicles and even a parking lot in advance.

Since the app was launched last week, 2,000 users have signed up, said BlueSG, a unit of France’s Bollore Group.

Two subscription plans are available – a premium yearly membership which costs S$15 per month with lower rental rates of S$0.33 per minute for a minimum booking of 15 minutes, and a weekly membership plan which does not require any recurring fee but charges S$0.50 per minute.

Taking a BlueSG trip from Toa Payoh to Mohammed Sultan, for instance, would cost premium members about S$5.61, while this translates to S$8.50 for weekly members for the same journey.

BlueSG hopes to roll out 110 electric cars and 42 stations with 165 charging points islandwide by the end of this year. And by 2020, the aim is to have 1,000 cars and 2,000 charging points.

“We are committed to make Singapore the second largest electric vehicle car-sharing service worldwide after Paris,” said Marie Bollore, managing director of Blue Solutions. 

“We look forward to working in tandem with the Economic Development Board (EDB) and the Land Transport Authority (LTA) to achieve urban mobility and a sustainable transport system in Singapore.”

LTA’s chief executive officer Nguyen Hoon Ping added: “We also hope that the establishment of BlueSG’s charging network and the setting of Type-2 charging as a nationwide standard, will pave the way for greater adoption of electric vehicles in Singapore, as we move towards a greener and more sustainable urban transport system.” 

The Bollore Group, which set up its Asia-Pacific headquarters in Singapore in September, is also planning to launch a Global Innovation Center here to undertake R&D projects in the areas of mobility and energy management solutions. 

It is also working with Nanyang Technological University to pilot an electric tram system around the campus in early 2018. 

SINGAPORE: Authorities have stepped up checks for mosquito breeding grounds around several blocks at Bedok Reservoir Road, after a rising number of dengue cases in the area. 

In a two-and-a-half-month period since the end of September, there have been 57 reported dengue cases in the cluster, which encompasses blocks 713, 715, 716, 717, 718, 719 and 721. 

This makes it the largest dengue cluster this year, said the National Environment Agency (NEA) on Monday (Dec 11), in response to Channel NewsAsia’s queries.

NEA said that since the cluster was notified on Sep 30, it has conducted “multiple rounds of inspections in residential premises and outdoor areas”. These include common areas in the estate.

The agency added that its officers have found and destroyed 47 mosquito breeding habitats – 31 in homes and 16 in common areas – since the end of September.

According to its website, Block 717 appears to be the worst hit, with 23 dengue cases. This was followed by Block 716 which had 17 cases.

There are currently four active dengue clusters in Singapore, said NEA on its Stop Dengue Now Facebook page last Wednesday. 

On Monday, a Red Dengue Alert banner was put up at a shelter linking blocks 714 and 715 in Bedok Reservoir Road. The alert indicates a high-risk area with 10 or more cases. The same banners were also seen at the sheltered linkway between blocks 717 and 718.

Residents in the affected blocks Channel NewsAsia spoke with said they were concerned about the speed at which dengue has spread. Madam Nor, a resident living in Block 719 with her elderly parents, her two daughters, husband and helper said it was the first time she has encountered a dengue outbreak on such a scale. She has been living in the area for more than 30 years.

“I’m just wondering how dengue numbers have gone up from 10 cases to 50 cases,” she said.

“I think they (NEA officers) have been doing some fogging but it doesn’t seem to be abating.”

Mdm Nor, who lives on the sixth floor, said her family has been taking precautions such as lighting mosquito coils and shutting the windows of their home.

“I was especially concerned about my daughters because it was the exam period and we couldn’t afford for them to be sick. Apart from closing the windows, I would also get my helper to spray insecticide around the house,” she said.

Meanwhile, residents of Block 717, the hardest hit within the cluster, have also been extra cautious. Channel NewsAsia spoke with two residents in the block who contracted dengue in the last two months. Mr Teo, who lives on the 10th floor, said he suspects he was bitten by an infected mosquito while he was jogging. Fortunately, his symptoms were not too serious and he recovered within a week.

But 68-year-old Mohammad Yahya was hospitalised for four days after he came down with dengue in early October. Both residents have since recovered and have taken to applying insect repellent as a precaution.

“We don’t sleep with the air conditioning on, so we apply the mosquito repellent spray before we sleep at night,” Mr Yahya said. He noted that NEA officers have been walking around more frequently and visiting the units to check for stagnant water in bathrooms and plants that may give rise to mosquitoes breeding.

“I myself have a lot of plants outside so I’ve been keeping an extra lookout. After all, it’s not just to protect my family but the neighbours as well,” he said.

NEA urged residents to allow its officers into their homes to carry out indoor spraying. Apart from the banners, it said posters have also been put up at lift lobbies to heighten awareness among residents and members of the public.

“NEA is also working with members of the community from Bedok Reservoir Road to conduct house visits to create awareness and to remind residents to practise the five-step Mozzie Wipeout,” the agency told Channel NewsAsia.

It said pamphlets and insect repellents have been distributed to residents during the visits.

Aljunied-Hougang Town Council, which oversees the area, told Channel NewsAsia it has been working closely with NEA, in areas including “joint operations on the ground and fogging exercises”.

“On a daily basis, our pest control contractor checks for potential breeding sites, and we will continue to conduct chemical oiling to prevent mosquito breeding,” the town council said. 

According to the Health Ministry’s weekly-published statistics on infectious diseases, there have been more than 2,500 dengue cases so far this year, far fewer than the 12,700 cases seen this time last year. 

SINGAPORE: Singapore remained outside of the top 20 most expensive locations in the world for expatriates, according to the latest cost of living survey by ECA International.

In a press release on Tuesday (Dec 12), the consultancy firm said Singapore was ranked 21st most expensive in the world and 9th most expensive city in the Asia Pacific region for expatriates, according to the survey.

In the same survey published in June, Singapore was ranked 24th most expensive globally and 10th in the Asia Pacific. It was ranked 16th most expensive globally and 9th in the Asia Pacific last December. 

“European currencies have performed very strongly over the past 12 months, outpacing many other currencies in the world – including the Singapore dollar,” said ECA International’s regional director for Asia Lee Quane.  

“This has resulted in Singapore slipping down the rankings slightly, with some of the more expensive European cities rising above it in the table,” he added. 

ECA International said Asian cities now lead the way as the most expensive locations to live in, with more than half of the top 50 most expensive locations surveyed this year being in Asia. 

A total of 26 of the top 50 entries were Asian cities, with 14 Chinese cities alone featured on the list compared with four EU cities and three from the US making it into the top 50.

Tokyo has maintained its position as the most expensive location in the region for expatriates, while Hong Kong and Seoul are the next two most expensive cities in the Asia Pacific respectively.

Angolan capital Luanda remained the most expensive city in the world, while Khartoum in Sudan rose 19 places to be ranked second in the world and Zurich remained third most expensive. 

ECA International said the twice-yearly survey is to help companies calculate cost of living allowances so that their employees’ spending power is not compromised while on international assignments. The surveys compare a basket of like-for-like consumer goods and services commonly purchased by assignees in 470 locations worldwide, excluding certain living costs such as accommodation and school fees, which are usually covered by separate allowances.