Singapore Diary. Part 6: Thomson, Hopkins, AsiaMedic, National Neuroscience

Continued from Part 5: TP Dental, KK Women's and Children's and Sentosa

Up again to jump in the rooftop swimming pool at 7. My last day here, and the first time I've seen anyone else at the pool. It's a German family of 3 who've already checked out and seem to be just killing time before their flight. Come to think of it, Singapore doesn't seem particularly crowded. Even though there are lots of skyscrapers and presumably many people living in them, you don't see the throngs that are apparent in other parts of Asia. I've still yet to see a real traffic jam or crowded sidewalk. The hospitals and stores aren't particularly busy either.

I start the day at Thomson Medical Centre, where founder Dr. WC Cheng and son Dr. Cheng Li Chang sit for interviews. We are shown around by Fenny Ng and Mary Wong, an Indonesian who contrasts the anti-Chinese riots and muggings she experienced in her native Indonesia with the serenity and stability of Singapore. Dr. WC Cheng's interview --where he speaks about hormone replacement therapy among other topics-- is here. Dr. Cheng Li Chang's interview about fertilty treatments will be published soon. I was joined by an Indonesian reporter who was a patient of Dr. Cheng's several years ago.

The first time I felt like I was in an American hospital was during my visit to Johns Hopkins International Medical Centre, a cancer clinic within the Tan Tock Seng Hospital. I don't say that as a compliment, either. We were greeted by what I can only describe as low-level bureaucrats who were totally unmoved by our request to conduct an interview with a physician or senior administrator. They told us it would take a long time to work through all the approvals. This was the only experience of its kind on the whole trip. Everywhere else I went people were friendly and obliging --not bureaucratic at all, even in the government hospitals. I can only hope the Hopkins style won't spread to the rest of the country.

For lunch my guide and I went to the excellent Whitebait & Kale restaurant in the Camden Centre on Orchard Road. As my guide offered to help me with the menu --written completely in English just like all the other menus and signs in Singapore-- it finally sunk in how easy it is to be an English speaker here. While people from the same ethnic group may speak to each other in their native language (e.g., Chinese) they speak to one another in English and it is the common tongue. It is easier to be an English speaker here than in Montreal or Hong Kong, for example, where English is also an official language. And English is spoken by everyone I encountered, not just the well educated or those in the tourist industry.

We were joined for lunch by Dr. Steven Tucker, an American Oncologist who lives in Singapore and is the president of the International Medical Travel Association. (I had interviewed Dr. Tucker by phone a few weeks earlier, so it was fun to meet him face to face.) After lunch I toured his West Clinic, an impressive facility in the same building. We started off in the waiting area, which was equipped with Motion M1400 tablet computers to allow patients to answer questions about their health status. (I own an M1400 myself and am friendly with Motion's CEO and founder, Scott Eckert, a colleague from my first job many years ago.) Unlike a typical American doctor, Steve knew all the prices for his services. That's because patients pay out-of-pocket and want to know. Talk about transparency --they have it in Singapore.

The West Clinic is very impressive, and there a number of thoughtful, patient-oriented touches. The room where patients receive IV chemotherapy treatment is called the Aquarium --since it is filled with a beautiful fish tank. The norm would be to call it the "treatment room," but as Dr. Tucker pointed out, "Everyone knows it's the treatment room. Patients don't want to be reminded all the time that they're sick."

After the West Clinic I went to the AsiaMedic Specialist Centre and met Dr. Colin Koh, who described their diagnostic and treatment services. The Centre, which is also very nicely laid out, includes advanced imaging services (including PET/CT), an eye centre, aesthetic centre, and wellness assessment centre. Dr. Koh showed me a variety of assessment packages, ranging from 280 to 1200 Singapore dollars. (All prices are in Singapore dollars: multiply by about 2/3 for the US dollar translation.) The Bronze package for people under 35 is a basic screening. The Diamond package, recommended for people over 45 is billed as "a comprehensive package for the management of heart/stroke & cancer risks and complications of chronic diseases and those with symptoms of menopause and andropause." The idea is to provide a comprehensive baseline and development of a "health compass" to navigate health risks. There is a long list of tests and services.

I asked Dr. Koh about whether it was really a good idea to perform so many diagnostic tests. After all, in medicine it seems to me that the saying, "What you don't know can't hurt you" has some truth to it. I've heard too many stories of patients whose false positives on tests led to physical and mental damage from unnecessary follow-up and worries. Dr. Koh's response was that these packages are especially important for patients from countries that lack good medical care. A rich patient from Indonesia might be well-advised to have the Diamond package in Singapore in order to identify problems that wouldn't be picked up at home.

My final stop of the day --and the week-- was the National Neuroscience Institute. It's part of SingHealth but somewhat confusingly is located in the Tan Tock Seng Hospital, which is part of SingHealth's competitor, National Healthcare Group. It wasn't terribly busy at this facility --they couldn't find any doctors to speak with and few patients were waiting. It was interesting to me that the advanced imaging equipment like MRIs were only being utilized about 8 hours a day. I don't understand why these pieces of equipment aren't utilized 16 or even 24 hours per day. I guess the self-pay system has something to do with it!

By this time I was feeling a little bit tired and ready to conclude my tour. I went back to the hotel, had dinner there, and packed up. I set my alarm for just after 4 am in order to be ready for my pickup. Couldn't really sleep so started my trip home a bit of a sleep deficit.

See Part 7: The trip home to Boston