Commentary: What Singapore can do to make the one ‘principal doctor’ model work

Morale and job satisfaction challenges are the likely factors here. Anecdotally, my fellow doctors tell me Internal Medicine training is tough and the practice even tougher in part due to tension and inadequate communication with organ-specific specialists. 

PUBLIC ENGAGEMENT

Finally, the public is used to the notion of the specialist as the “dua lo kun”. The assumption that the “big doctor” (in Hokkien) knows everything and has the wherewithal to integrate all the different considerations is implicit but sadly unrealistic as Singapore becomes super-aged. 

That said, the hospital clinician may be deliberately trained to have the competency but this is contingent on building up public trust in and credibility of the hospital clinician. The public has to be convinced that the hospital clinician model is a superior way to organise inpatient care – not an off-loading measure to save specialists’ time, not a cost-cutting intervention. 

It is also critical to avoid, at all costs, the misconception that public healthcare minimises access to specialist care and thus pushes patients to private sector care.