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Singapore Transforms Patient Care with Principal Doctor Model

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Singapore is set to revolutionize patient care in public hospitals by implementing a model where patients with multiple health issues will primarily interact with one designated doctor, known as the principal doctor. This approach, announced by Minister for Health Ong Ye Kung on September 20, aims to streamline healthcare delivery by integrating various specialties under a coordinated care framework.

New Care Model for Complex Health Needs

Under this new system, patients will benefit from a more cohesive healthcare experience, reducing the need to see multiple specialists. Previously, a patient with several health conditions might have had to consult various specialists separately, each leading their own team. For instance, an elderly individual hospitalized due to a fall might have seen a neurologist, a pulmonologist, and a nephrologist, each focusing on their area of expertise. This often resulted in repetitive medical histories, unnecessary tests, and fragmented treatment plans.

With the introduction of the principal doctor model, patients will mainly consult this central figure, who possesses broad-based competencies to manage their care effectively. The principal doctor will collaborate with a diverse team of healthcare professionals tailored to the patient’s evolving needs, thereby enhancing the overall patient experience.

The Ministry of Health (MOH) has indicated that this initiative is timely, especially as projections show that by 2026, one in five Singaporeans will be aged 65 and above, leading to an increased demand for integrated care solutions.

Enhancing Competencies and Career Pathways

This innovative approach is not only about patient experience but also addresses the professional development of healthcare practitioners. Minister Ong emphasized the need to train clinicians with broad competencies distinct from traditional specialist pathways. As of now, the MOH has progressively implemented this model across four key disciplines: general medicine, general surgery, orthopedic surgery, and pediatric medicine, which together account for over half of the specialists in Singapore’s public healthcare system.

Concerns about the workload of principal doctors have been addressed by MOH officials, who stated that the number of patients a doctor manages will depend on their specific care needs. Typically, a doctor manages between eight to twelve patients, but this could increase to twenty for less complex cases. Importantly, the ministry assured that “the quality of patient care will not be compromised.”

In instances where patients present with urgent new conditions, the principal doctor will have the authority to transfer care to another specialist if necessary. This flexibility is designed to prevent excessive specialization, ensuring that doctors maintain a broad understanding of their patients’ needs.

Additionally, the MOH is enhancing the career progression of hospital clinicians—doctors trained in a variety of disciplines to complement specialists. The hospital clinician program, introduced in 2020, currently includes about 150 doctors out of a total of 12,000 in the public healthcare system, with plans for further development.

With these changes, Singapore aims to create a more effective healthcare system that meets the growing demands of an aging population while ensuring that care remains comprehensive and coordinated. The introduction of a new apex grade for hospital clinicians, akin to that of specialists, further underscores the commitment to advancing healthcare careers and improving patient outcomes.

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