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Payments technology company Visa recently invited a group of Indonesian journalists, including The Jakarta Post’s Kornelius Purba, to visit several healthcare providers in Singapore. The following are his reports.
After the three-day working visit, where we had the opportunity to visit several medical centers here, I extended my stay in Singapore because I wanted to accompany my wife to meet with two orthopaedic surgeons at the Mount Elizabeth Medical Center.
The two surgeons listened attentively while, in Indonesian, my wife described in detail the pain she must endure following two surgical procedures on her spine, as well as her inability to walk without assistance. She has raised the same questions with several doctors in Jakarta, Malaysia and Singapore, who have honestly told her that she will never be able to walk normally again, and that she will need to depend on a wheelchair for her mobility.
She also suffers from serious osteoporosis following the operations, which needs intensive medication.
Both of them looked serious although they could only understand Malay, and I had to help with the English translation. They took notes, and asked her several questions. The consultation with the two doctors lasted about 30 minutes and they never tried to interrupt her. I felt uneasy because other patients were waiting outside. In Indonesia it is indeed a rare luxury to have such a lengthy conversation with a doctor.
The doctors also checked all the X-rays she had taken before and after her second surgery by the famous orthopedic doctor Oh Kim Soon at the Island Hospital in Penang, Malaysia in April, 2010. Senior doctor Tan Chong Tien praised the excellent results of Dr. Oh’s work, including the removal of a left rib.
“It was a very successful operation,” said the doctor, to the relief of my wife. His confirmation meant a lot to her, although she had previously received similar assurances from Indonesian doctors.
She was very satisfied with the service and medical treatment in Penang but direct flights from Jakarta to the island are limited and quite expensive. Most Indonesian patients at Penang hospitals are from Sumatra, especially North Sumatra and Aceh, because they are a short distance by plane.
I took my wife to Penang nearly three years ago, because she could no longer endure the pain she had to face almost every day following her first spinal operation in Jakarta in 2001. She was practically paralyzed for months after undergoing the medical procedure although she could still walk normally before entering the operating theater in a state hospital in Jakarta. Doctors had strongly urged her to have her thoracic spinal nerve 12 (T12) fixed, which had been recently damaged in a fall in our bathroom in March 2001.
After the consultation, Dr. Tan prescribed medicine for her osteoporosis and asked us to see his colleague Dr. Francis Wong to find a possible solution for her limited mobility.
Wong offered to operate on her left toe to make it stronger, but he made it very clear that the toe surgery would not actually help much in allowing her to walk normally again.
“It is up to you, but to be honest, you must consider it thoroughly because your walking ability will never return to normal again,” he said.
The doctors gave us their business cards. Many Indonesians may feel it strange how the doctors describe their educational backgrounds, because to us it is hard to escape the impression that they want to show off their academic credentials. Dr. Wong, for instance, described his experience as a fellow at the Royal College of Surgeons in Glasgow and in Edinburgh and as a scholarship winner in two hospitals in England.
Although it was our second visit to the hospital after our first in 2001 – where a neurologist there told my wife that she could never expect regain her ability to walk again – we were still suprised that we paid the medical bills and bought the prescribed medicines at the doctor’s receptionist. In Indonesia we usually pay directly to the hospital.
Paying the price
For ordinary Indonesians like us the rates are very expensive, even compared to the prices we pay in Penang. They will continue to rise for Indonesians because the exchange rate of the Singapore dollar against the Indonesian rupiah is steadily rising, while the Malaysian ringgit exchange rate remains stable against the rupiah.
Why must we pay directly to the doctors and not the hospital? We were told later that the doctors are tenants—under the flag of Orthopaedic International – at the Mount Elizabeth Hospital. The situation is very similar to shopping malls which rent floorspace for shops and other business activities. Doctors working at the Mount Elizabeth Medical Center are independent of the hospital and they work under different companies.
Is that system better for patients? Such a practice certainly helps us to understand business practices in the private sector healthcare industry in Singapore. Its profit-oriented business is more transparent than in Indonesia where doctors and hospitals are prohibited from advertising.
Mount E , the popular name of the hospital, is probably the most expensive but also the most popular for Indonesian patients. Indonesians make up the majority of private hospital patients in Singapore. Regular patients include former president Megawati Soekarnoputri. They reportedly spend huge sums in Singapore due to the poor health infrastructure in Indonesia and also to a lack of trust in Indonesian doctors.
Indonesian doctors apparently tend to pay poor attention when treating their patients because the supply and demand for doctors in Indonesia is still not balanced, and the laws are perceived to be too protective of healthcare givers in the face of powerless consumers. Very few malpractice cases become public as victims are too afraid to face the powerful health industry comprising the doctors and hospitals.
Meanwhile, the day before my wife’s consultation with the doctors here, healthcare provider Asiamedic Limited provided free basic medical check-ups for a group of Indonesian journalists. I was charged an additional S$40 (US$ 32.50) because I wanted to get information about my potential to get diabetes. They sent us the results of the medical tests by e-mail.
The result of my diabetes screening: Normal. The additional payment was worth it.
Attentive bedside manner still key to popularity of Singapore healthcare
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