Dr Desmond Wai

I was interviewed by Renald Yeo at The Business Times
Renald asked me whats wrong with a one-minute consult, as MaNaDr Mobile Health was reprimanded by Ministry of Health (Singapore)

I explained that MOH mandates that the standard of care of at teleconsult has to be equal to that of a physical inperson consult

I explain during a consult with a patient
1. We greet each other and break ice
2. We ask about his compalint
3. We discuss the possibilities
4. In physical consult, we do a physical exam if necessary
5. We have a plan like doing some investigations or giving some treatment
5. Patient will ask and clarify any of the above

For teleconsult, MOH mandates 2 extra jobs:
1. Need to confirm patients' identity.
2 need to get patients' location. If a patient collapses during the teleconsult, the teledoctor has to call for ambulance

I do not think one minute is sufficient for the above. I think 10minutes is a good time. For follow up patient, maybe shorter. But one minute is too short to have a reasonable consult

www.drdesmondwai.com

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I wrote to ST forum
I think we need fee benchmark for GP consults
Minimum fees cannot be lower than polyclinics consult fees
We should compete in clinical care standard
We shouldn't compete in low fees n survive by increasing volume

https://www.straitstimes.com/opinion/forum/forum-clinics-should-compete-on-quality-of-care

I was interviewed by Channel 8 on alcohol use disorder. Enjoy the video
https://www.youtube.com/watch?v=Qatg2okbBpE
https://www.8world.com/stories/morning-express/health-alcohol-use-disorder-2539036

www.drdesmondwai.com


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Desmond Wai Liver and Gastrointestinal Diseases Centre Dr Desmond Wai，韦俊韬医生, consultant hepatologist and gastroenterologist has over 20 years of experience in treating patients with liver (fatty liver, liver cirrhosis, Hepatitis) and digestive diseases (GERD, gall stones). Dr Wai has managed more than 100 live donor liver transplant patients...

I thank Yvonne Gomez for interview

https://omny.fm/shows/in-the-news-the-issues-that-matter-to-you/ep-161-should-we-forgive-medical-mistakes

I gave my thoughts on punishing dr for their mistakes
Actually,
1. Read mistakes are uncommon
2. Some patients feel bad outcomes are caused by negligence or malpractice of a dr or the hospital, which is not the case most of the time
3. Dr make misjudgement and this is understandable and should be forgivable
4. If we punish dr harshly for making wrong diagnosis, then dr will just not make any diagnosis and push the diagnosis to someone else, or do more investigations

www.drdesmondwai.com

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Edible insects

I was interviewed by Shin Min Daily News on edible insects and it was published on 9 July 2024
To sum up:
Edible insects and food products containing insect ingredients are not commonly consumed by humans in North America and Europe. By contrast, people in Africa, Asia, and Latin America have been consuming insects for centuries. There are 1,000 to 2,000 species of insects consumed globally. The Food and Agriculture Organization of the United Nations and other organizations have been promoting the cultivation and consumption of edible insects as alternative sources of protein (food security) and as sustainable forms of agriculture. Edible insects have high protein-to-fat ratios relative to plants or traditional meats, making insects a healthier and more nutritious food. The environmental footprint of insect production is minimal compared with the production of beef, pork, and chicken
Potential risks: 1) bacteria contamints like salmonella which is present in soild; 2) pesticides which is present in plants where insects feed on; 3) environmental toxins such as arsenic ; 4) parasites on the insects......
So, we need: 1) farmed insects rather than wild insects; 2) quality control like regular check on insects' bacteria load and arsenic contents; 3) Singapore Food Agency need to audit source of insects, like they way they audit overseas egg farms, pig farms, etc

www.drdesmondwai.com

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Happy 248th Independency Day USA!

Honored to be invited to celebrate the national day of USA. Ambassador Kaplan hosted a great party, honored to have a photo with him. Also a great time to catch up with old friends

www.drdesmondwai.com

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I wrote this to ST Forum
Salma Khalik wrote an articel 3 days ago comparing premium of different IP. But she does not give the full story
The one with highest premium is also the best in the SMA survery
So high quality comes with high price
Interestingly, the one with lowest premium ranked very bad in the same survey, so there is a reason for premium to be low

https://lnkd.in/gX3T65gR

www.drdesmondwai.com

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a bit long winded, my contribution to TODAY
bottom line is:
the issues that the young dr complains have existed for decades, and MOH and clusters have been working on them....
breaking bonds to join private sector carries risk, that they are not properly trained
Bottom line is that all aspiring medical students must do their due diligence before applying for medicine

Commentary: For young doctors, the price of breaking bonds could be higher than they think In truth, the push factors for young doctors to leave public service have been around for decades.

Forum: Less tolerance for medical mistakes now?
https://www.straitstimes.com/opinion/forum/forum-less-tolerance-for-medical-mistakes-now

I wrote this to Straits Times.
Many doctors are very concerned about the verdict of the case in which a GP missed a testicular torsion. His punishment is 12 months suspension
It is better to be safe, than sorry
If a patient presents with a complex or unresolving problem, it is best not to completely trusts the doctor’s own clinical acumen. Because if he is wrong, consequence is serious.
Best to have a low threshold to refer to other specialists, or to any further investigations like scanning and lab tests. If in doubt, just to emergency department if in doubt.
We are moving towards a zero tolerance for medical mistakes

www.drdesmondwai.com

#何伯
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#李国煌 #李腾

Forum: Less tolerance for medical mistakes now? I refer to the heart-warming letter by Dr Amreena Shamit (Doctors, don’t be too hard on yourselves when a mistake occurs, June 11). Read more at straitstimes.com.

I wrote to ST

Dr Yik and i wrote yo Strairs Times forum
We are not mutually exclusive
Seeking Second opinion is not a bad thing, esp if patient expectation or progress not met
But I highlighted the cons

It’s costly, often lead to more tests n
More invasive procedures , higher cost, n some delay

And second opinion often disagrees with first opinion
Many proceeded to seek third opinion which may be totally different from the first 2

I didn’t write in. Y letter. But some Dr would say things that patients want to believe who just is beneficial only to the Dr

Your thoughts?

Long wait time for nonurgent eye referrals

I wrote this to Straits Times Forum on the topic. I propose some solutions. The CHAS system has worked well for 10 years. And the recently launched national mental health GP partnership program appears workable.
We shall see

www.drdesmondwai.com

Interview on shin min daily on food poisoning and weather

Relationship between Weather and gastric flu is complex
behaviour issues are more improtant

Www.drdesmondwai.com

https://www.facebook.com/share/p/LHcjFBu1MeBppc1E/?mibextid=qi2Omg

https://www.linkedin.com/posts/edgar-tay-54611340_smokingkills-stopvaping-notoecigarettes-activity-7182177038156398592-bwRd?utm_source=share&utm_medium=member_android

www.linkedin.com

Forum: Unlikely that unproven treatments are causing healthcare costs to rise
https://www.straitstimes.com/opinion/forum/forum-unlikely-that-unproven-treatments-are-causing-healthcare-costs-to-rise

I was found to have Gallstones, do I need to remove my gallbladder

Full video in this link: https://www.youtube.com/watch?v=YR_Tg5g10rU

I share what is recommended when gallstones are found during healthscreening. Follow the AAFP guidelines as attached

https://www.aafp.org/pubs/afp/issues/2005/0815/p637.html #:~:text=SORT%3A%20KEY%20RECOMMENDATIONS%20FOR%20PRACTICE&text=Watchful%20waiting%20is%20indicated%20for%20most%20patients%20with%20asymptomatic%20gallstones.&text=Patients%20with%20biliary%20pain%20should,on%20first%20open%20operative%20day.&text=Oral%20dissolution%20therapy%20is%20recommended,or%20unwilling%20to%20undergo%20surgery.

www.drdesmondwai.com

#医生 carcinoma

Acute hepatitis A

I made a series of videos on acute hepatitis A. do log on to learn something about it

https://youtu.be/6mziZCAXjZ4?si=KkHaJ4_3CVwHDTwG

https://www.youtube.com/watch?v=schMMVwp6bE

https://youtu.be/NKYmWpi8-pM?si=-Nx0EoqNk3muVr1t

www.drdesmondwai.com



#医生 carcinoma