When I temporarily moved back to the USA in 2001, it seemed like the medical system was worse than before. Difficult to get appointments, expensive, etc.
Soon enough I was back in Singapore. A recent trip to the doctor illustrates some differences between the Singapore medical system and the US.
I'm allergic to erythromycin, a common antibiotic.
Despite this being on my records at every one of my doctors, I've twice been accidentally prescribed this medicine by doctors in Singapore. This has never happened in the United States. I only noticed the mistake because I double-checked.
I'm going to Laos on friday. It's a malaria zone. I want preventive medicine, and the CDC recommends a drug called Malarone.
So I went to a nearby office of the Raffles Medical Center network of clinics. (Since it's Singapore, and not the USA, I simply walked in, saw a doctor within ten minutes and paid $11SGD. (about 7$USD). ) The doctor was unfamiliar with Malarone, instead wanting to prescribe other more old-fashioned medicines (mefloquine). Fortunately, I had the CDC printouts and knew exactly what I wanted. She consulted her little books, wrote me the prescription, and off I went.
The weird thing was that she prescribed for me four tablets per day for seventeen days. I was suprised, because the CDC said for prophylaxis, the dosage is one pill a day (starting three days before the trip and for a week after).
The pharmacist was also suprised. She asked me, "are you suffering from Malaria?" "Uh no, it's prophylactic." She said, well then you only need one a day, and she confirmed this with her notes.
The doctor clearly understood that it was prophylactic, so why such a mistake?
Tonight I was reading the little instruction sheet that comes with the drug. Even used as a treatment for Malaria, you only take it for three days four times a day! I was scheduled to take it for seventeen. And this is not a cheap drug. A course of seventeen pills was 125$SGD.
I think these stories illustrate how the liability/malpractice environment of the US has notably made doctors more attentive to detail than those here. I'm sort of non-judgemental on whether one or the other is a better system, but I do think it is undeniable that the basic character of the doctors is affected by their liability. This should not exactly be a suprise.
Anyway, in Singpaore you are well-served to question everything you are told and prescribed.
On the other hand, I had corrective eye surgery in Singapore that was performed by one of the top specialists in the world and it was at least two years before the same treatments was available in the US.
Posted by Nils Blutig at December 2, 2003 09:52 PM | TrackBack