With early medical training occurring mostly in the public healthcare sector, it is not till years later where some amongst us may choose to transit into private healthcare. Careers Symposium has invited three doctors, Dr Noel Yeo, Dr Kenneth Tan and Dr Lim Hwee Yong, who have kindly shared with us their experiences and journey of venturing into the private sector of healthcare.
Dr Noel Yeo, Chief Operating Officer, IHH Healthcare Singapore
Dr Noel Yeo first shared with us a little on his transition into the private sector. After facing several barriers in applying for Ophthalmology and Orthopedics, Dr Yeo broke his bond prematurely by a year, and entered Healthway Medical Group as a private general practitioner (GP). He describes his switch of sectors as a lack of choice, rather than choosing to go into the private sector, due to his desire to leave the public healthcare system. However, upon discovering that he had gifts in managing businesses and people, Dr Yeo wished to learn more about hospital management and joined Mount Elisabeth Hospital in 2013. He eventually served as its CEO, and would go on to manage hospitals under Parkway Hospitals Singapore as well.
Dr Yeo’s sharing focuses on key considerations in the public versus private sectors.
Pay and Benefits
Where the pay is higher in private on a peer-to-peer comparison, Dr Yeo also feels that the higher workload in private healthcare may contribute to this difference. However, he emphasizes that one is able to decide their own workload in private healthcare. In terms of benefits, the healthcare benefits for both doctors and their dependents are less competitive in the private sector compared to the public sector.
Security and Progression
Where Dr Yeo states that whilst the public sector has a better perceived employability such as following the milestones in a structured residency programme, a key feature of working in private is the autonomy to carve out what one wants to achieve. In his words, “no one told that I could become a COO [Chief Operating Officer] after 10 years. {You have to] find your way and identify your own strengths, weaknesses, and top up skills by taking courses. Skills can be acquired on your own, but must be self-initiated”.
Competition and Workload
Competition may be higher in the private sector where many doctors are highly motivated and put in hard work. However, there is again the autonomy to decide one’s work-life balance and workload in the private sector.
Change and Innovation
Dr Yeo mentions that the private sector moves and evolves faster than the public sector due to the comparative absence of government-funded grants and subsidies.
Governance and Accountability
What comes with the autonomy in defining one’s goals and work-life balance, is also an increased individual ownership of governance and personal accountability. Dr Yeo emphasizes that being in the private sector comes with greater individual responsibility for one’s actions, without the support of an organisation.
Dr Yeo concludes his sharing with examples of crises he has faced in his job (a water hydrant bursting, a fire and COVID-19) and how he has managed these crises. To Dr Yeo, a job in the private sector is an exciting one, where self-ownership and self-development become key aspects of one’s career in order to progress.
Dr Kenneth Tan, Family Physician, Kenneth Tan Medical Clinic
Dr Kenneth Tan starts his talk with a reference to how Luffy, a character in known manga One Piece, enthusiastically states his dreams for the future. Similarly, Dr Tan encourages us to think about what kind of doctor we want to be. He shares that many people will advise to join a certain organisation or residency programme, but we can also have our own dreams and goals to start a solo practice--and realise years later that it was the right choice.
As a solo General Practitioner (GP), Dr Tan emphasizes that it is important to first know a few things: what doctor we want to be, what kind of patients we want to see, our scope of practice, business model and the benefits we hope to bring to society. Ultimately, we need to define our “treasure” and priorities, whether it be family, time, money or others.
Dr Tan shares about his own GP clinic practice. As a private GP, he not only sees “coughs and colds”, but also chronic diseases and even performs minor surgical procedures (toilet and suture, incision and drainage). He gives public talks to Family Service Centres to educate people in the heartlands on health issues. With COVID-19, his clinic has been able to take on a more active role in being a Public Health Preparedness Clinic and offering swabs to reduce the patient load at emergency departments. Dr Tan is also active in medical student education by taking and guiding medical students at his clinic.
Dr Tan then broadly covers the advantages and disadvantages of being a solo GP. A main advantage of being a solo GP would be the freedom and autonomy to determine multiple aspects: working hours, consequent pay, patient pool and profile, business model and most importantly, one’s priorities and goals in life. There is always something new to try, and the opportunity to proactively develop these skills. Being a solo GP also leaves time to pursue one’s passion, be it in clinical work, community work, research or education.
However, there are also disadvantages that come with being a solo GP. Where patient load is more within control in the public sector, private clinics often rely on word of mouth to reach out to patients. Effort must be made to reach out to both patients and colleagues that you lead as part of your team. A crucial aspect is the need to learn and manage the various aspects of a business model, including accounts, marketing, training, human resources and many more. Dr Tan acknowledges, though, that there are always blind spots when learning to run a business, and one must be prepared to fail as many things may not be within control.
Ultimately, Dr Tan hopes to “inspire people to go on their own journey”. Whether a GP practice succeeds depends on one’s management of both its clinical and business aspects as well as patients’ support for the practice. Yet, doctors in the private GP sector “do not go alone”—there will be other family physicians as well as your own staff team members who will support you in the journey.
Dr Lim Hwee Yong, Medical Oncologist, Novena Cancer Centre, Mount Elisabeth Novena Hospital
Dr Lim Hwee Yong begins with an overview of what he specializes in: cancer care. Recounting that cancer care has evolved a lot from when he was a medical student, he emphasizes how oncology involves a multi-disciplinary team and care encompassing not only multiple aspects of the individual patient (physical, mental, social, financial), but also considers the patient’s wider social circle. With today’s advances of oncology treatment, it is satisfying for Dr Lim to see how patients can continue going on with their lives after treatment. The holistic care of both a patient and the patient’s extended social circle, as well as the intellectual stimulation from oncological research, continues to motivate and inspire him till today.
Dr Lim then shares about the differences of various aspects between the private and public sectors.
Patient load
Where public organisations involve more bureaucracy, private healthcare offers the option to customize delivery of care based on individual preference. This means the ability to choose to see less patients in a day in order to spend more time per patient—which is especially important in oncology to address the patient’s and family’s concerns. Working hours and patient contact are also flexibly defined by the doctor in private healthcare. Thus, there is the option of building a closer doctor-patient relationship without the many time constraints of the public sector as well.
Working System
Without the need to work within a fixed pre-defined system, changes in the private sector can be effected much faster. For example, multidisciplinary tumour board discussions can take place faster, one can choose their own healthcare team members, and investigations for the patient can be run faster. This is also contributed by the abundancy of clinical resources in the private sector. In the public sector, Dr Lim notes that doctors would still be putting in a lot for patients, but this may not be conveyed as clearly to patients due to the system’s time limitations of a consult, and may lead to lower patient satisfaction.
Non-clinical Work
In the private sector, Dr Lim notes that there may be less opportunities for research participation and international engagements. However, this is not to say that there are none, and it is ultimately up to the individual doctor’s interests to pursue these opportunities. In terms of education, public doctors have sanctioned responsibilities for teaching the junior doctors and international exchanges, but private doctors may have more chances to educate the public and exchange information with colleagues of the same level.
Business Model
Dr Lim shares that managerial skills may be required when entering the private sector but are not mandatory if one chooses to join an established set-up. However, if one chooses to set up their own private practice, one must be prepared to settle many aspects of the business in the early phase. With time, these non-clinical duties can be delegated to staff members of the team.
Eventually, Dr Lim emphasizes that before transitioning to the private sector, it is crucial to hone one’s medical skills sufficiently first, which does take a long time and a lot of effort. One has to question if private sector care is what they really want by understanding the options and the challenges involved, speaking to friends or mentors, and asking themselves what truly makes them happy. Ultimately, the essential principle in Dr Lim’s words would to “always be the patient’s advocate, and do good for your patients”.
