Sunday, April 22, 2012

High Quality Hospital Care - Something Else to Like About Singapore

I had been feeling energy-drained, but by a week ago last Tuesday, I knew I was really sick.  About 10 AM I checked in for a consultation.  I had a fever and my red and white cell count were at dangerously low and high levels.  Plans for a nap followed by my evening class were shelved.  It was off to National University Hospital emergency room, post haste.  After a day of testing plus intravenous feeling and antibiotics to “stabilize” my condition, I left the ER ward and was admitted to the hospital, Ward 7B, room 23.  The night resident appeared about 10 PM and ordered further tests.  They would be processed by the lab overnight so that results would be available to my attending physician in the morning.
No - I am not going to chronicle the entire course of my treatment, which included five days of close companionship with my IV pedestal, decorated with multiple feeds and monitors. (When I failed to show it proper respect, it would beep alarmingly and if I did not quickly untangle myself nurses would appear).  Rather I will quote briefly from the letter I wrote to the Chief Executive Officer, NUS Hospitals.  The excerpt follows:
Dear [CEO]
I recently completed a seven day treatment regimen at the National University Hospital.  When I was discharged, your staff provided me with your “We Value Your Feedback” form.  However the quality of my care was so outstanding that checking boxes on a form seemed inadequate.  Also, as a manager of many years experience myself, I have always welcomed nuanced, constructive, feedback and taken it seriously.  I am assuming that you, too, might find such feedback useful.
To avoid redundancy and save time,  I have simply provided copies of letters expressing deep appreciation to my attending physicians, Dr. [ ------ ] and Dr. [ ------] ; also to the nursing and support staff of Ward 7B, Kent Ridge Wing, the venue where my care was provided.  In this note, I will only share my bottom line:  were I in need of major surgery, not residing in Singapore at the time, and the option was available,  I would unhesitatingly fly to Singapore and chose NUS Hospital for the procedure. I will be sharing  these sentiments to a wider audience via my blog,, which has a modest, but not insignificant, readership. Of course I have also shared personal accounts of my care with Singapore friends and professional colleagues.
[While there was one vexing problem, with internet connectivity] ... I would not want this relatively minor blip, attributable to outsourcing,  to over-shadow the professionally impeccable, proactive and humane treatment that characterized every other aspect of my stay - from Emergency Room to admission to final check-out with your Billing Department.  
While such high quality of service is the product of many individual efforts, it doesn’t happen without outstanding managerial leadership from the top.  Accordingly, I want to extend my thanks you personally for the care I received.  Thanks to that care, I survived an attack that could easily have become life-threatening; perhaps even life ending.  I have no doubt that experiences such as mine must be daily fare at NUS Hospital.  It must be very rewarding, at the end of arduous days, to know that your leadership is making such a difference in so many lives.
Respectfully, and with my best wishes,
The charges for 7 days of hospitalization, including emergency room, a private room and intensive care by two teams of physicians was less that $4,000 US total.  These were the total costs - before any insurance coverage.  The invoice, was clear, complete comprehensive and devoid of the pages of incomprehensible legal jargon and medical terminology that similar documents in the US feature.  “Would there be additional charges from ‘independent providers,’” arriving as much as several months later,  I asked. The billing officer responded with a puzzled “no.”  The bill was complete in every respect.
A few days after my discharge I was recounting my experience to a friend who has some contact with Singapore’s health-care establishment.  He told me of a consultant-staffed project that had as its goal “improving” Singapore’s health care system by adopting “best practices” from the United States.  I was shocked and saddened to learn of this possibility  In my view, the flow of information and expertise should be in the other direction.  Through there are occasional bright spots in the US system, especially for the very wealthy, Singapore has little to learn from a health care system that is, notwithstanding those few bright spots, costly, inhumane, complex and dysfunctional.   And my country has much to learn from the humane, efficient, cost-effective manner in which Singapore provides health care to its citizens.