Present Issue 
Past Issues 

Present Issue 
Past Issues 

SMA Editorial Board 

Letters to the Editor 


 may98.jpg (4709 bytes)  

This site is supported by Health ONE


Evolving Role for the Polyclinics

The effective family doctor is one who not only provides medical treatment, but also counsels and helps their patients to adopt a healthy lifestyle.

The address by Mr Yeo Cheow Tong, Minister for Health, at the official opening of Choa Chu Kang Polyclinic on 23 April 1998 highlighted a new role for the Polyclinic. The Health Minister also spoke about the NTUC model healthcare worker 1998. His address on the Polyclinic as a training ground for family doctors is reproduced below.

"I am very happy to be here today, to officially open the Choa Chu Kang Polyclinic. This is the latest of 15 polyclinics established by my Ministry, and will serve the residents of Choa Chu Kang and Bukit Panjang. Government polyclinics collectively provide 20% of primary health care in Singapore. They complement the care provided by the 1300 family doctors practising in 1000 private clinics all over Singapore.

Modern medicine has progressed rapidly in the past three decades, resulting in the development of new sub-specialties, and the continual introduction of new hi-tech medical equipment and sophisticated tests and procedures. However, despite all these developments, primary healthcare will continue to play an important role in the healthcare chain. Primary healthcare is the first-line medical care to the community. It is cost-effective and affordable, and very accessible to patients because government polyclinics and most GP clinics are conveniently located within residential estates.

One of the key players in the primary healthcare team is the family doctor. The effective family doctor is one who not only provides medical treatment, but also counsels and helps their patients to adopt a healthy lifestyle."

Role of Polyclinics in the Training of General Practitioners

"To achieve excellent service at the primary health level, our family doctors must be well trained. This will enable them to provide better medical care, with better outcomes, for their patients. Over the past ten years, my Ministry has been working with the National University of Singapore and the College of Family Physicians to upgrade the training of newly qualified doctors who wish to pursue a career in family medicine. The aim is to provide such doctors with a formal training programme, and supported by on-the-job training. This is then supplemented by continuous medical education to help family doctors keep pace with rapid changes in health care.

I am indeed glad that what started out as a vocational programme in 1988 has now developed into the postgraduate degree of Master of Medicine in Family Medicine. This three-year programme comprises two years of clinical training in hospitals followed by a third and final year in the polyclinics. The entire programme is designed to enable the doctor to practise independently as a family doctor.

The polyclinics have therefore taken on the additional role of a key training centre for family doctors. They provide the setting for a comprehensive family practice environment in a one-stop health facility, with an appropriate case-mix of child, adult and elderly patients. The polyclinics are staffed by medical professionals, many of whom are trained in family medicine, and have much experience in family practice. They are complemented by other members of the healthcare team, such as nurse educators, dietitians, medical social workers and pharmacists. This enables younger doctors working in the polyclinics to learn from the more experienced doctors. The availability of clinical laboratory and X-ray facilities, day-rehabilitation for the elderly, psychiatric and dental clinics helps the family doctor to maximise healthcare at the community level.

Since 1993, 63 doctors have obtained their Master in Medicine degree in Family Medicine. These doctors now play an important role in serving as trainers in Family Medicine. Such trained family doctors provide an internal referral system to the younger doctors, for them to refer their more difficult and refractory cases. Through this, the need for referrals to hospital specialists is reduced, saving costs and inconvenience for the patient.

Besides the trainees in family medicine, about 100 medical officers have the opportunity to work and receive training in the polyclinics per year. Undergraduate medical students are also trained in family medicine during their attachments to the polyclinics. This training in the family practice setting, beginning from the undergraduate phase, is aimed at making doctors focus on the holistic care of their patients. It provides a balance to their exposure to specialist care during their attachments in specialist departments of hospitals. The exposure to a family practice setting will also inculcate in the young doctors the culture of a good doctor-patient relationship.

Family doctors also have to continuously upgrade their skills to keep abreast of new developments in medicine. The polyclinics provide the environment for continuing medical education and organise programmes such as tutorials, workshops and lectures on common clinical problems to imbue in our doctors a culture of life-long learning."