Inspiration Behind Chan KM Geriatric & Medical Clinic
Up till 2000, there had been no private geriatric service in Singapore. Most of the geriatric clinics in Singapore were operating from (public) Restructured Hospitals. Although there were private clinics within their Specialist Outpatients, I saw a need to have geriatric clinics in the private sector. Public and private sectors fulfil a need of different sectors of society. I also felt that when things are directly under my control, I can serve my patients faster and more efficiently within the private healthcare sector.
Motivation Behind Chan KM Geriatric & Medical Clinic’s Specialization
I developed an interest in geriatric care when I was roped in to start a free clinic for poor residents living in the old Boon Teck Constituency. This soon developed into a Home Care Service as many of them became unable to come down to the make-shift clinic situated at their various Resident’s Committee Offices. I was going around to visit them at their own homes and raising funds to provide for their much-needed medicine. Very soon, I became their friend and saw the very conditions that they were living in. I felt a connection with geriatric medicine because not only did I need to manage their medical conditions, but I also saw how their health interacted with their social, psychological and environmental conditions as well. I must say that for the first time, I felt like a real doctor, one who could treat my patients holistically.
Success Stories of Patients Who Received Exceptional Care at Chan KM Geriatric & Medical Clinic
One of the most obvious benefits I could think of is the speed at which things get done. I recalled a patient was brought to see me for ‘suspected dementia’, but the appointment to a Specialist Clinic was almost 6 months later. After seeing her, I felt the cognitive changes were not typical of dementia and sent her for an MRI brain scan straightaway. The report came back as a cerebral lymphoma, and she was referred to my oncologist colleague for treatment.
There was also another 93-year-old lady who was suffering from functional decline and was on the verge of being confined to a wheelchair. She was independently mobile up to 6 months ago. Functional mobility is ‘everything’ for the elderly, not just for independence but also psychological and quality of life. I was able to manage her medical condition, get a team comprising of the dietitian and physiotherapist, to manage her and get her back on her feet again. She lived on for another few more happy years before she passed on.
Struggles and Challenges
The greatest challenges are always cost and manpower. In the private sector, I am not sheltered from inflation and price increases (rental, staff salaries, utilities, medication costs increases) which take place ever so frequently. Yet, I am unable to increase my fees in tandem with these increases. Many patients who seek treatment in the private sector are also price sensitive, and I too, want to cater to this group as well. Since my original intention of setting up the clinic was to help those who need my expertise rather than to manage my clinic purely as a business, I had to thread a fine line between the two.
Manpower is also another factor, and it is difficult to compete with Institutions like Restructured or Private Hospitals for nurses. So, I can only look for those nurses who only want to work during office hours, with no night duties or work on public holidays because of family commitments. This suits me just fine, but they are few to come by.
Managing The Demands Of Running A Successful Medical Clinic While Ensuring Quality Patient Care
Whether we like it or not, a medical clinic is different from a retail shop. Medical care should not be sold as a commodity. The health of the patient is still the priority. Through the years, I have learnt that if we live by the mantra of providing the best medical care for the patient, he or she will be our best advertisement, who will in turn bring more patients to the clinic. If I take care of my patients, the business will take care of itself.
Chan KM Geriatric & Medical Clinic’s Response To The COVID-19 Pandemic And Strategies For Ensuring Long-Term Success
The challenges of the Covid-19 pandemic were something that hit all of us quite unexpectantly, not just in its severity but also its duration. So it was quite unlike SARS in 2003 because it lasted a mere 6 months. Fortunately, our government stepped in and offered much help during the period. That helped a lot in terms of keeping the Clinic going.
The mode of operation also needed to be adjusted. Fortunately, in my geriatric practice, I was already doing house calls ever since I started private practice in 2000. I was also trained to do house calls during my HMDP training in Glasgow, UK way back in 1990. During the Covid period, while my attendance at the Clinic dropped, my house call load increased and that helped to keep the Clinic afloat.
Changes are always uncomfortable, especially when we have to learn new and unfamiliar skills. But it was during Covid that I had to learn and apply new technological skills like using Skype, WhatsApp video calls and Zoom meetings to do teleconsultation for some of my overseas patients. This knowledge will stay with me and will be helpful for me to continue at least a part of my work in years to come, as teleconsultations are only suitable for a selected group of elderly patients.
Identifying Areas of Improvement And Overcoming Obstacles At Chan KM Geriatric & Medical Clinic
We are constantly improving, although at a rather slow pace. We have gone into electronic medical records (EMR) which will substitute paper documents. This helps us to answer patient queries even when the clinic is closed because the clinical notes, medication records and lab results are accessible 24 hours. Personal and staff resistance to this change was the initial reason for this slow implementation of the EMR.
Other areas of improvement would be to build up our own capabilities to provide ancillary care for my patients. At the early stage of my Clinic, I had a joint venture with a physiotherapy clinic to start our own Home Care company where we provided nursing, physiotherapy, speech therapy and home care equipment to serve our patients. However, it didn’t work well because of staffing issues and cost concerns. So the company wound down after about a year in operation. Now, instead of doing this on my own, I linked up with individuals who could provide the service. But by outsourcing them, I have no control over the quality or standards of care provided. I can only sieve them via feedback from my patients who had used their services.
The Role Of Leadership Style In Chan KM Geriatric & Medical Clinic’s Success
I tend to think through the ‘business’ model and draft it out first, then seek out comments from others in the field and always open to changes and happy to listen to a wealth of advice. I always listen to whoever has something to tell me. Then, I will sieve through the advice and implement those that are relevant and helpful. While I tend to look at the broad picture, my wife is more meticulous and cautious and is often the one who comes up with good solutions to the problems faced by the Clinic.
Chan KM Geriatric & Medical Clinic’s Approach To Keeping Up With Advancements In Medical Technology And Treatments
Even as a geriatrician with at least 30 years of experience, I am still active in attending both local and overseas conferences, as well as in attending Continuous Medical Education (CME) activities. CME activities included lectures, reading of journals and webinars.
Valuable Advice For Starting A Successful Medical Practice Or Business
My first piece of advice was that as a doctor, our passion is to get our patients better and to heal them if possible. If you take care of your patients, your business will take care of itself. If we try to do it the other way round, try to take care of your business first, it will always end in failure because you will want to cut corners, give your patients a bad deal just to increase your profitability etc. Your patients will know if you have a genuine heart to care for them or if you are only after their money.
My second piece of advice is to be flexible. From the mainstay of my ‘business’ being clinic-based, it became home-based and teleconsult based during the Covid period. I believe the medical landscape is ever-changing and poses new challenges. The greatest challenge blocking our progress is often ourselves.
Visit Chan KM Geriatric & Medical Clinic’s website here.
