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There has been a huge jump in patients enrolling in the Family Physician scheme where they can cut queue time and see a senior doctor for chronic diseases. APRIL CHONG reports
 Polyclinic patients with chronic diseases can see a senior doctor directly and so avoid the general queue for common ailments or referrals to specialists.
They are also treated by the same doctor, usually one with a master’s degree in chronic disease management.
Under this Family Physician (FP) scheme, they need to pay only between $8.50 and $14.60 extra in consultation fees. The final quantum patients pay range between $18 and $24.
Patients in the general queue pay between $9 and $9.60 in consultation fees.
The first such FP clinic started at Ang Mo Kio Polyclinic in 2005 to cater to patients with serious or multiple chronic diseases such as diabetes, high cholesterol and hypertension, in a bid to more closely manage their conditions.
Now, all 18 polyclinics here have the FP clinic services.
Even though it costs more per consultation to see such a family physician at a polyclinic, the number of takers has grown.
At the National Healthcare Group (NHG) polyclinics, the number of FP clinic patients increased from 158 in 2005 to over 18,000 now.
The figures are also up at SingHealth’s polyclinics: from 289 patient visits in 2005 to 19,012 last year.
One person who has benefited from this scheme is housewife Angela Wong, 68, who has been seeing the same senior doctor for high blood pressure and diabetes for the past three years.
At each visit to Tampines Polyclinic, she spends about 15 minutes consulting the doctor; another 15 minutes is spent with a nurse who teaches her how to manage her diet and lifestyle.
Choosing the FP clinic has paid off for Madam Wong, whose badly controlled chronic problems are now in check.
Although she pays an extra $9 each time to see the doctor, she said “it is worthwhile, like going to see a specialist”.
Patients may enrol in this scheme on the advice or recommendation of polyclinic doctors.
The patient has consultations with and is treated all through by the same senior doctor.
Before the patient sees the doctor, a nurse specialising in chronic conditions will counsel him or her and explain diet plans and the use of medical devices such as blood pressure and glucose readers.
 “Patients benefit because we can spend more time educating them and the staff are senior doctors and nurses,” said Dr Paul Goh, the director of Tampines Polyclinic, who is also a senior consultant family physician.
For instance, at Tampines Polyclinic, FP clinic patients spend about 15 minutes with a doctor. For patients in the general queue, the average time is six minutes, due to the high patient load.
The FP clinic patient also sees other health professionals such as physiotherapists and dietitians when the need arises.
A patient in the general queue may not get the doctor they prefer and will usually spend more time waiting, said Dr Goh.
FP clinic patient consultations are by appointment only. Madam Wong, who visits the polyclinic every three months, usually sees her assigned doctor, Dr Goh, within 15 minutes.
She is out of the polyclinic within an hour. Previously, each trip would take two to three hours.
Apart from the shorter waiting time, there are other perks. Her FP clinic visits have taught her to be more aware of her condition.
“Before this, my blood sugar control was not very good and I never understood the seriousness of diabetes,” said Madam Wong.
Since enrolling at the clinic, she has learnt to stop indulging in durians and cakes and eats more brown rice and vegetables. She has also started taking morning walks and does some gardening.
Her blood sugar level has dropped from 11mmol/L (millimoles per litre) to an acceptable 7mmol/L.
Most FP clinic patients are above the age of 40. However, patients as young as 15 have turned up for conditions such as asthma, said NHG polyclinics’ director of clinical services, Dr Lew Yii Jen.
Patients at FP clinics pay a higher fee because of the longer consultations with senior family physicians and other health-care professionals.
However, these fees are still at subsidised rates and patients also get subsidies for medication and laboratory tests, added Dr Lew.
This option is also cheaper than going to hospital specialist clinics.
Another FP clinic patient, Mr Anthony Koh, 48, who works in sales marketing, enrolled at Clementi Polyclinic’s FP clinic after he was diagnosed with high blood pressure in 2006.
“It is better to see just one doctor instead of having different doctors see me each time, with each one having to go through my record files. I also need not queue for two to three hours,” he said.
He gets to spend more time discussing his condition with the doctors, nurses and dietitians.
He is happy to pay a consultation fee of $24 per visit – scheduled once every three months – compared to the general rate of $9.50.
His blood pressure has since dropped from 190/110 to 130/80 and the doses of his various medication have also been reduced, he said. He now takes 5mg tablets for high bloodpressure, compared to the previous 10mg doses.
While FP patients get to see more experienced doctors, the polyclinics give the assurance that these senior doctors are not exclusive to those who pay for the FP service.
When not seeing FP patients, these doctors also attend to other polyclinic patients in the general queue, said Dr Goh.
FP patient numbers
National Healthcare Group polyclinics
2005: 158 patients
2010: Over 18,000
SingHealth polyclinics
2005: 289 patient visits
2009: 19,012
Benefits
By paying between $8.50 and $14.50 extra in consultation fees, patients enjoy:
■ Shorter queue time
■ Longer consultations with a senior physician
■ Being treated all through by the same doctor
■ Access to other health professionals such as physiotherapists and dietitians
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