That remains constant for Prof Tan over his 40-year career as a doctor and administrator
IT WAS a taste of medicine that Professor Tan Ser Kiat will never forget. Doing rounds with his mentor, Professor Gordon Ransome, and fellow medical students in the 1960s, the group stopped in front of a diabetic patient. “How do you tell if someone has diabetes? You taste their pee,” said Prof Ransome, who dipped his hand into the man’s urine bag and licked a finger in front of the horrified bunch. The squirming students mirrored his action, only to be told by Prof Ransome after each had a sampling that he had put one finger into the acrid liquid, but a different one into his mouth. “He was teaching us the importance of observation, one of the most important lessons in medicine,” recalls Prof Tan, chuckling. Another time, he saw his late British mentor stop in his tracks to comfort a dying cancer patient. “The old Cantonese lady spoke no English, and he spoke no Chinese. He pulled up a chair and held her hand. No words were passed, but you could see the empathy flowing between them.”
That was when medicine was transformed from clinical interest into passion for Prof Tan. “Legends like him taught us not just the substance of medicine, but the values and ethics we need as doctors and in life,” he says. These are the same values that Prof Tan, 66, has carried with him in his 40-year career as a doctor and medical administrator. He has covered the whole spectrum of medical care: From his early days as an orthopaedic surgeon revolutionising treatments to re-attach severed limbs, to running SingHealth, the country’s largest health-care group, for the past 12 years. While the challenges changed with his job scope, one constant remained: Putting patient welfare first. He never imagined he would be a doctor.
A post-war baby boomer, he was the fifth of nine siblings whose earliest memory was being squeezed into a one-room flat in Chinatown. His parents later ran a provision shop in Geylang. He credits his primary school teachers with stressing the value of education and helping him make it to Raffles Institution. “Chinatown and Geylang, where we later lived, were heavily infested with gangsters, and I could have easily ended up a street urchin. But going to RI was a turning point because I mixed with a bunch of kids who were so focused on doing well,” he says. Although his parents wanted him to work after he completed his A levels, he saw his classmates apply for university, and yearned to do the same. He bagged a Colombo Plan scholarship to do veterinary science in Australia, but felt he could make a bigger difference by going into medicine. “I asked my mother, the family’s main decision-maker, and she said yes, provided I could be self-sufficient.” He succeeded by giving tuition throughout his medical training, and rose through the ranks after graduation to become SingHealth’s group CEO in 2000, in charge of the country’s largest health-care group comprising two hospitals – Singapore General Hospital (SGH) and KK Women’s and Children’s Hospital, five national specialty centres, and nine polyclinics.
When he first took over, SingHealth had a combined staff strength of 10,000. At his retirement last month, it had 17,000 employees. In 2010, SingHealth saw 190,000 in-patient admissions and 4.3 million outpatient attendances at its specialist clinics, polyclinics and emergency departments. Under him, the SGH Campus evolved into a medical powerhouse, boasting one of the largest and most comprehensive medical institutions in Singapore and regionally, equipped with an entire spectrum of medical specialties and services, from heart and liver transplants to complex brain operations. He also integrated procurement functions under his charge, reaping close to $200 million in cost savings over the past decade. And he oversaw the Herculean task of getting all IT systems across various facilities in the group onto a single platform. This means a patient can be seen in one place, say a polyclinic, and his records, ranging from laboratory results to medications, can be seen at another SingHealth institution if he gets treated there. In tandem, he pioneered the concept of academic medicine, which focuses on trying to improve the care and outcomes for patients through excellent clinical service, research and education, and training of staff. “This is not just ivory tower stuff. It is about real patient benefit through better knowledge and research, delivered by better- trained staff,” he stresses. “Seven years ago, when I proposed the idea of academic medicine, there were a lot of sceptics. Today, it is a given.”
Indeed, two SingHealth centres – the National Cancer Centre Singapore and Singapore National Eye Centre – have led the way towards developing a cohort of that rare breed, doctor-scientists, who are looking into better understanding disease and treating patients. Prof Tan has brought in millions of dollars in donations that go towards education, training and research, as well as subsidising treatment for patients who fall through the cracks. While medical care has improved tremendously since his days as a medical student, fundamental shifts are needed to ensure hospitals are not over-taxed, he feels. “There are too many people coming to hospitals, and we need to move out of hospitals. Demand far outstrips supply in terms of hospital beds, doctors and other medical staff. “With the double blow of an expanding and ageing population, the need to ramp up work at community hospitals and with general practitioners could not be more urgent. “Around 60 to 70 per cent of such care can be carried out in community facilities so that primary care hospitals can concentrate on the more complicated cases,” he says.
Since he retired last month, the orthopaedic surgeon still treats patients, but allows himself the “luxury” of arriving in the office an hour later, at 7am. He knocks off only at around 7pm, although he admits that in this wired world, “work never really stops”. The publicity-shy doctor rues the fact that he made the headlines for all the wrong reasons last year. Private surgeon Susan Lim – fighting to quash the Singapore Medical Council’s (SMC’s) right to continue disciplinary proceedings against her – said he had been her spurned admirer some 30 years back, and alleged that their prior history would lead to conflict of interest in her case. Prof Tan, who heads the council as well as the second disciplinary committee hearing the case against her for allegedly overcharging a Brunei royal patient, denied the incident strongly at the time. The never-married surgeon refuses to be drawn into comment on the incident as the committee is still investigating Dr Lim’s case. He also brushes aside his nickname as SingHealth’s most eligible bachelor, and attributes his singlehood to his all-consuming love affair with medicine. “In the early years, romance took a back seat, and my sole purpose was to do a good job, so I got stuck on the shelf,” he jokes. For the past few years though, he has been linked romantically with a retired accountant, who he prefers not to name. He maintains he has no regrets about sacrificing family life for his work. “I have seen Singapore’s health-care system transform from Third World to First. The last 40 years have been totally satisfying. It is an experience I would not exchange for anything.”