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					10   Personally Speaking



     Training Future Housewives
     is a Waste of Money
     Terence Lim counts the real costs




     I
         n Sex and the City, the multi-Emmy        of Singapore as a whole, we have to               If women doctors were to
         award winning American TV series          think of national interest.” And in           voluntarily offer their time for some
         not shown here, Miranda the               Singapore, national interest is very          aspect of national service, I am sure the
     lawyer once declared “men are                 often drafted in figures. Money talks         men would be far more demonstrably
     obsolete anyway, you already can’t            very loudly here.                             supportive of your current petition.
     talk to them, you don’t need them to               In a phrase, the government’s            In saying this, I fear I have sunk to
     have kids with, you don’t even need           current stand is that it’s not “worth it”     a totally communist mindset of
     them to have...”                              spending money educating “too many”           equalizing down. Which is why it
          I don’t know how closely our lady        who might decide to “give up medicine”.       should never happen.
     colleagues resemble successful non-           Of course all this is within the wider
     conservative 30-something New York            drive to prevent spiraling healthcare         COST OF MEDICAL EDUCATION
     women, but I have a hunch many                costs that includes measures such             Now back to those assumptions. The
     do occasionally think like Miranda            as approved medical school lists and          key phrases have been highlighted
     the lawyer.                                   small local classes. These measures           earlier. What we should be thinking
          Which is why it must be somewhat         have been very much in the news               is what “worth it”, “too many”, and
     frustrating to be a woman in a man’s          lately, as they have led to a shortage        “give up medicine” mean exactly in
     world. And even more so in the                of medical staff.                             today’s context.
     medical system here where it being                 It’s time to re-examine certain               Exactly how much money is
     a man’s world is not only a literal fact,     widely held assumptions that underpin         involved in local healthcare education
     but government policy. So let’s all           efforts to control healthcare costs in        is now wide open for debate and for
     applaud the Association of Women              the above fashion. One would be               once the newspapers seem to be on our
     Doctors for challenging established           foolhardy to ignore economic aspects in       side. Apparently the SMA had petitioned
     norms and for being unwilling to sit          healthcare but money may be speaking          for greater transparency in the past,
     by the sidelines waiting for things to        differently nowadays. And there are           but nothing had come out of it. It’s
     happen. Even if nothing comes out of          hidden figures in the equations.              time that MOH reveal their formulas.
     their petition to lift quotas, simply                                                       We are all waiting.
     getting those in policy positions to          NATIONAL SERVICE                                   This cost of medical education has
     justify their stand and salaries would        But before we go to that, let’s detour a      direct impact on female medical student
     be worth it. They have shown that at          little to gender issues again. Men here       quotas. If it’s shown that perhaps the
     least the fairer one-quarter of the doctor    are very familiar with this concept of        pricing mechanism (I really hope it’s
     population is not to be messed with.          national interest, I daresay much more        simply a difference in pricing rather than
                                                   so than most women. We can’t help it.         accounting) can be improved locally, then
     NATIONAL INTEREST                             Not after we have spent more than             perhaps the amount spent on educating
     Alas for the women, I think most men          two years of our already short youth          future housewives is not as much as
     think you are fighting a losing battle.       being its very definition.                    previously thought. Indeed, this will
     However, public opinion may yet be                  I wonder how many women think           impact the costs of educating entire
     won though. Hopefully that will be            national service here is discriminatory       cohorts of students, for the doctor
     comfort enough. This fight against, let’s     against men. They probably rationalize        husbands of these housewives would
     use the right term here – institutionalized   it in terms of national interest. It’s easy   also be cheaper to teach. Perhaps we
     gender discrimination – will probably         when you are not the one involved. In         can then expand the number of students
     be lost because of a simple fact: that of     the same way, many men in medicine            without changing the balance sheet,
     so called national interest.                  rationalize quotas for female doctors.        and uphold national interest with
         It’s the undertone in all of the                Personally I found my years in NS       our pockets and hands.
     Ministry of Health’s (MOH) comments           a good break, but it’s difficult not to
     on the topic. They say “Yes, we               think of gender discrimination – against      ECONOMIC VALUE
     know the policy is prejudiced against         men – when girls who were my JC               But this is just putting a current numerical
     women, but can’t you see we have              classmates are going to be registrars         figure on “worth it”. What’s more
     to do it because we have to think             next year while I am still a first-year MO.   important is to consider the future
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     S M A N e w s F e b 2 0 0 2 Vo l 3 4 ( 2 )
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  Page 10 – Training Future Housewives is a    figuring out the numbers. Everyone            taken to address this – which leads
Waste of Money
                                               seems to want a doctor these days,            to the final point. In the past, doctors
asset value of a doctor. What economic         from patients, to research labs, to           were not expected to “give up medicine”.
value she or he can add to the                 companies. It’s arguable whether over         In fact, those who did so – women mostly
economy; the return on investment,             or undersupply is worse, but what’s           – jeopardize things for future generations
so to say. In fact this has already been       certain is that some regulation is            of women doctors. But times have
discussed to death. Biomedical science         required. The perennial fear of “too          changed. Larger proportions of medical
has never been so “cool”, what with            many” is that healthcare costs will go        students may not practise “real” clinical
EDB and NSTB (recently renamed                 up because doctors create demand for          medicine in years to come. With the
Agency for Science, Technology and             their services. And the situation in some     breadth of opportunities opening up,
Research, or A*STAR) running full-             countries seems to illustrate this point.     hopefully equally bright sparks will
page scholarship ads. There is even a               That is true to a certain extent,        contribute to national interest by research,
new government agency set up just              and in particular if things stay status       management and invention.
to spearhead biomedical industry               quo. Simply put, if we have more                   “Giving up medicine” is hardly the
development, now that manufacturing            doctors and polyclinic consultations          fault of women. It’s the way society
is threatening to go red and flee north.       and surgical ward rounds still                is structured. An economy structured
     When one considers the amount of          remain those cursory if-you-are-not-          to reward non-practising male doctors
money a single doctor-entrepreneur can         dying-I’ll-take-a-minute affairs, then        in commerce will lead to men “giving
add to the Singapore economy by say,           certainly we will have excess doctors         up medicine” too. Should we then
inventing a new way to screen, treat or        creating demand.                              blame them? At least the women do it
scan, I think the question of “worth it”            However, if services improve, and        for nobler reasons. The important thing
might be deemed void. One has to               more doctors see fewer patients because       here is to create options so that no one
spend money to make money.                     patients are treated as such, then            with a medical degree needs to give
                                               “too many” will become just right. Of         up clinical practice totally just because
TOO MANY OR TOO FEW                            course, this is putting it simplistically.    she or he decides to do something
The issue of “too many” is an                  Money complicates once again. Fewer           else for a while, or for most of the day.
interesting one. What’s unusual about          patients may mean less money, and it’s             In every other career field, women
the calculations for Singapore’s local         foolhardy to assume doctors would be          tend not to go as far as men because
medical school intake is that unlike           Hippocratic. Patients themselves might        of family and marriage. In fact,
in practically all other fields, attrition     be unwilling to fork out more to be treated   many think this is a good way of
does not seem to have been taken               as patients. I doubt the government           dividing responsibility. We should
into account. It is as if everyone who         will subsidize the difference.                not penalize women for the sacrifices
graduates from medical school here is                                                        they make to look after our families.
expected to be a doctor till she or he dies.   “GIVING UP MEDICINE”                          This includes women doctors. Having
    Such calculations cry for a reality        What’s for certain is that we need more       strong families is in our national
check. But please don’t envy those             doctors and steps are already being           interest too. s

				
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posted:11/24/2011
language:English
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