original post here http://sgforums.com/forums/1390/topics/451013
I was an ex-MO in the SAF. Coming from having served some of the
busiest medical centres in singapore, i believe this puts me in an
adequate position to enlighten forumers here on some issues in the
SAF medical system.
Firstly, medical officers in SAF have two roles:
1) As commissioned officers in the SAF
2) As doctors in the SAF
We take the health of our servicemen seriously. Having served
MOCC training, we take many gruelling medical courses and
recertification of our Advanced Cardiac Life Support course and
also go on to take the Advanced Trauma Life Support course which
are both validated protocols/courses in the west dictating high
standards of care in resuscitation and emergency/disaster care.
Our medical centres, no doubt having few medicines compared to
the hospitals or GP clinics you see in our local civilian context,
is at least equipped medications to treat most common ailments and
each and every medical centre, i guarantee, has the essential
equipment and drugs for resuscitation.
Cases like Private Lee are indeed unfortunate. There is indeed a
chance that he has fallen through the loopholes. Having served as
an MO, and in fact, even being involved as a doctor in care for a
servicemen who passed away, i can say for sure that there is REALLY
alot of effort put in to prevent repeat episodes, and extensive
inquiry is actually carried out. SAF medical directives are
constantly revised in view of these incidents, and similarly they
are constantly revised so that they reflect the latest standard in
medical care.
SAF also has tie ups with various specialist/tertiary care
centres in singapore, leading to shorter waiting time and access to
tertiary facilities like advanced cardiac investigations in
National Heart Centre SGH.
All in all, with our dual roles in SAF, I can safely represent
my fellow medical colleagues in saying that first, we treat each
and every servicemen as patients first, then as SAF personnel.
This leads me to my next issue. SAF has a duty to maintain its
ops readiness, this includes sufficient manpower and equipment for
manning of its defence capabilities, ample training of its
servicemen (exercises, operations etc). This being said, we doctors
have a duty to ensure that while servicemen's illnesses and health
are being taken care of, we also have a duty as commissioned
officers that our men are trained well and of course safely. This
is why downgrading has to be strictly by-the-book following
directives to ensure that our men are properly placed in vocations
suitable with whatever disability or illness they may have.
Lastly, i will touch a bit on malingering. Based on personal
experience as both a doctor in civilian practice and having served
as an MO, i can say that there are indeed a good many malingering
cases. I shall classify them as follows:
1) Frank malingerers
2) Opportunistic malingerers
In my opinion, opportunistic malingerers are actually a normal
phenomenon - i.e. they are not true malingerers. Let me illustrate
with a case to show what i mean. Servicemen XX comes to medical
centre complaining of knee pain, there is evidence from examination
validating the symptom experienced, but definitely not as severe to
warrant too prolong a rest duration or strong medications.
Servicemen XX then continues to request MC for rest. This is a case
of opportunistic malingering, however it is normal, because these
are patients who are into the "sick role" mode, aka patient mode,
and hence need rest to recover. While i do nag at them at times, i
definitely do not charge these ppl to DB and definitely allow them
some rest duration in the form of light duties.
Frank malingerers are those who fake their MCs from external
sources, fake specialist letters etc so that they can find an
excuse to be downgraded. There is a clear case of secondary gain
from these ppl. i.e these ppl come in requesting for privileges
like excuse stay-in, changing vocations etc. I have personally
charged quite a few of them.
As an SAF doctor/officer i have both the duty to make sure my
men are adequately treated and at the same time, serve also as a
safeguard and deterrent so that servicemen do not take it as an
opportunity to malinger. With my illustration above, you can see
why it is important. Imagine a battalion has about 700 ppl. If just
10 percent reports sick, that is already 70 ppl. Imagine if we are
lax with MCs, and allow senseless downgrading, the battalion will
be down to just 10 people in 2 months.
On a personal note, i'd say - NS is only two years. What really
is so difficult and so physically tough? Any of us, if we ask our
parents, will clearly note that in the past, training was
definitely tougher. Today's servicemen have alot more conditioning
and preparation and health screening compared to servicemen of the
past.
Take it as a chance to boost up your physique, to lose weight,
to make yourself a healthier person. Go into NS/BMT/XX camp for
whatever vocation with an open mind, not with a mind to siam
training, not with a motive to get downgraded etc and you'll find
that the experience is actually not so bad.
