Hello from Singapore!

My name is Grace Chen and I'm an incoming P4. I'm currently working in Singapore at the National Healthcare Group Polyclinics (NHG) in Choa Chu Kang (CCK).

These polyclinics are government subsidized clinics where patients get treated for minor acute ailments and chronic conditions. Physician offices, labs, nursing stations, pharmacy are all located in one 3-story building. Because it's subsidized (read: cheap), our pharmacy serves 700-800 patients in a DAY alone. Needless to say, it's super busy every day.

Here are my observations so far on working in Singapore:

Technician role. at NHG, there's this advanced version of the tech-check-tech system. In fact it's more like tech-check-tech-check-tech-check-tech, and then it gets to the patient....without a pharmacist check. Technicians here can do every step of the process and are usually the ones doing the patient counseling before giving the meds to patients.

Pharmacist role. Definitely not as developed as in the United States. Because pharmacists do not have to be the final check in the dispensing progress, they help out with filling, typing, or dispensing whenever it's busy. There are, however, "pharmacy only medicines" (e.g. famotidine) that only pharmacists can dispense, so a pharmacist duty include triaging patients who ask for those medications.

Pharmacists also run anti-coagulation and hypertension/diabetes/lipid clinics but it's still in a nascent stage and the demand for pharmacist interventions is low. Pharmacists have no prescribing rights, so for every warfarin dosing change the pharmacist must first call the patient's doctor to get approval. This gets very inconvenient when the patient is sitting next to you and the doctor cannot be reached.

Languages. People here are so incredibly fluent in multiple languages and dialects. Bilingual (usually English and Chinese) is the norm, but someone like my pharmacy manager can effortlessly switch between English, Mandarin, Cantonese, Hokkien, and Malay. I'm currently learning to do inhaler and warfarin counseling in Cantonese, my goal is to do one anti-coagulation clinic session entirely in Chinese. Haha we'll see about that....

Work ethics. I am constantly amazed by how hard everyone works. At NHG pharmacies, the average work week is 42 hours (which means working on Saturdays!). The staff stay late and some are on their feet constantly but they rarely complain (contrary to my work experience in the US!)

The picture I have above is of the staff practicing their dance for "Family Day," a corporate-sponsored team-building day. It's definitely fun working with these people!

Anyways, today I have the day off because it's Vesak Day (Buddha's birthday)...so I'm off to the Singapore zoo and night safari!