Holistic health: Under one medical roof?

I was disbelieving at first, but soon figured out the situation. So I asked: "Not in Singapore, right?"

Right. He was working closely with doctors in Malaysia, Thailand and elsewhere. And my clarification triggered a rash of frustrated outpouring:

"What’s wrong with Singapore doctors?" he asked. "In the other countries, they are so open and eager to learn. They tell us, ‘Please, come and teach us’.

"In Singapore, they tell us to get lost! They are so closed minded. They have absolutely no regard for anyone who is not a medical person.

"Doctors elsewhere seem more interested in healing and helping people," he continued. "Even if they don’t accept what we do, at least they check us out. Doctors in Singapore seem only interested in medical science."

I related the above incident to several non-medical health practitioners and they all had similar stories to tell.

A naturopath recalled: "Once, we held a seminar on iridology (diagnosis through the iris) in Malaysia and, out of about 50 people who attended, there were at least four or five doctors. Here, you won’t find even one."

One acupuncturist noted: "In Thailand, the health ministry has a department of complementary medicine whose job is to conduct and encourage research. In Singapore, their job is to regulate practitioners."

Some reluctance on the part of medical doctors to accept non-medical therapies is well understandable, since the latter is often considered "unscientific".

It is true that some therapies are esoteric and questionable, so doctors need to proceed with caution. But the scientific evidence is slowly building up, and previously "alternative" therapies like osteopathy and chiropractic are now accepted as mainstream practices in many countries.

In the West, there are a number of medical doctors who write books extolling the virtues of alternative and complementary medicine. Around the region, there are doctors who set up clinics with non-medical practitioners.

In Singapore, we are a world class medical centre, but we shamefully lag behind many of our Asean neighbours and Hong Kong where it comes to collaboration between medical and non-medical practitioners.

SARS

This reminds me of a conversation I had with my Chinese sinseh during the SARS (Severe Acute Respiratory Syndrome) outbreak earlier this year (2003).

One Saturday afternoon, he and a whole lot of Chinese physicians were hauled up to the Health Ministry to attend a workshop where, among other things, they were taught how to wash their hands. He felt most insulted.

"They treated us like children," he complained. "They never respected us as health professionals. But we are just like doctors, we have also gone through five years of study."

The sinseh said newspaper reports from China and Hong Kong suggested that Chinese herbal medicine could help the fight against SARS.

Were local doctors and health authorities interested in doing more research? Were they interested in working together with Chinese physicians to try and find a solution to SARS?

No. In the slogan, "Let us fight SARS together", the emphasis seemed to be on "us" rather than "together".

Patients

The lukewarm response to alternative therapies here, it seems, is not restricted to doctors.

An osteopath told me: "When I went to Penang, I treated a wide spectrum of people – a mee goreng seller, truck driver, security guards, customs officers… Here, it’s always the same group of educated people and housewives."

And expats. Holistic health practitioners in Singapore rely largely on an expatriate clientele.

In fact, most practitioners are themselves expatriates. This actually speaks well for the government, which allows complementary health practitioners to practise here without much restriction.

Among the better-established complementary therapies, there are at most one or two Singaporeans in each field of practice.

"Australian naturopathic colleges churn out more than a thousand students every year. Not one of them is Singaporean," the osteopath pointed out.

"And do you know you can study chiropractic for free? Some American Chiropractic Colleges offer scholarships for four years of study in the US. It’s worth a quarter of a million dollars, yet nobody takes up the offer!"

True, there are positive developments here and there. For example, Health Management International, the people behind the former Balestier Hospital, recently conducted a course in "holistic nutrition" where concepts like yin and yang were discussed.

Also, Camden Medical Centre now has a few chiropractors, naturopaths, massage therapists and other non-medical healthcare givers setting up clinics there.

But are they just tenants paying rental? Like in Tanglin Shopping Centre where they all merely share the same landlord? Or do they actually work closely with each other, such as by referring patients?

Are doctors even allowed to refer patients to non-medical practitioners? Not likely, since they are forbidden to associate with them.

"Singapore is the only country in the world where, if a doctor sets up a joint practice with even state-registered health practitioners such as chiropractors and osteopaths, they are not allowed to share the same premises," the osteopath pointed out.

"Their clinics must have separate entrances and there must be a wall dividing them.

"Why can’t we, as Moses Lim* said, be ‘under one roof’ and live as one big happy family?"

* Moses Lim was the lead star in a Singapore television comedy, Under One Roof.