Thursday, March 27, 2008

Aesthetic Medicine and Snake-oil-My unabridged letter to the Straits Times

Hi Friends,
The below is the complete letter sent to the ST Forum page.

The editor chose to print only this sentence:
"As not all aesthetic treatment is “snake-oil” we should not throw the baby out with the bath-water by banning aesthetic medicine. "

That's his prerogative.
Mine is to publish it on this blog.

Now I know why Jeff Ooi and the gang up north had become cult figures! Maybe I can be famous too.


Dr.Huang Shoou Chyuan

PS: I remember I posted something about PAP and Economic Imperative.

The choice for them was $200 mil/year or a matter of principle. You guess which they picked?

My letter to the ST Forum page

Dear editor,

I like to make some comments about the “aesthetic medicine” issue and the apparent U-turn by MOH.

Public trust doctors- we should not abuse that trust

Despite protests from certain quarters of the medical community, I feel that it is right that doctors should be judged by higher standards than laymen. To say that if beauticians and Traditional Chinese Medicine (TCM) practitioners are allowed to carry out unproven treatment, doctors should be too is to ignore the good reputation that doctors in Singapore had taken decades to earn.

I do not agree that dubious treatments without any shreds of evidence should be allowed.As members of an honourable and ancient profession, patients inherently trust that any treatment recommended by us is not snake-oil. They assume the treatment is good for them and that it is evidence-based. They do not hold beauticians to such lofty standards.

This higher standard applies to all professions. Hence when a doctor, lawyer or accountant has “fraud” convictions, he will be deemed unfit to practice and be struck off the membership rolls.

Place of Aesthetic Medicine in Singapore healthcare

Recent action by the Ministry of Health (MOH) to ban unproven treatment ( and subsequent U-turn) has brought sharp focus on the place of Aesthetic Medicine in Singapore Healthcare.
Even amongst doctors, the views vary widely with one end of the spectrum feeling that treating normal face and skin is not “medicine” and should be best left to beauty salons. The other extreme is that the supply and demand for “beauty” in the marketplace should be left to play itself out without restraint and that economics would always find its own equilibrium. Willing buyer willing seller scenario.

My view is that Aesthetics is here to stay and will not be wished away. As not all aesthetic treatment is “snake-oil” we should not throw the baby out with the bath-water by banning aesthetic medicine.

Working towards win-win

The medical community, led by the Singapore Medical Council and the MOH, has to decide what treatment is proven and safe. It has then to decide who is competent to perform these. There would necessarily be several tiers where simple procedures such as Botox can be safely administered by trained GP’s and higher tier surgeries such as Liposuction, should be the preserve of doctors who had extensive training and who understand advanced anatomy and surgical pathology as these are potentially lethal in the wrong hands.

The authorities must provide ample opportunities for interested doctors to undergo structured instructions and the necessary certifications. Doctors should not need to learn Botox over a weekend in Bali.

Plastic surgeons should volunteer to impart their skills to fellow doctors who have passions for this field. This would help dispel notions that this is a “turf war” being played out. Although competition has lowered prices of procedures like Botox, the enlarged pie also benefit all doctors, even specialists. It is a win-win scenario.

Best of all, Singapore Medicine gets to keep its good reputation intact,

Dr.Huang Shoou Chyuan

Thursday, March 13, 2008

David Saul Marshall: What Singapore’s mass media will not tell you

Hi Friends,

Way back in October 2006, I posted an entry entitled “Lessons from Beyond the Grave- What 2 Singaporeans teach us”.

This was in two instalments.

Part One was the tragic tale of a certain Mr.Tan Jee Suan who was so poor and financially distressed that he felt that the only way out of his monetary troubles was to end his life in front of an MRT train. His parting gift to his children was $10. This was all that he had and it was for them to buy chicken rice.

In the one and half years since then, do we still have our Mr. Tan’s in our midst?

Part two was about Singapore’s first Chief Minister Mr.Marshall. I was very moved by what he said about "Noblesse oblige" in public service during an interview he gave to Dharmendra Yadav entitled “Meeting David Marshall In 1994”.

Noblesse olige literally means nobility is an obligation. It is defined as:
1. Benevolent, honorable behavior considered to be the responsibility of persons of high birth or rank.
2. the obligation of those of high rank to be honorable and generous (often used ironically)

Thanks again to Mr. Yadav. Without his publishing this conversation into the public domain, we would never have known what Marshall felt about Singapore’s move away from idealism etc.

Marshall is an idealist and humanist that I greatly admire. What was said in 1994 is just as relevant to us today.

As expected the Straits Times just glossed over the feature on Marshall on this his 100th birthday. I did not expect them to mention any of the points brought out in that 1994 interview and I did not get it!


Dr.Huang Shoou Chyuan

Sunday, March 09, 2008

Malaysia’s GE Tsunami and implications for Singapore

Hi Friends,

Malaysia’s rakyat has spoken

Malaysia’s rakyat (people) has spoken in no uncertain terms.

In one fell swoop, Malaysian political’s landscape was unimaginably changed. Barisan Nasional (BN), the national coalition which consisted of racially-based component parties which until yesterday was supposed to give the different races a representative voice in the higher echelons of political power is no more.

Malaysia’s politics reached the “Tipping Point” yesterday.

BN has lost its 2/3 majority and is now holding on to power ever so tenuously. It does not have the mandate to amend any articles of its constitution. MIC, the Indian party is decimated as is Gerakan (Chinese-based party with origin in Penang). The MCA (Chinese party) is close to being mortally wounded.

In the states’ legislatures, BN’s collapse was equally dramatic. Besides Kelatan ( which was expected), BN lost Penang (PM Abdullah Badawi homestate) , Kedah (Ex-PM Mahathir’s homestate), Perak, Selangor and just held on to Trengganu with the skin of their teeth! The BN now only rules 8 of the 13 states!

The Perfect Storm

Malaysia’s opposition had a Perfect Storm with the following players and circumstances all in some sort of heavenly alignment:

1.Mercurial Anwar hitting his zenith with Princess reformasi “Nurul” mesmerising the crowds.
2.Indian and Hindu disenchantment with alleged marginalisation. Hindraf riots.
3.DAP getting their act together with many credible personalities willing to come forward to be counted. Tony Pua worked in Singapore and Dr.Ramasamy who slayed Penang's Chief Minister Dr.Koh Tsu Koon was working in a think-tank in Singapore. Men with guts and principles!
4.MCA’s Dr.Chua ( no need to say more).
5.MIC’s Samy Vellu and his fake hair ( also no need to say more)
6.Mahathir ( whose side was he on?)
7.Rise of alternative media esply internet.

As a Singaporean, I observe all these happenings over the TV and’s website with concern and interest. The website has come a long way and was quoted extensively by Mediacorp’s Channelnewsasia last night!

We are thankful that there was no untoward public disorder or riots.

Hats off to the Election Commission and the police as it was a free and fair election and it looked like there were no major allegations of cheating or vote-rigging!

There is no doubt to me that the Malaysian BN would not be the only people doing a post-mortem.

Singapore’s PAP would be looking at the situation with concern and would definitely prefer not to get a surprise at our own GE in a few years’ time.

Not being connected at all to the PAP nor having any relations ( carnal or otherwise) with any PAP’s leaders, I can only guess at what the PAP would do next to prevent such a Tsunami from happening.

Likely Implications for Singapore

1.More and larger GRC’s. (Less single seat wards)
2. Heavy control of internet nearer the GE
3.PAP will fine-tune its feedback mechanisms to get more accurate messages from the grassroots.
4.Tighter control of MSM (Mainstream Media)
5. The disenfranchised and poor would be closely monitored to ensure that their unhappiness do not reach boiling point. Grass-root organs (PAP-aligned) would act as eyes and ears and will be the main channel for helping the poor. They will not look favourably towards any non-PAP group which wants to act as champions of the poor.
6.Internal Security ACT will remain in place. This would be handy for potential trouble-makers.
7. Opposition parties would not be considered partners but as necessary inconveniences.

Having said that, the idealistic side in me was hoping that someone with conscience within the PAP would feel that more should be done to allow greater voice from the people and the true feelings of the people should be made known- but the pragmatic side simply laughed and asked him to shut up!

Let us keep our fingers crossed and hope that Malaysia would emerge stronger after this and that calm and peace will prevail! Maybe Malaysia can also show the world that it is possible to have peaceful political transitions and that democracy is not something to be afraid of. You win some and lose some?


Dr.Huang Shoou Chyuan

Link: report