Apr 19, 2012

Singapore - Singapore docs upset peers in Indonesia


Last Saturday, well-known Singaporean oncologist Ang Peng Tiam held court before 800 attendees in a ballroom of a hotel in the Indonesian capital.

For about two hours, Dr Ang talked about how cancer in the early stages may show no symptoms, how even advanced cancer may still be curable, and about new chemotherapy treatments that do not cause patients to lose their hair.

Dr Ang is part of a wave of Singaporean specialist doctors from Parkway, Gleneagles and others, who are travelling to give talks in Jakarta and other cities such as Bandung in West Java. But local doctors, worried about losing business to Singapore, said this amounts to practising in Indonesia without a medical licence.

Dr Ang, medical director and senior consultant at Parkway Cancer Centre, made it clear during the talks that he was only giving general advice.

When one attendee asked about dietary restrictions for a person undergoing chemotherapy, he answered: "Eat and be happy." Dr Ang said he encouraged his patients to consume as much nutrients as possible.

Hospitals in Singapore and Malaysia are more expensive than in Indonesia.

For example, a single room at Singapore's Mount Elizabeth Hospital costs S$578 (US$462) a day, while at the Metropolitan Medical Centre Hospital in Jakarta, a similar room costs 1.5 million rupiah (US$163).

But some Indonesian patients are willing to pay more for higher-quality care and doctors who spend more time with them.

Patients in Indonesia have often complained that doctors here do not give them enough explanation about their treatment.

Neighbouring city Bandung has had doctors from Singapore coming to town as well this past year, an organiser told The Straits Times.

No one is keeping an official count but there are certainly more foreign doctors holding public seminars in Indonesia of late, including those from Malaysia, according to Dr Slamet Budiarto, secretary-general of the Indonesian Doctors Association (IDI).

More Indonesians now go to hospitals in Penang as a cheaper alternative to Singapore hospitals. Indonesians make up the bulk of foreign patients in Penang, with patient numbers surging from 202,000 in 2009 to 250,000 in 2010, according to the Penang government's website.

Lung cancer survivors Barita Manulang, 61, and his wife - from Jakarta - had been treated by Dr Ang, and they joined him at his recent Jakarta appearance to talk about the experience. They encouraged others not to fear cancer, noting that some patients easily lose hope or are in denial about their problem.

Dr Ang showed slides of other success stories. After hearing about how the young son of a vegetable seller from Batam had cancer in his testicle cured by Dr Ang, the audience burst into spontaneous applause. The boy, whose testicle had swollen to the size of a melon before treatment, was shown playing and sitting on Dr Ang's lap at the clinic after he was declared free of cancer cells.

About a quarter of Dr Ang's patients are Indonesians.

One attendee in her early 40s, who identified herself only as Ms Leli, said she found the talks useful. Ms Leli had a sister who died of breast cancer and she herself has ovarian cysts.

But the talks, Indonesian doctors said, are against the law as the Singapore doctors do not have licences to practise in the country.

"If a seminar is attended by fellow doctors, that is fine. But if the general public is invited, then that is illegal," IDI's Dr Slamet told The Straits Times.

Foreign doctors who wish to practice in Indonesia must register with the Health Ministry, must speak Bahasa Indonesia, and have a recommendation from their home country's doctors' association. There were 108,132 registered medical doctors in Indonesia in 2010, according to the government data.

Dr Ang said Indonesian doctors should not feel threatened by his talks.

"Indonesia is a huge country. There are more patients here than anybody can handle. We are trained to look after patients to the best of our capability. Whoever can do the job best is the best person for the patient."

Wahyudi Soeriaatmadja
The Straits Times



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