Insights on Healthcare

By Adriale Pang

Discovery+ is a series of online industry panels which give students the chance to interact with working professionals and learn about the careers they aspire to enter. These panels provide youths and working professionals with the opportunity to better understand industry trends, hear first-hand perspectives from industry professionals, and gain valuable advice on entering or navigating these industries.

On 7 December 2021, Advisory hosted Discover+: Healthcare, the 47th edition of the Discovery+ series. Speakers on the panel included:

• Li Lian Liew (Moderator), Director, Corporate Planning, Tan Tock Seng Hospital
• Andy Seet, Director, Sector and Partnerships Division, Agency for Integrated Care
• Chan Beng Seng, Group Director, Healthcare Finance, Ministry of Health
• Lillian Yeo, Director, Human Resources, Tan Tock Seng Hospital
• Min Hoe Chew, Senior Consultant General and Colorectal Surgeon, The Surgeons Pte Ltd
• Shirley Heng, Chief Nurse, Khoo Teck Puat Hospital and Yishun Health

Attendees included students at various levels of education with a desire to know the different career paths in Healthcare, and how to best position themselves for such roles. Below are some key points shared during the session:

What are the jobs available in the healthcare sector?

Singapore’s public healthcare system is not-for-profit, and consists of:

1. Ministry of Health (MOH),
2. Government-Funded Providers (3 healthcare clusters: National Healthcare Group, National University Health System, and SingHealth), and
3. Intermediate/Long-Term Care (ILTC) providers, made up of nursing homes and community hospitals.

The private healthcare system is typically for-profit, and includes companies involved in supply chain, medical equipment, health technology, consulting, financing, and support systems. Private health corporations and think tanks are also part of the private healthcare system.
3. Social service agencies, social enterprises, philanthropists, and funders might straddle across both domains.

The healthcare sector is extremely broad and offers a wide variety of jobs beyond doctors and nurses, which most are familiar with.

How does work differ between various occupations in healthcare?

Some work environments, such as A&E in hospitals, are very fast-paced. In contrast, other environments like nursing homes have a slower pace and are more personal. In nursing homes, for instance, the day-to-day work can involve caring for the same few seniors, as well as building rapport and long-term relationships with them. For youths interested in joining the healthcare sector, they should consider which environment they prefer to work in. It is important to ask yourself what inspires you more: the adrenaline rush, or the personal connection?

In terms of career paths, some occupations allow for a meandering career trajectory, whereas others are more linear. For instance, specialist surgeons or physiotherapists need to commit a significant amount of time to study their particular field, while administrators can move around different healthcare organisations more easily because they are geared towards more generalist tasks. Nevertheless, some specialists do transition into administrative, executive, or operational roles after their studies and training.

Notwithstanding these differences, people who work in healthcare are generally concerned with providing good healthcare, whether for the individual or for the entire nation, for the young or for the old, and for the at-risk or for the chronic. They achieve this broad goal via various approaches, such as direct service or policymaking. These can have either immediate or long-term improvements. Indeed, there are many other permutations of different focuses. Below are three examples that outline some different types of work, beyond the familiar jobs such as doctors, surgeons and nurses.

First, those in healthcare finance might ponder how to ensure the affordability and sustainability of healthcare financing policies, or balance government subsidies with MediShield Life and private insurance. They might also work to create payment structures that incentivise positive healthcare decisions and minimise moral hazards.

Second, service planners are concerned with how to deliver good healthcare for the entire nation both in the present and in the future.They review how healthcare is provided, and if they anticipate a gap in future healthcare provision, they make plans to fill that gap. This might involve planning for talent and infrastructure development.

Third, human resources (HR) workers carry out workforce planning. Such work was critical to staffing the National Centre for Infectious Diseases (NCID) with the skilled professionals it needed, just in time to meet the challenge of COVID-19. A whole suite of actions need to be taken to ensure that the right people are at the right place, and at the right time. These actions range from regulation, licensing, accreditation, to forecasting the size and composition of the workforce many years in advance. Every single worker hired is reviewed, to ensure that the manpower adds value, and that it is properly acquired, developed well, and competitively paid.

What are some misconceptions about the healthcare sector?

Acute care in hospitals is usually the most widely known as it is extensively publicised through media such as Korean dramas. However, the reality is that healthcare is also greatly focused on chronic care, preventive care, and terminal care (how to age and end life with dignity).

These aspects of healthcare cover a wide array of demands from patients, including wellness, rehabilitation, post-operative care, post-hospitalisation care, community-based support systems, befrienders, and more.

What are some challenges you face working in healthcare? How do you overcome these challenges?

For surgeons, some advanced surgeries are extremely complex and challenging. Though science and technology has advanced, practising medicine and surgery is still an art. It requires synthesis and application of theoretical knowledge, and also uniquely-human capabilities. For example, operating on a cancer patient may affect many different organs and thus requires a huge team of many different specialists. Not only is the surgery itself an uphill battle, working together cohesively in a large team is also tricky. Post-operation, the patient may even require a plastic surgeon because of the large cavity opened up, and a dietitian for follow-up care. The experience is tough for the patient, challenging for the surgeons, but rewarding because the patient is given a new lease of life.

More generally, the healthcare system is facing a manpower crunch. For instance, we are stretched for nurses. This is partly due to societal perceptions of nurses, whose jobs are often seen as laborious, tough, and underappreciated. There is an ongoing campaign to attract more to join the nursing profession, and the sector has also been working on emphasising the pathways for career development. This involves highlighting the experience of veteran nurses rising through the ranks from direct nursing work to heading policy and administration work. More generally, HR has also been looking at optimising every healthcare worker, not just nurses. This process includes redesigning career ladders, and equipping more healthcare workers with additional competencies to boost their sense of value-addedness.

Sometimes motivation dips occur, such as for those working in healthcare policy, where they are many steps removed from the physical delivery of healthcare, and where it may take years for them to see the fruits of their labour. They not only have to be patient, but also resilient, as not every policy they research and prepare eventually gets implemented. In such occupations, it is important to be motivated by the greater good, to remain cognisant of the lengthy but worthy payoff duration, and to also get a kick from solving challenging problems. These will allow you to remain excited by your work.

Frontline healthcare workers, in contrast, may face burnout for a multitude of reasons. Firstly, there are many fears associated with being a frontline healthcare provider: the fear of making mistakes, of possessing inadequate knowledge, and of compromising the health of oneself and loved ones due to infection during pandemics. Secondly, healthcare workers also constantly worry about ethical questions, such as how to care for each patient equally. Thirdly, healthcare workers have to handle distressed relatives and resolve conflicts on top of their everyday tasks. Finally, the COVID-19 pandemic has accentuated existing challenges for healthcare workers. On the one hand, they have to constantly put on highly uncomfortable personal protective equipment (PPE) while at work. On the other hand, even when commuting to and from work, they might be stigmatised on public transport. All these factors aggravate the feeling of being fatigued, stressed, and overwhelmed.

Yet, in the face of burnout, healthcare workers push on because they want to make a difference by serving the vulnerable. To get through tough times, they have created systems for workplace well-being. At an individual level, they remember to take time out for their hobbies. More generally, our healthcare workers continue to find strength in their colleagues and in their common core mission.

What are some upcoming trends in healthcare?

With the progress in healthcare technology, engineering is likely going to become more important in the industry. It is anticipated that Big Data and telemedicine will grow in a big way, but so will the appetite for cybersecurity regulation and licensing, such as the Personal Data Protection Act.

To meet the healthcare challenges of the future, employers may also be increasingly looking out for people adept in design thinking, systems thinking, and human factors knowledge. There is also a need for good writers to serve as policymakers.

How can youths get started with working in the healthcare sector?

Due to the pandemic, clinical attachments have been scarce, in order to protect participants from infection. Nevertheless, a good tip would be to proactively check the websites of healthcare organisations you are interested in for opportunities like internships.

Local hospitals do offer opportunities like management associate programmes and graduate traineeships, which allow participants to rotate among different teams and grow as healthcare administrators.

These opportunities provide participants with a safe environment to have a taste of the work in healthcare, and are often open to people from all backgrounds, not just those with healthcare-related credentials. You may be assigned a peer mentor or coach, attend sharings by industry veterans, and even have dialogues with senior leadership of the organisations.

Youths interested in joining the healthcare sector should start studying the multitude of tradeoffs inherent in healthcare, as well as creative ways to defy traditional tradeoffs. Employers may be more interested in hiring you if you have a firm grasp of healthcare concepts, even if you are not skilled in the nitty-gritty, because those can be learnt on the job. An intuitive understanding of costs and tradeoffs in healthcare, however, takes longer to develop.

Do you have any advice for those considering a career in healthcare?

First, do not be afraid to try out the industry, but eventually you will have to ask yourself whether you are willing to make the sacrifices necessary in this line of work. Everyday sacrifices made by healthcare frontliners include working shifts on public holidays and missing precious milestones like birthdays. Commitment to the greater cause matters.

Second, if you have passion for the job, and if you like the team you work with, burnout becomes less likely, and you will be more willing to make the necessary sacrifices. Being passionate makes it easier to achieve work-life harmony.

Finally, on-the-job learning is important, so be willing to learn and adapt. This definitely requires resilience, so learn to enjoy solving problems in teams.