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Public Health Spaces

Public Health Spaces

A Public Health Stranger in the Land of Medical Care

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Posted by Stewart Auyash at 8:42AM
Pain like a constant dagger in my back

I finally gave in and saw a health provider for my painful upper back. It felt like a bad stiff neck that normally would go away in a couple of days. Only it didn’t go away.

I made an appointment with an orthopedist. He had a tiny two room office in a fancy medical center complex. There was no examining table in the room only a bench. He spent about 3 minutes asking me questions and said I needed an x-ray, which I got immediately by going down the hall to an imaging clinic.  I waited for the results and they gave me the x-rays to take back to the doctor.

Back in his office, the doctor said that my problem was inflammation. He recommended an injection of shincort and a course of the medication celebrex. I  had never heard of shincort and asked him if it was like cortisone. He said it was a new and improved version. I am never eager to get invasive treatments, but I was in pain and desperate to heal (I signed up for a 168km bike ride at the end of the month) so I agreed to the shot as well as the celebrex.  He said I would see improvement in 3 days.

Before leaving his office, I paid the bill, which amounted to $350 US dollars. I do have insurance but I am not sure what they will pay given that this is Singapore. The bill included no diagnosis and no codes which are usually required by my insurer.

I was no better after 3 days so I decided to find a physical therapist. I’ve had mostly positive experiences with PTs in the US (some of whom are my colleagues at the College). They usually give me ultra sound, nerve stimulation, and exercises.  Here they are called physiotherapists. They are quite common but I could find none in the vicinity in which I live.  So I picked one based its website and on the ease at which I could get there (about 45 minutes on the bus/train).

In a few days I was a patient at a clinic where Sylvia examined me.  I told her the diagnosis the doctor provided but she didn’t fully agree. She asked me to lie face down on the examining table and started massaging and pressing my neck area. It was painful, but she said the massage would help and I told her to proceed.

After 10 minutes, she checked my next tightness and pain. It was less tight, but not good enough for Sylvia, so she pressed more. After 4 times of massaging and checking, she said that was all my neck could take in one session. She gave me a heating pad for 10 minutes and told me to return in a few days.  When I left the office, I could actually move my neck to the right without pain for the first time in a month.

Every day, my neck improved a bit more. I returned to Sylvia for another treatment and it improved further. I was a happy and recovering patient. By the way, each treatment cost about $56 and I don’t know what insurance will cover.  Most of all, I liked the hands on treatment – no machines- and I felt better.

I wanted to learn more about Singapore’s health system, but I didn’t think I would do it from a patient’s perspective.  In 2000,  Singapore’s health system was ranked 6th best in the world by the World Health Organization while the US was 37th. Check out ( or for a rock’n’roll version:

 I can move my neck but I hope I can ride my bike for 168km.

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