SINGAPORE MEDICINE 40 Years of the Singapore Medical Association Editorial: Singapore Medical Journal 1999; 40(04). by Kenneth Lyen Over the past forty years, the practice of medicine in Singapore has been transformed profoundly. In 1959, poor children ran around muddy kampongs barefoot, and malnutrition still existed. Medical services were focused on providing basic no-frills primary care. A general practitioner could see over a hundred patients a day. Sometimes in the middle of the night, the general practitioner might be asked to make a house call to places as far away as Jurong, which involved driving for more than an hour through the swamps over unlit bumpy roads. Destitute patients who could not afford to pay for medical services sometimes paid in the form of farm produce, like poultry or eggs. It was in this climate of medical practice, that the Singapore Medical Association and its mouthpiece, the Singapore Medical Journal, was born. Over the past four decades, the increased economic prosperity in Singapore, more than anything else, has resulted in a healthier population. Universal immunisation, improved sanitation, water supply, and a slew of newer medicines have also contributed to this improved health. Hitherto common diseases such as tetanus, polio, tuberculosis, kernicterus associated with glucose-6-phosphate-dehydrogenase deficiency, have become virtually eradicated. The Singapore Medical Association has always tried its best to represent doctors’ interests. As the concerns of both doctors and their patients are so closely intertwined, the Association has always given patients’ interests equal attention. Furthermore, the Association has always maintained good relations with the Ministry of Health. Over the years, it has evolved to better represent the sentiments and aspirations of its members. Today, the Singapore Medical Association has emerged to become the undisputed single body that best represents doctors’ interests and opinions. Forty years have brought us to the brink of a new millennium. What does the future hold? In a world of blindingly rapid changes, the Singapore medical profession must be able to assimilate new technologies sensibly, without profligate spending that could drain away scarce resources. As knowledge becomes more readily available, and patients have easier access to information, the role of the doctor must be secured by adhering to its fundamental strengths, which are to provide prompt and personalised services when called upon, and to remain a friend, counsellor and guide to one’s patients. New medical and technological developments will inevitably generate fresh ethical dilemmas for doctors to ponder. In this, the Singapore Medical Association is best placed to discuss and meet these challenges. If the past is a guide, then the future for the Association promises to be bright and successful.