Yours Toothfully by Dr Chan Joon Yee

It’s the Hungry Ghost Festival now and some people seem to have forgotten that living people get hungry too. Anaesthetist Dr Kelvin Ngiam told me that many surgeries have been cancelled, but over at my end, I’m seeing a record number of wisdom tooth surgeries - the kind of treatment that sees the largest number of no shows.

Last week, someone called up on the phone, wishing to see us urgently at 1.00pm that day. From experience, lunchtime appointments are terribly unreliable. People are often very happy that they can book an appointment at lunchtime, but they don’t value the opportunity. From experience, most of these folks would take their time to enjoy their lunch and before they know it, it’s time to go back to the office and the poor folks who expect them to turn up would be sitting through lunch on empty stomachs.

Sometimes, these folks turn up way past lunchtime and ask for MCs or time chits. If they are not so busy that they can only come at lunchtime, why bother to book their appointments during lunchtime and deprive others of their lunch? After years of research on hundreds of subjects, I’ve come to the conclusion that some folks just love to indulge in the pleasure of being able to book a appointment at an unusual time. I figure that any clinic that offers midnight appointments will be full of appointments and no shows. Unlike airlines where you pay to book a seat, booking for dental appointments is free. The more convenient it is to book an appointment, the higher the chances of no shows. Computer geeks who try to sell me software that allows people to book my time as they would book air tickets have no idea how people behave.

In spite of all the bad experience, I waited for that patient as she sounded very genuine. We tried to call to remind her when she didn’t show up after 1.00pm. Well, she didn’t bother to answer her phone. Many of these folks actually deliberately turn off their phones to avoid being reminded and my growling stomach realised too late that this genuine sounding patient was no exception to the rule.

Fortunately, if you can say that being one hour late is better than never, the patient showed up at 2.00pm and I was starving. To restore mental equilibrium in these cases, I have to charge more. Yet, I find it strange that empathy seldom ends up at the receiving end of such abuse. Whenever I relate such incidents to people who are never at the receiving end, they seem to be surprised that we are annoyed with these people.

“Maybe they have something urgent to attend to. Have some compassion.”

yao mo gao chor ah? Compassion for the inconsiderate folks who cause others to suffer? Every one of those who failed to show up and ensured that they were not contactable by switching off their phones or not answering had something urgent to attend to? I’m totally compassionate towards anyone who has something urgent to attend to. Even if he says that he suddenly remembers it’s his grandmother’s birthday. But empathy or compassion comes only after I have confirmed the extenuating circumstances.

Imagining extenuating circumstances against all the odds is called foolhardy and I wonder if the the folks who appear to forgive everyone who is patently inconsiderate by imagining extenuating circumstances on their behalf really practice foolhardiness in their daily lives. Yeah, maybe this and maybe that.

Life is short. Spare me all the maybes.

We are a Medisave accredited day surgery centre.

Everybody wants to announce that after going through all that paperwork, briefings, training etc to become a Medisave accredited day surgery centre. Why do we go through all that trouble? Well, being able to draw from the patient’s Medisave to pay for surgical treatment is really cool. The patient is happy to tap into frozen savings, not having to pay cash and day surgery centres offering these services can look forward to better business from patients who may find it difficult to pay hundreds of dollars in cash. It’s a win-win situation.

Sure, the number of surgical cases rose after we became Medisave accredited. But along with those minority of genuine surgical cases, came a majority of irritating enquiries.

“Wa, your clinic accepts Medisave payment ah? Good wor. Ei, I do scaling can use Medisave or not?”

“For surgery only. Here is the list http://luckyplazadental.com/medisave/”>

“Scaling cannot ah? The filling can or not?”

“Please check the list of surgical procedures that are covered.”

“Filling also cannot ah? Then braces leh?”

“…………”

It happens on the phone, it happens at the reception counter and it happens especially in email enquiries. Certainly, these people must either have seen the We are a Medisave accredited day surgery centre. sign at our clinic or saw our webpage with a list of claimable surgical procedures. So why do they still ask us these questions?

“Crown can or not huh?”

“Root canal can or not huh?”

As we receive more and more of these emails, we become more and more convinced that Singaporeans are becoming functionally illiterate. Is the word “surgery” such a piece of proprietary jargon that laymen can be excused for not knowing what it means? That’s obviously not true. Whenever we mention surgery to someone with an impacted wisdom tooth, he/she runs for the door. So why don’t people understand what surgery means when they see the word Medisave? Does seeing the word Medisave diminish one’s ability to read?

Perhaps it’s a little like the Hokkien pengs of yester-years who didn’t understand any orders in English except “book out”. Or could all these irritating enquiries come from spies acting on behalf of competitors who just want to see us wasting our time explaining to fake patients who pretend not to know? We may never know the source of the problem, but literacy aside, anyone not willing to pay for something not claimable is obviously not a very good patient to begin with.

“Hello, Tan Ah Kow si bo?” [is that Tan Ah Kow]

“Wa see. Lee siang?” [that's me. who is this?]

“Wa see Dr Chan.” [I'm Dr Chan]

“Si mi Dr Chan? Ban kee ei si bo?” [what Dr Chan? Pull teeth one is it?]

“#$@%&^!

Yes, it must be one of those nightmares recalling those years in Hougang. We didn’t exactly breeze through dental school. We had a hard time with patients who didn’t trust us. We were give a hard time by lecturers who probably believed in no pain, no gain.

I remember how absolutely ecstatic I felt when MOH staff first addressed me with a Dr in front of my name. In the Army/Navy, it was “sir” here and “sir” there. I really looked forward to private practice, but alas, the “Drs” and “sirs” suddenly disappeared. Instead, heartlanders from Jurong to Hougang called me “ban kee ei”. It didn’t matter that my name was on the cards and the wall. I was still addressed as “ban kee ei” and like a “ban kee ei”, I was sometimes treated like a barber, sometimes like a char kway teow man and sometimes even like a maid.

“Slope or straight? How you want your sideburns?”

That’s the sort of questions i had to ask my denture patients. Made to the patient’s order. Forget about designing dentures the way the school taught. The patient wants it his way, you’d better make it his way to avoid all the argument or worse, non-payment.

“Chilli or no chilli?”

You’d better follow the patient’s taste. Don’t argue if they insist on chalky white teeth.

“I lazy to brush. Clean my teeth for me.”

That’s when you’re treated like a maid. It doesn’t matter if my teacher told me so proudly that we are consultants and educators of oral hygiene and not teeth-cleaners. In private practice, you clean teeth for a living.

It’s been more than 20 years now. I’m quite used to all that abuse. But one that I still can’t get over, is being called “ban kee ei”. I think there should be a law that punishes people for calling dentists “ban kee ei”. Fine? Imprisonment? Caning? No, that would be too light. Let’s implement a form of punishment called TAGAD. Anyone found guilty will be barred from all dental clinics in Singapore. All dentists here will not be allowed to treat them and they are not allowed to even step into a dental clinic for a period of 10 or more years depending on the severity of the offence.

What happens if they get a toothache while on TAGAD? Well, that’s what TAGAD is for. ToothAche Go And Die.

Yes, it should be “how would I know?” in English, but a direct translation from proper Chinese 我怎么知道?, Singaporean Hokkien: “wa mana ei zai?” or Thai : “ja roo dai yung ngai” would be “how I know?”.

Like “how would I know?”, all the remarks above are often made in indignance or denial of responsibility. Sometimes, such denial is fair. For instance:

“How would I know you would come visit me if you didn’t call beforehand?”

“How would I know there is an appointment if you didn’t tell me?”

“How would I know you were standing behind the curtain?”

“How would I know you were sleeping under the car?”

When you do things or make plans that others cannot reasonably expect to do or plan, “how would I know?” is a reasonable response from them when something undesirable or disastrous happens.

But there are also instances where “how would I know?” is unreasonable. There are too many of such examples in my daily activities and encounters. Indeed “wa mana ei zai” is not a good excuse when such things are common knowledge. Of course, we can’t know everything; not even if it’s common knowledge. When these gaps are identified, the best thing we can do is to acknowledge our lack of knowledge, learn it, remember it and move on.

Of course, issues concerning “face” and “ego” affect everyone. We all feel good when our egos are stroked. We all feel unpleasant when we are embarrassed. Such feelings are universal. Not so universal, however, is the typical response from people whose egos are bruised. In some societies, including certain levels of our own society, shocking violence may greet a person who has not show respect for someone’s “face” or “ego”. Identifying and bringing someone’s mistake or shortcoming to light is sometimes viewed as an unforgivable sin. Simply criticising someone or forcing him to admit a mistake can result in extreme violence.

When dealing with these individuals, it would be wise to just walk away when they say “how I know?” when their mistake has been pointed out. Pursuing further for an apology may result in the scene above.

On a milder yet no less extreme and unreasonable note, there are cases where the ignorant control freak decides and dictates what everyone can do or can’t do and then turns around to shirk all responsibility when it turns out that their decisions have not been that good.

“This is your plan. Your idea. Look what’s happened.”

“How I know?”

“You insisted on this and that, threatening when it’s not done according to your wishes. Look what has happened?”

“How I know?”

Huh? Shouldn’t you be listening to others and not throw tantrums at people who may know better because they have been in the business for decades?

“How I know?”

Push it at your own risk.