31 Aug 2011
By: POON CHIAN HUI
AT LEAST three public hospitals have drastically reduced the time taken to treat people who go to their accident and emergency (A&E) departments for non-urgent back and neck pains.
At Singapore General Hospital (SGH), National University Hospital (NUH) and Changi General Hospital (CGH), a doctor will call for a physiotherapist if a patient is deemed suitable for early therapy.
This is unlike other public hospitals, where patients with such non-urgent pain would first see the A&E doctor to get an appointment to consult a specialist at a later date. The latter would then refer the patient to a physiotherapist.
SGH principal physiotherapist Irene Toh said the process could take up to a month before the patient sees a therapist and gets pain-relieving treatment.
The early intervention, which helps patients recover faster, is meant for those with back and neck pains that are not serious enough for immediate action such as surgery or hospitalisation.
Ms Toh said these people might still find it hard to cope with the pain while they wait for an appointment to undergo therapy. For example, they may find it difficult to walk or may experience pain when sitting or standing.
At SGH, which rolled out the service as a pilot project in June last year, the therapist will, after assessing the injury, apply remedies such as heat or ice. He will also take the patient through exercises.
NUH was the first among the three to tackle the problem in 2008.
Its rehabilitation department senior manager Frances Hew noted that this helps to prevent an injury from escalating into a chronic pain condition.
This translates into savings for the patient too.
“Once the problem becomes chronic, it takes longer to get better. This will cost the patient more,” she said.
Patients also learn how to avoid aggravating their injury at home or at work.
According to an SGH study of 125 patients, many recover faster. Those who took up the new service were compared with patients who did not. They were assessed four to six weeks later, when they had to return to the hospital to see a specialist.
Those who received physiotherapy on the day of their A&E visit scored 20 per cent to 30 per cent better on a disability scale rating their ease in performing daily activities.
Some ended up requiring fewer therapy sessions, while others even cancelled specialist appointments as they had recovered, said Ms Toh.
Faster recovery also means hospitals get some relief from the severe bed crunch they currently face. It was reported yesterday that several hospitals had to resort to borrowing ward space at other places, like community hospitals, to house their patients.
At CGH, 58 A&E patients got early physiotherapy under the initiative, which started last October. Only six of them had to be hospitalised, said Ms Elaine Gomez, manager of CGH’s rehabilitative services.
“Previously, all 58 would have been admitted,” she said.
At all three hospitals, patients pay a regular A&E fee of about $80, and extra for the therapy they get.
At NUH and SGH, the treatment fee ranges from $30 to $50. At CGH, it costs $80.
For Ms Melissa Lai, it was money well spent.
The 20-year-old polytechnic student fell and hurt her spine last week. She visited a hospital’s A&E ward and was told she could consult one of its physiotherapists only two weeks later.
“I couldn’t wait for two weeks,” she said. “I was crying in pain – I couldn’t walk, sit down or sleep properly.”
Two days after the fall, she sought help at SGH’s emergency ward, where she was attended to by a physiotherapist. The latter applied electrical stimulation, which helped to block the pain, and taught her to perform some simple exercises.
The effects were immediate. Ms Lai, who ranked her initial pain as a “nine out of 10”, said it became a “five” after the 45-minute session.
The visit cost her about $120 in all.
After another two sessions – paying only the treatment fee – with the same physiotherapist within a week, she is now as good as new.
“I was supposed to have one more session, but I have totally recovered,” said Ms Lai. “I didn’t expect to recover in less than one week – I thought such injuries take at least two weeks to heal."
Email: chpoon@sph.com.sg
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