A Day in The Life of A Singapore ENT Specialist

Do you ever wonder what happens in a “typical” day of a top Ear Nose Throat (ENT) specialist in Singapore? That’s the funny thing, no day is quite the same for me as an ENT specialist because every patient we see and treat is completely different, even though they might seem to present with the same set of ENT symptoms! I see my ENT patients at both Mount Elizabeth Novena hospital and Gleneagles Hospital in Singapore. So our patients have the flexibility to be treated at both these easily accessible ENT clinics in Singapore. They can also choose where to have their ENT surgery: Some patients prefer Gleneagles Hospital because Gleneagles is closer to their home while others may prefer Mount Elizabeth Novena hospital because it appears newer!

So what usually happens first thing in the morning in my line of work as an ENT specialist in Singapore? I wake up, get dressed and drive to one of the above hospitals to check on my ward patients who have been admitted for elective Ear Nose Throat ENT surgery or who have been admitted urgently for ENT conditions which have made them sick enough to go to A&E. After examining my patients and giving the relevant treatment plans to the ward nurses, I then head down to our top ENT clinic in Singapore to start seeing new and followup patients with my clinic nurses. New ENT patients in Singapore need to be carefully assessed with a thorough history taken from them followed by a detailed examination to then decide what the next course of action is e.g. Do they need a scan like a CT of their sinuses or an MRI scan of their inner ears? Do they need allergy testing to investigate their blocked runny nose, sneezing and watery eyes? Do they need an accurate hearing test which we easily do in our clinic as part of the hearing workup? We always try to arrange all the investigations on the very same day in the very same place to save our patients time and hassle: We know you’re all very busy people!

When we see our followup patients, we want to check if they are feeling better on the course of medications that we prescribed for them at the first appointment. We may also review any outstanding test results with them to decide if further tests are necessary. Sometimes, if the medications we gave them don’t seem to be helping much, then we may have to consider surgery as a way to treat their Ear Nose Throat condition. For example, if a ruptured eardrum fails to heal and keeps on becoming infected, then surgery to repair the eardrum “hole” is indicated to give a dry safe ear to prevent further ear infections. If someone finds it difficult to breathe through their blocked nose, then they may need surgery to unblock the swollen tissue inside their nose and correct any deviated nasal septum (crooked bones inside the nose). If someone keeps falling ill with severe sore throats, then he or she may benefit from having their tonsils removed (tonsillectomy). It really depends on what their symptoms are and how badly they are suffering!

On some days, we go to the operating theatre to perform surgery on patients who have not improved on medications. I get changed into a clean scrub suit, put on a special cap to shield my hair and change to clean comfortable shoes. Depending on the type of case, it also means checking and re-checking that all the equipment I need is available and in good working order! There’s nothing worse than having the light bulb in the microscope suddenly go out halfway through operating on somebody’s ear (yes, that has happened to me before….)

For sinus surgery, we have to check that the CT scan is all ready to help us plan the surgery with an Image Guided System (IGS), kind of like a GPS map for your sinuses. For ear surgery, we also need the facial nerve monitor which is an alarm system that beeps if we come near the important facial nerve when operating in the ear. I like to bring in my own special set of ear instruments when operating because sometimes, these are not available in the sets provided by the hospital. For throat surgery eg tonsils and adenoids, we make sure that the coblation system is ready for us to use: A special electric current bathed in cool saline to help us cut soft tissue without causing too much heat damage. The list of things to check and prepare sometimes seems endless…..but it’s all part of being a safe and competent ENT surgeon.

After the ENT surgery is completed, we then go over to the recovery area to check on our postoperative patients to make sure they have woken up well after surgery. Then we seize the opportunity of 15-20 minutes to quickly grab a well-earned bite to eat (and the obligatory cup of tea!), before heading back to the ENT Clinic to continue seeing patients there. We don’t always get this lunch break though and sometimes, it’s tough not to be able to have lunch till after 2 pm, trying to gobble down something in 5 minutes before starting the busy afternoon clinic.

Not forgetting of course, there is often a lot of paperwork to plough through and finish off e.g. memos to write for patients, insurance forms to fill in for patients to proceed with their claims, medical reports to write, medicolegal reports to complete for court cases and accident-related cases, answering numerous emails from patients, families, insurers, colleagues, other specialists etc.

I usually finish my day by about 5.30pm but sometimes, if I am on-call covering for ENT emergency cases, then I may still have to continue working to see both adult and children patients who present with ENT illnesses or trauma in the Accident and Emergency department of either Mount Elizabeth Novena hospital or Gleneagles hospital.

And what about working during the weekend? Our ENT clinics are usually open on Saturday mornings too in addition to the usual weekday working hours: Saturdays seem to quite popular with patients, probably because people have to work on weekdays and can’t find the time to come have their ENT conditions sorted out with us. Even on Sundays, I may still have to come in to see ward patients or ill patients who are not yet ready to be discharged home yet.

Sometimes, we have to appear in court as expert witnesses for ENT medicolegal cases or to provide professional opinions on different perspectives of eg. accident-related cases which have caused tinnitus, dizziness, headaches, fractures of the nose or ear bones. This adds a refreshing note to my regular line of work: After all, variety is the spice of life 🙂

Ultimately, no patient is exactly the same. Every single patient has a valid unique concern for us to listen to and try to help them deal with: That’s really what makes being an ENT specialist in Singapore interesting, exciting and enjoyable. I love my job: Hear well, breathe well, live well!

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