The General Medicine Clinic at TTSH

In today’s era of medical sub-specialisation, the General Medicine Clinic continues to play a relevant role in providing a secondary level of care in the clinical evaluation and management of patient profiles deemed too complex to be handled by the primary care practitioner.

At Tan Tock Seng Hospital, the General Medicine Clinic offers medical consultation for adult patients over a wide variety of conditions.

As the general medicine specialty traditionally adopts a broad perspective, it is well-poised to manage patients with undifferentiated and multiple co-morbidities, requiring further evaluation and management. Thus, the clinic referrals can be classified into two broad categories.

1) UNDIFFERENTIATED CONDITIONS

Undifferentiated conditions include clinical problems such as involuntary weight loss, dizziness, lower limb edema, anaemia, prolonged fever, polypharmacy as well as abnormal laboratory results that need further workup. Some examples are persistent electrolyte imbalance and proteinuria.

2) DIFFERENTIATED CONDITIONS

Differentiated conditions of moderate severity which are difficult to control for various reasons can be referred to our clinic for further evaluation and management. Hypertension, diabetes mellitus, hyperlipidemia and chronic kidney disease (stage 3 and below) are some examples. Organspecific diseases of a more severe stage may be more appropriately managed at the respective subspecialty clinic.

When the above-mentioned disease entities cluster together in a single patient, especially in the presence of progressive target organ damage, management can be complex and may warrant referral to our clinic. Collaboration with other sub-specialties as well as allied health departments are considered in order to manage the patient holistically and expediently.

Complex cases with multiple disease entities also fall under this category when two or more of the above conditions require collaboration with other specialties as well as allied health departments to manage the patient in a more holistic manner.

In addition, there are also clinics of special interest within the Department of General Medicine.

  • Hypertension Clinic Possible secondary, resistant and difficult to control hypertension cases can be evaluated and managed.
  • Vascular Medicine Clinic Venous thrombosis and peripheral vascular diseases are diagnosed and treated.
  • Perioperative Medicine Clinic Uncontrolled medical conditions such as hypertension and diabetes mellitus are optimised before operation.
  • Obstetric Medicine Clinic In KK Women's and Children's Hospital, chronic medical conditions such as diabetes, hypertension and asthma are monitored and managed closely before and during pregnancy as well as postdelivery.

It is the goal of the General Medicine Clinic to discharge the patient to primary care, once the clinical evaluation is completed and the subsequent management of the patient is stable.

 

Dr Teong Hui Hwang is a Senior Consultant in the Department of General Medicine in Tan Tock Seng Hospital. She obtained her M.D. (with distinction) degree at the University of Alberta, Canada and became accredited as a specialist in internal medicine with the Specialist Accreditation Board, Singapore in 2002. She has a special interest in the field of hypertension.



Dr Adeline Chin is a Senior Registrar in the Department of General Medicine in Tan Tock Seng Hospital. She graduated from Universiti Kebangsaan Malaysia in 1993 and obtained her MRCP (UK) in 2003.