Dear Fellows and Members of the Academy,

Over the past few weeks, AMS has successfully conducted its Annual General Meeting and Elections for the office of Master-Elect.

God willing, I will have the honour of serving as your Master till mid-2028.

We extend a warm welcome to the following new Council Members:

NEW ELECTED COUNCIL MEMBERS	DESIGNATION
Dr Ho Choon Kiat	Censor
Dr Chua Wei Chong	Censor
NEW APPOINTED COUNCIL MEMBERS	DESIGNATION
Dr Lee Tze Wee	President, College of Anaesthesiologists
Dr Mohanarajah S/O S Senathirajah	President, College of Dental Surgeons
Dr Jason Lim Shau Khng	President, College of Obstetricians and Gynaecologists
Dr Ng Chee Eng David	President, College of Radiologists
Dr Matthew Yeo	President, College of Surgeons
Dr Giles Tan Ming Yee	President, College of Psychiatrists
Dr Roger Foo	President, College of Clinician Scientists
Dr Ling Moi Lin	Chair, Chapter of Pathologists
Dr Faheem Khan	Chair, Chapter of Intensivists
Dr Wong Wei Mon	Chair, Chapter of Family Medicine Physicians

I wish to put on record my appreciation to the Council members who have retired, in particular, to past Master Alan Ng and past Assistant Master (Administrative Affairs) Ho Kok Sun for their sterling contributions to AMS.

The challenges that AMS face in the next 12 months are significant if not daunting. These include an increasingly difficult practice climate in the private sector for our specialists. The recent media coverage of an Integrated Shield Plan (IP) insurer withholding pre-authorisation from certain private hospitals and even removing doctors from preferred physician panels because they refuse to admit IP patients to the insurer’s preferred facility providers.

In this context, it is good and timely that the Minister for Health has recently pointed out in a 1 July 2025 Facebook post that private surgeon bills have increased by only 0.4% a year on average for the period 2019 to 2023. This annual growth rate of 0.4% is likely lower than general inflation in Singapore for the same period. I hope insurers reflect on this and do not take further steps to make life any harder for private specialists. It is also worth mentioning that private specialists’ fees should at least keep up with general inflation in the long run as growth of fees lagging behind general inflation for prolonged periods is not sustainable and conducive to the provision of good quality healthcare that Singaporeans deserve.

In the same post, Minister Ong has said that the “current situation…. is clearly unsustainable”. The current focus by insurers appears to be on facility providers and their charges, since private specialists’ bills are not even keeping up with inflation. But I would like to suggest that another area of focus could be the insurers themselves.

Insurers should be scrutinised for their management and distribution (i.e. mainly costs of paying financial advisors) costs. With a claims ratio of about 77% in 2024, (i.e. 77% of premiums collected go to paying healthcare providers for services provided), it can be argued that the IP sector is not cost-effective, i.e. too much of the premiums collected does not go to pay for healthcare provision but other things. In comparison, in America, Obamacare stipulates that the claims ratio of an insurer to be between 80% to 85%.

To address the current problems besetting the IP sector, we can adopt a two-pronged strategy. On one hand we need to look at ensuring the financial sustainability of the IP sector, on the other hand, we should also seek to improve the cost-effectiveness of IP as a health financing tool. The two are equally important.

Therefore, we should rightfully focus on facility fees now and also at the same time scrutinise how we can cut the management and distribution costs of IP insurers so that more money can be directed to raising the claims ratio to say, 80%, and in doing so, the IP sector can pay more for the actual delivery of healthcare to IP policyholders. Each party has to take some pain in the process, doctors (slower growth in fees), facility providers (slower growth in fees), insurers (Less money for management and financial advisors) and policyholders (more co-payment and deductibles).

Internally, the budget for this year for AMS is forecasted to run a deficit. This is not a sustainable trajectory for the long run. We will have to find ways to plug this gap through a combination of cost controls and revenue generation by various means, including considering seriously the option raising our annual membership fees. We have not raised our annual subscription fees for 26 years, since 1999. In hindsight, periodic modest increases would have been preferable. Persisting with annual deficits is not viable; as I highlighted in my first message: we risk courting the same fate as New Zealand Medical Association’s, which ultimately had to dissolve.

The core challenge for AMS remains that of relevancy to our Fellows. How does a professional guild like AMS remain relevant to specialists in Singapore when recognition of who is a specialist is now defined by statute and effected by a statutory body (Specialist Accreditation Board). This is a question that many Masters and Councils before the current one have had to grapple with. I believe that if AMS remains relevant, then the problem of financial sustainability of AMS will largely solve itself.

There is no magic bullet to this. Relevancy means more work. Each College and Chapter will have to work harder to deliver meaningful activities that our Fellows find relevant and exciting to be part of. And for the smaller colleges and chapters, they may have to reach out to a larger audience than their fellows.

A good example is the College I belong to – College of Public Health and Occupational Physicians (CPHOP). It is a relatively young college – The Chapter of Public Health and Occupational Physicians was formed in 1999 and it gained College status only in 2013.

Every year, the College organises an annual Public Health and Occupational Medicine (PHOM) Conference that is not only well attended by our Fellows, but by non-fellows as well: healthcare professionals involved in health administration and public and occupational health. This year, the College will hold its 19^th Conference. In recent years, the PHOM Conference has introduced a third track – Aviation Medicine in addition to Public Health and Occupational Medicine, which has also attracted its fair share of attendees.

The surpluses generated from the Conference goes to fund some of the other activities of the College, such as the annual Study Trip, which has also been well received. Fellows who go for the Study Trip get a grant of $500 while Ordinary Members (i.e. residents) receive a $200 grant from the College.

I have said at the last CPHOP AGM that one should not count that dollars and cents when one decides to join a professional guild such as AMS. Certainly, I have never done so, whether as a member of SMA or College of Family Physician Singapore (CFPS) or as a fellow of AMS. But for those who do, it would be abundantly clear that a CPHOP Fellow gets back more from the College than the $500  annual fees (plus prevailing GST) paid to AMS if he participates in most of the College’s activities.

Over the next 12 to 24 months, the AMS Council will look into how each College and Chapter can deliver relevancy to its Fellows if we are to remain true to what AMS was originally founded for: the collective professional advancement of the medical and dental specialist community in Singapore.

Relevance is survival.

Warm Regards,

Wong Chiang Yin

Master

Academy of Medicine, Singapore