In order to provide continuity of care, ensuring universality and equity of care and optimising efficiency in health services, doctors, nurses, pharmacists and other healthcare workers need to break down silos and work as a team in the healthcare system, i.e. to build a model of Integrated Care System.  They need to team up with social workers and volunteers in order to “engage” individuals in their neighbourhoods, educate them about health issues and encourage them to comply with health recommendations. In all these endeavours, primary care doctors play a critical role on centre stage. They are the ones coordinating teams of healthcare workers to reach out to the public, community centres and beyond. They orchestrate the teams and triage patients to the right experts, the most appropriate investigations and treatment centres, in the most efficient and cost-effective manner. Nurses, particularly community nurses, will also be instrumental in delivering care in the community, guarantee continuity of care, and training individual families to look after their sick loved ones at home. In this new shift, digitisation of health data and medical knowledge will help to educate the public and ensure equity of healthcare. 

What does this mean to our medical school and medical students? If this movement is successful, sweeping through different jurisdictions around the world, there will be a fundamental change in the healthcare system. As a medical school, our teaching and research units need to be cognisant of the changes and prepare our future doctors accordingly. Healthcare ethics and patient behavioural science need to be emphasised. Technology will be used in patients’ home to empower them to take care of themselves. The current funding model and resource allocation need to be revamped. Last but not the least, our medical students need to be prepared to work in this new system. 

All these changes are certainly coming to our society. With the health budget in Singapore spiraling every year; with the Ministry of Health about to launch the Healthier SG transformation in the near future; with the change of funding models of hospitals and the public healthcare system, we are going to see many changes in the local healthcare landscape. As a future doctor, paying attention to what is coming in the medical and health services is important. I urge you to learn and practise working with nurses and the allied healthcare workers as a team. I would like to nudge you to think about healthcare for the elderly with multi-morbidity of chronic illness. Medical silos need to be removed. Major changes of healthcare is coming. Fasten your seatbelt and brace yourself for a rapidly changing world.