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Dr. Steven Tucker is an American physician living in and practicing medicine in Singapore. He currently focuses on adult general medicine and cancer treatment, and is an expert in medical technology and digital health.

What are some of the major differences you have found between practicing medicine in Singapore and the U.S.

Practicing medicine in Singapore is nearly identical to practicing in the U.S.. We have the same tools, tests, and medications. However, relationships between doctors and patients can be somewhat different. In the U.S., patients increasingly use the Internet to access medical information, and there is a longer history of shared decision-making between doctors and patients. The same is not true in Singapore or Asia, where the traditional, paternalistic role of the physician is predominant. In both countries, though, I think it is important that physicians state opinions and let patients know what they feel is best for them.

How has healthcare changed in Asia since you first arrived

I arrived in Singapore in 2006, and healthcare has progressively changed, with the most significant change being the advent of the Internet. My practice style encourages patient engagement and empowerment, so I welcome patients who use, and even mis-use, the Internet. The key to using the Internet for health is understanding how to use search terms and the difference between using the Internet for diagnostic purposes and information mining when a diagnosis is certain.

The other major change since I arrived is that we rely heavily on mobile communication because patients visit Singapore from countries all over Asia, Russia, and the Middle East. Early on, thousands of patients from Indonesia communicated with their doctors solely through Blackberry Messenger. WhatsApp is another popular communication tool between doctors and patients. Given that most patients pay directly for their medical care in Asia, there is an expectation that the doctor is readily available, and in fact, many of us provide our mobile numbers and email.

Have Health Web 2.0 tools helped you improve the quality of care you provide?  If so, how have you used these tools to scale or expand

I use a variety of mobile tools to communicate with patients. I am very fond of Twitter as a health and medical education tool. It’s an excellent platform for listening to what is happening in the patient community.

We keep up-to-date with information on wellness, diet, activity, sleep, mindfulness, and oncology, using free web tools. I use a variety of sources to gather this content, which is streamed directly to the site. It is an incredibly efficient way to disseminate information and this is content I think my patients enjoy. The advent of wearable technology and photo-sharing also makes me a more communicative doctor. We do not provide medical advice via open forums but use social media platforms so that patients can reach out to us and then be redirected appropriately into more secure health communication channels.

What have been the most exciting advancements in oncology treatments in the past few years for you

What I am most excited about in oncology is not treatment, but prevention. I am a big believer in individualized therapy and wellness, and do a lot of work around genomic profiling. I see a lot of women with hereditary breast and ovarian cancer, and increasingly, we have identified women with moderate-risk breast cancer genes and have begun to consider screening and prevention strategies for these patients.

Most lifestyle-associated cancers, including breast, prostate, and colon are strongly associated with sedentary lifestyles, obesity, poor diet, and sleep disruption. We leverage mobile and wearable technology, as well as frequent laboratory testing, to spur behavior change, which improves wellness and reduces the risk of cancer. These programs are individualized and can tailored around the presence or absence of hereditary cancer genes, such as BRCA1 and BRCA2.

What is the mobile culture in Singapore or Asia like? How are mobile devices and behaviors different inside and outside of medicine

Mobile culture in Asia is definitely well ahead of North America and Europe in my experience. Our patients have been using instant messaging and SMS for many more years than the U.S.. Additionally, while HIPAA was developed with great intent, the reality is that it seems to be a barrier to direct communication. Singapore has its own version of HIPAA, but doctors and patients are free to communicate via text message or any electronic medium, so long as there is consent.

Follow Dr. Steven Tucker on Twitter here: Steven Tucker

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