ORIGINAL ARTICLE
Qualities of a good Singaporean psychiatrist: Qualitative
differences between psychiatrists and patients
Phern-Chern Tor
1
MBBS MMed (Psy) &
Jacinta O.A. Tan
2
MBBS MA (Oxon) MRCPsych (UK) MSc (Child Health distinction) (Warwick) DPhil (Oxon)
1 Department of Psychological Medicine, National University Hospital, Singapore, Singapore
2 College of Human and Health Sciences, Swansea University, Swansea, UK
Keywords
Asian, psychiatry, qualitative, quality, Singapore
Correspondence
Phern-Chern Tor, MBBS, MMed (Psy),
Department of Psychological Medicine, National
University Hospital (S) Pte Ltd, 5 Lower Kent
Ridge Road, Singapore 119074, Singapore.
Tel: +65 67 795 555
Fax: +65 67 795 678
Email: torphernchern@gmail.com
We declare that this thesis is an original work
and has not been published or submitted
elsewhere.
Ethical approval was given by the NHG Domain
Specific Review Board reference A/10/237.
Conflict of interest: We declare that we have
no relevant conflict of interest.
Author contribution: Both authors
contributed equally to study design, data
interpretation and manuscript preparation, and
are in agreement with the content of the
manuscript.
Received 5 January 2014
Accepted 3 July 2014
DOI:10.1111/appy.12149
Abstract
Introduction: Pilot studies in Singapore established four themes (personal
values, professional, relationship, academic-executive) relating to the
qualities of a good psychiatrist, and suggested potential differences of
opinion between patients and psychiatrists. We sought to explore differ-
ences between patients and psychiatrists regarding the qualities of a good
psychiatrist.
Methods: Qualitative analysis of interviews using a modified grounded
theory approach with 21 voluntary psychiatric inpatients and 18
psychiatrists.
Results: One hundred thirty-one separate qualities emerged from the
data. The qualities of a good psychiatrist were viewed in the context of
motivations, functions, methods, and results obtained, mirroring the
themes established in the pilot studies. Patients and psychiatrists mostly
concurred on the qualities of a good psychiatrist, with 62.6% of the
qualities emerging from both groups. However significant differences
existed. Patient-specific qualities included proof of altruistic motives, dili-
gence, clinical competence, and positive results. What the psychiatrist
represented to patients in relation to gender, culture, and clinical prestige
also mattered to patients. Psychiatrist-specific qualities related to societal
(e.g. public protection) and professional concerns (e.g. boundary issues).
Discussion: The results of this study demonstrate that patients and psy-
chiatrists have different views about the qualities of a good psychiatrist.
Patients may expect proof of care, diligence, and competence from the
psychiatrist, along with positive results. In addition, psychiatrists should be
mindful of what they represent to patients and how that can impact the
doctor–patient relationship.
Introduction
Singapore is a small city state (710 km
2
) on the tip of
the Malaysia Archipelago and one degree north of the
equator in South-East Asia. It has a population of 5.3
million people consisting of three main ethnic groups
(Chinese, Malay, and Indian). Its official language of
business and education is English, and the literacy rate
is 96% (Department of Statistics Singapore, 2012).
While there is much consensus in published
Western literature regarding the core qualities of a
psychiatrist (Royal College of Psychiatrists, 2009;
American Psychiatric Association, 2010a,b; Royal
Australian New Zealand College of Psychiatrists,
2010), there is only preliminary evidence that patient
and health care provider views on medical care in Asia
differ significantly (Pang, 2008), while the challenges
facing psychiatrists in Asia are similar (Chong, 2007).
A pilot quantitative survey (Tor et al., 2009) was
conducted to look at the qualities of a good psychia-
trist in Singapore, which showed that there were four
main themes for the qualities of a good psychiatrist
(in order of importance): professional qualities, per-
sonal value qualities, relationship qualities, and
Official journal of the
Pacific Rim College of Psychiatrists
Asia-Pacific Psychiatry ISSN 1758-5864
135 Asia-Pacific Psychiatry 7 (2015) 135–142
© 2014 Wiley Publishing Asia Pty Ltd