Speaker 1: Shanghai, September 26th, 1998, my parents awoke to faint cries between labor breathing from their first child. At 18 months old, I was dying, and they didn't know why. They rushed me to the only children's hospital still open. And that night, my mom never carried me in her arms for fear that I would just go. After a few hours, they got a diagnosis. I had type 1 diabetes. Unsure of what that meant in terms of raising a child, they decided to evacuate me back to Singapore, essentially moving their lives back home. The first question my mom asked the doctor there was whether she'd be able to see me grow up. Now, university wasn't even in the question at that point. She just wanted to know if I'd get past childhood and if I'd be able to see her again. The medical staff, though, focused on treating my condition in a very mechanical way. And that left my mom's emotional stress in a corner. So I've had type 1 diabetes for most of my life. It's an autoimmune disease, which means that I have to do daily injections or wear an insulin pump. As I am right now. And I have to check my blood glucose multiple times a day. Having a chronic illness can feel quite isolating. So last year, I decided to write to a pen pal in Australia. She also has type 1. And in one of her letters, she said she doesn't like being called a diabetic. Instead, she introduces herself as a person with diabetes. Now, to those who aren't familiar with this disease, it may seem like a small thing to fuss over. I mean, if we identify people based on their hair color, their nationality, then if our health statuses are just another feature of us, being called a diabetic, an amputee, it shouldn't matter so much, right? At a discussion group by Diabetes UK, I decided to ask my table the same question. Would it bother you if somebody called you a diabetic rather than a person with diabetes? And the agreement was unanimous. But why does the mere description of a disease matter so much? Because the term diabetic is loaded. It's loaded with the presumption that we are wholly responsible for our disease, for the outcomes that medical staff and society judge us upon. Essentially, because we're seen as accountable for our self-care, we're also assumed to be responsible for our measurable health outcomes. Now, this is seeing the patient as their disease. But tonight, I want to talk about how disconnecting the two, seeing the patient as more than their disease can essentially change our delivery of health care. Health care systems in developed countries are striving towards a new paradigm, what is known as patient-centered care. In this, patients would share in the decision-making process, rather than being told how to take care of themselves. Governments are realizing that by empowering patients and making health decisions, this leads to better patient outcomes, because they become happier with the treatment that they're getting. I remember being so afraid of going back to fencing when I first got my insulin pump. I was so afraid of my opponent's weapon striking the plastic tube connecting my pump to my body, because if that happens, then there'll be lots of bleeding. I'll have to change the whole set. And I didn't want to go through all of that hassle. It's just too much to deal with. So for a whole term, I didn't turn up to any training session. And when I talked to my endocrinologist back in Singapore, he was shocked. He suggested ways to protect my insulin pump, strategies to manage this disease whilst doing such an intensive sport. My doctor worked with me. He respected my lifestyle decisions. He showed me how to fit diabetes into my life, rather than how I had to fit around my diabetes. He showed me how I am not my disease. Patient empowerment doesn't mean the patient is always right. Certainly, it doesn't mean any disrespect to the amazing training our healthcare professionals already go through. But I believe that the way medicine has been traditionally practiced has focused too much on dissecting the patient into their individual health failings. We're not seeing all of these parts as a whole person. With the rise in the number of people living to old age, we need to drastically change the way we deliver healthcare. Because the key to good, long-term sustainable care is patient empowerment. And how are we supposed to care for them if we don't know what they want? One of my uncles has mild dementia, high blood pressure, and cataracts. My aunt, his caregiver, she only wants to fix the last two. She doesn't feel that his dementia is causing any big challenges in her daily caregiving. So they went to see his doctor. And the doctor listened to my aunt's health priorities, signed my uncle up for some simple cataract surgery, prescribed medication, and that was it. They didn't need to go through extensive complicated dementia treatments, which may have very well induced more emotional stress for their family. The doctor worked with them to achieve my uncle's health goals, even though that meant not addressing every single one of his conditions. With the rise in the aging population, these generations are now living with three, four, five different conditions that all interact with each other. Treating them will mean ensuring both their safety and happiness, but that may mean not addressing every single one of their health conditions. And that is okay. That is okay. I know it sounds counterintuitive, but patients and their caregivers will actually be more motivated to take care of themselves if they know they've had a part in the decision-making process. And there's a societal benefit, too. It can be cost-saving. If patients don't want to go through unnecessary, expensive medical procedures, then why should we push them to do it? When we see patients as more than their disease, we are changing the paradigm from doctor versus patient to doctor and patient versus disease. So the next question is how do we get there? Benjamin Zander, conductor of the Boston Philharmonic, proposes a method called giving an A. It all started when he walks into his music class at the start of the academic year, and he says to his students, guys, at the end of this year, you're all going to be getting an A. That's right. The top grade. Sounds like a good deal, right? But I want you to write a letter addressed to me imagining yourself in the position a year from now telling me why you deserved your A. And that's what they did in that very first class. You see, by doing this, Zander has allowed the students not to be defined but that singular letter grade, and instead explore their passions, their motivations for why they wanted to take his music class in the first place, and allowed that to carry them throughout the year. In the world of health, this would mean asking patients what they want to achieve out of their health care. When doctors give patients an A, they choose to line up with the patient to combat their disease. Rather than lining up with the standards against the patient, they're inviting them as colleagues rather than speaking to them from a position of power. And patients then become equally valid wheelers of knowledge about their own health. They're seen as individuals rather than just an amalgamation of their health conditions. Ladies and gentlemen, this simple act of giving an A will revolutionize centuries of doctor and patient relationships. From this, we get two immediate results. The first is that doctors get new information about what the patient's thoughts and fears about their illnesses are. They can address any knowledge gaps. When doctors give patients an A, they're opening up to a new point of view. Second, the patient gets to speak about any insecurities, any concerns they've had about their illnesses, their health in general, things that they may not have spoken about because of the traditional power inequality in the doctor and patient relationship. These two results are what I believe will carry us towards the patient-centered care system we need. I'm not calling for a survey monkey type of intervention. No. That's too superficial. I mean, we don't know if hospitals will read our feedback or if they'll even address it in the way that we want them to. No, no, no. What I'm proposing, it's a method by which healthcare systems can holistically respond to us as individuals rather than segmenting and segregating us into all our different illnesses. Nineteen years ago, if the medical staff had talked my mom through what it meant to raise a child with diabetes, what it meant to go through that emotional stress, then maybe she wouldn't have had such a traumatic experience with my diagnosis. Maybe she'd be able to look at old photographs and not feel guilty. By realizing that accountability does not necessitate personal responsibility, we are seeing patients as more than their disease. This allows doctors to give patients an A, which then puts both doctor and patient on a level battleground, united in achieving the patient's health goals. So tonight, tonight I invite you to join me in support of a health policy that facilitates communication with this very attitude. Because effective communication is achieved. When we have both sides learning from each other. This three-step process is what will help us truly achieve the patient-centered care systems we need. Thank you. Thank you, thank you, thank you. Thank you, thank you, thank you, thank you. Thank you, thank you. Thank you. Thank you, thank you. Thank you. The next consultation is a woman who completed public reference Course especially in Australia Beach Public Health Zones and