On top of his achievement in establishing Urology in Singapore and training generations of doctors, Prof Foo Keong Tatt continues to strive to improve care for patients.
Can you imagine dedicating some 30 years to advocate for something you believe deeply in, against strong headwinds? Most people would have given up, but not Professor Foo Keong Tatt.
Prof Foo is perhaps best known for establishing Urology as a specialty in Singapore. He is also an expert in benign prostatic hyperplasia (BPH), commonly described as enlargement of the prostate gland that causes urinary symptoms as men get older. It turns out that BPH, though common, is still a somewhat controversial clinical problem. “There is as yet no agreement on the definition of the disease,” said Prof Foo, Emeritus Consultant with SGH.
The dominant Western thinking is to treat patients based on symptoms, which is not always appropriate, said the professor. “For instance, some patients do not have symptoms, yet they do suffer from prostate obstruction and can still cause harm,” explained Prof Foo.
A man of art, a man of science - doing water colour painting at home.
With research and evidence gathered from his decades of practice, Prof Foo has for many years been proposing a uniquely original concept and system of staging the disease by severity to guide clinical decisions about treatment. He presented his idea in papers and presentations at urological meetings.
Finally, in 2017, a prominent American urologist (Prof Claus Roehrborn) acknowledged Prof Foo’s work on his original concepts and research on clinical BPH for the past 2 decades, at the European Association of Urology meeting in London.
“The honors are not important. What is more important is to get your idea accepted, after so many years,” said Prof Foo. “It confirms that our research is correct, and patients can get appropriate treatment.”
Walking paths less travelled
Such tenacity is perhaps unsurprising for someone who undertook the arduous path of establishing Urology as a specialty in Singapore. Prof Foo headed the very first Department of Urology in SGH when it was set up in 1988.
“In the 1970s, there was no specialty called Urology. There was only General Surgery. Patients with obstructing prostate causing urine retention or bladder stones were being treated with open surgery. I was a lecturer in the University Department of Surgery in SGH when I took sabbatical leave in 1976 to go to the United Kingdom to train in the specialty and new procedure such as transurethral resection of the prostate(TURP),” recalled Prof Foo. TURP is minimally-invasive with less bleeding and pain post operatively, as there is no open wound. It was the introduction of TURP and other minimally invasive procedures which eventually led to the establishment of Urology as a specialty.
PM Lee Hsien Loong presenting a scroll done by Dr Tan Bien Kim to Prof Foo during the 30th Anniversary of SGH Urology Department in Nov 2018.
“If we had continued under General Surgery, the specialty could not have flourished. We needed our own clinic and our own specialised equipment, not general surgery equipment. Our doctors also needed training in new procedures,” said the Professor.
What motivated him to set out on this pioneering path? “We simply wanted our patients to get better treatment.”
Training generations of urologists
Since then, Prof Foo has trained several generations of urologists. “Most of the urologists in Singapore were trained in SGH, including the heads of urology departments in most of the public hospitals,” pointed out Prof Foo.
To gain recognition for Urology as a specialty, Prof Foo had also founded the Singapore Urological Association. He worked with the Specialist Training Committee of MOH to train and certify the specialists. Today, some 30 years later, the Association boasts a membership of about 100 specialists caring for patients in both public and private sectors.
Teaching round with medical students from NUS 2017
The influence of Singapore Urology is also felt beyond our shores in other parts of Asia. SGH is currently the seat of the secretariat of the Urological Association of Asia (UAA), of which Prof Foo was the Secretary General from 1998 to 2006, and Director of Asian School of Urology (ASU) 2006 to 2010.
“Under this Asian school of urology, many of our urologists brought our knowledge to countries such as Myanmar, Bangladesh and Cambodia to share with their doctors. Even China – I remember going there to give lectures 30 years ago. They have since advanced and I now go there to learn from them,” said the Professor.
Foo KT, The Flute player
A leader chosen by his peers, Prof Foo represented Asian urology when he was appointed vice chairman of the International Consultation of Urological Diseases (ICUD) in 2000. His good work and influence led to the subsequent inclusion of the UAA in the ICUD.
It’s always about Purpose
In addition to his clinical and leadership achievements, Prof Foo also inspires his students with his lifelong philosophy of staying true to their purpose.
“In the practice of medicine, we must always remember our core purpose, which is to improve care for our patients. We do not just treat patients, but we care. To care, we need to have compassion. We do not just care but must strive to improve on the care. And to improve on the care, we need to do research, and to teach the next generation of doctors to be better than us,” the Professor had written, in the book A Philosophy of Balance, published in his tribute.
“There is a need to return to fundamentals. I always ask my students to think ahead, what are you going to do next? Even after we have a diagnosis, the next question to ask is Why treat? Is the condition life-threatening? Sometimes the treatment is not 100% effective, and the side effects can be worse than the treatment, even causing harm,” explained Prof Foo.
He spoke of the core values that make a good doctor – Compassion and Competence, as well as Collaboration. “We can work together with each other even if we have different views, as long as our core purpose is the same.”
Performing for patients and staff in the ward at SGH Music Fest.
Inspired former students and grateful patients of the Department of Urology have come together to set up a professorship in the name of Professor Foo Keong Tat.
The target is for a $5 million endowed fund which will be a permanent funding source that ensures that for generations to come, urologists in SGH will receive support for important scholarly work and continue the legacy of Prof Foo, to constantly improve care for patients.
Prof Foo’s wish for the professorship is that it will go to Singaporeans who will serve as the leader and model in carving out their own path and definition, so that generations of doctors will continue to learn how to treat the patient first, and then his disease.
During the COVID-19 pandemic, an unexpected measure of his impact on his patients surfaced. SGH received a donation of 500 packets of chicken rice for our staff. The stallholder was simply grateful for Prof Foo’s care of his father.
Philosophy of Life
• In our attitude to fellow beings, events, or things
• There should be no hatred, no complaint and no regrets
• Have good motives, speak well of others and do good
Prof Foo has published a book The Grading and Staging of Clinical BPH for Optimal Care. Intended for both clinicians and patients, it is available from firstname.lastname@example.org in both English and Chinese.
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