Prescribing Work as Medicine

Recognising how meaningful work can be as vital to recovery as medical treatment, SingHealth’s new Return-to-Work Toolkit is reshaping rehabilitation by empowering healthcare teams to help patients re-enter the workforce.

"Having been unemployed for many months, it is not easy to get a stable job that can suit me," shares Mr Z (not his real name), a 28-year-old who has lived with congenital heart disease his entire life. "Employers see me with heart problems and they think that I am going to be a liability to them."

For months, Mr Z faced the double burden of managing his medical condition whilst navigating the challenges of prolonged unemployment. The rejection and stigma weighed heavily on him, but his determination to achieve financial independence and contribute to his household never wavered.

"I am thankful for the support that I receive from my friends, social worker and hospital. They believed in me, journeyed with me and set goals slowly and walked with me through each stage," he reflects.

Today, Mr Z is employed in a flexible security-related role that accommodates his health needs. "I can rely on myself, I don't burden my family or rely on assistance. Most importantly, I can choose to have a better life."

Mr Z's journey exemplifies a growing understanding within our healthcare system: that meaningful work can be as vital to recovery as medical treatment itself. Recognising this, SingHealth launched a comprehensive Return-to-Work (RTW) toolkit that is reshaping how healthcare teams approach rehabilitation by empowering them to help patients re-enter the workforce.

Beyond the hospital walls

For many patients, recovery doesn’t end at hospital discharge. Those recovering from a stroke, accident, or battling chronic health conditions, often require a more holistic approach that goes beyond medication and follow-ups.

With SingHealth’s newly launched RTW toolkit, healthcare workers are equipped with the resources to assess a patient’s readiness for employment and build their confidence for the journey, ensuring patient care extends meaningfully beyond the hospital walls.

Dr Robin Low, Senior Consultant, Occupational and Aviation Medicine, Changi General Hospital (CGH), explained that this move was developed in response to the growing evidence that meaningful work is an important aspect of healing.

“When patients step back into the workplace, something remarkable happens: Their mental health improves. Their sleep patterns normalise. Their sense of self-worth soars,” he shared.

Employment creates meaning and allows healing

The benefits of work stems from how it gives patients a sense of normalcy. It allows them to focus on their skills and abilities, rather than their illness.

With work, patients are also reminded that they are more than their medical condition. They have a chance to contribute, to feel valuable. This in turn helps build confidence and self-efficacy, all of which can help with the recovery process, Dr Low said.

“The simple act of contributing to a team project or mastering a new skill sparks joy and pride that no prescription can match,” he emphasised.

In addition, the workplace allows patients to socialise, whether to reconnect with colleagues or make new friends. These relationships provide emotional support to buffer against isolation and increases patients’ resilience.

Importantly, these benefits are not exclusive to full-time employment. Part-time and flexible work arrangements have shown to have similar positive effects.

A multidisciplinary approach

However, Adjunct Associate Professor Bee Yee Tan, Group Chief Allied Health Professional, SingHealth, cautioned that re-entering the workforce is often easier said than done.

“The process is a complex journey that goes beyond physical healing, involving emotional, psychological, and societal challenges such as stigma, fear of rejection, loss of identity and financial stress,” she said. These are obstacles that the RTW Toolkit hopes to help patients overcome.

Development of the toolkit began in 2023 and started out with the two-year pilot of the Bounce Back Lab (BBL) project, an initiative involving all three public healthcare clusters  in collaboration with Ministry of Health (MOH) and Workforce Singapore (WSG), with the purpose of providing integrated support to patients in their journey to return to work.

Recognising patients’ unique circumstances and conditions, SingHealth fielded a multidisciplinary team including occupational therapists, medical social workers and pharmacists to address their needs, including emotional, psychological, and societal challenges such as stigma, fear of rejection, loss of identity, and financial stress.

Empathy and collaboration key to success

For Adrian Tan, Senior Medical Social Worker, CGH, participating in the BBL project only reinforced his belief in the need for both collaboration and empathy.

“You’re not just discussing the process of returning to the workforce—you’re helping to rebuild someone’s world. Each conversation is an opportunity to transform anxiety into anticipation and doubt into determination,” he said.

This is why the RTW Toolkit, which was developed based on insights from the BBL project, focuses on building relationships and connections with patients. There are tips for conversation starters and how to uncover patient needs. Healthcare professionals are also equipped to identify the unspoken concerns during their conversations with patients, and how to use success stories to build confidence.

The BBL project also demonstrated the value of cross-collaboration to overcome skills gaps, mental health concerns and financial challenges. As such, the toolkit includes visual flowcharts to help clinicians quickly identify the right referrals. This is complemented by comprehensive directories of Social Service Agencies (SSAs) and employment support programmes, making it easier to connect patients with the help they need. A mini-kit intended for patients’ use in self-referral for help was also created.

Abstract from the RTW toolkit

Looking to the future

The RTW Toolkit may be in its early stages of development, but Adj Assoc Prof Tan has high hopes it will eventually become an established tool for all healthcare professionals.

“It is expected to be most effective when combined with empathetic, personalised guidance and strong therapeutic relationships that professionals foster with patients,” she emphasised.

Echoing her sentiments, Adrian added: “By mastering these conversations, we can help guide patients to navigate their way back to meaningful employment and renewed self-worth.”

For patients like Mr Z, who now enjoys financial independence and is "planning for the future," the toolkit represents more than just a return to work. It's a pathway to reclaiming dignity, purpose, and hope. As our healthcare system continues to evolve, this innovative approach demonstrates how the prescription for recovery, sometimes comes not from a pharmacy, but from the profound human need to contribute, connect, and find meaning in life.

All it takes is a desire to open doors for our patients. The RTW toolkit for healthcare professionals, as well as a RTW mini-kit of resources for patients self-referral, is accessible at www.singhealth.com.sg/news/announcements/return-to-work-toolkit