Doctors seek clarity and guidance on procedures in new appeal letter

SINGAPORE (Mar 13): More than 1,200 individuals have signed a new letter of appeal drafted by three doctors to ask the Ministry of Health (MOH) and the Singapore Medical Council (SMC) for clarity on how they should verify the identities of patients, as well as their families and carers, in the scope of their work.

It comes in the wake of SMC on March 5 slapping a $50,000 fine on National University Hospital psychiatrist Dr Soo Shuenn Chiang for issuing a memo to a patient’s brother. Pretending to be the woman’s husband, the brother had called Dr Soo claiming the patient was suicidal.

Dated March 11, the 10-page letter of appeal for guidance says the judgement “erodes trust in the patient-doctor relationship, and compromises patient safety in emergencies”.

The letter was prepared by breast surgery consultant Dr Tan Yia Swam; ear nose and throat specialist Dr Tay Su-Lin Valerie; and neurologist Wee Chee Keong, after consultation with 150 of their peers.

While acknowledging that Dr Soo had participated in events that did breach the patient’s medical confidentiality, the group says the punishment was harsh and, as a precedent, “will surely foster defensive medical practice that will damage patient-doctor relationship”.

The medical industry has a doctor-patient relationship “which is not found in any other industry,” they add.

Already, there are general practitioners refusing to give routine injections, following a January decision by the SMC to fine an orthopaedic doctor $100,000 for not detailing side effects to a patient.

Doctors say this renders the healthcare system less efficient, as patients end up going to specialists, where costs are higher, when these procedures can be performed by GPs.

The latest letter asks SMC and MOH to provide guidance on how doctors should verify identities, especially if doctors are dealing with emergencies where the patient’s life is in danger and immediate treatment is required.

It queries the minimal steps that authorities believe should be taken, as well as the protocols to adhere to if the carer or relative has no formal or documented relationship with the patient.

The letter also includes 13 real-life examples from doctors, such as an urgent email request from a patient who is overseas for a copy of his anti-epileptic medication prescription.

“How do I insist on verification?” the anonymous doctor writes. “If I decline, what if he has a fit in his hotel room and dies? At best, he has to see a doctor overseas, explain his condition, hope that he is getting the same drug at the same dosage, or even the exact formulation. All I want is to help people.”