SMC must act fast to stem the loss of confidence in self-regulation process

MOH must help stem loss of confidence in SMC self-regulatory process

In more than 35 years as a doctor in Singapore, I have never felt more despondent as now and I am certainly not alone in losing confidence in how self-regulation is administered by our Singapore Medical Council (SMC).

Three recent SMC cases have shocked doctors namely :

1. " Kawasaki" case (2017) when pediatrician Dr Chia Foong Lian was suspended for 3 months for missing a difficult diagnosis;

2.  "Steroid" Injection case(2019) when orthopedic surgeon Dr Lim Lian Arn was fined $100,000 for failing to tell his patient the wrist injection could have side-effects such as discolouration of the skin and

3.  " Medical Confidentiality "case ( 2019) when psychiatrist Dr Soo Shuenn Chiang was fined $50000 for writing a memo to the ambulance service/ police to get an alleged "suicidal" patient admitted to Institute of Mental Health. He was found guilty of breaching medical confidentiality.

There was an unprecedented petition drive by a hitherto conservative medical professionals who then signed 3 petitions consisting of 1000, then 6400 and 8400 signatures respectively.

Let me make it clear. The doctors I know who signed the petitions are serious minded people who do not put ink to paper lightly as their professional reputations are at stake!

MOH forms a workgroup in March 2019 to  “review the taking of informed consent and SMC disciplinary process”.

How MOH Workgroup can help Singapore Healthcare

To the workgroup, I quote Stephen Covey and say,

“Let’s start with the end in mind.”

How do I want Medicine to be practised in Singapore?

1. In good faith, I will use all my skills and knowledge to help every patient.  Many diagnoses may initially remain elusive but this is not necessarily negligence.

2. Many treatments/medications have known complications that are often unavoidable. I may not have the time to explain every one of these complications nor do I feel that I have to. Many of these are minor. Eg Cancers

3. Patients are often treated as part of a family unit and I have always shared relevant knowledge with their loved ones for them to make collective decisions. Eg Elderly parents

4. Our courts have reiterated that the Bolam-Bolitho test is relevant as a measure of a doctor’s action during Diagnosis and Treatment ( eg Surgery) . Briefly, this test says that if the doctor's action is supported by a responsible body of medical opinion and is logical, he is not guilty of negligence.

5. I personally feel that the Modified Montgomery Test is the reason for increased healthcare cost and defensive medicine and should be severely curtailed notwithstanding the learned judges’ views. ( NB Court of Appeal says MM Test should be used for “Advising” patients)

I wish to fulfil my dream of being a good doctor.Please help me!

Dr Huang Shoou Chyuan