Dr Mona Tan touched on some of the reasons behind rising medical costs in her letter ("A shared responsibility for healthcare costs"; Dec 7).
I would like to add that there are several more.
First, rental rates for clinic space have skyrocketed. Some landlords even demand a percentage of the clinic's gross takings.
It is common for landlords to increase the reserve price for clinic space or to raise the rental rate when they find that medical practitioners are interested.
Second, there is an unusual phenomenon of non-medical professionals running medical practices.
By this, I mean that some non-medical companies sell premium health screening services without proper pre-test counselling or post-test consultation. Some also sell unproven supplements to the public.
The bottom line and returns are the determining factors in the way these businesses are run, rather than patients' interest.
Third, the public listing of medical organisations means they are answerable to shareholders.
This leads to higher costs and creates a potential conflict of interest.
Practitioners in primary care face the same pressures raised by Dr Tan.
When our patients read medical information online but lack medical insights, they tend to overreact and request many tests.
Doctors need to reassure our patients, but there are also times when we need to order more tests to examine the root cause of an illness, rather than just treat symptomatically.
Perhaps a brief explanation or the patient's clinical notes should accompany the claim submission.
It is for these reasons healthcare costs in Singapore are rising uncontrollably.
Insurers do not have any details on the consultation or the reasons for the tests and could conclude that claims are being made unnecessarily.
Leong Choon Kit (Dr)