If defensive medicine were to be blamed for rising healthcare costs in the First World, then the combination of advanced medical technology and Internet with defensive medicine is the perfect recipe for disaster ("Remove cap on clinics in commercial developments to rein in rentals"; Dec 21, 2016).

Studies have confirmed that a medical practitioner receives fewer complaints and earns more money when he practises defensive medicine.

In a well-educated society connected to the Internet, patients are well-informed of the differential diagnoses, and the various advanced technologies to investigate as well as the management options.

Much of the information is not appropriate to the situation.

However, when faced with a patient well-armed with Internet medical information and many anxieties, a medical practitioner has little option except to exclude all causes and allay their anxieties by clearing all doubts.

This is different from over-servicing which is unethical.

The former is self-induced anxiety by the patient from over-information from the Internet, while the latter is supplier-induced anxiety saddled on him by the medical practitioner who has more medical insight.

It is easy to blame the practitioners, the administrators, the pharmaceutical companies and the insurance agencies for rising costs. However, newer technologies and medical innovations are equally liable.

Everyone has a duty to rein in skyrocketing health costs.

For the medical practitioners, it is prudent to discuss with patients before investigating.

Similarly, the public needs to understand medical information from the Internet better. They may wish to consult their doctors before requesting newer, more expensive and unnecessary tests.

Policymakers should enforce the relevant medical laws to regulate such indiscriminate testing.

Medical advertisements on the Internet are not currently regulated. It is difficult but not impossible to control them.

We must be ahead of technology to rein in rising costs.

Leong Choon Kit (Dr)