What kind of signal is the Singapore Medical Council sending out when a small lapse of not accounting for a non-major side effect of a routine, minor procedure costs a doctor an astronomical fine of $100,000 (Doc fined $100k for not warning patient of injection side effects; Jan 22)

It is understood that the Montgomery test for negligence, where all complications and side effects of procedures must be explained in detail to patients, now applies.

Still, patients will always deny full comprehension even when details of any procedure have been fully explained to them. It is also common for them to protest that they had not been told anything when they institute proceedings against medical personnel and institutions.

It is an area opportunistic, disgruntled patients can exploit, and where doctors will always be held hostage.

The doctor is in a quandary as in the final analysis, it is just one person's word against another. The signing of consent for a procedure also guarantees nothing, as the Singapore courts have determined that it does not absolve the doctor of any responsibility.

It appears that for doctors to fully indemnify themselves, recordings of all consultations must be made for conclusive proof that they have satisfied the Montgomery test. Just don't be surprised if consultation times are stretched, waiting times longer and charges increased.

One really cannot blame doctors for practising defensive medicine, despite constant exhortations by the authorities for them not to do so, when they seem defenceless against a litany of suits and a non-empathetic SMC quick to find fault among its own kind in the medical fraternity.

Yik Keng Yeong (Dr)