Forum: Ultra-short teleconsultations can’t ensure quality of medical care
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The recent revocation of MaNaDr Clinic’s licence by the Ministry of Health underscores the importance of maintaining rigorous standards in telemedicine practices ( Telehealth provider MaNaDr admits to lapses that led to revoking of clinic licence
Investigations revealed that a very large number of teleconsultations by MaNaDr Clinic doctors involved very short sessions on video call that lasted one minute or less. Such practices raise significant concerns about the adequacy of patient evaluations and the justification for subsequent prescriptions and medical certificates.
While not every consultation requires a lengthy discussion, a one-minute consultation – whether in person or virtually – is not acceptable and falls short of professional expectations.
Even when patients present with seemingly straightforward issues, a good family medicine consultation should always consider the broader context of the patient’s health.
This includes chronic disease management, lifestyle advice, opportunistic screening, and efforts to shape positive health-seeking behaviour. A consultation concluded in mere seconds or a minute is a missed opportunity to provide holistic, patient-centred care, which is fundamental to the practice of family medicine.
Moreover, a teleconsultation must not be treated as a shortcut. It demands the same standards of care as an in-person visit. This includes taking a proper history, reviewing symptoms thoroughly, arriving at a reasonable diagnosis, and ensuring the patient understands the management plan. Omitting these essential steps puts patients at risk of misdiagnosis, unsafe prescriptions, and delayed treatment of serious conditions.
The Singapore Medical Council’s Ethical Code and Ethical Guidelines are clear: Doctors are duty-bound to deliver competent, compassionate and appropriate care.
Ultra-short consultations also breach core ethical principles such as beneficence (the duty to promote the patient’s well-being) and respect for patient autonomy (by providing enough information for patients to make an informed decision).
As we embrace technology in medicine, doctors must hold fast to their professional and ethical responsibilities. Telemedicine can greatly improve access to care, but it must be delivered with the same diligence, care and thoroughness as face-to-face consultations.
Wong Tien Hua (Dr)
President
College of Family Physicians Singapore
