For all the good that medical doctors in general do, it is the conduct of their fallen brethren that tends to stick in the public mind. One reason is the wide gulf between society's high expectations of an honourable profession and the often egregious nature of the actions of its black sheep. A recent example is the private doctor, paid by an employer, who issued a mere one day of medical leave to a worker who lost a fingertip in an industrial accident. Money also drove a few private clinics to cheat the Health Ministry when claiming subsidies for patients under the Community Health Assist Scheme.
In recent years, the avarice of certain doctors has publicly pitted members of the profession against each other. The Susan Lim saga was an extreme case of overcharging, involving as it did a royal family, but ordinary private patients, too, have had cause to complain about escalating specialist fees.
One might ask if the trust traditionally reposed in the profession has been eroded, leading to a more transactional relationship between the doctor and patient. Cases of moral lapses include a well-known plastic surgeon who was temporarily suspended from practice after he was convicted of letting another man take the blame for his speeding offence. Worse was the doctor, with 40 years' experience, who was described as being "particularly cunning" by the judge who dismissed his appeal after he was found guilty of molesting a female patient repeatedly.
On the flip side are doctors doing pro bono work, and mentors and teachers in public hospitals who inspire the young to give back to society which has given their profession many opportunities, high status and the privilege of self-regulation. To ensure the work of upstanding doctors is not overshadowed by the errant few, the profession as a whole must bring the ethical tenets of medicine to the fore.
It is incumbent on the Singapore Medical Council to vigorously investigate instances of unacceptable practice and conduct. And medical school enrolment panels should ensure candidates who lack the motivation to serve honourably are sieved out, whatever their scholastic records. Those who are merely calculating or lack integrity will not do credit to the profession - especially when it must deal with a host of difficult ethical issues. These include resource allocation when demand exceeds supply, decisions to limit or cease treatment, conflicts of interest when the doctor is also an entrepreneur, and moral dilemmas created by innovative therapies. Patients might also seek a doctor's judgment about end-of-life issues, some of which might involve family conflicts. Alongside applying modern clinical skills and up-to-date knowledge, young doctors should not overlook building old-fashioned trust.