For the first time in 20 years of practising aesthetic medicine, Dr Shiau Ee Leng had to close her five clinics for two months.
Though she is now able to see around half of her patients with certain conditions, they account for only a third of her income. More time is needed before her ClearSK Healthcare Group of clinics, which have around 50 staff and doctors, can fully reopen.
Conditions like acne and skin pigmentation, inflammatory skin conditions, viral warts and acute eye conditions can be treated during phase one.
However, non-urgent aesthetic procedures like Botox and plastic surgery have yet to receive the green light from the Ministry of Health (MOH) even after the circuit breaker was lifted last Tuesday.
The decision spurred an appeal by Dr David Loh, president of the Society of Aesthetic Medicine, who wrote on May 29 to Associate Professor Kenneth Mak, MOH's director of medical services, requesting that aesthetic services resume for two days a week from last Tuesday.
MOH did not grant his request but replied in an e-mail that doctors can proceed with semi-urgent cases. "MOH will not micromanage on deciding which conditions are considered semi-urgent," it told Dr Loh.
If the doctor is acting based on the guidelines set out by the ministry and can provide sufficient medical justification, the service may proceed, MOH added. These healthcare institutions may also be audited for compliance.
Dr Loh told The Straits Times, after MOH's e-mail: "Those performing aesthetic work had to stop since April 7. Now in phase one of reopening, MOH has stipulated a limited number of procedures that can be done. But this does not work for everyone."
"I am perplexed why the authorities cannot trust doctors to limit their own load during phase one. Is that not micromanaging?" he added.
When approached by ST, the ministry said there was no change in its stance.
Nothing much has changed for Dr Loh, who is co-founder of the clinic David Loh Surgery, which focuses on treatments like Botox, fillers and various lasers. He still cannot see a single patient.
"This health crisis is also an unprecedented economic crisis, and everyone is suffering. Closing for a few months to slow the pandemic is the least we can do, but the financial impact is going to be severe. I do not dare to face it yet," he told ST.
In its reply to Dr Loh, MOH said doctors should consider the medical necessity and time sensitivity of the patient's condition. Clinics should also consider their manpower constraints when operating and whether they can provide the appropriate infection prevention and control measures.
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As president of the Society of Aesthetic Medicine, Dr Loh had also earlier written to MOH, on behalf of 150 doctors practising aesthetic medicine in private practice, to appeal for the full reopening of their services in phase one to protect livelihoods.
In its letter to Prof Mak on May 20, the society stressed that aesthetic practice does not utilise critical medical facilities like intensive care units and hospital beds, and would not put a strain on existing healthcare resources.
With high standards of hygiene and safety, the risk of Covid-19 spread is very low.
Dr Audrey Looi, the medical director of Ava Eye Clinic, which specialises in cataract and oculoplastic surgery, said: "All of us understand MOH's efforts to keep the Covid-19 situation under control, but what we would appreciate is a greater focus on safety measures rather than a blanket ban that is easy to implement but takes a huge toll on businesses.
"The Jobs Support Scheme has helped with pay cheques but the remaining amount is still significant... Other business costs have to be considered, and these do add up."
Dr Karen Soh, the medical director of Prive Clinic, which has two clinics and a total staff count of around 25, said: "Income ground to a near halt, and I didn't cut the pay for all my staff the last few months.
"But if this continues beyond this month, we may not have a choice but to institute pay cuts or no-pay leave for long-term survival."
Others, like Dr Soh Lea Sar, founder and director of Healthsprings Laser and Aesthetic Clinic and Healthsprings medical group, said it was still too early to determine the true impact.
She had to limit appointments to half the usual number, which gave her more time to sanitise the rooms after each treatment.
"Many patients have relapses of acne, eczema and worsening of their pigmentation... We have increased inquiries for weight management but are still unable to provide this service. We hope that all service restrictions will be lifted soon," she said.
She provided teleconsultation and delivered medication to her patients while her two aesthetic clinics were closed during the circuit breaker period. She has three other general practice clinics, which remained operational.
Dr Chua Jun Jin, a plastic surgeon at Mount Elizabeth Medical Centre, is now able to see only 20 per cent of his usual patient load.
He said there have been appeals to the authorities from plastic surgeons, such as a letter sent to MOH on May 20. The same letter was also sent to the Ministry of Trade and Industry and National Development Minister Lawrence Wong on May 21.
"We are very perplexed and are seeking explanation as to why community health screening... and aesthetic services cannot resume while acupuncture for facial slimming, the full suite of hairdressing (services) and even pets can start to get basic grooming. More businesses should resume," Dr Chua said.
