Doctors welcome broad review of medical regulatory process

It will be completed by end of the year; last review was in 2013

Doctors here have welcomed the Health Ministry's move to carry out a "very comprehensive review" of the medical regulatory landscape, which is overseen by the Singapore Medical Council (SMC).

"The SMC and its processes must have, and must be able to maintain, the confidence and trust of medical professionals, patients and the general public," said Senior Minister of State Edwin Tong, in announcing the move yesterday.

The review, to be completed by the end of the year, will task a committee to relook the entire regulatory process - from the filing of complaints to having appropriate sentencing guidelines.

The last review was in 2013 and this latest one comes after the SMC appointed a 16-member committee in January to help ensure errant doctors get disciplinary sentences which are consistent and fair.

General practitioner Yik Keng Yeong told The Sunday Times yesterday that the SMC, which is a statutory board, should have a permanent disciplinary tribunal of doctors who are fully focused on each case's details.

Currently, the tribunal comprises different people, both doctors and lawyers, for different cases. Dr Yik said for consistency's sake, it would be good to have a permanent body of people to apply similar judgments across a range of cases.

"It's not possible now to have doctors staffing a tribunal for the long term as there would be medical emergencies or they are running a practice," he said. "That said, there might not be enough work for them to be doing this full-time. "

The last review was in 2013 and this latest one comes after the SMC appointed a 16-member committee in January to help ensure errant doctors get disciplinary sentences which are consistent and fair.

Dr Muhammad Iqmal Abdullah of Wan Medical Clinic suggested the SMC can work with existing platforms such as the Singapore Mediation Centre, which handles civil and commercial disputes, to filter out cases.

"For some complaints, it might be more appropriate for another body to step in," he said, noting that some SMC complaints might be business-related and that such a move would save time.

Gastroenterologist Desmond Wai said the SMC has, in general, made fair judgments. But he noted there have been several cases where the disciplinary tribunal has made decisions that caused an uproar among doctors.

One involved suspending a paediatrician for not diagnosing an infant with Kawasaki disease in 2017. Many doctors weighed in to say it was a mistake that any physician could make.

Dr Wai said: "If a doctor makes a mistake, there will be no sympathy. But if someone does what everybody else is doing and gets punished, there might be panic in the community."

It would be good, he said, if the SMC's disciplinary tribunal could be transparent about how it arrives at its judgments.

He cited the $100,000 fine given to surgeon Lim Lian Arn in January for not telling a patient of possible complications from a commonly used steroid injection as one that needed further explanation. The Health Ministry later stepped in and asked the SMC to apply to the High Court to review the decision by its disciplinary tribunal.

A version of this article appeared in the print edition of The Sunday Times on March 03, 2019, with the headline 'Doctors welcome broad review of medical regulatory process'. Print Edition | Subscribe