A workgroup tasked to review the Singapore Medical Council's (SMC) disciplinary processes made recommendations that would lead to faster and fairer handling of complaints against doctors, in turn allowing earlier closure for patients and doctors.
These included the setting up of a new committee to sieve out frivolous and vexatious complaints made to the SMC, which gets an average of 165 complaints a year. Those found to have made such complaints could be made to pay costs.
The new plan is to conclude cases within 18 months, with some resolved as early as four to six weeks. It can take up to six years or more to resolve a case now.
More resources will be pumped in to clear the backlog of 223 complaints and 40 disciplinary hearings over the next 21/2 years.
The workgroup, which made 29 recommendations in all, also called for the creation of guidelines on what doctors need to tell patients about the more common procedures so that they can make better informed decisions.
It was set up in March by the Ministry of Health (MOH), following two high-profile cases in which the doctors were first punished, then exonerated in complaints made against them.
Before these two cases made the headlines, there was already growing disquiet within the medical fraternity.
Why it matters
Patients must be able to trust that their doctor is doing the best for them and, in turn, doctors must be able to trust that the disciplinary system is fair, transparent and clear.
The workgroup said the trust in these relationships is under "serious threat of erosion".
The fear is that more doctors, distrustful of the system and fearing that their patients would lodge complaints, would move towards defensive medicine. This includes giving patients too much information, ordering more tests and procedures than necessary, or even possibly refusing to treat high-risk patients.
Such practices can confuse or make patients more fearful, and lead to higher healthcare costs and possibly increasing litigation.
Doctors have said that the package of recommendations is a move in the right direction. As their faith in the system grows, they can better focus on advising the patient as best as they can.
What lies ahead
The MOH accepted the workgroup's recommendations earlier this month.
Senior Minister of State for Health and Law Edwin Tong had said that where needed, the law will be changed, and this should happen by the first half of next year.
Doctors said they hope patients understand that medicine is not an exact science.
Dr Wong Seng Weng, medical director of The Cancer Centre, said there is a real danger in following the letter, rather than the spirit, of recommendations on the discussion of diagnosis, prognosis and treatment options.
Hopefully, increased use of mediation, as recommended by the workgroup, will help strengthen the trust between patients and doctors.
The workgroup said that 90 per cent of complaints do not involve professional misconduct, and a high proportion of them have elements of communication breakdown. So far, only about 2 per cent of the complaints each year are referred for mediation.
Mediation provides a forum for patients to seek answers and redress directly from the doctor in appropriate cases, it said.
Education will also play a part in improving matters, with all doctors to be educated on medical ethics and decision-makers in the disciplinary process to be trained.
Colorectal surgeon Teoh Tiong Ann, who has served on the SMC's complaints committee for about six years, said the training of decision-makers will introduce "consistency in all decisions in the very difficult sphere of medical ethics and conduct".
TOMORROW: EDUCATION
