Psychiatrist suspended, fined for irresponsible drug prescription

SINGAPORE - A 63-year-old psychiatrist was suspended for six months and fined $15,000 for prescribing medication to a patient, despite knowing that he was at risk of abusing it.

Dr Siew Hin Chin also failed to carry out a proper evaluation of the patient's conditions -anxiety, insomnia and obsessive compulsive disorder - before giving him the drugs, a Singapore Medical Council (SMC) disciplinary tribunal found.

The patient had sought treatment from Dr Siew at Simon Siew Psychological Medicine Clinic in January 2010 and remained under his care for nearly four years.

His "complex case" involved multiple chronic illnesses as well as relationship issues with his family, wife and girlfriend. The man had been to see another doctor and was already on several types of medication.

But during the time that he was under Dr Siew's care, the patient was prescribed 20 kinds of medication, including anti-depressants, anti-anxiety drugs, sleeping pills and anti-convulsants used to stabilise his mood.

The Singapore Medical Council's (SMC) disciplinary tribunal found that Dr Siew did not check to see whether these drugs were effective, if there were any side effects or if the patient was at risk of developing drug tolerance or dependency.

He also did not implement a plan to wean the patient off his medication or keep proper medical records for him.

In addition, he did not follow up on whether he had the potential to abuse the drugs, despite his frequent visits to the clinic to collect repeat prescriptions ahead of schedule. The man's family members raised concerns about this issue five times.

A complaint was eventually lodged with the SMC by the patient's mother, who was "concerned with the high number of medications prescribed".

Dr Siew was "at all material times aware that a reasonable and competent doctor in his position would have exercised caution in the way he prescribed medications," the SMC said in its published grounds of decision on the case.

The inquiry's judgement took into consideration mitigating factors, such as his extreme remorse, early plea of guilt and good track record over 40 years.

"At all material times, he acted according to what he believed to be in the best interests of the patient," said the lawyers representing him in the grounds of decision.

Dr Siew has already taken steps to improve his practice. These include being more cautious when dispensing medication and not prescribing sleeping pills to new patients.