Medical "code of conduct"

Straits Times 13th Jan 2010

It was good news that the SIN government taken steps in updating the Changes in doctors' code of practice and conduct.

THE Medical Registration Act, strengthened on Monday with tougher enforcement and oversight, comes 12 years after it was gazetted though the period seems rather long without much updates. During that time, patients' expectations of doctors' competence and "ethical" observance rose sharply with an outpouring of medical information in books and online. Although much simplified for layman use, a lot of it comes from doctors themselves and reputable hospitals and medical schools. An impression began to be formed that some doctors here who had malpractice and other complaints made against them were getting off lightly. You see some cases of patients suing doctors but not much impact on these professionals though.  Another grievance was that complaints took too long to be investigated and results were not made public.

The new penalties and professional requirements written into the amended Act are thus forbidding, in the circumstances. Fines for doctors in breach are raised by a whopping 10 times to $100,000 ( but I think this sum is not going to hold much weight or cause any stir compare to the money they earn yearly ) and they can be suspended for longer than the present limit of three years. Most significant is a refinement of the law of evidence: Health Ministry investigators can remove documentary and other evidence from a doctor's office without notice. This will eliminate negative inferences, as the practice has been for the doctor complained against to produce the records. The Medical Council's count of statutory members and outside personnel hearing cases will also be augmented to expedite clearing of complaints. And to keep matters focused, lawyers will have a role in disciplinary tribunals adjudicating on complaints.  

Without prejudice to doctors, the majority caring of patients' welfare, the lay public will see the enhancements as an overdue balancing out. Doctors' actions undoubtedly will be scrutinised more closely and the development should properly be regarded as a social advance, of benefit to patients (their rights) and doctors (their professional standing).

The process of advancement is incomplete, however, until transparency is made an ingredient. Hearings and outcomes of complaints before the Medical Council are closed-door affairs. This has to change. Citing patient confidentiality is not as convincing an argument in serving justice, as giving cause to the unquestioned virtue of full disclosure. Justice has to be seen to be done and I think our health minister is working hard on this and have full confidence in him and no doubt about his capability looking back at his actions for the past two years on health cost and fee, H1N1, etc.