What exactly is a good doctor-patient relationship? A relationship takes two parties to nurture. Much of what takes place in a relationship remains unwritten but understood. If everything were to be written down and signed, then it would be documented as a contractual relationship between signatories. But a doctor-patient relationship is more than a blunt legal contract. While good case-notes are a cornerstone of good care, they only represent medical and factual recordings of this relationship.

It is a relationship where doctors undertake the following (non-exhaustive) to their patients:

a) to be non-maleficent (do no harm)

b) to be beneficient (do good)

c) to respect patient confidentiality

d) to respect patient autonomy and self-determination

e) to be truthful and not withholding relevant information

It is a relationship whereby patients undertake on their part to also reciprocate with the following (also non-exhaustive):

a) to be truthful and not withholding relevant information

b) to consent to be questioned and physically examined

c) to be compliant with doctors’ advice and management to a reasonable degree

d) to make payment for services rendered (when there is no third-party payment)

All this takes place against the backdrop of the law of the land, and common etiquette and courtesy expected of a reasonable and responsible adult. Some of the above obviously do not apply to children, and psychiatric and certain severely ill patients. The doctor-patient relationship is therefore one of trust and mutual respect, without the need for written contracts, formal or informal. We believe that this is the way for a good doctor-patient relationship to develop, which in turn is crucial for good care.

Now, in the light of this, what do we make out of Dr Charles Loo’s rules for his 6-10 Clinic & Surgery as reported on 2 November 98 in The Straits Times? Not only are his rules under scrutiny, but the nature of the doctor-patient relationship as well. But let us first examine his Rules. Certainly, upon careful scrutiny, there is nothing that is blatantly unethical about the Rules. They do not really put the patient at any great disadvantge. In fact, there is much truth in what Dr Loo claims, "all the rules are about common courtesy and etiquette". However, the fact that rules are so declared for "common courtesy and etiquette" demeans if not nullifies the quality of the common courtesy and etiquette so obtained. More importantly, can a good doctor-patient relationship arise and grow out of such an "adversarial" and "distrustful" stand?