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News from Council

1. MOH Survey on Antibiotics Prescribing Practices in General Practice 1999

The SMA sent out a circular to all members on 24 June 1999 regarding the above Survey conducted by MOH. In the circular, we mentioned that we have written to Singapore Medical Council to request that the doctors involved in this Survey will be protected should their patients complain of breach of confidentiality arising from this Survey. The SMCís reply received on 25 June 1999 is as follows:

"We understand that the survey is conducted by inspectors from the National Pharmaceutical Administration of the Ministry of Health. These officers are empowered under the Poisons Act to extract the information from the records in the clinics. Doctors can be assured that their patientsí confidentiality will be respected."

In a separate letter to an individual member who has written directly to MOH, Dr Chew Suok Kai, Director of Epidemiology Disease Control gave the same assurance that the confidentiality of the patients will be respected in the survey.

Dr Chew added that "the Private Hospitals and Medical Clinics (Amendment) Act 1999 provides for the supply of information relating to the patientís diagnosis and treatment by the doctor in charge of the clinic to the Director of Medical Services without prior consent of the patient. The same Act also safeguards medical confidentiality by providing penalties against the unauthorised use of the information obtained."

We extract the relevant Acts of the Private Hospitals & Medical Clinics (Amendment) Act 1999 below for your reference:

11 (3) The Director in order to -

(b) assess the quality and appropriateness of the facilities and services provided and the practices and procedures being carried out at the private hospital, medical clinic, clinical laboratory or healthcare establishment, may, at any time, require the licensee or person having the management or control of a private hospital, medical clinic, clinical laboratory or healthcare establishment to furnish such information as the Director may require relating to -

(iii) the condition, treatment or diagnosis of any person who has been or who is being treated or examined at the private hospital, medical clinic, clinical laboratory or healthcare establishment, notwithstanding that the prior consent of such person has not been obtained.

12 (2) The Director and an authorised officer shall not disclose any information which is contained in the medical record, or which relates to the condition, treatment or diagnosis, of any person, as may have come to his knowledge in the course of carrying out any investigation or performing any duty or function under this Act unless the disclosure is made -

(a) under or for the purpose of administering and enforcing -

(i) this Act;

(ii) the Infectious Diseases Act (Cap. 137); or

(iii) the Termination of Pregnancy Act (Cap. 324);

(b) for the purpose of any disciplinary proceedings under the Dentists Act (Cap. 76) or the Medical Registration Act (Cap. 174); or

(c) for any other purpose with the consent of the person to whom the information relates or the representative of such person.

16. If any person discloses to any other person any information obtained by or given to him in pursuance of this Act he shall, unless the disclosure was made in the performance of his duty, be guilty of an offence and shall be liable on conviction to a fine not exceeding $5,000.

(Please refer to the excerpts amended Act on N13, N14 and N15).

2. Best Doctor International

Some members have received invitation to list their names and practices in the database of "Best Doctor International", a healthcare services company based in the United States that provides information to the public about and access to the "best" medical care. The same company has also approached the SMA to assist them in corresponding with our members regarding their current project.

We would like to advice members not to accept their invitation to be listed on the Best Doctor International Network as "Best" doctor suggests that doctors in the list are superior to others. Our advice is based on the SMC Ethical Code and the Private Hospital and Medical Clinics Advertising Guidelines.

Furthermore, we have written to Best Doctors International that the SMA cannot subscribe to the concept of the "Best Doctor" project as it runs contrary to the ethical concepts that govern medical practice. We pointed out in the letter that: ĎAll doctors who hold a valid practice certificate in Singapore are deemed to be competent within their areas of practice. If they are proven to be contrary, then action can be taken to remove them from the stateís medical register. There is therefore no need for a listing of good doctors that you are proposing.

"Best" doctors, as stated in the list are certainly NOT the only doctors who can provide competent care. The actions of listing them and circulating them to the public would give the doctors outside the list an unfair disadvantage. The doctors on the list will also be under pressure to meet expectations from patients, which may be unreasonably high.í

We have also brought this matter to the attention of the SMC and MAAU.