Doctors warned against overcharging, overtreating

Posted on March 20, 2018.

SMC tells doctors it won’t hesitate to take action; MOH monitoring charging practices

Salma Khalik Senior Health Correspondent

Doctors in Singapore have been warned that they will face action from the body that regulates them, as well as the Ministry of Health (MOH), if they overcharge patients or put them through superfluous treatments.

This comes on the heels of recent moves to rein in balloon-ing healthcare costs, partly brought on by “hefty and ques-tionable insurance claims” in which some doctors were said to have played a part.

Needless treatments and inflated medical charges were mentioned in Parliament earlier this month to explain the decision to stop further sale of full insurance riders that leave patients with nothing to pay for their treatment.

A spokesman for the ministry told The Straits Times: “The MOH is monitoring doctors’ charging practices, and action will be taken in cases of those who overcharge and/or over-service their patients.

“This includes referring egregious cases to the Singapore Medical Council (SMC). Insurers and patients can also lodge such complaints to SMC.”

Meanwhile, all 13,500 doctors in Singapore have received a circular from SMC which indicated that it would not hesitate to act against any doctor found flouting the guideline against overcharging and overtreating patients.

It said patients fully or largely covered by insurance may be less likely to contest the fees charged by a doctor. “However, patients’ acquiescence to a doctor’s fees does not absolve the doctor of the responsibility of charging reasonable fees.”

The SMC also reminded doctors not to subject patients to unnecessary tests or treatments that are not clinically required, just because a patient wants them.

It said: “Acting in a patient’s best interests does not mean doing everything a patient wants.”

The SMC acknowledged that there is no prohibition against hospitalising a patient for what is normally a day surgery.

But it sent out a warning: “Doctors must not recommend hospitalisation where there is no clinical justification to do so and for the primary purpose of charging higher fees.”

Even where a doctor does not set the fees, so long as he has a material financial interest, “he must satisfy himself that the fees abide by SMC’s ethical standards”.

Senior Minister of State for Health Chee Hong Tat had told Parliament earlier this month: “Some of the examples of over-consumption and over-servicing are – to put it plainly – disturbing.”

He cited several cases, including one where a patient, fully covered by his health insurance, “made claims for 12 nose scopes in a year, without clear medical need”.

One specialist in private practice told The Straits Times: “We tell ourselves, with a tinge of envy, not to be lured to the ‘dark side’.”

He added that with no fee guidelines, and willing patients who do not have to pick up the tab, some doctors try to test for every condition, no matter how unlikely.

Another doctor said the problem of overcharging goes beyond just doctors: “Private hospitals rent out rooms where rates are pegged to the amount of business you bring in. There is a tendency to over-service.”

The SMC spokesman said: “The SMC investigates complaints of alleged over-servicing and over-charging by doctors. It can take disciplinary actions against errant doctors… and has done so before.”