Thursday, April 21, 2016
Singapore - Ensure clear line between medicine and business
Advertisements promoting health screening and various medical services are rampant.
Medical tourism is now a major engine of economic growth, and Singapore has ambitions to be a world-class medical centre.
But we must ensure that we do not capitalise on any economic exploitation of the anxious "well".
I often see patients who, in their naivety, have been lured to various screening and imaging centres.
Often, a CT scan is conducted and the patient informed that the machine is state of the art and that the radiation dose is "low".
If one screens older individuals, incidental coronary disease is often present.
The patient is then told that serious "blockages" are present and that an angiogram is required, with the possibility of an immediate implantation of a stent.
Sometimes, the doctor advising the patient is also a major investor in the enterprise. Such issues of conflict of interest are not addressed.
I am all for enterprise, but not at the expense of the uninformed, somewhat gullible and easily intimidated patients, many of whom come from neighbouring countries with poorer medical facilities.
Perhaps we need a mechanism like the Stark law in California, where it is mandatory for patients to be informed whenever they are referred to any imaging, diagnostic or treatment centre where the doctor has a financial interest.
Patients should also be informed if there are plans for the enterprise to launch a public offering.
Medicine and business are simply not compatible.
The medical profession should stand up and uphold its basic principle of patient advocacy at all costs.
To distinguish ourselves as a centre of medical excellence requires an infrastructure that ensures that patients' rights are respected, particularly their rights to seek alternative opinions and to participate in decision-making.
They must also be appropriately warned of any conflict of interest.
Christopher Chew Yee Chian (Dr)