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)
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