SMC shouldn’t confuse message with messenger
(11 Jan 2013)
I AM perplexed and disappointed by the Singapore Medical Council’s response (“Disciplinary cases fairly heard: SMC”; Wednesday) to feedback on its disciplinary processes.
While the council is fully entitled to defend its position, its comments about Dr T. Thirumoorthy and Dr Chua Boon Ling were uncalled for. These two doctors offered feedback to improve a process that the Court of Appeal had openly criticised, even using the words “legally embarrassing”.
Even if the council disagrees with the feedback, it should make a clear distinction between the message and the messenger.
It is appropriate to vigorously challenge the validity of comments or suggestions. It is inappropriate to cast aspersions on those offering these comments, and attack them rather than their ideas.
As a doctor, I am saddened by the conduct of the council and its treatment of fellow doctors offering feedback. As a Singaporean, I am alarmed at the hostility towards alternative perspectives.
Jeremy Lim (Dr)
SMC should relook its role
(11 Jan 2013)
I AM disappointed that the Singapore Medical Council (SMC), in its letter (“Disciplinary cases fairly heard: SMC”; Wednesday), chose to focus on the smaller point of financial considerations instead of its role as “prosecutor, judge and jury”.
The SMC has done a good job in most of the cases involving errant doctors peddling addictive medications for financial gain.
However, its track record in other cases is more spotty. Some doctors have the view that if they ever get called up for an SMC disciplinary hearing, they would be unlikely to get a fair trial. This has led, as Dr T. Thirumoorthy pointed out, to doctors resorting to defensive medicine (“Medical council: Prosecutor, judge, jury”; Dec 30).
It is good that the SMC now appoints non-member doctors to the disciplinary tribunal. But it should not give the impression that the doctors are appointed because they toe the official line, as this could fuel distrust on the ground.
There is also the question of whether the training for these ad hoc appointed doctors is sufficient. Medicine often is a matter of professional opinion rather than an impartial study of the facts of a case. The influence of a lawyer on the tribunal may or may not make a difference, depending on the individual.
The SMC and the Health Ministry should relook their roles. Having the ministry as the complainant, an independent non-appointed tribunal as the investigator and jury, and a fully elected SMC as judge is something worth exploring.
Disciplinary cases fairly heard: SMC
(9 Jan 2013)
THE article (“Medical council: Prosecutor, judge, jury”; Dec 30) reports the opinions of Dr T. Thirumoorthy, suggesting that the Singapore Medical Council’s (SMC) concurrent roles of prosecutor, judge and jury cause conflicts of interest.
The SMC’s cases reported in the media recently were dealt with under the old Medical Registration Act as the complaints were made before the amendments came into force on Dec 1, 2010.
The SMC is now no longer bound by law to appoint its council members to the disciplinary tribunal. Experienced doctors and lawyers can now be appointed to the tribunal as members or as the chair. As the SMC continues to push for such changes, we hope that doctors will support these in the public interest.
The report cites Dr Thirumoorthy as pointing out that it is not in the SMC’s interest to lose a case, and “if a doctor is acquitted, SMC has to bear its own legal fees”. This suggests that disciplinary cases may be unfairly heard. Such a serious allegation must be corrected.
The tribunals and disciplinary committees (DCs) are formed to determine the truth through fair and independent hearings. The council never directs the outcomes of any hearing, nor has it made the issue of legal fees a factor influencing the decisions of the DCs. We hope that Dr Thirumoorthy, during his tenure as a council member, acted fairly, like all his colleagues on the council.
In his letter (“Lack of experience in ethics hinders SMC”; last Thursday), Dr Chua Boon Ling implied that the DCs lacked maturity and training in ethics to judge their peers. His insinuation can mislead the public. A doctor of the same name, Dr Chua Boon Ling, convicted by the DC for inappropriate prescribing in 2010, was in fact ably judged by three very senior doctors of high standing, namely, a former president of the Singapore Medical Association (SMA), a former executive director of SMA’s Centre for Medical Ethics and Professionalism, and a respected family physician.
It is important that the SMC lays out the facts correctly and responsibly in the media, as many senior doctors and laypersons sacrifice many hours serving on the DCs in the interest of the public. Their good work should not be discredited by frivolous comments.
Lau Hong Choon (Dr)
Professional Conduct & Professional Standards Division
Singapore Medical Council
Lack of experience in ethics hinders SMC
(3 Jan 2013)
I AGREE with Associate Professor T. Thirumoorthy (“Medical council: prosecutor, judge, jury”; Sunday) that there is clearly a conflict of interest in the disciplinary process of doctors. Most doctors would not see this conflict of interest until one is unfortunate enough to be involved in a disciplinary inquiry.
Another point is the competence of the doctors sitting in judgment of a colleague. The Singapore Medical Council (SMC) is made up of volunteer doctors, half of whom are elected by doctors working here and the rest appointed by the Health Ministry. They come from various disciplines of medicine and are distinguished in their specialised fields.
However, in a disciplinary hearing, the topic of debate is nearly always medical ethics, which was not extensively taught in medical schools in the past.
Although the council has a set of ethical codes and guidelines, sitting in judgment of one’s colleague requires more than just reading the ethical codes.
One has to have the maturity (in life and professional experience) and training in the field of ethics to be adequately equipped to judge one’s peers. This is true of Prof Thirumoorthy who regularly conducts courses on ethics for doctors.
An inexperienced member of the council stands the risk of being overly influenced and reliant on the prosecution lawyers, who also may not be well-versed in medical ethics.
Coupled with the conflict of interest in the disciplinary process highlighted by Prof Thirumoorthy, this means there may not be a fair trial. The recent cases where the appeal court overturned the SMC verdict clearly show the need to review this process.
Chua Boon Ling (Dr)