Moral Ethnic
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ST Forum
Feb 25, 2006
REACTIONS TO CLINIC TURNING AWAY PATIENTS
Wrong to refuse any patient at closing hour
I WAS shocked to read Mr Lim Boon Hee's letter about doctors who refused to treat patients (ST, Feb 24). He claims that the doctors can turn away patients at the clinic's closing hours. He is totally wrong.
The medical profession is not like any other business. A convenience store owner can decline to sell to customers who knock at the shop's closing time but not a doctor.
Every doctor takes a pledge that he will put the interests of the patients first. A doctor has a social, moral and legal duty to attend to a sick person at any time.
Suppose a doctor refuses to treat a sick person because he has to go home and the patient dies. The doctor can be held responsible for it.
Natarajan Nageswaran
I am appalled by Lim Boon Hee remarks who seems to have been a responsible indiviual who often contributed to the ST Forum. Where have all the moral ethics gone to? -
ST Forum
Feb 25, 2006
Doctor's duty to save lives, not watch the clock
I AM shocked and read with disbelief Mr Lim Boon Hee's views in 'Doctors at fault? That's not always the case' (ST, Feb 24).
I am not a medical doctor but I know what is professional ethics. To the man-in-the-street, a doctor's job is to save lives.
When a clinic operates till midnight, it means that as long as the patients are at the clinic before midnight, the doctor has a duty and obligation to attend to them.
If there are worries that the doctor and his staff will go home late, then don't operate until midnight. It's as simple as that.
I was very shocked at Mr Lim's view in supporting the clinic operating during holidays and attending only to its regular customers. This is placing commercial considerations over everything else.
My four children had taken Klacid MR when they were sick. But it was always the last resort before my family doctors prescribed it for my children, and only after other antibiotics fail to have any effect on their condition.
Klacid MR is usually not prescribed on the first visit. I was told that where possible, we should let our body build up resistance rather than rely on antibiotics to fight the germs.
Tay Sok Khoon
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you mean ethics?
check out what's happening in the world now..
it is a sad sad indication of where we are in the world when those who throw away ethics are the ones who move up the highest...
i still think if the doctors are not required to take the Hippocratic Oath these days, they should do it again...
it would remind them why they are a doctor... -
next time i go to the clinic for visit at closing time.
if they say they r closing, can i sue the clinic?
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Originally posted by the Bear:you mean ethics?
check out what's happening in the world now..
it is a sad sad indication of where we are in the world when those who throw away ethics are the ones who move up the highest...
i still think if the doctors are not required to take the Hippocratic Oath these days, they should do it again...
it would remind them why they are a doctor...
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Doctor?
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Hippocratic Oath
I swear to fulfill, to the best of my ability and judgment, this covenant:
I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.
I will apply, for the benefit of the sick, all measures which are required, avoiding those twin traps of overtreatment and therapeutic nihilism.
I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.
I will not be ashamed to say "I know not," nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery.
I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.
I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.
I will prevent disease whenever I can, for prevention is preferable to cure.
I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.
If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help. -
Ethics? This is not Stone Age. Who cares about ethics now? Money makes the world goes round. That applies to everybody. Talking about ethics, some clinics have even resorted to marketing approaches to boost sales. It has been reported in the Sunday Times and the reporters query about their ethics. Some of those vitamins basically have no use for health, but doctors are selling it.
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SAF MO best doctors around... the best i hhave seen...long live MO
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well DR's are suppose to SERVE the society..
refusing patient's is a no no..
charging extra after hours is a no no..
well..some doc are like that..money minded rascals....
let that guy try and see if his son got high fever and he comes to my clinic and i say..sorry man...after hour d lo..byebye!
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Ministers are supposed to serve the society, but unless you pay them millions they will be corrupt.
What do you think is the message the government is sending to our young people? "There is no free lunch...you have to be realistic....you cannot attract the best people by relying on atruism...." With these messages we get from the government, why should anyone be surprised? Doctors are not stupid...they can see where the government is heading.
If society expects the medical consultation to be a social service rather than a purely commercial transaction, then society must put their money where it matters. Medical students pay $18000 a year for their studies in NUS and acquire a huge debt when they graduate. As I have mentioned before, we can only expect to produce doctors who want to earn as much money as possible quickly to repay the debt.
I know many young doctors do locums to supplement their income in the hospital. In addition to the long hours in the hospital they work additional hours in such clinics. I cannot imagine how they can function if they sleep past midnight each day and start early the next morning dealing with seriously ill patients.
You must also put yourself in the position of the clinic staff, who were the ones who sent the patients away in any case. They have a contract and no overtime is offered if they stay later. Obviously they do not want to take additional patients. The doctor may have an ethical obligation and is governed by the Singapore Medical Council in this regard but not the clinic staff.
In addition, there are 24-hour clinics and emergency departments available for those who are very ill.
Whilst I think every doctor must attend to any seriously ill patients in any circumstance, I do believe one must not expect doctors to be saints when society clearly does not accord that kind of high regard to medical practitioners any longer today.
What the clinic should have done is to accept the patients but charge a high premium (say, $50 extra) for seeing patients outside of their operating hours. The money should then be given to the clinic staff for staying back later. -
You know where the country is headed when people at the top say they will only help when there is a budget surplus.Originally posted by oxford mushroom:Ministers are supposed to serve the society, but unless you pay them millions they will be corrupt.
What do you think is the message the government is sending to our young people? "There is no free lunch...you have to be realistic....you cannot attract the best people by relying on atruism...." With these messages we get from the government, why should anyone be surprised? Doctors are not stupid...they can see where the government is heading.
If society expects the medical consultation to be a social service rather than a purely commercial transaction, then society must put their money where it matters. Medical students pay $18000 a year for their studies in NUS and acquire a huge debt when they graduate. As I have mentioned before, we can only expect to produce doctors who want to earn as much money as possible quickly to repay the debt.
I know many young doctors do locums to supplement their income in the hospital. In addition to the long hours in the hospital they work additional hours in such clinics. I cannot imagine how they can function if they sleep past midnight each day and start early the next morning dealing with seriously ill patients.
You must also put yourself in the position of the clinic staff, who were the ones who sent the patients away in any case. They have a contract and no overtime is offered if they stay later. Obviously they do not want to take additional patients. The doctor may have an ethical obligation and is governed by the Singapore Medical Council in this regard but not the clinic staff.
In addition, there are 24-hour clinics and emergency departments available for those who are very ill.
Whilst I think every doctor must attend to any seriously ill patients in any circumstance, I do believe one must not expect doctors to be saints when society clearly does not accord that kind of high regard to medical practitioners any longer today.
What the clinic should have done is to accept the patients but charge a high premium (say, $50 extra) for seeing patients outside of their operating hours. The money should then be given to the clinic staff for staying back later. -
gone with the rain.
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Then do away with the clinical staff. Doctors can take turns to be administrative staff like the clinical staff do. I just don't see why they can't do that.Originally posted by oxford mushroom:Ministers are supposed to serve the society, but unless you pay them millions they will be corrupt.
What do you think is the message the government is sending to our young people? "There is no free lunch...you have to be realistic....you cannot attract the best people by relying on atruism...." With these messages we get from the government, why should anyone be surprised? Doctors are not stupid...they can see where the government is heading.
If society expects the medical consultation to be a social service rather than a purely commercial transaction, then society must put their money where it matters. Medical students pay $18000 a year for their studies in NUS and acquire a huge debt when they graduate. As I have mentioned before, we can only expect to produce doctors who want to earn as much money as possible quickly to repay the debt.
I know many young doctors do locums to supplement their income in the hospital. In addition to the long hours in the hospital they work additional hours in such clinics. I cannot imagine how they can function if they sleep past midnight each day and start early the next morning dealing with seriously ill patients.
You must also put yourself in the position of the clinic staff, who were the ones who sent the patients away in any case. They have a contract and no overtime is offered if they stay later. Obviously they do not want to take additional patients. The doctor may have an ethical obligation and is governed by the Singapore Medical Council in this regard but not the clinic staff.
In addition, there are 24-hour clinics and emergency departments available for those who are very ill.
Whilst I think every doctor must attend to any seriously ill patients in any circumstance, I do believe one must not expect doctors to be saints when society clearly does not accord that kind of high regard to medical practitioners any longer today.
What the clinic should have done is to accept the patients but charge a high premium (say, $50 extra) for seeing patients outside of their operating hours. The money should then be given to the clinic staff for staying back later. -
Because it will be very expensive for the patients. Consider the difference in salaries between the doctor and the clerk. If the doctor were to do the administrative duties as well, he will see fewer patients and so must charge more per case.Originally posted by ndmmxiaomayi:Then do away with the clinical staff. Doctors can take turns to be administrative staff like the clinical staff do. I just don't see why they can't do that. -
Originally posted by the Bear:
You know the pun... they call it the Hypocritic Oath
[b]Hippocratic Oath.[/b] -
Heehee, I was thinking of double salaries, which means when work as clerk one salary, when switch back to doc mode doc's pay.Originally posted by oxford mushroom:Because it will be very expensive for the patients. Consider the difference in salaries between the doctor and the clerk. If the doctor were to do the administrative duties as well, he will see fewer patients and so must charge more per case. -
well, i guess in the day where the plastic surgeon earns the most, and the plastic surgeons who do cosmetic surgery which earn more than those who do real work of correcting birth defects, this is going to happen...
reminds me of where i work..
those with no ethics climb so fast.. and those who work responsibly, are never elevated from their current job...
oh well..
as long as my conscience is clear, the crawlers can go brown-nose their way or stab their way to the top.. it's their business
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In one swift move, the bulk of X-rays are now outsourced to India for reporting. Local radiologists must either move into a different subspecialty to do therapeutic radiology or lose their jobs. Even so, they will probably have a pay cut because there will be less work for more of them.
How do you tell young doctors that medicine is not just a trade? I think this policy move is correct if we want to lower healthcare costs but the adverse effect of this is that we may see the beginning of the end of diagnostic radiology in Singapore. Why should any young doctor want to specialize in this field when they can make more as cosmetic surgeons? Besides, the Indian cosmetic surgeons in Bangalore are too far away to compete with them for patients here... -
wooh.. when did chit chat become speaker's corner.Originally posted by oxford mushroom:In one swift move, the bulk of X-rays are now outsourced to India for reporting. Local radiologists must either move into a different subspecialty to do therapeutic radiology or lose their jobs. Even so, they will probably have a pay cut because there will be less work for more of them.
How do you tell young doctors that medicine is not just a trade? I think this policy move is correct if we want to lower healthcare costs but the adverse effect of this is that we may see the beginning of the end of diagnostic radiology in Singapore. Why should any young doctor want to specialize in this field when they can make more as cosmetic surgeons? Besides, the Indian cosmetic surgeons in Bangalore are too far away to compete with them for patients here... -
Opposite views.
Extract from ST Forum 28/2/06
AM disgusted with the letters 'Wrong to refuse patient at closing hour' and 'Doctor's duty is to save lives, not watch the clock' (ST, Feb 25).
Both preached the principles about a doctor's obligations. I wonder if they have missed the point completely in the rebuttal by Mr Lim Boon Hee. The fact is most patients go to a clinic for non-emergency conditions such as flu or common cold.
Correct me if I am wrong. There is currently no strain of pathogen causing the influenza or common cold that's acutely present just a few minutes before midnight. Most of the patients would have been experiencing symptoms in the preceding hours and there is no reason for them to be attended to when they decide to turn up at the clinic at closing time.
These patients should not blame others for their own procrastination. Closing time does not equate end of registration time. It is meant for the doctor to finish seeing cases that had the courtesy to present themselves in the ten to twenty minutes before closing time.
Granted the rare situation where a patient presents himself at the clinic in an emergency, it is the doctor's right to refuse any other patient, subject to his judgment.
In the same vein, if he refuses to see a patient who then collapses, it's his responsibility to bear.
There's no need for the 'man in the street' to take the high ground and preach to a doctor his professional obligations. It is typical that patients here use rhetoric to justify their lack of consideration.
In essence, it just seems wrong for the doctor to do anything that displeases the patient.
Perhaps Singaporeans have their perception of reality tainted by medical dramas from Hollywood or Caldecott Hill which depict photogenic doctors going out on a limb to uphold the patients' interests.
Let's keep it real and bear in mind that doctors are not individuals with super-human capabilities but are human beings who need a well-deserved rest at the end of a long day in the clinic.
Tan Shian Ming -
I don't know about you but what will happen to patient confidentiality issues when your medical records are sent overseas for diagnosis?Originally posted by oxford mushroom:In one swift move, the bulk of X-rays are now outsourced to India for reporting. Local radiologists must either move into a different subspecialty to do therapeutic radiology or lose their jobs. Even so, they will probably have a pay cut because there will be less work for more of them.
How do you tell young doctors that medicine is not just a trade? I think this policy move is correct if we want to lower healthcare costs but the adverse effect of this is that we may see the beginning of the end of diagnostic radiology in Singapore. Why should any young doctor want to specialize in this field when they can make more as cosmetic surgeons? Besides, the Indian cosmetic surgeons in Bangalore are too far away to compete with them for patients here... -
And just how often are we're gonna be having any 'budget surplus' when ALL our money is SWALLOW UP in a 'well-deserving' manner by them...? Whenever we have elections..?Originally posted by charlize:You know where the country is headed when people at the top say they will only help when there is a budget surplus.
Hmm... MAYBE we should just hold ELECTIONS every month... Then SINGAPOREANS could be RICH...? -
no need,... the 1900 numbers on TV is enough to boost economy...Originally posted by Devil1976:And just how often are we're gonna be having any 'budget surplus' when ALL our money is SWALLOW UP in a 'well-deserving' manner by them...? Whenever we have elections..?
Hmm... MAYBE we should just hold ELECTIONS every month... Then SINGAPOREANS could be RICH...? 
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Originally posted by charlize:I don't know about you but what will happen to patient confidentiality issues when your medical records are sent overseas for diagnosis?
