SMC guidelines apply even for electronic MCs: MOH

SINGAPORE — The Ministry of Health (MOH) has cautioned that the issuance of medical certificates (MCs), whether in a paper or electronic format, carries with it the “responsibility to ensure that the patient requires it on medical grounds and that such grounds have been arrived at thorough comprehensive medical assessment”.

MCs must be given according to the principles set out in the Singapore Medical Council’s ethical code and ethical guidelines, an MOH spokesperson said, in response to TODAY’s queries about patients seeking medical consultations online and getting electronic MCs more conveniently.

In these cases, doctors must also ensure security protocols to prevent fraud, she said.

She added that virtual consultations are “typically conducted as an extension of care for stable patients”, such as after a doctor has had a face-to-face assessment and is satisfied that his or her patient is suitable for an e-consultation.

“Where face-to-face consultation is not practical, and care is exclusively delivered (virtually), the quality of care provided should not be compromised. A face-to-face evaluation/consultation should ideally be done soon after,” the spokesperson said, adding that the onus is on the doctor to ensure such a practice.

“Having disclaimers on such platforms will not absolve the doctors of any professional misconduct, negligence or incompetence,” she pointed out.

“If in doubt, doctors should offer to see the patients face-to-face, so that they are able to conduct a proper physical assessment of the patient.”

The MOH did not respond to queries on whether there are concerns of “fee-splitting” or “fee-sharing” between the app providers and doctors.

The SMC came down hard on fee structures for third-party administrators last year, and has since barred doctors from paying fees to such agents, which help process medical claims that are calculated as a percentage of fees that doctors charge their patients.

Mr Erman Tan, 53, president of the Singapore Human Resources Institute said that firms typically accept MCs issued by their approved healthcare partners.

“Organisations in the public sector are more conservative, but start-ups and tech companies are warming up to the idea of e-MCs, which may be more in line with their culture of encouraging work-life integration,” Mr Tan said.

Ms Fiona Bartholomeusz, 49, managing director of creative agency Formul8, said that her firm recognises the convenience of virtual health consultation services.

“We work so much in the digital space and, for a service-based company, time is money.

I’d much rather (that) staff can first check with a doctor from the comfort of their own homes or even in the office, than them being inconvenienced by having to sit for hours in a waiting room just to get advice for basic medical ailments,” she said.