28th October 2003, 05:25 PM
ethical or not?
Can anyone offer me advice on what I should do? Should I write in to the straits times or?
A Traumatised Experience in a Clinic
Four months ago, in June, I broke my coccyx (tailbone at the end of the spine) when I sat down onto a sofa in a café. I accidentally landed with great impact (loud crack sound) onto the ‘solid’ seat as the space between the table and sofa was very narrow and the cushion of the sofa was too thin. Since then, I have been constantly experiencing pain. I have sought medical advice three months ago but my doctor told me if I did not experience pain and numbness in my legs or constipation, it would not be so serious. The tailbone would heal by itself within two months.
At that time, I did not have any pain in my legs or constipation. However, three weeks ago, I sprained my ankle and foot. Recently, it did not recover but instead swelled and developed rashes. I did not know if this is due to food or medication allergies. I thought it might have some linkage to the breakage of the tailbone as some nerves of the lower body might be affected. Damage to the tailbone threatens damage to the nerves of the lower body, thus I decided to seek medical advice again. This time, I decided to go to a private clinic that has X-ray facilities so that the doctor can more easily diagnose whether the tailbone had been pressing into my nerves. I was also hoping to get a reference/recommendation letter to a specialist in this area. Besides, my foot had a terrible itch, so I wished to have some ointment or injection to alleviate the pain or stop the itch.
On Monday 27 Oct 2003, my boyfriend accompanied me to a clinic. The signboard indicated the availability of two doctors, one male and one female. At 5.25pm, I got a queue number and I passed my NRIC to a female receptionist for first time registration. I waited at the counter for her to return me my IC but she did not. This lady went for dinner by 6pm. I waited for more than half an hour but still my IC was not returned to me. I went to the reception counter again to request for my IC back and asked them if this was the standard practice of holding onto people’s ICs for first time patients. The male receptionist said no but refused to give me back my IC, giving the excuse that I could only get it back at the neighbouring dispensary counter after I have seen the doctor.
As the queue was not moving and the female doctor had left, I asked the dispensary nurses when the doctors would be in. They replied to me that the doctor was in already. I decided to leave and was about to ask for my IC again. I hoped that they would return it back to me. Suddenly, the counter, at the male doctor’s room, beeped and flashed for my queue number. Relieved at a chance to get medical consultation, I went to his room, accompanied by my boyfriend. When I sat down, the middle-aged male doctor began speaking in a loud with deep urgency and impatience. When I told him of my tailbone problem, he even sneered at me during the whole duration when I elaborated about the breakage of my tailbone. I got jeered at when I asked him for medical advice.
Instead, he kept on asking me what I think should be the solution and what should be the treatment. I wondered silently to myself: “Isn’t a doctor supposed to give medical advice and recommend treatment or alternatives? Why is he asking me for my opinion?”
“Do you know what this clinic is for? What is this clinic doing?” He mocked derisively aloud. I shook my head, taken aback at his question as I thought I might have gone to the wrong clinic. “You don’t know? What can a small clinic like this do? What do you expect from us, such a small clinic? What are your expectations? What do you expect us to do? Do you expect me to perform an operation now and remove the fractured bone?! We can do nothing!”
“No… I didn’t.” I said. He offered not a word of sympathy; I was an object of deep ridicule, scorned and sneered at his will. Tears had welled up in my eyes and threatened to stream down my cheeks. I fought back the tears and listened quietly to his admonishments. Eyes brimming with unshed tears, I glanced up at him, imploring him to stop ridiculing me with my eyes. But he did not stop.
Then, my boyfriend, who stood one corner of the door, came to the rescue: “We seek your expert advice on this, Doctor.”
“Yes, I can offer you my expert advice. What any doctor can do is offer you some painkillers and advice. What do you think we can do? Yes, we can only offer you painkillers and our expert advice.” He reinforced on his words.
“Since you have the pain for almost half a year, 4-5 months. Even a bone fracture would have healed by now. What time does it take for a bone fracture to heal? Yes, 2-3 months. Your fractured tailbone would have healed by now. We can do nothing! The fault is not with us! You have problem! The problem lies in you. What do you expect me to do?!”
“But I broke my spine..”
“Spine?! You broke your spinal cord?” He jeered.
“Yes, isn’t the tailbone part of the spine?” I asked. He gave a snort.
“ Can you recommend me a specialist?” I ventured.
“ Can, of course I can! I know of very good specialists in Singapore. In fact, there are many good specialists overseas, the better ones are all over the world. But the problem is: who is going to pay for your medical bills? Can you afford to pay?” His mocking tone took me aback again. I wondered to myself: “Is the financial inability of a patient to be sneered at?”
I tried to prevent further mocking by going to the next health issue – my foot. I told him I sprained my foot three weeks ago and that I had applied medication on it.
He said: “ Who asked you? Who told you to do so? Women come into my office, jumping at me for their conditions. I always get scolded by them.”
I wondered silently to myself again: “Huh. He often got scolded by women. Does it mean that the women who visited him were also subjected to the same treatment as me?”
I tried to defend myself but I was not eloquent enough in my oral speech. He continued his mocking. At long last, I asked him if he could just give me some medical advice and recommend a specialist instead of scolding me. But he continued ranting on and on. I could not take it anymore and walked out of his office as I did not come to be mocked and ridiculed.
I went to the receptionist and demanded my IC to be returned back to me. But the clinic assistants refused to return it back to me. I kept asking my IC to be returned back to me after that, they said the doctor said later, I must wait. Then, they said that he said I could not get back my IC unless I paid up.
We went to the doctor’s office again and asked him to return me my IC. When he refused, we asked for his name card so we could lodge a complaint against him. He repeatedly claimed not to have any name card but contradicted himself by also saying that he could not and did not want to give us his name card.
Eventually, I paid up sixteen dollars for this consultation that I did not even receive any helpful medical advice and medication. It is such an irony that patients have to pay to be sneered at.
Last edited by innovas1; 29th October 2003 at 10:00 AM.
28th October 2003, 05:26 PM
I have a few queries. Is it a must or legal right for clinics to detain a person’s IC after registration? Personally, I have always gotten back my IC immediately after any first time registration at a clinic, this is the first time I have been denied my IC. It seems as if I have walked straight into a ploy. By retaining my IC and refusing to return it back to me until I have seen the doctor and paid for my medicine, is this an ethical medical practice? The IC is an important identification document for Singaporeans and permanent residents, no one has the right to detain your IC. An IC cannot and should not be used as a threat to make a patient see the doctor and pay for the medical fees. It should not be used as a threat to prevent patients from leaving to seek another doctor too.
The next point is that should a patient be denied healthcare based on the doctor’s judgement that he/she is unable to pay for the medical bills? He should not even mock at his patient’s financial ability. Patients must be given dignified care and humane treatment. He must give medical advice and behave sensibly, as befitting that of a doctor. He should not let the social standing of the patient influence his professional decision. Does it mean that if he finds me rich enough to afford a specialist by first look, then he will recommend me a specialist? Is everyone not equal in the eyes of the Law? Is reality so harsh that a poorer patient cannot even be given due respect and equal treatment as a richer one?
The contempt that I have received from this male doctor is truly hurtful. Is this the ethical and moral behaviour that a doctor should exhibit? To scorn patients and mock at them, is this accepted in the medical profession? Are doctors not supposed to keep to the Four Bioethical Principles? These principles are:
1. Autonomy - respect for the individual and their ability to make decisions with regard to their own health and future. Actions that enhance autonomy are thought of as desirable and actions that 'dwarf' an individual and their autonomy are undesirable.
2. Beneficence – obligations to benefit the patient and weigh the benefits.
3. Non-maleficence – obligations to avoid causing harm.
4. Justice- obligations of fairness in the distribution of benefits and risks.
These principles are prima facie.
The final question is: Subjected to scorn and deep ridicule, should a patient still be liable to pay for such a doctor’s consultation? When the doctor shows you impatience? When the doctor asks you what medical treatment do you think you should receive? When no proper treatment is recommended, no reference of specialists, no medication is given? When your IC is held against your wishes to make you stay? When a doctor holds you in his contempt? Treats you as a person with low economic status?
I hope that this would serve as a sound reminder that Singapore is a far way from being a global medical hub should this kind of black sheep continue to exist in this profession. Such unethical actions should be eliminated, only then would we be closer to our goal.
[According to Singapore - Codes and Declarations (MEA2A), the SMC Physician's Pledge is:
"I solemnly pledge to:
dedicate my life to the service of humanity;
give due respect and gratitude to my teachers;
practise my profession with conscience and dignity;
make the health of my patient my first consideration;
respect the secrets which are confided in me;
uphold the honour and noble traditions of the medical profession;
respect my colleagues as my professional brothers and sisters;
not allow the considerations of race, religion, nationality or social standing to intervene between my duty and my patient;
maintain due respect for human life;
use my medical knowledge in accordance with the laws of humanity;
comply with the provisions of the Ethical Code; and
constantly strive to add to my knowledge and skill
I make these promises solemnly, freely and upon my honour.” ]
28th October 2003, 05:32 PM
28th October 2003, 05:40 PM
Write to ST Forum.
If you need a reference to see a specialist, PM me. I can give you the contact of a excellent, reputed GP who can refer you.
28th October 2003, 05:41 PM
I sympathise with you.
His jeering and scorn could be due to the fact that the doc seems pissed off with the medical profession here... the fact that he kind of took you to the challenge when he picked on issues like what he could do as a doctor, what small clinics could do, and how much one can actually afford for specialist treatment.
I'm saying the above just to give that doc the benefit of doubt.
Then again, there are medical quacks out there who are really out for the money and are therefore NOT professional in their medical assessment of a patient. I've met several in S'pore, unfortunately and there's not much to protect the innocent (and often suffering patient) from these medical conmen.
Your case seems genuine. Perhaps if you really wanna take it up, I'd say ride on the media wave for now, especially when the NUH docs are being sued for the NS boy's demise due to the lack of medical professionalism.
It'll be a wake up call for slacking doctors in S'pore who think they can earn that extra dollar to get their BMW without putting in the effort to alleviate suffering people's pains.
Go for it!
28th October 2003, 06:07 PM
SHAME on this doctor! I'd have @#$@^ him upside down.
write to ST, your letter is a little too long though, not sure if you can write to CASE etc.
best wishes to the recovery of your health
28th October 2003, 07:18 PM
Very unprofessional.. Would have gotten hell from me if I'm there....
Complain to some organisation that keep tab of all doctiors registered in singapore. Can't remember the name but it's something like the Law society of Singapore. Or the Singapore engineers association or something something...
Case and New paper would be another good place to start.
28th October 2003, 08:34 PM
Totally unacceptable attitude.
Maybe our resident doc, Streetshooter would like to comment on this, and probably provide some avenues as to where she can actually point this issue out...
28th October 2003, 08:59 PM
28th October 2003, 09:01 PM
he has no right to do anything he did.
in fact you have the right to take legal action against the clinic (i.e. SUE THE F$#@ OUT OF HIM) for detaining your i/c without consent, for defamation, for making you feel depressed, for not doing his job as a doctor, and some other charges that i can't name coz i'm not a lawyer.
but one thing is for sure the clinic has no right to detain your i/c at all. last time got LAN shop or something detain someone's i/c then kena sued because it's considered like.. what.. something illegal lah. lol.
anyway i think it's good to complain somewhere. actually if it's too long it's okay. you can write to ST forum, either they shorten it, or they'll report it as an article for you. i think they will maintain anonymity. basically this complaint should be lodged with CASE as well as the medical society, as well as STB so that they can blacklist this clinic just like it blacklisted some camera shops.
hope you recover from your stinging problems soon. cheers.
28th October 2003, 09:01 PM
What an a**hole doctor.. Sue him!!, defame him!!, tear down his clinic name!!, burn the whole damn thing!!..
sigh, shame to a noble profession..
28th October 2003, 09:07 PM
yes..u won't know if someone will use the IC to borrow book from library or buy hp until few mths later when library or mobile company send u a warning for not paying bills
Originally Posted by sequitur
also there may be risks that the IC may get lost or mixed up
one of the mobile company lost my father IC last time cos they keep it during registration for new line, although they manage to find the IC in the end, he still got a free hp as compensation
Anyway, hope that u will get well soon
28th October 2003, 09:15 PM
Incidentally, a few things to consider:
1. Tailbone (coccyx) fractures can and should be straightened at the time of injury, by doing a per-rectal examination. This will reduce residual pain. See http://www.ncemi.org/cse/cse0907.htm.
2. The spinal cord ends quite far above the tailbone, so it is quite impossible for a fractured tailbone to cause any nerve damage. What the doctor told you was factually correct (although we all know it's not what you say, it's how you say it that matters). The treatment IS basically painkillers and rest.
3. Your ankle itchiness is very likely due to the plasters and/or liniments which you applied. A simple steroid cream should be able to solve your problem.
28th October 2003, 11:07 PM
Originally Posted by StreetShooter
I think CS can be a 2nd "Ask Dr. Health" segment already..
Thanks for the information!
29th October 2003, 12:06 AM
I would say you should first of all seek proper medical treatment to make sure you are alright.
Then write to the media,or call-up the ST hotline or something.....scumbags like these who are so unprofessional should not be allowed to practise.
Generally,patients pay the money to seek medical treatment,not to be jeered at by the doctor.They forgot that it's the patients who pays their salary!!!
And who the f@#k does he think he is to hold your IC? If it was me,I would let him continue to hold my IC,refuse to pay and proceed to make a police report that my IC has been unlawfully retained by the clinic.Blow up the issue and make sure the entire SG is aware of such a doctor.Destroy his career !!!
Last edited by Ah_Seng; 29th October 2003 at 12:12 AM.
29th October 2003, 12:53 AM
Yeah, wat eagles_creek say is true. we are paying for his services and professonalism and not there asking for charity!!!
29th October 2003, 08:33 AM
Originally Posted by eagles_creek
Well, now, that's a little vindictive, isn't it?
29th October 2003, 09:35 AM
i'm going to write in a letter. Thanks everyone for your kindness. I believe the doctor could have arranged for an X-ray at the very least. I think the doctor is going to retire soon (old-~60yrs but looks younger)..
ANyway, I seen a second doc, and he arranged for me to have an X-ray first. He gave me painkillers, calcium, gastric relief(in case the other tablets cause gastric pain) and anti-inflammation tablets.
By the way, I didn't know Streetshooter is a doctor....
I only had the rashes 3 weeks after the sprain. I ate some cuttlefish and seafood and a chinese physician's medicine last Saturday and got rashes..
I normally do not eat seafood.
Streetshooter, does it mean I do not have any grounds to complain against the doctor?
Although what i said is true, but if the complaint acquit the doc, the doc can file a suit against me? If this is the case, then there is no justice in Singapore, no hope in the world!
ANYWAY, i have taken the name of the clinic down first, in case i get accused of 'baseless allegations'. So, i'll post it out next time if justice is served.
i dun think the reputation of the medical group should be unnecessarily pulled down by a black sheep.. Hopefully, he is the only one.
Coccydynia is often diagnosed based on clinical evaluation of the patient. X-rays and MRIs are used to determine other causes of pain in the spine, such as muscle strains. Pain from that area can also be due to cancer, which, although rare, makes it important to see a physician to rule this out.
Treatment of coccydynia usually involves injections of an antiinflammatory medication to the area. Sometimes in severe cases, surgical fusion of the vertebrae may be needed.
Last edited by innovas1; 29th October 2003 at 10:38 AM.
29th October 2003, 01:59 PM
5. The Declaration should be made before or affirmed by the Commissioner for Oaths at the Council’s office located at 16 College Road, #01-01 College of Medicine Building. Please call at 6372 3070/61 to make an appointment before you come.
No stamp duty is required.
6. After endorsement, please return the Statutory Declaration to:
Chairman, Complaints Panel, Singapore Medical Council,
16 College Road, #01-01 College of Medicine Building, Singapore169854
7. The Complaints Committee will acknowledge receipt of your complaint and inform you of the its decision in due course. Investigations may take up to 3 months in most cases, and longer in others. It is the prerogative of the Committee to decide whether a complaint should be heard in person and no complainant has the right to be present during the investigation. The Committee cannot divulge confidential information at any point during the investigation.
woa lau, so long.. I think by the time it ended, the doctor is past his retirement age as he got his medical degree in 1965!
29th October 2003, 02:03 PM
Eh must get a sworn SD meh? from what i see of ur link, it only says a signed letter. where did u get these additional requirements from?
Originally Posted by innovas1