East Asia

Teleconsultation services under scrutiny as MOH seeks to tighten issuance of MCs

In Febuary, MOH said Medstar Medical Clinic & Surgery was under investigation for issuing medical certificates MCs without any audio or video consultation on its telemedicine website, PocketCare. 

Investigations found that the clinic, which is located along Serangoon Road, had been “providing consultation through a self-service text-based questionnaire”. MCs were subsquently issued without any audio or video interaction with patients.

The PocketCare website was also found to have featured claims that patients could “Get Your MC or Get a Refund”. 

Dr Viknesh Shanmugam, the medical practitioner who issued the MCs following the consultations, has been referred to SMC for investigations into possible breaches of its ethics code.

MOH also issued a notice to Medstar, stating Director-General of Health Kenneth Mak’s intention to take regulatory action, including a three-month suspension of its telemedicine services and the need to rectify its consultation services before it can be resumed. 

PROPOSED AMENDMENTS 

Teleconsultation services by registered practitioners, have been regulated since Jun 26, 2023, read the circular. 

According to the regulations, real-time, two-way interactive audio-visual communications like video consultations must be utilised when teleconsulting with new patients.

“MCs should not be issued via teleconsultations to new patients solely based on the patients’ requests without proper assessment by a medical practitioner to determine if the issuance of the MCs is warranted,” said MOH and SMC. 

The recognition of MCs issued by registered medical practitioners is a “professional privilege”, the circular added, noting that this reflects the “high regard for and the trust” that society has placed in the profession.

While noting that the issuance of MCs is a “clinical decision”, the circular stressed it is “imperative” that the issuance of MCs adheres to the guidelines in SMC’s ethics code, which state that MCs “must be issued to patients only on proper medical grounds arrived at through good clinical assessment” – regardless of the mode of the consultation.

As such, MOH intends to impose a requirement on all licensees to ensure that every MC issued for a patient must include the name and medical council registration (MCR) number of the issuing medical practitioner. 

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