Dr fined $100k for not telling patient possible side effects

[Victor68]

https://www.straitstimes.com/singapore/4000-sign-petition-over-singapore-medical-council-ruling

 

What do you guys think of this recent case? If doctors are to run through a series of possible side effects and risks, do you really understand? Right now, you simply has to sign a document before any procedure. Do you really read and say, no I better not go through this or you just have no other alternative.

 

Is there a better way to address this and ensure doctors ensure they discharge their duties in the best interest of their patients.

[Wind30]

We had a Long WhatsApp discussion with my old classmates.

 

I read through the case file.... cut Long story short.

 

Doctor plead guilty. Never contest. He did not advise patient of any side effects either verbally or written. He literally did nothing. There is a loooong line from doing nothing to defensive medicine.

 

I think the fine is justified and proportional to the pay of the guy involved. Are you going to fine him of one day of his salary? That is like a slap on the wrists. Notice he chose the fine rather than contest as the prosecution was going after five month suspension.

 

I wonder how many signatures we will get if we start one in support for informed consent. Informed consent I think is non negotiable.

 

If nothing serious happen, can doctor waive inform consent??

 

Just like saf, if nothing happens, can officers just turn a blind eye to safety procedures???

Edited January 26, 2019 by Wind30

[Victor68]

The question here is, do doctors have the obligation to always remind patients of side effects and how such advice is going to help patient? Patient decide to proceed or stop?

 

What is the solution? As a patient, i am always asked the standard questions and told the standard risks. At the end, I still have to proceed as recommended. Maybe, if their is something the doctor is not sure, then to recommend for 2nd opinion?

[Wind30]

The question here is, do doctors have the obligation to always remind patients of side effects and how such advice is going to help patient? Patient decide to proceed or stop?

 

What is the solution? As a patient, i am always asked the standard questions and told the standard risks. At the end, I still have to proceed as recommended. Maybe, if their is something the doctor is not sure, then to recommend for 2nd opinion?

??? Are u questioning the need for informed consent???

 

Different treatment have different risks. Nothing is standard. Ultimately it is the patients decision to proceed with the treatment. Doctors have different considerations than patients. Example patient wants to recover with the least amount of costs. Private Doctors have a business to run, they want the most profit while still ensuring a favourable outcome.

 

I don’t believe u are questioning the need for informed consent, the WhatsApp discussion I had was focused mainly on what is informed consent and the maginitude of the fine, whether it is appropriate.

[Tonyng]

This is not about the facts of case; the doctor’s guilt or even about informed consent.

 

But lack of wisdom of SMC and choosing to pander to a disgruntled patient who suffered mild side effects from a simple one-time injection with a overreacted punitive and thereby creating an unhealthy precedent for the system at large.

 

Next time no happy just complain to SMC - and SMC will reprimand- system will react accordingly - by passing costs (time or insurance or distrust) down to future patients.

 

No biggie. People will get the healthcare they deserve.

[Ash2017]

The question here is, do doctors have the obligation to always remind patients of side effects and how such advice is going to help patient? Patient decide to proceed or stop?

 

What is the solution? As a patient, i am always asked the standard questions and told the standard risks. At the end, I still have to proceed as recommended. Maybe, if their is something the doctor is not sure, then to recommend for 2nd opinion?

 

 

What about ....

 

politicians who promise this and that but never keep

car you buy never explain eg whether you can just drive off without first let the engine oil circulate, or else shortened the engine life?

if you buy from toast box, they never tell you eating their laksa will send your blood cholesterol sky high

if buy Panadol from Watson the counter never tell you if you take more than 10 tablets one shot can kill you (if you say got instructions, so does procedure side effects are found all over respected website)

sitting and squatting toilet can increase risk of piles why public toilet never say

Chinese medicine why they never tell you that it may not work after taking xxx times must go see western doctor

 

so how and where do we start or stop

[Jamesc]

I would like a doctor to tell me what the side effects are

 

and to protect the doctor I would like to sign saying I have been told.

 

Fair to the doctor and fair to the patient.

 

 

And if a female doctor have to examine my intimate areas

 

I would also like a female nurse to be present to make sure

 

the doctor is not touching me unnecessarily and making

 

uncalled for remarks like why so big and hairy?

 

 

 

[Fcw75]

It’s the patient making big hoo ha.

 

I had this steroid injection for my tennis elbow and heel pain a couple of times. Yes, that area will become swollen and painful but it will go away after 2 or 3 days.

Edited January 26, 2019 by Fcw75

[1fast1]

 https://hobbitsma.blog/2019/01/25/about-that-100000-fine-for-an-injection/

 

A very good analysis by a very bright colleague. Expands on, and provides a reasoned analysis supporting what @Tonyng wrote.

 

That's not just scare-mongering or alarmism, by the way. That is actually exactly what's likely to happen. Doctors are already reacting with alarm en masse.

 

https://www.straitstimes.com/singapore/health/doctors-ask-moh-if-they-must-now-spell-out-all-possible-side-effect-after-doctor

 

I can't add a whole lot to what "The Hobbit" has already written, but I might add a few words in a separate post later about why I think both SMC and this doctor cocked it up for everyone in the profession (and ultimately, for the patients too).

 

 

 

Edited January 26, 2019 by Turboflat4

[Tonyng]

Itâs the patient making big hoo ha.

 

I had this steroid injection for my tennis elbow and heel pain a couple of times. Yes, that area will become swollen and painful but it will go away after 2 or 3 days.

After this case, GPs will stop doing it, as do even some specialists - leaving a smaller pool of specialist with higher risks - meaning more costs in your next injection.

 

And more people going to gov specialists for this simple injection - making a needed orthopedic appointment even longer.

 

And also a lot other simple procedures in other specialities too.

 

All in - system will adjust accordingly - so don't complain hor, people will get the healthcare they deserve.

[Victor68]

Would this resulted in doctors asking all patients to sign acknowledgement document to cover themselves. Anyway hard to verify if they have verbally explained. Signed document is the best but not good for earth. More papers and filing.

 

It is not that doctors are never at fault but this case is rather strange reading from media report. All treatments have risks, then how? Maybe SMC should give more details.

[Wind30]

https://hobbitsma.blog/2019/01/25/about-that-100000-fine-for-an-injection/

 

A very good analysis by a very bright colleague. Expands on, and provides a reasoned analysis supporting what @Tonyng wrote.

 

That's not just scare-mongering or alarmism, by the way. That is actually exactly what's likely to happen. Doctors are already reacting with alarm en masse.

 

https://www.straitstimes.com/singapore/health/doctors-ask-moh-if-they-must-now-spell-out-all-possible-side-effect-after-doctor

 

I can't add a whole lot to what "The Hobbit" has already written, but I might add a few words in a separate post later about why I think both SMC and this doctor cocked it up for everyone in the profession (and ultimately, for the patients too).

The hobbit is anonymous? I read this post yesterday and frankly I was disgusted by it. All the money talk.

 

Let me add another conclusion... every specialist spend two minutes explaining the side effects of the treatment to the patient. Ya the specialist doctor can bill us for the extra two minutes, let’s hope it’s not 1k.

 

The scenario here is about specialist care. How often do u visit the specialist? I only visit the specialist when only really bopian. Is it so hard to spend a few minutes to explain the cons of the treatment to the patient?? Remember we are not talking about common cold.

Edited January 26, 2019 by Wind30

[Nlatio]

If kena hospitalise one.... every damn thing they do they will ask for consent and sign this sign that... sometime repeated several time....that's fine cause u not going anywhere.... but if in a clinic.... knn.... the fellow need to take 10 kind of medicine.... will take 1 hour, exclude Q&A just to finish talking..... the poor fella outside waiting think already send to A&E   

 

Seriously, doctor give medicine.... tell you got this and that side effect, but it's the best medicine to cure the illness.... LL also take.... else how, go see another few doctors or go ask in Forum for advise first??? 

[Jamesc]

What so difficult about a doctor explaining the risk and side effects so the patient

 

can make an informed decision if he wants to embark on a procedure?

 

If a doc wants to do anything that might stop me trying to have more children next

 

time I would want to know.

 

Don't snip here and snip there and snip something very important off.

 

 

 

[Jamesc]

If after the procedure the side effect is something important don't work anymore

 

$100,000 compensation also I won't be happy.

 

 

Anyone here would be happy if something important didn't work and the doctor

 

didn't tell you about this side effect?

 

 

[Nlatio]

What so difficult about a doctor explaining the risk and side effects so the patient

 

can make an informed decision if he wants to embark on a procedure?

 

If a doc wants to do anything that might stop me trying to have more children next

 

time I would want to know.

 

Don't snip here and snip there and snip something very important off.

 

 

 

I am quite sure the doctor will want to find way for you to have more children.... 

 

And the only one going to do any snipping will be my barber.... 

If after the procedure the side effect is something important don't work anymore

 

$100,000 compensation also I won't be happy.

 

 

Anyone here would be happy if something important didn't work and the doctor

 

didn't tell you about this side effect?

 

aiyo that is mis-diagnose.... but if the doctor tell me this is the only medicine that will save me from a illness..... but the side effect will be my important part cannot work during 1st and 15th of each month.... how??? 

 

Take, save my life but live with some side effect... don't eat.... every year people go Mandai pay respect.... 

[Wind30]

If kena hospitalise one.... every damn thing they do they will ask for consent and sign this sign that... sometime repeated several time....that's fine cause u not going anywhere.... but if in a clinic.... knn.... the fellow need to take 10 kind of medicine.... will take 1 hour, exclude Q&A just to finish talking..... the poor fella outside waiting think already send to A&E

 

Seriously, doctor give medicine.... tell you got this and that side effect, but it's the best medicine to cure the illness.... LL also take.... else how, go see another few doctors or go ask in Forum for advise first???

How often do u take steroid injection? I am 43 years already and I haven’t taken one yet. If I need to take one in the future, I hope the specialist can spend two minutes telling me it will discolor my skin.

 

Even my gp will tell me some antibiotics will cause gastric issues as side effects.

 

This case, the doctor said NOTHING. ZERO.

 

There is a looooooong spectrum from saying nothing to explaining every single thing. Go read up the law. The expectation is reasonable disclosure. U just need to say something....

Edited January 26, 2019 by Wind30

[Lala81]

How often do u take steroid injection? I am 43 years already and I havenât taken one yet. If I need to take one in the future, I hope the specialist can spend two minutes telling me it will discolor my skin.

 

Even my gp will tell me some antibiotics will cause gastric issues as side effects.

 

This case, the doctor said NOTHING. ZERO.

 

There is a looooooong spectrum from saying nothing to explaining every single thing. Go read up the law. The expectation is reasonable disclosure. U just need to say something....

There are other cases whereby patient having signed consent form for operation claim that side effects not explained. And that even written consent is not accepted as legally acceptable as long as all patients doubts not answered.

If the thing went well. Sure of course patient has no doubt. If the thing didn't go well. Surely patient has some doubt.

If I tell u ten things, would u remember all ten even ten mins later?

So unless u have a video recording with audio of all consultations, there is no defence currently acceptable.

Just check how many minor side effects, not even talking about major, on any drug or procedure. Ten is nothing.

Gastrointestinal side effects are probably 1/30 side effects for antibiotics. Just the most common.

U can Google any known symptom in medical knowledge and it will be linked to antibiotics.

Giddiness, vomiting, diarrhoea, fever, rash, headache, numbness, double vision, joint pain, muscle pain and on and on and on and on...

Edited January 26, 2019 by Lala81