Short consultations, multiple MCs: MOH intends to revoke MaNaDr Clinic's licence

[UPDATE Dec 20] MOH has revoked MaNaDr Clinic's licence after considering their representations.

In a statement, it said that it "has assessed that an entrenched culture of disregard for the applicable ethical and clinical standards exists within the organisation".

A clinic at Beach Road that issued medical certificates (MCs) to patients after "very short" teleconsultations is expected to have their licence revoked by the Ministry of Health (MOH).

On Thursday (Oct 24), MOH said that its investigations showed that MaNaDr Clinic is unable to continue providing outpatient medical services in a "clinically and ethically appropriate" manner.

The clinic's outpatient telemedicine services have been suspended since Aug 16. 

MOH's investigations found that a "very large number" of cases involved video call teleconsultations that lasted for a minute or less, and ended with the medicine prescriptions and issuance of MCs.

"Such short consultations raise concerns about the safety and quality of clinical care provided to the patients," the ministry noted.

The clinic also issued multiple MCs to the same patients within a short period of time.

MOH also said that the clinic had "questionable and poor documentation".

Some patient case notes were found with detailed information disproportionate with the short duration of the teleconsultation, while other case notes were "extremely sparse or brief", potentially compromising the continuity of patient care.

Based on these findings, the health ministry said there is reason to believe there is "an entrenched culture of disregard for the applicable clinical and ethical standards within MaNaDr Clinic".

MOH hence issued the clinic with a notice of intended revocation of licence on Thursday.

Upon revocation, MaNaDr Clinic will no longer be authorised to provide outpatient medical services at its Beach Road premises and offer house calls and telemedicine services.

MaNaDr Clinic Pte Ltd has 14 days to make representations to MOH.

41 doctors referred for possible professional misconduct 

The health ministry said it will also refer 41 doctors to the Singapore Medical Council (SMC) for inquiries into alleged professional misconduct related to the clinic's telemedicine services.

Of the doctors referred to the SMC, 13 had worked as locum practitioners providing teleconsultations at MaNaDr Clinic while being employed by the public healthcare institutions (PHIs) or MOH Holdings.

These doctors had breached their employment terms by undertaking external employment and conducting secondary clinical activities without the approval of their employers, and most had provided teleconsultations while on active duty in the PHIs, MOH said.

Five of them have since left the public healthcare sector, and seven have been dismissed. The remaining doctor was subjected to disciplinary action, due to lesser severity of his actions.

"Doctors who practise telemedicine are reminded to abide by the SMC's Ethical Code and Ethical Guidelines at all times.

"MOH views these inappropriate practices and their potential impact on patient safety very seriously and will not hesitate to take further action against doctors, including referral to SMC, for any found to have engaged in professional misconduct."

The ministry said it will continue to monitor and audit other licensed providers of outpatient medical services who provide teleconsultation services to ensure that these virtual consultations are conducted in compliance with regulatory requirements.

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lim.kewei@asiaone.com