Court tells SMC to relook case against Dr Georgia Lee

SINGAPORE - In an unprecedented move, the Court of Appeal has asked the Singapore Medical Council (SMC) to relook a case before the court, in the light of a judgment given last month in a similar case.

In the current case, aesthetic doctor Georgia Lee is appealing against paying the full cost of an SMC disciplinary committee hearing, which found her guilty of three of six charges of practising non-evidence-based aesthetic procedures.

Her appeal follows that of aesthetic doctor Low Chai Ling, who had also been found guilty by the council of providing similar treatments.

Last month, the Court of Appeal threw out the case against Dr Low, who appealed against the verdict itself.

On Tuesday, Senior Counsel Tan Chee Meng for the SMC and Ms Kuah Boon Theng for Dr Lee met Judge of Appeal V.K. Rajah in chambers. Counsel will appear before the court again on Oct 22 after consulting their clients.

Veteran lawyer Myint Soe, who represented Dr Low and has been dealing with medical litigation here for more than 30 years, told The Straits Times that the appeal court's action in asking the SMC to review a case is highly unusual.

"In my experience, it hasn't happened before. This is an extraordinary situation," he said.

Last December, the SMC found both doctors guilty of professional misconduct.

They were fined the maximum $10,000, censured and asked to give an undertaking not to repeat the offence.

Dr Low, found guilty of five of seven charges, was told to pay 80 per cent of the cost of the SMC hearing, while Dr Lee was ordered to pay the full cost.

Last month, the Court of Appeal, comprising Justice Rajah as well as Chief Justice Chan Sek Keong and Judge of Appeal Andrew Phang, threw out the case against Dr Low.

The judges accepted that the five procedures Dr Low was found guilty of - mesotherapy, mesoglow, stem cell extract facial therapy, sonophoresis and carboxytherapy - had plainly not met the standards of evidence-based medicine (EBM), which means they had not been proven through large-scale clinical trials.

They also said the SMC disciplinary committee had been right in rejecting Dr Low's argument that a medical treatment was "generally accepted" if widely practised by a large number of doctors.

"The assessment of whether or not a particular medical treatment is generally accepted must be scientific rather than empirical. Illegitimate or unethical practices are not legitimised merely because large numbers of doctors engage in them," said Justice Rajah in the court's written judgment.

However, he found it "puzzling" that the SMC took a different approach from that of its expert witness, by "flatly condemning any treatment that failed to meet the exacting requirements of EBM".

He also said it was not possible to find Dr Low guilty of procedures performed in 2007, before guidelines were spelt out in 2008. And he found the SMC unjust for singling out doctors to prosecute when many were offering similar treatments.

The court also criticised the SMC for apparently not knowing what exactly it was prosecuting Dr Low for.

This is because in the midst of the disciplinary hearing, Dr Low was told that she was being prosecuted because, unlike other doctors, she had not stopped providing the treatments upon receiving a letter from the Ministry of Health.

Justice Rajah pointed out that her seemingly wilful behaviour was not the subject of the prosecution, and he described the disciplinary hearing as "legally embarrassing".

Asked what its next steps would be, the SMC told The Straits Times this week: "SMC respectfully notes the issues raised in the Court of Appeal's judgment and will need time to carefully study the issues which have been put forth, before commenting further."

The complainant in both cases was the Ministry of Health.

When asked why it had singled out Dr Low and Dr Lee, a ministry spokesman told The Straits Times: "Where appropriate, MOH may refer to the SMC information that has come to its attention about possible professional misconduct by doctors, and this may lead to the SMC taking professional disciplinary action."

He said the same happens when a complaint is lodged by a member of the public.

He added that the ministry's interest lay in protecting the safety and health of the public and ensuring that all doctors and registered health-care practitioners maintain high professional standards at all times.

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