Mailbox: Unfair to blame doctors' fees

I am an anaesthesiologist who has been in private practice for 14 years.

The letters by Dr Tang Kok Foo ("Reasons for soaring private health-care costs"; last Thursday) and Dr Ong Siew Chey ("Consider fee guidelines, medical oversight"; last Friday) gave the impression that ethical standards of our doctors have fallen drastically.

Their assertions must be challenged.

It is unfair for Dr Tang to blame medical professional fees for high health-care costs.

Advances in implant and surgical techniques have resulted in better outcomes for patients and should not be construed as malpractice.

The use of high-tech equipment also comes with extra costs.

Another factor is the higher expectations of patients.

My son is a polyclinic doctor. Every day, he has requests from patients for referrals to specialists for conditions that family doctors can manage.

Some of his colleagues practise defensive medicine and will make the referrals for fear of missing something serious or receiving complaint letters.

If patients do not insist on private specialist treatment, fees would not be so high.

In fact, if one compares the specialists' fees here with those in the United States and Hong Kong, one will find that our doctors are not overcharging.

If medical professional fees are to remain affordable, then we have to tackle issues like the high expectations of patients, increased property costs of clinics and rising medical indemnity costs.

Patients should demand to know the cost of professional fees before consenting to procedures. If they feel it is too high, they can seek another opinion as the fees charged by private medical specialists can vary quite a bit.

All the specialists I know do not perform unnecessary procedures for generating income. Granted, there may be the rare case of unwarranted operations but this is very hard to prove when we do not know the specifics of the case.

As for fee guidelines, a patient may value a certain doctor's skills and is willing to pay much more. Where there is freedom of choice, equality of professional charges is unrealistic.

Dr Tang is free to make a complaint to the Singapore Medical Council if he has proof of specialists overcharging or performing unwarranted procedures.

Chong Jin Long (Dr)

This article was first published on Aug 19, 2014.
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