Teen turned away by clinic for not having enough cash

Miss Maria Schooling's legs had an infection that needed pills and a cream to treat.
PHOTO: Teen turned away by clinic for not having enough cash

The student had a persistent rash on her thighs, which spread to the rest of her legs last Sunday night.

The itch became so painful and unbearable that 18-year-old Maria Schooling decided to go to the doctor at about 11pm.

She took a taxi to a nearby clinic about 10 minutes away from her home and hobbled in at about 11.15pm.

But she got a rude shock when she was turned away after she told the clinic assistant that she had only $50 cash with her.

Miss Schooling told The New Paper on Tuesday: "I was pretty desperate to see a doctor because both my legs were affected. They were swollen and had pus and bumps all over. All I wanted was some relief cream."

Expensive

Before that, the clinic assistant warned her that the bills would be "expensive", citing a consultation fee of $47.

The incident happened at Kao and Tan Family Medical Centre and Surgery at Jalan Membina, opposite Tiong Bahru MRT station.

It was the nearest clinic available at that hour for Miss Schooling, who lives at Telok Blangah Rise.

A partner of the clinic, Dr Tan Teck Jack, has since apologised for the incident. He said that the stand-in doctor on duty that night was not aware of the situation.

The clinic assistant has since been suspended pending the clinic's investigation.

Miss Schooling said that she had tried to get enough money by making a few harried phone calls.

When she finally had enough at 11.45pm, she said she was turned away again - the clinic assistant told her firmly that the clinic, which runs from 7am to midnight, was closed for registration.

Miss Schooling, who was accompanied by a friend, Miss Alison Sin, was infuriated that the clinic assistant did not inform them of this earlier.

The women had remained in the clinic till 11.30pm while they called their friends and relatives for help to transfer money into their accounts and only left the clinic to withdraw money from a nearby ATM.

Miss Sin, 24, a freelance in-line skating instructor, said: "It felt like she did not see the point of entertaining us because we were kids and all she thought about was the money. We kept saying that this is urgent, but she did not even ask us what was wrong."

Earlier, Miss Schooling had also asked if she could leave her identification card with the clinic and her mother, who was working the night shift, would return the next morning with more money.

She even asked the assistant to speak to her mother over the phone.

Both requests were turned down.

Her mother, Mrs Angela Schooling, a printing foreman, said: "I couldn't do the transfer (of money) because it was a peak period at work at the time.

"It infuriated me that she refused to talk to me over the phone and when I called the clinic, no one picked up."

Eventually, the teenager returned home and resorted to iced towels and cold showers to ease the itch. She could see the doctor only two days later because she had difficulty walking initially.

On Wednesday, Miss Schooling, accompanied by her mother, went to the same clinic. The bill came up to $82 for three types of oral medication and steroid creams.

The doctor said it was an infection, and her itch was aggravated by eczema. Miss Schooling said: "If I had seen the doctor earlier, I wouldn't have scratched so much and it wouldn't have spread or there wouldn't be scars now. "What if someone had been in a more serious situation than me?"

Clinic doctor: We are not heartless

The incident that happened to Miss Maria Schooling was a one-off involving a part-time staff member who worked at the clinic once a week, said Dr Tan Teck Jack, a partner at the Kao and Tan Family Medical Centre and Surgery.

The manager of the clinic, who identified herself only as Christine, told The New Paper that the clinic assistant did not know how to handle the situation and it was too late to call her superiors.

She did not inform the locum doctor because he was not in charge.

Busy

The clinic assistant later turned the patient away because she was busy attending to other patients.

The clinic manager said that the assistant did not have the password to access the cash register for further transactions and tally accounts after midnight. There is usually a full-time staff member who has the password.

Citing the incident as an example of poor communication skills, Dr Tan said that he has never turned a patient away.

"We are a clinic in the heartland and not heartless or mercenary.

"There were several occasions when I actually forked out money from my own pocket to pay for the patient's medical bill.

"In cases when a patient does not have enough money, we'll allow them to come back another day.

"Sometimes they don't come back, and we'll just waive it," he said.

He has since apologised to Mrs Angela Schooling, Miss Schooling's mother.

The clinic assistant has also been suspended, pending investigations.

The clinic, which has been in the Tiong Bahru area for the past 12 years, has three regular doctors and a locum doctor who works from 10pm to midnight.

Medical needs come first

Patients will usually not be turned away because of financial difficulty, said doctors The New Paper spoke to.

Instead, their medical needs will be met first, said Dr Clarence Yeo, who runs Killiney Family and Wellness Clinic at Killiney Road.

"It is only reasonable that we attend to the patient first. They can come back and pay later. Some of them might choose to leave an identification card behind," said Dr Yeo.

Dr Madeleine Chew of MW Medical, which provides mobile medical services, agreed.

"We'll look at the severity of the situation and if the case is genuine. But most doctors would give treatment anyway," Dr Chew said. She also pointed out that payment is normally not mentioned until treatment is given.

"We discuss payment only after that, and if the patient cannot pay, there are options such as adjusting the medication," she said.

Help for payment

Likewise in hospitals, patients who cannot pay their medical bills can approach staff members for help, according to the websites of public hospitals.

They will be referred to schemes such as Medifund and government assistance schemes such as the Medication Assistance Fund. Doctors TNP spoke to agreed that clinic workers play a role.

In Miss Maria Schooling's case, the clinic assistant did not consult the doctor before turning her away.

"The staff member could have handled the situation better in this case. If she was unsure, she could have consulted the doctor," said Dr Yeo.

Dr Chew said that she does not give her staff explicit instructions on what to do in a situation when a patient does not have enough money, but it is a matter of judgment.

"It's basic human decency. Most people will not turn away someone who needs help."

This article was first published on May 24, 2014. Get The New Paper for more stories.