The prescribing of a drug or treatment, or referrals to hospitals or health centres, should not be based on a financial incentive.

The Medical Protection Society (MPS) is reminding doctors that the patient’s interest should always be the main priority and their judgment should not be clouded by money or gifts.

Dr Teoh Ming Keng, MPS Head of Medical Services Asia says: “The Singapore Medical Council (SMC) endorses the World Medical Association’sInternational Code of Medical Ethics that states that doctors should not receive any financial benefits or other incentives solely for referring patients or prescribing certain products.

“When prescribing a drug or treatment for a patient, a doctor’s choice should be based solely on the medical interests of the patient. They should avoid accepting any incentive that may compromise, or that may be regarded by others as likely to compromise, their professional judgment.

“It is also unacceptable to receive payments or benefits from pharmaceutical firms if they could influence your professional assessment of the clinical value of drugs or appliances, particularly in relation to research projects. It is the doctor’s responsibility to be aware of these risks and to ensure these do not get in the way of their professional practice.”

Use of chaperones

MPS is also aware of complaints arising from doctors not using chaperones when conducting intimate examinations. A doctor should always have a chaperone present in the consultation room when conducting an intimate examination regardless of the age or sex of the patient.

Dr Teoh says: “It is the doctor’s responsibility to manage and maintain professional boundaries – and using chaperones effectively is a way of managing consultations with patients.

“A chaperone adds a layer of protection for the doctor and can provide comfort and reassurance for the patient. The doctor should record the identity of the chaperone, with any relevant issues or concerns, so these can be used as evidence if issues are raised by the patient.”

MPS has created factsheets which cover the key issues relating to perverse incentives and chaperones. This is in addition to new factsheets with essential and practical advice on a range of medicolegal issues for doctors in Singapore – these include medical records and safe prescribing.

MPS hosts a series of risk management workshops in Singapore throughout the year. There are no further workshops for 2011 but new dates will be released for 2012 soon. Visit the events page of the website for more information.