THE drive to make Singapore a regional medical hub has provided the pull factor for public sector doctors to move into lucrative private practice.
The gulf in earnings is now glaringly obvious to the medical fraternity.
A supposedly straightforward surgery performed by a specialist in private practice (estimated to cost $25,000) resulted in "complications" and a staggering $62,450 bill for surgeon's charges alone. That same patient recently underwent corrective surgery at the National University Hospital and paid a modest $342 in doctor's fees ("Doctors' fees need a relook" by Mr Philip Williams; last Tuesday).
The push by SingaporeMedicine - a multi-agency government-industry partnership that promotes Singapore as a world-class health-care destination - has seen a steady inflow of wealthy foreign patients, driving up the income of specialists in private practice. On the other hand, their counterparts in restructured hospitals have seen their remuneration remain largely stagnant.
The lure of private practice lies in the flexibility of doctors to be their own boss and determine their own working hours as well as their retirement age.
Since private hospital charges are not under the Ministry of Health's (MOH) purview and there are no fee guidelines for doctors in private practice, there is effectively no regulation in place to prevent overcharging.
Dr Tang Kok Foo argued that doctors' bills are the most rapidly escalating component of private health-care costs ("Reasons for soaring private health-care costs"; Aug 14, 2014).
Doctors have to be guided by their conscience when handling patients. The customer usually deals with his physician from a position of disadvantage and is compelled to submit to a recommended course of treatment.
The fees that are eventually levied are also seldom challenged.
It is time for MOH to step in to review and regulate doctors' charges to protect patients from being overcharged.
Under the current fee-for-service model, which offers unbundled services paid for separately, specialists are given an incentive to provide more treatments as payment is dependent on the quantity of care, rather than quality of care. Patients at private hospitals have cause for worry.
Edmund Khoo Kim Hock
The gulf in earnings is now glaringly obvious to the medical fraternity.
A supposedly straightforward surgery performed by a specialist in private practice (estimated to cost $25,000) resulted in "complications" and a staggering $62,450 bill for surgeon's charges alone. That same patient recently underwent corrective surgery at the National University Hospital and paid a modest $342 in doctor's fees ("Doctors' fees need a relook" by Mr Philip Williams; last Tuesday).
The push by SingaporeMedicine - a multi-agency government-industry partnership that promotes Singapore as a world-class health-care destination - has seen a steady inflow of wealthy foreign patients, driving up the income of specialists in private practice. On the other hand, their counterparts in restructured hospitals have seen their remuneration remain largely stagnant.
The lure of private practice lies in the flexibility of doctors to be their own boss and determine their own working hours as well as their retirement age.
Since private hospital charges are not under the Ministry of Health's (MOH) purview and there are no fee guidelines for doctors in private practice, there is effectively no regulation in place to prevent overcharging.
Dr Tang Kok Foo argued that doctors' bills are the most rapidly escalating component of private health-care costs ("Reasons for soaring private health-care costs"; Aug 14, 2014).
Doctors have to be guided by their conscience when handling patients. The customer usually deals with his physician from a position of disadvantage and is compelled to submit to a recommended course of treatment.
The fees that are eventually levied are also seldom challenged.
It is time for MOH to step in to review and regulate doctors' charges to protect patients from being overcharged.
Under the current fee-for-service model, which offers unbundled services paid for separately, specialists are given an incentive to provide more treatments as payment is dependent on the quantity of care, rather than quality of care. Patients at private hospitals have cause for worry.
Edmund Khoo Kim Hock
