Complaints against docs up, but few result in disciplinary inquiries

SINGAPORE — The number of complaints lodged against doctors has increased sharply, with the rate of complaints last year hitting its highest in at least a decade.

Last year, 213 complaints were filed against 259 doctors, said the Singapore Medical Council (SMC) in its 2014 annual report, which was released recently. This is 24 per cent more than the 172 complaints received in 2013.

The number of complaints received per 1,000 doctors rose to 17.2 last year, up from 15.7 in 2013. The previous high was in 2008, when the rate was 16.2.

The complaints received last year mainly involved allegations that the services provided were not of the quality expected, said the SMC, a statutory board that registers and regulates more than 12,000 doctors here.

But the increase in complaints may not be cause for alarm, as experts spoke of the need to delve into other figures for a more meaningful picture. The rate of complaints does not necessarily imply that patient care has waned, said the Singapore Medical Association (SMA), which represents the majority of doctors here.

“It is to be expected that with better education and a more affluent population, patients are more aware of their rights,” said SMA president Wong Tien Hua. “Also, with population growth, statistics also point to a heavier patient load across the board, from public medical facilities to privately-run clinics.”

Patients benefit from the avenue provided to address their concerns, within a system that seeks truth instead of taking sides, he added.

Dr T Thirumoorthy, executive director of SMA’s Centre for Medical Ethics and Professionalism, said: “What is important is to work out what proportion of the complaints were dismissed and how many ended in a Disciplinary Tribunal hearing over the years. That would make a more meaningful analysis.”

Policymakers can then decide how medical education can be altered to ensure better performance and fewer complaints, said Dr Thirumoorthy. Doctors found guilty by disciplinary tribunals should be offered remediation so they are better skilled after returning from suspension, he added.

Indeed, the bulk of complaints do not result in formal inquiries and a significant proportion are dismissed.

The SMC considered 378 cases last year, which included cases carried over from previous years. Of the 169 cases that were not adjourned to this year, 18 cases — or about one in 10 — were referred for disciplinary inquires, while one doctor was found by a health committee to be unfit to practise due to a medical condition.

The remaining 150 cases did not result in formal inquiries. Of these, 100 were dismissed, three were referred for mediation and one was withdrawn. Forty doctors were issued letters of advice and six were issued letters of warning.

Last year, a total of 23 disciplinary inquiries were concluded, with 17 of the inquiries resulting in penalties ranging from censures to fines and suspension. Two of the remaining inquiries were withdrawn, two resulted in acquittals and two are pending decisions by the High Court.

SMA’s Dr Wong applauded the SMC’s continued publication of disciplinary cases where doctors are acquitted, but noted that the number of complaint cases adjourned to the next year remains high at more than 55 per cent last year. A delicate balance is needed between observing due process and ensuring the process is not excessively prolonged, he said.

“The delay is a cause for anxiety to both doctor and patient,” added Dr Wong.

On a brighter note, the number of doctors in Singapore continued to rise last year, reaching 12,263, an increase of 7.3 per cent from 2013.

SMC president Tan Ser Kiat noted an increasing trend of overseas-trained Singaporeans and permanent residents returning to work here. Last year, there were 160 of them.