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Isn't that exactly the way things are done in Singapore? We charge whatever we feel like?
SINGAPORE - Yesterday, surgeon Susan Lim had her appeal to overturn an overcharging conviction dismissed by the Court of Three Judges.
She was appealing a decision by a disciplinary committee to suspend her from practice for three years, impose a financial penalty of $10,000 on her and require her to be censured in writing, the Singapore Medical Council (SMC) said in a press statement.
She was also ordered to pay to the SMC the costs and expenses of and incidental to the disciplinary proceedings and made to undertake, after her return to practice, a requirement to charge her patients "no more than a fair and reasonable fee for her medical services".
On August 16 last year, Dr Lim filed an appeal asking for the DC's decision to be set aside or alternatively, varied; and for some of the costs and expenses of the proceedings to be borne by the SMC.
Yesterday, the Court of Three Judges upheld the DC's decision on both conviction and sentence and dismissed Dr Lim's appeal with costs.
The Court of Three Judges said that "the idea that the practice of medicine is, above all, a calling of the highest order is a historical cornerstone of the medical profession."
Hence, they found that "it is therefore clear, in our view, that every doctor is under an ethical obligation to charge a fair and reasonable fee for services rendered to his or her patient. The corollary of this is that overcharging would constitute an abuse of trust and confidence placed by the patient... and this would (in turn) constitute conduct that is dishonourable to the doctor as a person as well as in his or her profession, ie, it would constitute professional misconduct."
The Court found that there was sufficient evidence to make out all 94 charges of professional misconduct for overcharging against Dr Lim and the DC had examined all the charges and arrived at the correct decision in convicting Dr Lim of every charge.
The Court rejected the argument that contract or commercial obligations trump ethical obligations.
In the review of the invoices, the Court found that "what is immediately apparent from the above invoices is not only the excessiveness of the fees set out therein, but also the somewhat opaque manner in which they were issued."
"Moreover, in the course of the analysis, we have also demonstrated that the Appellant's invoices were rendered in an overwhelmingly unsystematic, arbitrary and, ultimately, opportunistic manner, further buttressing our finding that the Appellant's fees were in fact excessive and bore no relation to the services actually provided."
In relation to other invoices, the Court found that Dr Lim "was simply charging whatever she liked in amounts that were truly unconscionable and which therefore constituted serious professional misconduct."
On invoices involving third party specialists, the Court said that: "A recurrent pattern observed in the above charges is that the Appellant's invoices fees were often many multiples of the amounts invoices by the third-party specialist concerned.
"In the circumstances, it is clear, in our view, that there had indeed been excessive overcharging by the Appellant..."
In endorsing the DC's decision on all grounds, the Court observed that this was "clearly one of the most serious cases (if not the most serious case so far) of overcharging in the medical profession in the local context".
Given the grave nature of Dr Lim's professional misconduct, the Court of Three Judges noted that "it is not surprising that the DC meted out the severe sanction which it did" and affirmed the sentence meted out by the DC.
