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Drs in Singapore should avoid implementing Macau casino like tactics to earn more.

Discussion in 'The Political / Serious Zone [no rep deductions]' started by bic_cherry, Jul 6, 2017.

  1. bic_cherry

    bic_cherry Alfrescian Old Timer

    Jan 5, 2010
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    Drs in Singapore should avoid implementing Macau casino like tactics to earn more.

    Junkets are middlemen who lend high-rollers money, arrange accommodation and are paid around 40% of the casinos' take in return. [Macau’s gambling industry (10Dec2011)]

    A medical professional isn't a casino operator, as such, the medical practioner should NOT pay any direct referral fees, except costs of public educational advertisements on news media about factual health topics and the professional medical services their clinics provide.
    Should any such medical junket operator services be deployed to also cover for accomodation, transportation, insurance claims arrangements, entertainment costs etc, then it is only professional that the bill be transparently itemized to show exactly what the fee to the junket operator is, how much the accomodation, transport and entertainment etc costs so that foreign paitients can feel that Singapore doctors are trust worthy rather than people whose morals are equal to casino operators whose intent is to empty the bank accounts of any unsuspecting patient/ medical insurance company. Transport, entertainment, accomodation costs are also obviously non-medical related costs, and as such, insurance companies shouldn't be deceived into covering such costs as included into any medical clinic bill simply due to the loophole which allows Singapore medical doctors to hire/pay medical junket operators a portion of the patient's final medical bill.

    It would be more professional I think for Singaporean medical specialist to visit neighbouring countries/ improve the reading materials available on their clinic websites to give publicly available, updated medical information for both patients and other medical professionals (who will then refer suitable patients (without kickbacks to referrer)/ (self-refer for educated patients) to the most qualified medical specialists). Even if the nature of the medical specialist is so earth shaking that GPs/ other specialist are unaware of its existence, then the medical specialist concerned should focus on publishing scientific papers and giving talks rather than bribing some random jobseeker with zero/minimal medical qualifications with generous kickbacks to sweet talk / deceive unsuspecting tourists/ patients with empty promises knowing that in the hands of an unscrupulous medical practitioner, there can be no end to investigations, referrals and interventions to inflate the eventual bill.

    Should any medical concierge service be necessary, then the patient should settle the bill for transport, entertainment, accommodation seperately with the concierge service as medical professionals shouldn't moonlight as travel agents but should focus on educating the public at large and fellow medical practioners in other specialities about improved healthcare options rather than utilise shady referral / overcharging methods that casinos are ought to use like robbers who destroy the financial health of BOTH patient and insurance company alike.

    Fee splitting of medical bills is a conflict of interest
    PUBLISHED JUL 4, 2017, 5:00 AM SGT
    The splitting of fees, where a portion of the doctor's bill is paid to third-party administrators, is likely to be another reason for the escalating cost of private healthcare (Doctors' fees: Administrators must change formula by July 1; June 24).
    There are also concerns that doctors may offer patients unnecessary services to cover this additional cost.
    Another form of fee splitting is when diagnostic facilities offer schemes where referring doctors collect the full charges for tests from their patients, but are then billed at a later date, minus the discounts.
    Dr Ernest Wang claims there is no basis to say that doctors may over-investigate because they do not receive any referral fees from private hospitals for ordering laboratory and radiology tests (Rational approach to rein in healthcare costs is more critical; April 28).
    However, such rebates have been around for years, and act as an incentive for doctors to refer more patients for tests, which is undeniably a conflict of interest in medicine. Patients can never be completely certain that they genuinely require the tests.
    I agree with Dr Wang that doctors' fees alone are not responsible for the escalating cost of healthcare; fee sharing probably plays a part in causing patients to fork out more for diagnostic services.
    The splitting of fees is unethical but is such an established practice in the private sector that most doctors eventually get sucked into it.
    Diagnostic centres know that paying commissions to doctors ensures a steady stream of referrals. To counter the competitive advantage of the first mover of such promotional schemes, other diagnostic facilities will start to offer even more generous incentives.
    As it has become an industry norm, doctors no longer need to refer patients to a particular provider, as kickbacks can be obtained from almost any of them.
    For a profession where credibility rests almost completely on trust, this perception of escalating greed in private healthcare is doing irreparable damage to the doctor-patient relationship.
    In order to preserve the integrity of professional judgment as well as promote public trust, doctors must not allow their decisions regarding a primary interest to be unduly influenced by any secondary concern.
    Edmund Khoo Kim Hock

    A version of this article appeared in the print edition of The Straits Times on July 04, 2017, with the headline 'Fee splitting of medical bills is a conflict of interest'.

    Last edited: Jul 6, 2017

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