you can only die well if you have lived well. life is more precious to cling on to if its always been a struggle.
as they say, easy come, easy go....
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Patient seeks private treatment due to long wait at public hospital
- Thread starter makapaaa
- Start date
you can only die well if you have lived well. life is more precious to cling on to if its always been a struggle.
as they say, easy come, easy go....
How do you know that we have "many kind, gentle and compassionate doctors in our hospitals"
Just look at the Dr Susan Lim case, the fact that she thought she could get away with over charging a patient by millions, shows that there are problems.
after taking up cycling they became early demise
I believe all of them are GPs
... at one time I was told by one .. "Sorry, sir - I am not familiar with oncology drug"
How do you know that we have "many kind, gentle and compassionate doctors in our hospitals"
Just look at the Dr Susan Lim case, the fact that she thought she could get away with over charging a patient by millions, shows that there are problems.
it will do you a lot of good if you would not comment on this very complicated case...unless you know the case very well and unless you know this good doctor very well too....better to shut up and stop making a fool of yourself here.
I may not be a medical expert but do you have to be an expert to know that someone is being cheated
Susan Lim was found GUILTY by her own peers. If you know anything about the medical community in Spore they usually close ranks & protect their own but in this case they couldn't ignore this case because it was so outrageous
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http://www.breakfastnetwork.sg/?page_id=109
The cost of Susan Lim’s $24m bill
Poor doctors. It’s a tough enough job to “first, do no harm”; now there’s “do not charge outside an objective ethical limit”.
Exactly what is this “ethical limit”, and who decides when the limit is breached? That’s the head-scratching puzzler today, after the Court of Three Judges yesterday ruled against Dr Susan Lim in her appeal case after she was censured by the Singapore Medical Council for overcharging her royal patient from Brunei in 2007.
A quick refresher: Dr Lim was investigated after the Health Ministry received a query from their Brunei counterpart about her patient’s $24 million bill. The bill was for medical treatment for about six months in 2007. The SMC stepped in, and in the end ruled that the $24m bill was unreasonable. They suspended her for three years and fined her $10,000. Dr Lim took the battle to the courts, lost, and appealed. Yesterday, she lost that appeal.
To be honest, it won’t take a medical or legal expert to believe Dr Lim indeed overcharged her patient. $24 million – that’s pretty incredible, even for a top cancer specialist.
ST did a nice comparison in one of its reports today by showing how much Dr Lim charged her patient for a common procedure – flushing a small medical device beneath the skin with medication. Her fee was $16,800; most doctors charge about $200. At the National Cancer Centre, the procedure would have cost a patient only $50.
But after the ruling yesterday, people raising their eyebrows this morning at the news may be more surprised about the substance of the court’s written judgement, than at Dr Lim’s math.
In a strongly worded statement, the judges said that the case 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”. They also described her fees as “unsystematic, arbitrary and, ultimately, opportunistic”.
It’s hard to square that description with how we like to think about doctors – kind, gentle, big-hearted. It’s the same with teachers who abuse their students – our sensibilities are offended when we see those charged with taking care of others taking advantage of them instead.
For that reason, Dr Lim’s actions will seem not only mercenary but morally repugnant.
But the court’s decision yesterday went further than just saying she was greedy and behaved badly. It set an ethical precedent for all doctors – that they have to ensure not only the health of a patient’s mind and body, but also of his or her wallet.
Moreover, that this duty went beyond “contractual and market forces” – meaning, it does not matter if the sum is reasonable according to a patient’s financial ability, or any supply-demand factors – a doctor’s fee has to answer to a higher, moral standard. In fact, “Such obligations necessarily trump contractual or commercial obligations where there is conflict between the two,” the court said.
Who decides whether there is any conflict or not in the first place? No wonder the doctors are flummoxed. Specialists who spoke to ST said as much. Dr Lam Pin Min who chairs the Government Parliamentary Committee for Health said that the $24m figure aside, many doctors were “apprehensive and unclear” about where these ethical limits lay, adding: “There are really no clear guidelines at the moment. What the healthcare industry needs is a better definition of what this ethical limit is so as to avoid any ambiguity in the future.”
Others are also wondering why doctors are being singled out – even if the practice of medicine is “a calling of the highest order”, to quote the court.
Another question is – if Dr Lim’s case is the most serious, what were the other cases of overcharging, and why didn’t those cases trigger this expansive ruling on how doctors should go about their businesses?
That said, this ruling will undoubtedly protect patients; it’s a stern warning to specialists like Dr Lim who before could fleece rich patients simply because there wasn’t a provision in the SMC’s ethical code that prevented them from doing so.
But for the majority of doctors, the ethical considerations they grapple with will have more to do with life-death issues rather than how much to bill a patient.
A vague and ambiguous rule to observe an “objective ethical limit” has the potential to clog the courts with specious claims – not to mention a doctor’s valuable time and energy. If that happens, the judges’ ruling yesterday may end up doing more harm than good.
The cost of Susan Lim’s $24m bill
Poor doctors. It’s a tough enough job to “first, do no harm”; now there’s “do not charge outside an objective ethical limit”.
Exactly what is this “ethical limit”, and who decides when the limit is breached? That’s the head-scratching puzzler today, after the Court of Three Judges yesterday ruled against Dr Susan Lim in her appeal case after she was censured by the Singapore Medical Council for overcharging her royal patient from Brunei in 2007.
A quick refresher: Dr Lim was investigated after the Health Ministry received a query from their Brunei counterpart about her patient’s $24 million bill. The bill was for medical treatment for about six months in 2007. The SMC stepped in, and in the end ruled that the $24m bill was unreasonable. They suspended her for three years and fined her $10,000. Dr Lim took the battle to the courts, lost, and appealed. Yesterday, she lost that appeal.
To be honest, it won’t take a medical or legal expert to believe Dr Lim indeed overcharged her patient. $24 million – that’s pretty incredible, even for a top cancer specialist.
ST did a nice comparison in one of its reports today by showing how much Dr Lim charged her patient for a common procedure – flushing a small medical device beneath the skin with medication. Her fee was $16,800; most doctors charge about $200. At the National Cancer Centre, the procedure would have cost a patient only $50.
But after the ruling yesterday, people raising their eyebrows this morning at the news may be more surprised about the substance of the court’s written judgement, than at Dr Lim’s math.
In a strongly worded statement, the judges said that the case 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”. They also described her fees as “unsystematic, arbitrary and, ultimately, opportunistic”.
It’s hard to square that description with how we like to think about doctors – kind, gentle, big-hearted. It’s the same with teachers who abuse their students – our sensibilities are offended when we see those charged with taking care of others taking advantage of them instead.
For that reason, Dr Lim’s actions will seem not only mercenary but morally repugnant.
But the court’s decision yesterday went further than just saying she was greedy and behaved badly. It set an ethical precedent for all doctors – that they have to ensure not only the health of a patient’s mind and body, but also of his or her wallet.
Moreover, that this duty went beyond “contractual and market forces” – meaning, it does not matter if the sum is reasonable according to a patient’s financial ability, or any supply-demand factors – a doctor’s fee has to answer to a higher, moral standard. In fact, “Such obligations necessarily trump contractual or commercial obligations where there is conflict between the two,” the court said.
Who decides whether there is any conflict or not in the first place? No wonder the doctors are flummoxed. Specialists who spoke to ST said as much. Dr Lam Pin Min who chairs the Government Parliamentary Committee for Health said that the $24m figure aside, many doctors were “apprehensive and unclear” about where these ethical limits lay, adding: “There are really no clear guidelines at the moment. What the healthcare industry needs is a better definition of what this ethical limit is so as to avoid any ambiguity in the future.”
Others are also wondering why doctors are being singled out – even if the practice of medicine is “a calling of the highest order”, to quote the court.
Another question is – if Dr Lim’s case is the most serious, what were the other cases of overcharging, and why didn’t those cases trigger this expansive ruling on how doctors should go about their businesses?
That said, this ruling will undoubtedly protect patients; it’s a stern warning to specialists like Dr Lim who before could fleece rich patients simply because there wasn’t a provision in the SMC’s ethical code that prevented them from doing so.
But for the majority of doctors, the ethical considerations they grapple with will have more to do with life-death issues rather than how much to bill a patient.
A vague and ambiguous rule to observe an “objective ethical limit” has the potential to clog the courts with specious claims – not to mention a doctor’s valuable time and energy. If that happens, the judges’ ruling yesterday may end up doing more harm than good.
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I may not be a medical expert but do you have to be an expert to know that someone is being cheated
Susan Lim was found GUILTY by her own peers. If you know anything about the medical community in Spore they usually close ranks & protect their own but in this case they couldn't ignore this case because it was so outrageous
You know what is the difference between a doctor & a plumber?...almost the same, your pipe starts to leak badly at 3am in the morning & on a holiday, you call one...the bill is outrageous. The same with a doctor & a plumber, you have a leaking faucet, you call the plumber...the more dumb you are, the more you going to get rip off, all you need is a washer replacement, but the plumber sells you a new faucet set; the doctor the same, in another way.
You have expensive fixtures...WC that says TOTO..etc.. you have gold taps...the plumber will not only want to change the washer, but the tap, the sink..the...
That is what was happening to Susan Lim...all the 'plumbers' in the trade, know all the tricks...but she was charging $1,000 for a change of faucet...while the washer is only 20cts a piece..
So, now you know the plumbers & doctors are nearly the same...
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