Rules on MC may be tightened following employers’ feedback on doctors issuing them excessively

MOH considering tightening conditions around MC issuance in Singapore

Singapore’s Ministry of Health (MOH) is looking into tightening the rules governing the issuance of Medical Certificates (MC) by doctors.

This is due to feedback from employers that doctors have reportedly been issuing MCs excessively after outpatient consultations, specifically during teleconsultations.

There have also been instances where doctors allegedly issued MCs for non-medical reasons, such as the patient simply not wanting to attend work or school, or repeatedly issuing MCs to the same patients without referring them to further physical consultations.

As such, the Ministry is now asking for doctors’ opinions on amending the Healthcare Services Act to tighten the conditions around the issuance of MCs.

Employers note excessive MC issuance, particularly after teleconsultations

According to The Straits Times (ST), doctors received a circular on 22 April reminding them of the conditions under which they should be issuing MCs.

The circular reportedly said that doctors should issue MCs within the context of “an existing patient-doctor relationship” and on the “duty of care the doctor owes the patient arising from this patient-doctor relationship”.

Apparently, MOH has received feedback from employers and government agencies about the excessive issuance of MCs after outpatient medical service consultations.

It singled out teleconsultations as one of such consultations.

MOH asking for doctor’s opinions on amending Healthcare Services Act

The allegations that the circular listed include:

• Giving out MCs for non-medical reasons, such as “when patients mentioned that they had just wanted a certification to skip work or school, but they were not sick”.
• Repeatedly issuing MCs to the same patient without referring them to physical consultations for further assessment and follow-ups.
• Issuing MCs without proper clinical assessment and follow-up, and instead basing it on patients’ self-reported reasons in the teleconsultation platform or application.

The circular also highlighted the Singapore Medical Council’s (SMC) Ethical Code and Ethical Guidelines. They state that practitioners should only issue MCs “on proper medical grounds arrived at through good clinical assessment”.

It was jointly endorsed by Professor Kenneth Mak, director-general of health at MOH, and Professor Chee Yam Cheng, president of SMC.

Additionally, MOH asked doctors for their opinions on its proposal to amend the Healthcare Services Act, to tighten the conditions under which doctors can issue MCs.

Also Read: ‘Get your MC or get a refund’: Little India clinic under investigation for issuing MC without consultation

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Featured images adapted from MaNaDr, for illustration purposes only.