MOH seeks greater clarity on clinic charges

04 Oct 2007, The Straits Times

Question

Name of the Person: Goh Kian Huat

Private clinics should give details of charges

I REFER to the report, 'Docs dispensing drugs: System not without its benefits, says Khaw' (ST, Sept 21).

I fully agree with Health Minister Khaw Boon Wan's view that the current system of allowing private doctors to prescribe and dispense drugs has its benefits. Doctors know what medicine they carry and are flexible to prescribe alternative medicine in the event they do not have a particular drug.

This arrangement allows patients to enjoy the convenience of a one-stop service. Otherwise, patients who are sick may have to make a separate trip to a pharmacy to buy the prescribed medicine. In the event that the pharmacy does not carry the medicine or runs out of it, the patient may have to make a reservation and collect it on another day. Alternatively, he will have to go to another pharmacy.  Moreover, patients who consult doctors at night can buy their medicine from a pharmacy only the next day.

In addition, with the profit from dispensing drugs, doctors can lower their consultation fees. Otherwise, they will have to charge a higher consultation fee to cover their operating cost. This will result in a higher total cost to the patient.  However, currently, the costs of consultation, tests and medication are not transparent in private clinics. Patients are told verbally the total charges payable and so are at the mercy of the clinics and have no way to compare prices or detect any error of overcharging.

The Singapore Medical Council no longer provides guidelines on consultation fees. Doctors are free to charge their own consultation fees and are not obliged to tell their patients.

Therefore, it is timely that private clinics should provide a bill itemising the cost of consultation, tests and medication to their patients, as suggested by Mr Khaw.  With the IT available, doctors should be able to comply with this new requirement.

Reply

Reply from MOH 

In “Private clinics should give details of charges” (ST, 1 Oct),  Mr Goh Kian Huat asked for greater transparency in clinic charges and bill itemization so that patient’s interests are protected.

MOH fully agrees with his comment. Patients should also know what they are paying for, including any additional charges for investigation, treatment, and procedures. Doctors should also always act in the best interest of their patients and it is good practice for doctors to issue drug prescriptions so that patients have a choice of where to fill their prescriptions.

Currently, the PHMC Guidelines require all medical and dental clinics to inform patients prior to consultation, the charges which are likely to be incurred for consultation, investigation and treatment.

To provide for greater transparency, MOH is revising the PHMC guidelines to specifically spell out that common charges should be prominently displayed in the clinics.  The charges may be displayed in the form of a fee range and shall include consultation fees and charges for vaccination/immunization, health screening and medical reports, where applicable. 

The new guidelines will also set out that doctors must give prescriptions to patients who want to purchase the medicine from a pharmacy, if they request for it.

In addition, itemized billing for medical and dental clinics will be put into effect by April 2008. This time period is to allow the clinics to configure their IT systems for itemized billing.

MOH is currently informing the doctors of the various changes. A copy of the circular is available on the MOH website at www.moh.gov.sg/mohcorp/publications.

We hope that these changes will make fee charges more transparent so that members of the public can make more informed choices on their healthcare provider.