GIVING PATIENTS THE BENEFIT OF THE DOUBT
Other clinics and telemedicine providers CNA spoke to said doctors have to assess patients based on trust and good faith.
Raffles Medical’s Dr Ryan Thian Wan Lee said teleconsultations rely on obtaining a detailed medical history from patients and observing visual cues during video calls.
“While there are no specific protocols exclusively designed for doctors to issue medical certificates via teleconsultation, the underlying process and considerations remain consistent with those followed in a physical clinic setting,” said Dr Thian, who is a senior family physician.
A Fullerton Health spokesperson said the process of consulting a doctor online involves mutual trust – in that “a patient entrusts his condition to a doctor for proper treatment, and that doctor trusts that the patient’s predicament is genuine”.
When in doubt, doctors are advised to review a patient’s MC record, and if there are concerns of malingering – deliberately feigning symptoms – doctors will refer a patient for an in-person assessment.
Dr Wong Jiayi, the assistant medical director at Minmed Group, said most symptoms reported during a typical consultation would not be visible. For instance, a patient with migraine may not have any physical signs of it.
“Unless there is a history of abuse, we should take the reported symptoms in good faith. This is true whether it is a teleconsult or a physical clinic visit,” she said.
Dr Mok Boon Rui, founder of Pinnacle Family Clinic, told CNA the clinic has its own system to check how many MCs have been given to a patient.
While he has not seen many “abuse cases” in his practice, Dr Mok said that if he suspects abuse, he would still give the patient a day or half a day of sick leave and ask them to visit the clinic for a physical examination.
“(Whether the patient is an) MC seeker or MC abuser, they are still humans, they can still fall sick. It is our duty to look after anyone regardless of whether they are an abuser or not,” said Dr Mok, who is a family physician.
Dr Lee Joon Loong from Paddington Medical Clinic added that a patient might have some underlying issues, such as problems at home, for malingering.
“The MC system is just a system but I’m here to address the medical problems, even the psychological issues that patients face,” said Dr Lee, who is the clinic’s medical director.
Giving an example of a patient visiting him for a headache, Dr Lee said he trusts the patient is reporting the symptoms accurately.
“Even if I don’t pick up any signs of examination … apart from the symptoms reported by the patient, I still give my patients the benefit of the doubt.
“They may just need a day off … just a piece of paper that they need. But more importantly, it’s the trust between doctor and patient that is still paramount,” said Dr Lee.
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