A doctor at Raffles Hospital has been convicted of professional misconduct and suspended for six months, after he failed to comply with the "applicable standard of conduct" in the management of a construction worker who had a fractured hand.
In a press release on Tuesday (May 10), the Singapore Medical Council (SMC) said that Dr Wong Him Choon's conduct was an "intentional and deliberate departure from the standards observed or approved by members of the profession of good repute and competency".
In its statement, SMC said the patient was brought to Dr Wong Him Choon on Sep 3, 2011 by his supervisors after an accident at the construction site, where the worker suffered an injury to his right hand.
Dr Wong, 51, assessed that the patient had sustained a distal radius fracture and a metacarpal fracture, and performed a surgery on his hand early the next day. The worker was discharged on the day of the operation, and a medical certificate was issued to cover his hospitalisation from Sep 3, 2011 to Sep 4, 2011.
The doctor also certified his patient fit for light duties for one month from Sep 5 – the day after his surgery. Dr Wong reviewed the patient on Sep 7, 2011, and scheduled a further review on Oct 5, 2011.
However, on Sep 11, 2011, the patient went to the Accident & Emergency department of Changi General Hospital as he was experiencing pain and was hospitalised for 19 days.
During the Oct 5, 2011 review, Dr Wong then issued the patient with a backdated medical certificate to cover his absence from Sep 6, 2011 to Nov 20, 2011.
The doctor faced one charge of professional misconduct, in that he had failed to exercise due care in the management of the patient by certifying insufficient hospitalisation leave and inappropriately certifying the patient to be fit for light duties at work.
Dr Wong pleaded not guilty to the charge.
A disciplinary tribunal hearing was then held on Jun 15, 22 to 25, 2015; and Sep 15, 2015.
The tribunal accepted expert testimony that the applicable standard for someone with a distal radius fracture that had been fixed and a metacarpal fracture that had been treated conservatively was two weeks of medical leave.
It also agreed that Dr Wong had failed in his duty to discuss with the patient and establish if there were adequate conditions for his rest and rehabilitation, or the ability of light duty in his job before certifying him fit for light duties.
Nonetheless, the tribunal initially acquitted Dr Wong on the basis that there was insufficient proof that his actions were intentional and deliberate.
The SMC then filed an appeal to the High Court against the tribunal's decision, and the Court subsequently overturned the tribunal's acquittal of Dr Wong on Tuesday (May 10, 2016) and convicted Dr Wong of professional misconduct.
The Court noted that Dr Wong had considered "irrelevant factors" in issuing the medical certificate and "disregarded the patient's wellbeing", said SMC.
Citing aggravating factors, SMC asked for a suspension of four months, and the High Court then sentenced Dr Wong to suspension from practice for a period of six months, according to the statement.
Aside from the suspension, Dr Wong will be censured and will give SMC an undertaking to abstain from the same or similar conduct. He will also cover SMC's costs for the legal proceedings.
CASE REPRESENTS CONCERNS OF DOCTORS COLLUDING WITH COMPANIES: HOME
The SMC said the disciplinary tribunal proceedings arose from a complaint from the Humanitarian Organisation for Migration Economics (HOME), a charity that focuses on the rights of migrant workers. It had lodged a complaint against Dr Wong to the SMC with the patient's permission.
In a separate statement, HOME said it was "heartened" by the decision and "glad that justice had been served".
It said that the complaint was made because of concerns that doctors could be "in collusion with companies to discourage workers from taking medical leave and filing work injury compensation claims, even though the workers were seriously injured".
HOME said it saw "dozens" of workers with such cases and were "disturbed" by an increase in the number of cases. It had also faced challenges filing complaints for some workers, as the latter were afraid of reprisal from their companies, adding that it sees at least 15 workers a year who are not given sufficient medical leave.
The charity claimed that in some cases there was an "unethical and symbiotic relationship" between the employer and the doctor, as employers are willing to pay a premium for treatment if it means net savings and benefits accrued at the expense of their worker’s well-being, and the doctors are assured a steady flow of patients from companies from the various industries that rely heavily on foreign labour.
"Other than serving as a barrier to legal recourse for their injuries, issuing insufficient medical leave deprives workers of the much-needed rest they need after sustaining such serious injuries," HOME said.
It added: "HOME urges doctors in Singapore to take a stand against such practices, because in addition to tarnishing the image of the medical profession it has adverse consequences for the health and wellbeing of workers."