By: Leong Sze Hian and regular medical practitioner insider

I refer to Yik Keng Yeong’s (Dr) response “Simple for patients to find appropriate doctors” (Straits Times Forum, Jan 7) to Dr Hajime Ichiseki’s view (“Third-party agents helpful in matching patients to docs“; Dec 20, 2016).

It states that “getting a referral to an appropriate specialist in Singapore is direct and simple. Any visit to a general practitioner or hospital will ensure patients get attended to by the needed specialist or subspecialist. The doctor and patient then play equal roles in determining appropriate therapies. A third party is superfluous. Still, there is a role for third-party agents in ancillary matters. In such cases, fixed fees collected by them need to be clearly stated and made known to patients, separate from what the doctor charges.”

Fees sharing issues?

After writing “Medical fees sharing outlawed finally” (Jan 3) – my medical practitioner insider and I were talking about some issues similar to the outlawing of fees sharing.

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Free benefits?

Several years ago – medical groups started to give free accident insurance for a few months to newborn babies.

Initially, the medical groups paid for the premiums, but subsequently third parties paid the premiums.

Mutual benefits?

Over the years – we understand that this has evolved into third parties paying upfront cash benefits to medical groups.

Tender to highest bidder?

We understand that one medical group recently put out a closed tender, and about 10 third parties made proposals to bid for an automatic free medical expenses cover for one year for newborn babies.

Similar issues to fees sharing?

We understand that the proposals may include cash benefits, referring patients, etc.
How different are such arrangements to the fee sharing that is now forbidden under the ethical code?

Implications for consumers?

At the end of the day – what are the implications for consumers?

Wouldn’t possible allotment to the highest bidders be ultimately detrimental to consumers?

Wouldn’t it push up the cost to consumers ultimately? Wouldn’t there be a risk that referrals will be made on the basis of who gives the best mutual benefits to the companies or in a sense – fee sharing directly or indirectly – instead of on the basis of the best medical practitioner or provider that can give the best treatment and care or cost value to the patient?