Tuesday, July 28, 2009

Singapore Medical Council's ongoing battles

The Straits Times reports today on the ongoing battles of the Singapore Medical Council against the Ministry of Health's continuing efforts to enable a non-medical Chairs for the disciplinary tribunal.

I personally don't have have any objections to it although many of my colleagues are resistant to the idea. I don't really subscribe to the argument that issues are so complex difficult for non-medical people to grasp. I think that's a lot of bull. It might have been true in the past when the level of education was low, and when medical issues were seldom discussed in public. This is no longer the case. Medical issues are now widely discussed and there is a fairly good understanding of medicine and bio-medicine outside of the profession. In fact the converse might be true, that many medical issues are now so inter-disciplinary and technologically complex that even doctors themselves have difficulty grasping all the implications of the cases.

One additional issue for some of my colleagues to consider is the Physician's Pledge which compels each physician to "respect my colleagues as my professional brothers and sisters". Although well meaning, the pledge effectively signals a closing of ranks around professional colleagues who are effectively 'in the family' as professional brothers and sisters.

But having said that, a number of problems plague this discussion. The chief one for me is, why single out the medical profession? I think the medical profession has been the most transparent and open with regards to the working of its disciplinary tribunal. It has probably been the most scrutinized and commented upon. Regardless of any perceived deficiencies, it has functioned 'well' so far. So why the sudden, almost urgent need to reform the system? Does the Ministry of Health know something it is not telling us? Has there been any evidence that the system is not working? And on a more Machiavellian note, are there any other forces at play that are perhaps driving this relentless drive to change the status quo?

Perhaps it might be better all round if this reform was undertaken as a cross-professional effort, so that the reforms at the SMC can be seen as only the first step in reforming all the professional guilds.

2 comments:

Robin said...

Peers review can sometimes end up in peers support... the line drawing exercise being comrades et al.

haha.. you are wise to know the difference

gigamole said...

Well, professional guilds are structured primarily for protection of self interest. It is to some extent an antiquated concept. You can read about the history of guilds here at Wikipedia:
http://en.wikipedia.org/wiki/Guild

One can question if the structure and function of guilds adequately enable the guilds to 'self-regulate'. That, to a large extent underlies the necessity to 'reform' these guilds.

The focus on the Medical Council is unfortunate, because the reform would have had much more power of persuasion if it could be seen to be objective and inclusive across professions.