July 12, 2006I know this journalist - David Boey. He was a frighteningly brilliant military expert who once worked for Jane's Defence. A bit sad to see him now writing articles about SAF doctors who cheat on their MCs.
Ex-SAF doc suspended for falsifying MC
After leaving SAF in disgrace, he isnow censuredby medical council
By David Boey
A YOUNG doctor discharged from the armed forces for falsifying a medical certificate has been suspended from practising by the Singapore Medical Council (SMC).
Former Singapore Armed Forces (SAF) regular, Dr Kevin Ong Shu Shien, 29, was 'discharged with ignominy' - meaning he left SAF service dishonourably - after he pleaded guilty to 'falsification of an official document' under the SAF Act in December 2004.
Dr Ong, who was then a medical officer with the Headquarters Medical Corps, had falsified a medical certificate (MC) in December 2004.
More than 1 1/2 years later, Dr Ong was facing another tribunal, this time from the SMC.
The council said yesterday that it held a disciplinary inquiry on May 29 this year to look into Dr Ong's case and, following the hearing, ordered that he be censured and his medical registration suspended for three months.
This means Dr Ong cannot practise during his suspension period, which began last Thursday.
In a statement, the council's disciplinary committee noted that Dr Ong had 'cooperated with military authorities in their investigation and that he was genuinely contrite for this offence'.
But it explained that the doctor's offence 'was a serious one that breaches the high level of trust that the public places in the profession'.
It said Dr Ong is now serving the remaining period of his national service liability.
Very few doctors have been convicted for falsifying MCs.
Only two cases have made the news since 1990.
In August 1992, a doctor who gave medical certificates to two national servicemen was suspended for one year.
Then, in October 1994, the council suspended another doctor for six months for issuing certificates to six patients without proper medical grounds.
Though doctors rarely go astray, more than 100 people have been brought to book for forging their own MCs since 1990.
Forging an MC is a criminal offence.
The sentence for forging or using a false certificate is up to three years' jail or a fine or both.
dboey@sph.com.sg
Anyway, I wish David Boey had not omitted some rather basic facts in this article. Like - whose MC was it, and how did Dr Kevin Ong actually falsify it. As I see it, some likely scenarios would be:
- (1) he increased the number of days on his own MC;
(2) he backdated his MC, to cover for his own AWOL; or
(3) he sold MCs to SAF servicemen who weren't sick.
Well, all of the above are wrong, and I guess Dr Ong needs to be punished in some way. However, I wonder how such offences can really be said to "breach the high level of trust that the public places in the profession" and why the Singapore Medical Council, in particular, should get involved.
Would you really distrust a doctor, as a professional, because of an offence like the kind that Dr Kevin Ong committed? Personally, I would be more likely to distrust a doctor if he was known to prescribe unsuitable medicines, or make grossly wrong diagnoses, or if he didn't ask what drug allergies I have.
By analogy, Singapore lawyers will easily get suspended or struck off if they are convicted of some offence that involves dishonesty (for example, cheating, forgery or criminal breach of trust). That's because honesty is key for lawyers (they handle large amounts of clients' monies). However, Singapore lawyers do not get suspended or struck off for offences like speeding or drink driving or littering. There isn't any clear connection between such offences and their ability to adhere to professional standards.
So let's assume that Dr Kevin Ong had committed an offence like (1) or (2). The question is - should the SMC care? Does the matter really have any relevance to SMC's role and responsibility? Does Kevin's behaviour really mean that he will not be a good doctor to his patients?
You could also think of this way - if Dr Kevin Ong had falsified not an MC, but a annual leave application form or a parking coupon, should the SMC get involved?
Over to you, dear readers.
+++++++++
Technorati: Singapore.
64 comments:
In Singapore, doing small crimes don't pay, must do big ones.
Like the NKF dude, still enjoying his holiday abroad?
:)
The issue here is that a doctor also has a 'social' function, especially when it regards MCs.
In fact, the MC is largely a social construct which just happens to involve medicine. I suppose the 'public' in this case refers to employers and schools who need to be able to trust doctors to issue MCs judiciously.
In any case, if a doctor cannot be trusted to handle MCs the way the profession expects him to,then the SMC has the right (and duty?) to censure him.
What I am keen to find out, however, if how someone decides if an MC has been issued 'without proper medical ground'. It is not hard to come up with a reason to justify why you didn't think someone was fit for work that day.
I agree with you that Mr Boey should have written more details about the case as you mentioned. It is hard to comment about the case as such.
I would just like to share some added information from the medical circles.
For one, a regular SAF medical officer is usually a Local Study Award recipient (ie scholar). These guys disrupt from NSF, study medicine under the LSA scholarship and then return to serve the remainder of their NS liabilities and continue to serve their LSA bonds in the armed forces.
Of course, it is entirely possible that Dr Ong was not a LSA scholar and chose to sign on with the SAF during his Medical Officer Cadet Course or thereafter.
The question for me is which one is he? If he is an LSA scholar, then he also has a hefty bond to pay up, now that he is discharged from the SAF. Why wasn't this mentioned? Perhaps he is not an LSA scholar.
As for forging MCs. Again more information is needed.
As a doctor, it is not easy to justify NOT giving an MC to a patient who gives a HISTORY of symptoms suggestive of common URTI, gastroenteritis etc. In fact as a SAF MO it was an absolute chore for me to have to handle queries from commanders on why certain soldiers were given MCs and at the same time queries from the parents of servicemen why their sons were NOT given MCs!
Personally when a patient tells me he has a stuffy nose, been coughing ,having muscle aches, joint aches and is feeling very fatigued (all symptoms of a cold or flu) I would be compelled to believe his history rather than suspect him to be lying. If I did the latter it would be unprofessional to be honest.
And MC of 1 day is not out of the ordinary for patients who bother to visit the doctor and give such a history. However we do monitor the MC taking track record of patients. If the frequency is high and/or there are patterns in the timing of the MCs, we will enquire further.
This is why it is rare that doctors are called up for faking MCs (ie sell MCs). Unless the doctor gives a particularly long period of medical leave for a condition that does not warrant it, it is hard to sound any alarm bells.
When I was a SAF MO I once caught a soldier for forging his MC. It was reported in the New Paper. But I never set out to catch him. He had come to endorse his MC for a elbow bruise after he had hit it against a railing (according to him). He produced an MC from a RMG clinic for 7 days home leave. I had examined him and found his elbow to be only very slightly contused with full range of pain free movement. I felt it was excessive and called the clinic to speak to the doctor. My intention was to ask her for permission to change the MC to 7 days of light clerical duties (He was a clerk). But the doctor said she saw no such patient on the date of the MC and the serial number of the MC was from very old MC books.
Investigations later revealed a scam involving the nurse at the clinic.
As it is I think there is a lot more than meets the eye with regard to Dr Ong's case. There have been many rumours and I personally think that forging an MC is not the only offence he committed, but they chose it as a way to punish him as severely as possible.
Imagine if a clinic chooses to "sell" MCs, that would give the clinic a potentially unfair advantage. Many "patients" would flock to that clinic. I guess for that alone, the SMC need to send a strong deterent message that falsifying MCs are strongly (very) discouraged.
Chee Soon Juan lost his teaching job over a taxi fare claim, so Dr Ong's "harsh sentence" is not so isolated a case. If you're gonna be fixed, you will be fixed.
I think the issue is about malingering. But the news report doesnt give any detail on the exact offence. IMO it is better to give more MCs than less, after all the patient can only be better off with more rest than less. A doctor with a bigger heart my give more rest days than another.
I have noticed about this Boey reporter. He always write on military related stuff... thought he might be related to a SAF general by the same surname. But i could be mistaken.
I agree with you. In fact in one case during my time as a SAF MO, my fellow MO was rebuked by the chief of the medical corp for NOT giving MC to a soldier who had a sprained knee. The excuse running marching and jumping for 1 week was deemed not good enough for the guy.
Turns out the fella slipped and fell in the slippery toilet and suffered a dislocated knee a few days into his excuse.And his parents made a complaint to the then Minister of Defence.
The comment from CMC was "Give MC. Then you pass the responsibility over to the parents."
After that we all gave MC to practically everyone. Even those who refused to have an MC were given one.
Anyway, the headline say until he kana suspend for a very long time, only 3 months nia!!!!
Here is how i see it.....
I go see doc, doc ask me: "How are you today?"
I say: "Today VERY tired becos not enuf sleep from World cup. Doc, can give me 1 day MC to rest? Also I need some pain killers for my headache."
Doc say: "Ok!"
I proceed to PAY for my medicine and consultation (MC).
So, is the doc selling me MC????
The si lang garmen moufpiece, always like that one, keep some info here and there then make until the fellow like some murderer then make the garmen like some hero saving the day! Knn.
If I doc, I will give MC, I don wan the fellow step out of my clinic then faint and die, at least i cover my own backside 1st!!!
Anyway, to all the docs, can docs give themselves MC?? Can doc give backdate MC?
Ok doctor cannot give himself MC.
MCs cannot be backdated also.
The way backdating is "checked" is that the MCs are all serial numbered. If the date of the MC is not in running order with the serial numbers ie later serial number got MC dated for earlier then a suspicion of a backdated MC is there.
I also agree giving the patient the benefit of the doubt. In fact it's not so much a doubt but that the doctor should trust that the patient is truthful about their complaints and the patient should trust that the doctor has their best interests at heart. Parson's sick role for you.
Hmm...actually I think the SMC should spend time looking into some clinics famous for giving out MCs easily, which is often visited by working people and NSFs alike.
Like what Mr Wang had pointed out, more details should be given in this article written by Mr Boey.
In a previous article, Mr Wang was postulating that full-time journalists don't have specialised fields of knowledge because the only thing they know well was journalism.
Bloggers, on the other hand, would have their spheres of expertise because they have careers/interests outside of blogging.
Yet in Mr Wang's own words, David Boey is an expert in military matters. More examples probably abound, it's just that we are unaware of their prior careers and experience.
As for this article, like what most people are saying, it's hard to comment without more information.
This brings me back to another point I made some time back (re: a school to be closed down) - Mr Wang could consider doing his own checks and tapping on his sources, instead of solely relying on ST articles for his commentary.
This would give an added dimension to his analysis. Must value-add mah.
Wah
Very enlightening to read this entry and all your readers' comments
I think the issue here is that, unlike misdiagnosing or mistreating an ailment, an MC necessarily involves a third person - the person reading the MC.
A patient has the choice of choosing his doctor. If he doesn't trust the doctor, he can switch. The person reading an MC does not have such a luxury. In order to rely on the MC he must trust all doctors in general.
I think it's a pretty serious issue. It's not quite consumer protection. I see it as part of the social contract that gives doctors the power to do their jobs properly.
Another thing I would like to know: in what capacity is Dr Ong 'serving the remaining period of his national service liability'?
OK, I'm a busybody sometimes too...
Yeah that was what I was thinking of also as a was reading the ST article.
The suspension runs while he is in the SAF serving the remainder of his NS liabilities? In some way that's shortchanging the SAF isn't it?
Maybe he's clearing his ORD leave.
But I thought there was something about his exam leave.
I think the question to ask is, internally, who has the power to charge a MO? And who would charge an MO?
WOSEs wouldn't. If I were an RSM, I wouldn't. Officers below my rank probably wouldn't. The department heads wouldn't. Which leaves the CO as the most likely personnel to charge a MO.
Which is why when I was in army, different MOs had to deal with CO with regards to giving MCs out. The numbers on record, as well as the number of downgrades are vital to the CO as the unit moves towards operational readiness. The MO also has to play his cards well even if he is compassionate towards those that really need medical attention.
The rumours are there, the numbers are definitely not there. Take my post as a reply of delusional nature if you would.
Personally, I would distrust the MOs who refuse to give MCs even more--those who insist that you are ok when you are not, those who say you are malingering when you aren't.
thor666,
i believe it is out of the co's league to charge a mo (mo minimum rank cpt). the co can only recommend a charge and someone higher up, say div commander, does the charging.
Anon: noted, though I can't verify.
Don't matter. I do know the CO can put a lot of pressure on the MO.
I don't hazard anyone from the gahmen to be reading this, but if you do, take this discussion to be positive and rectify the error, rather than punish people for letting out classified/confidental/secret information.
One thing to note. Dr Ong served in HQMC.
As far as I remember, my friends who were sent to HQMC hardly saw patients. They were doing paper work, drafting papers, replying complaint letters from MPs etc. Never saw a single patient.
So I don't think it had anything to do with Dr Ong giving MC to soldiers.
It probably had something to do with his own MC/leave situation.
But I can confirm that HQMC MOs almost never see patients. And as a regular, this guy probably was more likely doing paper work. I know of NO regular SAF MOs who see report sick to be very frank.
Seeing patients is ranked very lowly in the SAF Medical corp. A common comment I got from my colleagues at HQMC and HQAMS was always "Wah your life easy! Only see chow keng". Writing papers and all was deemed more important in the bigger scheme of things than doing the work of a doctor ie seeing patients.
AS such the guys up there are totally out of touch with what goes on at the ground level.
From my time as an NSF SAF MO I have lots of unhappines with the SAF medical corp and the way they prioritize what's important.
You guys are quite right to say that you prefer and better trust a doctor who gives MC rather than not. That's the perception of most people at the ground level. But it is NOT the perception of the commanders and COs. They would apply indirect pressure to influence the MO to be more stringent.
But if there was any complaint or problem, they would immediately say that they "never interfere with medical decisions"
Hmm, are the doctors usually trained for combat situations? Because I would think in the armed forces and the high density of doctors there should be at least some practice leh.
If war comes, then how? Then they will have no experience dealing in the horrific brutalities.
Well, I guess an Army physician is different.
Also, some people do seem to complain about the inequality in the armed forces concerning high ranking officials' children, so I just have this sliver of hope he was forging stuff for them and something was found out.
Nah that would never become an issue. It's shooting themselves in the foot and they very rarely do that.
thor666,
yes, a CO can certainly put a lot of pressure on an MO. This happened to a doc friend of mine. According to his tale, a NSF was recommended downgrade by his superiors and unit CO. He does not concur and suggested further tests and observations instead. The MO began to get scrutinised during parades and all kinds of petty little things surrounding the medical centre. Later he found out that the NSF is a young relative of the CO. LOL
anyway sorry for the off-topic.
Back to Mr Wang's question of "Should the SMC care?"
FYI, there is a set of ethical guidelines put out by the SMC (check out their website), by which doctors are expected to follow (this includes issuing of MC's). If a complaint is received by the SMC that a doctor had failed to meet any of these guidelines, they proceed to investigate & discipline accordingly.
He probably falsified an MC that another doctor issued to him ... I don't think doctors issue MCs to themselves.
Assuming the above is correct, it's not correct to say that this has something to do with Kevin Ong unethically issuing MCs in his capacity as doctor. He didn't. In fact, HQMS doctors just do paperwork, they don't see any patients, how can they be issuing MCs.
I think this is the point Mr Wang was trying to make.
Medical certificates
The issuance of a medical certificate by a doctor carries with it the
responsibility to ensure that the patient deserves it on proper medical grounds
and that such grounds have been arrived at through good clinical assessment
as detailed above. Medical certificates may neither be post-dated nor
back-dated and shall start from the day of consultation or procedure, except
where it is clear that a patient’s absence from work prior to consultation is
consistent with the patient’s clinical presentation to the doctor and there is
medical justification to issue the certificate.
The certificate which is issued after the medical examination should specify
the expected period of illness and if appropriate, whether the illness renders
the person unfit to attend court.
As a medical certificate carries with it a professional and legal responsibility,
the doctor must sign the certificate personally and if another person has
filled in the details on his behalf, he must satisfy himself that the details
are correct before signing.
A doctor shall not amend the provisions of a medical certificate given by
another doctor without assessing the patient personally and consulting the
doctor who gave the medical certificate initially.
"A doctor shall not amend the provisions of a medical certificate given by another doctor without assessing the patient personally and consulting the doctor who gave the medical certificate initially."
That last bit is of course another possible reasons why Dr Ong got into trouble?
Maybe a serviceman submitted an MC and he revoked it without consulting the original doctor who issued it?
Anyway all this is just speculation. This is how poor journalism is. When it throws up more questions than answers.
See what I mean?
The obligations are all about the things which a doctor must do, when he treats a patient and is issuing an MC.
Kevin Ong wasn't treating any patient and he wasn't issuing an MC. He was falsifying an MC that had been issued to him as a patient.
In other words, he is really very much like any other SAF serviceman who falsifies an MC.
Those other SAF servicemen wouldn't get any punishment from SMC, would they?
I see what you mean. And as u rightly pointed out, what has that got to do with SMC then right?
"if Dr Kevin Ong had falsified not an MC, but a annual leave application form or a parking coupon, should the SMC get involved?"
Needless to say, the answer is yes. SMC can get involved and he could be taken to task. It is akin to a police officer caught speeding or fighting outside his working hours, wun you expect him to be taken to task by the police force?
Heheh. Then if a doctor is caught speeding or fighting outside his working hours, would you expect him to be taken to task by the SMC?
I dunno. Maybe. But seems like a rather odd idea to me for SMC to do so.
There are always the catch-all 'improper act or conduct which brings disrepute to his profession' and 'any offence implying a defect in character which makes him unfit for his profession'.
See the Medical Registration Act for more details. :)
Well, watch out then, Angry Doc. Better not speed or fight or lose your temper .... Might bring disrepute to your profession. :)
"You've been a bad boy, angry doc..."
*slap on wrist*
I just read the Chinese papers - it seems he forged/falsified an MC for himself.
I'm not sure I would accept an MC excusing a doctor that was issued by him?
As I recall, my school required an *independent* doctor, ie. not parents, not close friends or relatives, to excuse a student. (This clarification was issued at a lecture a smart schoolmate of mine decided to pipe up, "isn't Dr. Ong an Independent doctor? har har har har...")
Oops, left out a preposition in my last post when I was editing it.
I meant a "a lecture where".
Hi friends,
It is not useful to discuss the matter about SMC and Dr. Ong until we have all the facts.
The medical profession is an ancient and noble one. Doctors are not just trained in knowledge and facts about diseases but are also expected to be men and women of high ethical standing and integrity. Their morals must be above reproach.
Only if we consistently demonstrate to our patients that we have their welfare as our only concern can we expect trust from our patients. Yes, I know that most of us doctors do feel that it is not fair that we are looked on almost as demi-gods and that we are humans too. But patients trust us with our lives and we cannot betray that trust.
We dispense the medicines and MC's only if this will help the patient. No other motives.
Hence, when the SMC (which comprises senior respected doctors- some of whom are elected directly by fellow doctors) finds out that any doctor has any moral defect (from criminal records like fraud etc), it is their duty to probe to see if this person is fit to remain a doctor.Too many bad sheep will tarnish the reputation of all of the rest ( I am not passing judgment on this particular case)
I know that every profession ( law/architecture/accounting/engineering) has high moral standards and take similar action to maintain high standards of their profession. That is why it is paramount that everyone take serious interest in their professions and vocations to ensure that only upright men/women lead them in their professional bodies.Same for political leadership.
I will write more on this (medicine and ethics etc) when time permits.
Sometimes, we need to trust the system. Not everything in the system is rotten.
Cheers
Dr. Huang Shoou Chyuan
Mr Wang,
You might also want to read this, with regards to medical doctors in SIngapore playing the dual civilian-military roles.
http://takchek.blogspot.com/2005/06/military-civilian-doctors.html
Just curious: what about the combat medics?
Soong: What about the combat medics?
Mr Wang, I have a feeling you're deliberately not raising the constitutional idea of "double jeopardy" because you think it's too technical for your readers.
The basic idea is that a person shouldn't be tried / punished twice for the same offence. That is, Kevin Ong shouldn't be punished under the SAF Act AND also by the SMC.
Screw the SAF lah! Knn...
Surely the SMC knows that a doctor doing national slavery cannot be said to be able to fully comply with the hippo-something oath or perform his medical role as diligently as those outside. The SMC should award him a medal instead!
Double jeopardy does not apply as SMC is more of a professional disciplinary body than a judicial body.
If you recall, there was the case of a GP whose wife operated a bubble-tea stall on the same premesis as his clinic. They had a fall-out and there were accusations levelled at each other. He was found not guilty by the court, but his actions were still found to be 'unbecoming' and he was censured by SMC.
In fact, if you read the Medical registration Act, double jeopardy is specifically provided for, as a doctor can be censured for 'any offence implying a defect in character which makes him unfit for his profession'.
Save them the trouble of finding out whether you are guilty - they just decide what form of censure based of the offence you were found guilty for.
Basically, none of you know what is going on. I was a regular with this guy in his previous unit. He was not charged by SMC of any defect in moral character (Section 45b MRA). Only his behaviour (issuing a forged MC for himself - yes this is a case of poor journalism) was in question (Section 45a MRA).
Medical Registration Act
45. —(1) Where a registered medical practitioner is found or judged by a Disciplinary Committee —
(a) to have been convicted in Singapore or elsewhere of any offence involving fraud or dishonesty;
(b) to have been convicted in Singapore or elsewhere of any offence implying a defect in character which makes him unfit for his profession;
It was not a case of double jeopardy either (at least that is what SMC says). The court martial ruled that he was to be discharged from regular service with liquidated damages (rank demotion - seperate decision). The SMC ruled for professional censure, 3 months suspension (minimum suspension) and letter of undertaking not to commit such an offence again.
He enjoyed seeing report sick in PLC and going for ATEC exercises. The medics there respected him and enjoyed having him around. He issued more MCs than was usual for NSF or regular MOs. He also did his share of pencil pushing, but hated it. In fact, everywhere he was posted to in the SAF or hospitals, he was well-liked.
Unfortunately, while in hospital doing traineeship, he was almost continually being called back for SAF exercises, parades and courses. To justify his absence for a test 3 months ago, he panicked and forged an MC to prevent a charge of AWOL. This was discovered by a clerk and he was court martialled 6 months after the act. And it went downhill all the way. There was no other reason or incident. I will love to share more about him but I think it's time to let the matter rest and give him some peace.
Question: Go find out how the LSA (Med) scholars scheme has changed since 2004 (the court martial). Find out how many LSAs signed on this year.
i think i may know who the guy who posted anonymously before me is.
anyway.
zero signed on this year.
and worse still, there are still SAF doctors trying to figure out how to break their bond after they realise how shitty the system is.
which they can't.
so they meet the relevant people to discuss their options.
none of which will allow them to break their bond.
even if they get discharged with honour or ignominy, they still have to serve out the remaining of their NS liability.
most SAF MOs sign up for LSA(Med) for the money and free tuition fees.
and they regret it shortly after they graduate and serve a while in the medical service.
it's really discouraging when you see all this.
very discouraging.
A bit strange though. If he was so well liked.....
I suspect while the men on the ground liked him and the hospital staff and colleagues liked him, maybe the SAF medical corp bigwigs did NOT like him.
From my experience in the SAF, you will be best served to get people in positions of power and influence to like you. It is far more important than having the men on the ground like you.
On the wrong ball I guess.
Just a question, you mean to say that Dr Ong still has to serve his 12 year bond for being a LSA?
But he is discharged from the SAF right?
How does that work? What happened to his LSA bond?
You were saying he cannot break it (ie pay it up?)
So serve in SAF as what? Discharged liao right?
Confusing....
Just a question, you mean to say that Dr Ong still has to serve his 12 year bond for being a LSA?
But he is discharged from the SAF right?
since he is discharged from SAF with ignominy, his regular service period will be computed into a certain period. this period will be considered as serving national service. then his total ns liability subtract away that period = remaining ns liability he needs to serve.
How does that work? What happened to his LSA bond?
they will most likely compute liquidated damages and ask him to pay up.
You were saying he cannot break it (ie pay it up?)
no, SAF doctors cannot break their bond unless they are discharged. but most of the time, when they are discharged, they are discharged because they are unable to practise anymore due to permanent injury or because they committed an offence. and why commit an offence to break your bond? it will impugn your integrity for a very very long while. possibly your whole career as a doctor.
So serve in SAF as what? Discharged liao right?
serve as NSF. i heard of cases where they just close one eye and let discharged MOs serve in a capacity as a civilian MO. i've also heard that some even work as medics or admin assistants. bear in mind these are just hearsay.
I love my blog. I learn something new every day.
I guess the same goes for us the 'outsiders' who read your blog.
Aiya, jo boh loh! I oso wat, cho bo for almost a year after I break bond! Kana posted here and there, but have to serve my liability.
But I was lucky I do not have to pay back $$ (old contract), if not i can start selecting a HDB flat to play superman, probably during a Meet the People Session at the same block.
Hi anonymous 13July 10.56
Thanks for clarification.
Hope Dr. Ong is well.
I don't think SMC could have done less than that.
Life sucks!
Dr. Huang ( good thing I've done my fair share of NS and now just look on from outside )
dont blame him, not his fault, boils down to upbringing
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