The Ministry of Health said it will take enforcement or regulatory action if it finds a doctor or dentist issuing medical certificates (MCs) without "proper medical grounds."

This was following feedback from employers, government agencies, and schools about the "excessive" MCs issued by medical professionals.

Contravening the act

MOH released a circular on the issue of medical certificates (MCs) sent to doctors on Apr. 22, 2024.

In the circular, the ministry said it had received feedback regarding the "excessive issuance" of MCs and was considering tightening its rules in response.

An MOH spokesperson told Mothership on May 28 that the feedback came from employers, government agencies, and schools.

Feedback included allegations that MCs were issued when patients mentioned they just wanted to skip work or school, and without proper clinical assessments solely based on self-reported reasons.

MCs were also repeatedly issued to the same patients without a referral for further assessments for the purpose of abusing their medical leave privileges.

The spokesperson added that MOH is reviewing the feedback and will take "enforcement or regulatory action" if a doctor or dentist is found contravening its ethical code and guidelines.

According to the 2016 edition of the ethical code, medical certificates "must be issued to patients only on proper medical grounds arrived at through good clinical assessment”.

"Hence, doctors are responsible for ensuring that MCs issued to patients are justified on proper medical grounds and that the decision to do so had been arrived at through good clinical assessment," MOH specified in the circular.

It added that this is true "regardless of the mode of consultation" and should not be influenced by extraneous and non-medical reasons.

The proposal

In response to the feedback, the ministry intends to tighten regulations on the issue of MCs.

It is currently considering a proposal to require all doctors and dentists to ensure that every MC issued must include the clinician's name and medical council registration number.

Under this proposed change, clinicians found advertising or allowing the issue of "anonymised" MCs would be in breach of the requirement, MOH said.

In the Apr. 22 circular, it requested feedback on the proposed amendment from clinicians.

Mothership understands that the deadline for feedback submissions on the proposal is closed as of May 20, and the ministry is now assessing the feedback.

Top image from NUHS and Singhealth website