MOH to revoke MaNaDr Clinic's licence, 41 doctors to be investigated for misconduct

The Ministry of Health (MOH) intends to revoke the licence of MaNaDr Clinic following a probe that found many patients receiving "very short" teleconsultations, with some lasting less than a minute.

The clinic can no longer provide all outpatient medical services, including physical, temporary and remote consultations once its licence is revoked, the ministry said in a notice on Oct. 24, 2024.

The clinic will no longer be authorised to provide outpatient medical services via their clinic at 371 Beach Road City Gate, at temporary premises such as patients' residences, and remotely via teleconsultations.

"This is in view of MOH’s assessment that MaNaDr Clinic is unable to continue providing outpatient medical services in a clinically and ethically appropriate manner," MOH said.

Revocation of license

On Aug. 16, 2024, MOH issued a direction to MaNaDr Clinic to stop the provision of outpatient medical services via teleconsultation until further notice.

Since the direction, MOH has conducted investigations into the clinic practices.

The ministry found that a "very large number of cases" seen by the clinic "involved very short teleconsultations with video calls that lasted one minute or less in duration".

The sessions concluded with the prescription of medications and issuances of medical certificates (MCs).

"Such short consultations raise concerns about the safety and quality of clinical care provided to patients, including whether the medications and MCs were prescribed and issued on sound medical grounds," the ministry said.

Some patients were also issued multiple MCs over a few different teleconsultations within 30 days.

In some instances, patient case notes contained detailed information that did not commensurate the short duration of the teleconsultation.

In other cases, patients case notes were overly brief, which potentially compromised the continuity of patient care.

"Based on these findings, there is reason to believe that there is an entrenched culture of disregard for the applicable clinical and ethical standards within MaNaDr Clinic," the ministry concluded.

Misconduct inquiry

MOH will also refer 41 doctors who provided teleconsultations at MaNaDr Clinic to the Singapore Medical Council (SMC) for possible professional misconduct.

These doctors have potentially breached one or more of the ethical guidelines in SMC's Ethical Code and Ethical Guidelines (ECEG), through providing short teleconsultations and repeated issuance of MCs.

MOH is also reviewing whether Siaw Tung Yeng, the principal officer and clinical governance officer of MaNaDr Clinic, has discharged his duties satisfactorily, and will assess his suitability to continue acting in these capacities.

Of the 41 doctors who provided teleconsultations at the clinic, 13 were doctors who worked as locum practitioners who were simultaneously employed by the public healthcare institutions or MOH Holdings.

These doctors have breached their employment terms by undertaking external employment and conducting secondary clinical activities without the approval of their employers.

Furthermore, most of them provided teleconsultations while on active duty in the public healthcare institutions.

Five have since left the public healthcare sector.

Of the remaining eight, seven have been dismissed.

The remaining doctor, due to the lesser severity of his actions, has been subjected to disciplinary action.

"Doctors who practise telemedicine are reminded to abide by the SMC’s Ethical Code and Ethical Guidelines at all times,” MOH said.

“MOH views these inappropriate practices and their potential impact on patient safety very seriously and will not hesitate to take further action against doctors, including referral to SMC, for any found to have engaged in professional misconduct.”

Top photo via Google Maps & MaNaDr website