‘Engrained culture of disregard’: Ministry of Health intends to revoke MaNaDr’s license for medical services

SINGAPORE – The Ministry of Health (MOH) has issued a notice to MaNaDr Clinic of its intention to revoke its license for the provision of outpatient medical services in all its service delivery modalities, including physical, temporary services and remote

“This is in view of the MOH’s assessment that the MaNaDr Clinic cannot continue to provide outpatient medical services in a clinically and ethically appropriate manner,” the MOH said in a statement on October 24.

In addition, 41 doctors who provided teleconsultations at the MaNaDr Clinic will be referred to the Singapore Medical Council (SMC) for possible malpractice inquiries as they may have breached one or more of the ethical guidelines of the Code of Ethics and the Ethical Guidelines of SMC, the ministry said.

This comes two months after the MOH issued a direction to the telehealth company to stop providing outpatient medical services through teleconsultation until further notice.

MOH investigations found that a very large number of cases seen by MaNaDr Clinic doctors involved very short teleconsultations with video calls lasting one minute or less; issuance of multiple MCs over a short period of time; and questionable and poor documentation of patient case notes.

“Based on these findings, there is reason to believe that there is an entrenched culture of disregard for clinical and ethical standards applicable at the MaNaDr Clinic,” the MOH spokesperson said.

These guidelines relate to the doctor’s duty of care, the clinical assessment of patients, the provision of telemedicine, clinical records, the issuing of medical certificates and the prescribing of medicines.

Of the 41 physicians referred to the SMC, 13 were working as substitute professionals providing teleconsultations at the MaNaDr Clinic while employed by public health institutions or MOH Holdings.

These doctors had breached their terms of employment by doing outside work and carrying out secondary clinical activities without the approval of their employers, MOH said.

Most of these physicians had also performed teleconsultations while in active service in public health institutions.

Since then, five have left the public health sector, the ministry said.

Of the remaining eight, seven have been dismissed. The remaining doctor, due to the lesser severity of his actions, has been subject to disciplinary action, the MOH spokesman said.

“Doctors who practice telemedicine are reminded to comply at all times with the ECEG of the SMC. The Ministry of Health takes 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 anyone who has engaged in professional misconduct “said the ministry spokesman.

The MaNaDr Clinic has 14 days to make representations to the MS.