Complaints against doctors have been growing in Singapore in recent years. The reputation of this once highly regarded profession has taken a hit. The high incidence of doctors being hauled to court for a variety of offences has not helped. The following screenshot is taken from a reminder from MOH to a dental clinic whose licence is about to expire. Note the hefty penalty.
Now take a look at the penalty meted out to people who are not qualified dentists practising dentistry in premises not licenced as clinics. Note that this applies to qualified practitioners whose licences have merely expired. Now let’s take a look at how unqualified people are treated.
April 2024
A woman who learnt how to perform dental procedures on herself during the COVID-19 pandemic began offering such services to customers in Singapore.
She would book hotel rooms in Singapore to perform procedures such as maintenance of braces and veneer application. However, her ruse was up when a disgruntled customer reported to the authorities that she could not floss her teeth after having veneers put in by the so-called “dentist”.
Siti Shahrima Abd Rahim, a 37-year-old Malaysian, was fined S$2,500 by a district court on 8 April 2024.
May 2024
After learning how to fix dental veneers from her former employer, Ding Zhiyan started her own salon at Far East Plaza and provided these services between 2022 and 2023. In one instance, she fixed her customer’s veneer in her home after the veneer dislodged a day after she installed it. The 37-year-old Chinese national pleaded guilty to two counts of practising dentistry despite not being a registered dentist. She was fined S$5,000
The prosecution sought a S$2,500 fine for each charge Ding pleaded guilty to. This took into account the fact that Ding had fully cooperated with the authorities during investigations and had pleaded guilty at an early stage.
Ms Tan added that Ding has not had any brushes with the law previously.
Ding asked for a low fine amount as her mother has cancer and she needed money for medical expenses.
In her brief sentencing remarks, District Judge Lorraine Ho acknowledged that no actual harm was caused to Ding’s customers “thankfully” — although they needed “some touch up”.
For practising dentistry without a practising certificate and not being a registered dentist, Ding could have been fined up to S$25,000.
Which do you think would put ignorant members of the public at greater danger? Unqualified people performing procedures in unlicenced premises or qualified practitioners performing procedure in premises where the licences have expired? It’s $25,000 versus $100,000. A slap on the wrist for these offenders; a slap on the face for the qualified dental practitioners who have to apply and pay for multiple licences and collect 70 continuing education points every 2 years to remain in practice.
Policies have a tremendous impact on our small businesses which are slowly dying out. Sole proprietorship may soon be a thing of the past. We are seeing an unprecedented closing down of F&B establishments. Even Covid didn’t kill so many. What is wrong? Perhaps our hawkers can share with me. The old school clinics operated by just one or two doctors that people from my generation are so familiar with, are also facing “extinction”. Why? Because of the new admin load that the authorities put on them. With the implementation of NEHR, clinics do not just need to set up the platform, doctors and dentists who used to be able to function as clinicians, must now manage huge databases and cybersecurity. All this means time, money and commitment. Transparency was never an issue with small, old school practices. Bills were simple and easy to understand. Disputes were rare. But once the “industry leaders” move in, bills became complicated. MOH now requires all clinics to “itemise” their bills. It may help with “transparency” but itemisation gives the creative “industry leaders” a lot more leeway to charge more with their “itemised” bill. The simple and honest old school practitioners get a lot of unnecessary work if not headaches having to split their bills into many parts.
Space and allowance for outliers? Nope, the new policies in the new business environment are killing off the unambitious practitioners. Doctors and dentists who own their own property must have once thought that they could run stress-free, low turnover practices towards retirement. Make no mistake, these unpretentious setups are still very welcome and appreciated by heartlanders. Old doctors running traditional clinics had no targets. They only did the needful at a comfortable pace because they didn’t struggle with overheads and admin procedures. They could afford to see just a few patients a day, providing quality, personalised care. But once subjected to MOH inspection, it’s not about the quality of care but rigid hardware, software and accounting requirements which again is the industry leaders’ forte. The writing is on the wall. The old school clinics are fast on their way out. As new regulations and requirements (“industry leaders” already complying with) pile up, the commitment required to run a medical and dental practice will make it a lot less worthwhile to continue operating a modest turnover, friendly neighbourhood clinic. A lot of the work involved in running a new generation “smart” clinic will be non-clinical. Again it’s not a problem for “industry leaders” who operate remote admin centres at One North or Science Park. These admin costs are passed on to patients. To make all the effort and commitment worthwhile, small clinics may need to maximise their resources to operate 12 hours a day 7 days a week. Which potentially retiring doctor or dentist would want to do that? Unknowingly perhaps, the new regulations are killing off the kind of doctors and dentists that my generation is familiar with. Replacing these veterans are the “industry leaders”, operating a chain of clinics with branches in every part of the island, going all out to”maximise resources”. Very often, the doctors’ names are not even displayed on the clinic premises. Most are young practitioners with a monthly “sales target”. To dispel the notion that doctors may prioritise targets over patient interests, all doctors and dentists are now required to pass an ethics course.
Will passing the ethics course ensure that the public gets protected from greedy/desperate practitioners whose mortgages are three times that of their predecessors without an income that is three times theirs? Go figure. Will we not see higher medical bills, more complaints against the qualified practitioners and more people patronising the unqualified, cheaper practitioners?
It’s not just the medical profession. Our society has become one where only those who are in the position to chiong can succeed. Operate long hours, promote products and services aggressively. The artisanal, personalised approach is replaced by high productivity, highly automated processes. Where is our work life balance when economic output takes precedence over lives befitting humans? Why are we blaming young couples for low TFR? So many people are frightened by Trump tariffs when they cast their votes on 3 May, but how have Trump tariffs hurt us? How can these discussions help us? Aren’t most of our problems like high cost of healthcare self-inflicted? I’m really going to miss our doctors without targets.
