SINGAPORE: MaNaDr Clinic, which has been under investigation for providing extremely short teleconsultations, was stripped of its licence on Friday (Dec 20).

It will no longer be able to provide outpatient services at its clinic at 371 Beach Road City Gate, at temporary premises such as patients' homes, as well as remotely via teleconsultations, the Ministry of Health (MOH) said in a media release.

The ministry had issued a notice to MaNaDr Clinic in October, informing it of the intention to revoke its licence. Forty-one doctors who conducted teleconsultations for MaNaDr Clinic would be referred to the Singapore Medical Council for possible professional misconduct.

"After careful consideration of MaNaDr Clinic’s representations, and based on the findings from MOH’s investigations, MOH has assessed that an entrenched culture of disregard for the applicable ethical and clinical standards exists within the organisation," the ministry said.

It noted that a very large number of cases seen by MaNaDr Clinic involved very short teleconsultations.

"In a sampled month, more than 100,000 teleconsultations involved video calls with patients of one minute or less in duration, with the shortest being one second," MOH said.

"The prevalence of such inappropriate practices suggests a lack of effective internal oversight, controls and governance to ensure that outpatient medical services are consistently provided in a clinically and ethically appropriate manner by all its doctors."

All the clinic's related accreditations and participation in MOH's financial schemes, like the Community Health Assist Scheme, MediSave and Healthier SG, will cease.

MOH has asked MaNaDr Clinic to inform all affected patients to ensure continuity of care.

"Affected patients may wish to visit other nearby CHAS, MediSave, or Healthier SG clinics instead," the ministry added.

MOH said it will continue to monitor licensed providers of outpatient medical services that provide teleconsultation services to ensure that teleconsultations are conducted in compliance with requirements, adding that it will not hesitate to take regulatory actions if necessary.

NEW MC REGULATION

Amid scrutiny of telemedicine platforms and the issuance of medical certificates (MC), MOH on Oct 14 implemented a new regulation requiring all licensed healthcare services to ensure that every MC issued includes the name and registration number of the issuing medical or dental practitioner.

In its circular earlier this month, it said that this information would be required "for the purposes of accountability and transparency of the issuing practitioner". 

“This will complement the Ethical Code and Ethical Guidelines of the (SMC) and Singapore Dental Council that all MCs carry a professional and legal responsibility and that it must be filled and signed by the medical or dental practitioner personally,” MOH said.

If the MCs are generated electronically where signatures are not required, they must still include the name and the issuing practitioners’ registration number.

Earlier this year, MOH sought feedback on this new regulation and did not receive any objections.

The health ministry said it may conduct "random audits" of MC issuances.

"Non-compliance to this new regulation may result in enforcement actions being taken," MOH said.

These include but are not limited to written censure, financial penalty, modification of licence conditions, shortening of the licence term, or suspension of licence.