Defensive medicine practice not practical: Lam Pin Min
A doctor's suspension sparked a discussion over defensive medicine practice in Parliament yesterday.
The senior paediatrician had failed to treat and diagnose, in a one-year-old boy, Kawasaki disease - a childhood disorder that can lead to severe cardiac complications if left untreated.
MP Lim Wee Kiak raised doctors' concern over the suspension and asked if the Ministry of Health (MOH) advocates doctors sending all cases for detailed diagnostic tests to avoid misdiagnosing rare conditions.
The answer is no, said Senior Minister of State for Health Lam Pin Min. He added that such defensive medicine practice deviates from good clinical practice and will drive up healthcare costs unnecessarily.
On Dr Lim's question of whether MOH should issue standard practice guidelines on diagnosis for all potentially rare illnesses, Dr Lam said: "It is neither possible nor practical...
"Doctors would have to exercise their clinical judgment in such situations.
"However, in this particular case, there were already existing international guidelines which warranted further investigations to diagnose Kawasaki disease, given the symptoms and signs of persistent fever, red eyes, red cracked lips and a rash."
He also stressed the importance of "enhanced awareness", should the patient develop further symptoms that point towards Kawasaki disease.
"My advice to doctors is to stay calm and not overreact, and second, to read and understand the proceedings of the disciplinary tribunal and appreciate the rationale and considerations of the judgment," he said.
"Very often, when doctors read the headlines, they will jump to a conclusion that if (they) miss a fever and therefore miss Kawasaki disease, (they will) be suspended for three months, and that is actually not the case."
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