INVESTIGATION INTO MEDSTAR MEDICAL CLINIC & SURGERY FOR ISSUANCE OF MEDICAL CERTIFICATES WITHOUT AUDIO OR VIDEO CONSULTATION

The Ministry of Health (MOH) is investigating Medstar Medical Clinic & Surgery for issuing medical certificates without any audio or video consultation on its PocketCare website (https://pocketcare.sg), and has referred its registered medical practitioner, Dr Viknesh Shanmugam, to the Singapore Medical Council (SMC) for investigations into possible breaches of the SMC Ethical Code and Ethical Guidelines (ECEG).

2. In February 2024, MOH received information that PocketCare, a telemedicine service provided by Medstar Medical Clinic & Surgery, had been advertising on Instagram and its website that its patients would be able to obtain a medical certificate in five minutes for $5.99 nett, with no video consultation required.
 
3. Preliminary investigations reveal that Medstar Medical Clinic & Surgery has been providing consultation through a self-service text-based questionnaire, and issuing medical certificates thereafter, without any audio and video interaction with patients. As there is no real-time two-way engagement with an attending doctor during the service, patients could potentially provide false or inaccurate responses without any verification made on those responses by a doctor, and obtain a medical certificate for a period of one to two days without appropriate clinical assessment. Patients who require a proper consultation may also not obtain the appropriate clinical assessment to manage their medical conditions.

4. Medstar Medical Clinic & Surgery is currently licensed under the Healthcare Services Act 2020 (HCSA) to provide outpatient medical services. MOH has assessed that the consultation provided by Medstar Medical Clinic & Surgery through PocketCare, without any audio or video modalities, may amount to a contravention of Regulation 30 of the Healthcare Services (Outpatient Medical Service) Regulations 2023, which states that a licensee may only provide outpatient medical services by remote provision to first-time patients if the outpatient medical service is provided through real-time two-way interactive audiovisual communications.

5. The PocketCare website was also found to have featured claims that patients could “Get Your MC or Get a Refund”. MOH investigations are ongoing as to whether the statement amounts to a contravention of the Healthcare Services (Advertisement) Regulations 2021.

6. To safeguard patients’ interest, MOH has issued a notice to Medstar Medical Clinic & Surgery, stating the Director-General of Health’s intention to take regulatory action in respect of its consultation, including a three-month suspension of its remote mode of service delivery and the need to rectify its consultation services to be compliant with the Healthcare Services (Outpatient Medical Service) Regulations 2023 before it can resume the remote consultation services. In addition, MOH has referred Dr Viknesh Shanmugam, the medical practitioner of Medstar Medical Clinic & Surgery who issued medical certificates pursuant to the consultations, to the SMC for investigations into possible breaches of the SMC ECEG .
 
7. All healthcare providers licensed to provide outpatient medical services by remote provision are reminded to fully comply with the HCSA and its subsidiary legislation, including the Healthcare Services (Advertisement) Regulations 2021. All registered medical practitioners performing or planning to practise telemedicine should also abide by the SMC’s 2016 ECEG. MOH will not hesitate to investigate and take regulatory and/or enforcement action against licensees who have contravened the HCSA and its subsidiary legislation, as well as refer any errant registered medical practitioners to the SMC for disciplinary action.