Angry Doctor

Saturday, August 12, 2006

Interesting question

Well, the reply from SGH on the issue we discussed earlier is published in the ST forum today:

Test results free, if requested at consultation

I REFER to the letter, 'Charging extra for medical report unfair' (ST, Aug 7), by Mr Paul Chan Poh Hoi.

We agree fully with Mr Chan that patients are entitled to know their medical conditions. Hence, patients are given copies of their laboratory test results or radiology reports, at no charge, when they make the request during consultation at our Specialist Outpatient Clinic.

However, if their request is subsequent to the clinic visit, a small processing fee is imposed for efforts needed to verify the authenticity of request, trace the records for the right set of information to be given and mailing of the results to patients.

Copies of X-ray films are also available for a small reproduction fee.

Medical reports, whether general or specialist, go beyond test results. They are prepared after review of the medical history documented in the patients' medical records. Charges are levied for both types of medical reports.

Wong Loong Kin Chief
Financial Officer
Singapore General Hospital

Says it more succintly than angry doc managed to.

Another letter also published today asks a rather interesting question:

Do medical test results belong to patients?

I REFER to the letter, 'Charging extra for medical report unfair' (ST, Aug 7).

The issue of patients not receiving a copy of their medical test results is not a new one. Patients still do not receive a copy of the results of extensive and sometimes expensive investigations, as a norm. When discharged from hospital they usually receive a one- or two-page summary with very little useful information.

Very often, a family physician will have to send a note with the patient to ask for more information at his next appointment. Patients often ask, 'You mean we can ask for the results?' To be fair, this situation is common, both with public and private health-care providers.

For a meaningful discussion of this matter, one question must be answered with a 'Yes' or 'No': Does information belong to the patient? - and I am not referring to medical records or notes that the doctor makes during the care of the patient but to the results of medical tests and investigations.

Until this issue is clarified, we will not see progress on this matter. Would the Ministry of Health care to respond?

Dr Ajith Damodaran

I must say I don't have the answer to that one. Under the SMC Ethical Code a doctor cannot withhold medical information from a patient or another doctor whom the patient wishes the information to be communicated to.

This helps us circumvent the question, but doesn't really tell us who actually 'owns' the data that is the test results. I'll be awaiting the Minstry's respond too.



  • Hi, I would just like to say I enjoy your posts alot. And it also shows that i'm not the only angry one around with an impending rupture aneurysm, often aggravated by malignant patient relatives, non-clinicians, administrators and the system. Cheers!

    By Anonymous Anonymous, At August 13, 2006 8:58 pm  

  • This is my reading of it:

    If a patient goes to the hospital for treatment of his cancer and the consultant ordered various investigations as part of the diagnostic process, the results of the lab tests belong to the hospital. The patient has only purchased the hospital's service, not the lab test. Lab test results have always been accepted as part of the case notes. In the same way as the case notes of the patient belong to the hospital, lab test results also belong to the hospital.

    It might be a different situation if a patient goes to a clinical lab and requests for a blood test to be done. In that case, the patient is purchasing a lab service. The results of the lab test belong to the patient but of course, there is no interpretation or advice on management. If that patient brings the lab test results to see his GP, he then purchases the consultation service and the lab test results remain the patient's property.

    By Anonymous Anonymous, At August 14, 2006 9:05 pm  

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