Angry Doctor

Friday, August 29, 2008

Loss 2

angry doc is still in pain. More pain than before, in fact.

Nevertheless, a blogger's got to do what a blogger's got to do.

angry doc would thank fellow Clearthought-bloggers Leng Hiong and Edgar and blogger Han Solo for looking at the "evidence" behind "alternative therapies for autism" in the recent discussion on The Online Citizen.

angry doc hasn't got anything to add to the dicussion, but he would like to draw his readers' attention to this parliamentary Q&A on the issue, which he reproduces below:


Autistic Spectrum Disorder
27 Aug 2008

Question No: 578
Question By: Ms Denise Phua Lay Peng

To ask the Minister for Health what measures are being taken to protect the interests of patients with special needs/disabilities from practitioners offering non-evidence-based medical or alternate treatments.

Reply from MOH

1. There are two main levels of protection against such unethical exploitation of patients.

2. First, the Medical Registration Act requires the doctors to practice [sic] ethically. They will be subject to disciplinary action if they use treatments which are not in the interest of their patients.

3. Second, patients and their care-givers must exercise due diligence and consult the right practitioners. When in doubt, they should first check it out with their trusted family physician. Alternatively they could seek a second opinion from the practitioners in the public clinics for patients with special needs, before accepting any unconventional or unusual treatment.

4. Helping patients with special needs is often a long journey. It is understandable why some families become anxious, embarking on remedies that promise them hope of a rapid “cure”. The Internet has further promoted the dissemination of theories and practices, many of which are questionable and without scientific basis. For instance, the use of controversial Complementary and Alternative Medicine (CAM) treatment for children with Autistic Spectrum Disorder (ASD) is popular in the West, despite an absence of scientific support. My Ministry will work with MCYS and its VWOs concerned to educate the families on how to evaluate such information and not be taken in by pseudoscience and unsubstantiated theories. Meanwhile, my Ministry is also collaborating with the Academy of Medicine to formulate Clinical Practice Guidelines to assist doctors in Singapore in diagnosing and managing children with autistic spectrum disorders. The efforts will include compiling the evidence for the various treatments and to disseminate a layman’s version to patients and their caregivers.


While MOH Clinical Practice Guidelines (CPGs) have their limitations, they do provide a handy compilation of references on the subject being discussed, together with glossaries on levels of evidence and grades of recommendations. While they can be a little technical, they are actually available for download from the MOH website by medical professionals and laymen alike.

angry doc is looking forward to receiving a copy of the CPG on autism treatment later this year, and he hopes to be providing a link to the CPG on this blog then.

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4 Comments:

  • Thanks for this helpful information. Looking forward to reading the Clinical Practice Guidelines when it's completed.

    By Blogger Paths, At August 31, 2008 3:30 pm  

  • Looks like the debate at The Online Citizen continues.

    I wonder if Darren's view (ie. just accept CAM because other people already accept it and it's old so it should be respected)is common among doctors?

    By Blogger Lim Leng Hiong, At September 02, 2008 12:02 pm  

  • I am not sure about the proportion of doctors in each camp, but we span the spectrum from Darren to "TCM is just like eating grass".

    Even amongst those who acknowledge the role of evidence in assessing CAM, there are those who argue for applying different yardsticks to assessing CAM.

    By Blogger angry doc, At September 02, 2008 12:55 pm  

  • @angry doc, I am not sure about the proportion of doctors in each camp, but we span the spectrum from Darren to "TCM is just like eating grass".

    Then you should go and research TCM and make real sure whether your statement holds any water, or else we find ourselves of not contributing real value to our patients. What grass are you thinking, anyway.

    I will be back to check on your latest. Bye, and enjoy blogging like no body read anyway. LOL.

    By Blogger Its ME, At July 25, 2009 11:08 am  

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