Angry Doctor

Tuesday, December 14, 2010

A penny for your thoughts? 3

Mr Tan defends his $30 price-tag for a medical report on his blog.

angry doc is no longer surprised by how people who cannot and do not produce a goods or a service nevertheless feel they have a right to tell those who do how much to charge for what they produce; but he *is* surprised by how someone with Mr Tan's work experience views the issue of medical report.

What exactly does Mr Tan mean when he refers to a "routine report", which he suggested doctors charge $30 for? If it was simply a case of to "write down what is the problem with me relating to a specific medical condition", then angry doc would say that most doctors will probably not charge a separate fee at all, but consider it as part of the consultation. But is that really all that is required "to support an insurance claim or application for insurance"?

Doctors (and patients) who have been asked to fill up a "routine" insurance claim form will realise that that is not the case; the typical insurance claim form runs to nearly a dozen pages, and oftentimes requires a doctor to report the reason for consultation, diagnosis made, and treatment rendered for *every* visit the patient made to a clinic!

Blogger Cyke also points out that the cost of a medical report do not just go to the doctor's fee, but includes the administrative work required.

Those facts aside, we are still left with the subjective question of when a fee is considered "excessive".

Doctors, and the institutions they work for, charge at the end of the day "what the market will bear", which is to say what they can get away with. So if, as Mr Tan seems to believe, "there is no free market here - but a monopolistic situation", why aren't doctors charging say $800 instead of $80 per medical report? Why do most restructured hospitals charge a fee around that mark?

Well, because there is a market here, despite what Mr Tan claims - a doctor (or hospital) who charges $800 per medical report on a routine basis will find himself off the approved list by insurance companies, and unless he is really that good, find that few patients will go to him.

Mr Tan asks: "The consumer would want a low cost, and the doctor would want a high cost. How can this be resolved in the "free market environment" in Singapore?"

Well, angry doc asks: "What is driving the demand for medical reports?"

If you know why people want medical reports, if you understand why they need medical reports, then perhaps you will begin to have a clue as to how to lower the cost for medical reports (or do the reverse...).


  • I wrote a reply to his earlier post which he deleted citing "personal attack". Well let's see.

    When professionals like doctors, lawyers and engineers put their name to paper, they expose themselves to possible liability. This cannot merely be a form-filling exercise when a doctor has to give a professional opinion to which he can be held accountable by an open court or the medical tribunal.

    How can one then just look at the "cost" of a doctor presumably just "filling some forms"?

    I work in heavy industry and we pay a bomb to professional engineers to sign off inspection reports. Of course, the cost of his signature is negligible (ink cost) but his fees reflect the fact that he is putting his name on the line. Not to mention the fee needs to reflect in a way the enormity of the matter.

    People DIE from industrial accidents and the first person hauled up is normally the person who signed off the forms. What price do you put on this professional liability risk he is exposed to?

    (And yes, I read his complaint about SCDF. I'm speechless basically.)

    I also pointed out a glaring inconsistency in his views. He believes that financial consultants should be paid to give advice (instead of earning from commissions) but on the other hand he quibbles with professionals who have more liability issues to deal with. I find this unbelievable and pointed it out to him. This was presumably the "personal attack" part he alluded to. Frankly, I think he needs to get a grip!

    By Blogger dsowerg, At December 15, 2010 11:32 am  

  • Well, he implied I was a "monkey", and allowed comment that called me "black sheep" and "bad apple", so his "no personal attack" policy is selective.

    I decided not to post on his blog after I saw his comment on your post.

    By Blogger angry doc, At December 15, 2010 12:11 pm  

  • I notice that the previous thread is missing on his blog. AngryDoc - you have made a wise decision to remain on this blog.

    By Anonymous Anonymous, At December 15, 2010 2:41 pm  

  • It's still there - probably a glitch, that's all.

    There is also another post dated 12th Dec where Mr Tan reveals that he received a letter from NDC clarifying that when they meant was the $80 only covered part of the cost of the report.

    I suppose by posting his 13th Dec post, Mr Tan feels NDC is costing their reports too high still.

    By Blogger angry doc, At December 15, 2010 3:20 pm  

  • Confession: I am a government doctor and I hate writing medical reports - especially the ones with long and complicated medical histories. If "consumers" are finding $30 too expensive for a medical report, I strongly suggest that they keep their $30 and I keep my time. Fair?

    By Anonymous Government Doctor, At December 22, 2010 2:11 pm  

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