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INFORMATION FLOW

A position statement on the role of stents in carotid artery stenosis drafted by a group of concerned doctors from the Neuroscience Society is published in this issue of the SMA News. Another article summarises the salient points presented in this year’s Haridas Memorial Lecture organised jointly by the Singapore Paediatric Society and the SMA. Yet another announces the new office bearers of the Society of Anaesthesiologists.

These, together with peer reviewed articles in the scientific section of this journal and other features in the SMA News provide the information flow that oil the wheels of our healthcare system.

The subject of medical advertisement was the focus of a profession-wide discussion and debate last year. A consensus has been forged. 

The SMA Council has finalised a  “Guideline for private and restructured hospitals for the publication of professional notices in the SMJ”. The SMA News would, for the first time, accept for publication announcements of services provided by hospitals, in addition to the usual CME and staff recruitment advertisements. The guidelines for clinics and doctors remained unchanged for now. For example, only advertisements of the change of practice addresses or commencement of new practices would be accepted.

This cautious liberalisation is in line with providing more channels of information flow within the profession. With this liberalisation, doctors would have more timely information regarding access and facilities offered by the hospitals when advising or referring patients.

The scope of the classified advertisement sections would also be widened. New sections such as CME and Conferences, locums available and SMA membership privileges are added. The SMA hopes that with these new services, this monthly publication would become the reference for topical information for practitioners.

The circulation of SMJ is restricted to doctors and those in the healthcare profession. The editorial audit of its contents ranged from rigorous peer review in the scientific section, to a less restrictive approach for service announcements as long as they are within the guidelines drawn up. The readers, being discriminating healthcare professionals should be able to discern the relative significance of the information in the various sections.

However, the approach taken on information flow from the profession to the public has to be different as there is a wide asymmetry of knowledge. When publicising medical achievements and breakthrough in the lay press, doctors should be more circumspect. Announcements of achievements such as the continuing ‘sperm meets egg’ saga could be subjected to professional scrutiny between the covers of a journal such as this before being splashed on the front pages of the lay press.  

The article on technology assessment, the position statement on carotid artery stenting and the cautious liberalisation of announcements of services provided by hospitals represent different approaches adopted by the profession to harness information flow to better serve the interest of patients and society.

SMA believes that “liberalisation of advertising guidelines should and must be in the direction of facilitating more rational and appropriate utilisation of medical services and not such that it presents more opportunities to exploit the vunerabilities of patients, be they Singaporeans or foreigners. This is due to the fact that while the well-educated may be enlightened and informed enough to make a discerning choice, the average consumer of medical services may not be able to make a rational decision based on real medical need.”

This point was also emphasised in the White Paper on Affordable Health Care that ‘ill and worried patients and their families depend on doctors to advise them on the treatment they need. They are not fully informed dispassionate consumer who can make objective choices among competing alternatives.

The SMA had, in a submission to the Ministry last year reiterated this point.