It is customary to take stock this time of the year, of what was achieved in the past year in preparation for the Annual General Meeting in April. The reports that are published in this year’s annual report reflect policies adopted by the team at the helm of SMA in recent years.

The SMA membership has increased in tandem with the stature of the organisation. Its membership has increased by 700 doctors in the past three years. The total membership of SMA is now 3186 out of 4912 doctors presently registered with the Singapore Medical Council (SMC). In terms of percentage, this works out to be 65%. Historically, the percentages of SMA over SMC members by year have increased from around 56% before 1994 to 60% in 1995, 62% in 1996 to the present high of 65% (see figure).

The percentage increase is particularly marked in the sector representing the doctors in government/restructured sector. Almost three-quarters of all doctors presently in this sector are members, up from less than half prior to 1994. Beyond numbers, what is more significant is that senior members of our profession who were not members or who may have resigned in the past are now members. We are even more truly the national organisation.

The New Singapore Medical Journal (SMJ) incorporating the SMA-News launched in January 1997 continues to play its role as the monthly forum of the profession. It publicises and reports the activities of many medical organisations in Singapore. It also stimulates debate and discussion on important health policy issues.

Three ethical initiatives were taken in the year. Firstly, the Advisory Committee on the Advertisement Guideline set up with the endorsement of the authorities has produced clear statements as to what are acceptable for clinic advertisements. Secondly, the Ethics Committee published a public document defining how the committee manages cases. Thirdly as a follow-up to last year’s ethics convention, a joint ethical guideline would be published governing relationships between the medical profession and the pharmaceutical industry.

In the light of these initiatives, the recent need to define the professional role of the doctor versus the retail pharmacists in treating minor ailments therefore seems more of a distraction. The undercurrent still lurking belies the need for greater transparency in practice matters such as the fees charged to patients for various services rendered. The SMA would further encourage more doctors to clearly define their consultation fees as distinct from fees of other services delivered in clinics. In this connection, a guideline of consultation fees during extended opening hours and in 24-hour clinics would be published later this year.

Commercial forces that are bent upon making a quick buck from patients are continually testing the ethical fabric of medicine. Who should protect the interest of the patient? The Singapore Physician Pledge places that on the doctor who must swear to put the interest of the patients as his first consideration. It is the duty of every doctor, as physicians, as practitioners and hopefully as members of the SMA to ensure that these commercial forces are harnessed to serve patients in an accountable manner.