Doctors’ autonomy is essential for patient welfare

PUBLISHED : Thursday, 18 February, 2016, 5:46pm
UPDATED : Thursday, 18 February, 2016, 5:46pm

I read Mike Rowse’s article (“Doctors must swallow their bitter reform pill”, February 1) with interest.

As a medical doctor working in Hong Kong for more than 30 years and involved in training local/overseas medical students as well as overseas graduates attempting the licentiate examination, I feel compelled to share with readers my misgivings of Rowse’s observations.

Autonomy is critical to the professional status of doctors who must advocate for the interests of their patients. At times, this might run counter to the government’s interests, for example, pushing for expensive life-saving treatment for individuals.

Changing the balance to make appointed members take up more than 50 per cent of the seats will put the Medical Council under the government’s direct and indirect control. As the council governs doctors, they will be indirectly under the control of the government. Losing the autonomy means that we may not be able to advocate for the best interests of our patients all the time.

I have been an examiner for overseas medical graduates and I can assure readers the examination is fair and not, as Rowse suggested, “the buffer of the protectionists’ wall”. It is a wall to protect Hong Kong citizens from below-standard medical practices.

The US spent over 15 per cent of gross domestic product on private and public medical services, versus 5 per cent for Hong Kong in 2013. Yet the medical service outcome measures of the US and Hong Kong are comparable because doctors in public hospitals here employ much less expensive investigations and more simple clinical methods, like taking a complete history and a thorough physical examination.

They do this with someone who has, for example, recurrent headache to diagnose migraine, or chronic cough to diagnose asthma, to avoid sending all of them for the expensive CT scan.

The current Hong Kong licentiate exam bends over backwards to accommodate overseas medical graduates by allowing candidates to pick Cantonese, Putonghua or English as the medium of exam.

Rowse could try to urge the medical bodies in the US administering the US Medical Licensing Examination, the mandatory examination for all foreign medical graduates practising in the US, to also allow use of languages other than English, like Spanish or Cantonese, for the clinical part of the examination, as a doctor who can treat our chief executive would certainly be qualified to treat a Cantonese-speaking patient in America.

Dr Daniel Ng, Ho Man Tin