First, doctors should take their own medicine
The Chinese saying, wealth weakens the body, explains why, growing up in the 1960s, I had never heard of healthy people going for a medical check-up, while today health checks are common practice.
It is a good thing. Instead of depending on health-care professionals to fix the problem when something goes wrong, one should take charge of one's own body.
In many western countries, it is not uncommon to find individuals armed with loads of information gathered from the internet on a particular health issue before consulting a doctor about the problem. If patients are encouraged to participate in taking care of themselves, do they really need a doctor's permission before they go for blood tests and other non-invasive diagnostic procedures?
Interpreting blood test results and reading a radiologist's report are not exactly quantum physics, and if the check-up reveals an abnormality, people will generally seek help from a doctor.
The South China Morning Post recently reported on the Hong Kong Medical Association's warning to the public that health checks directly promoted by private laboratories without a doctor's supervision could result in unnecessary tests and even health hazards.
Private laboratories were also accused of telling their clients that more tests mean getting a better deal. The warning typically reflects the monopolistic attitude of western medicine in Hong Kong.
Private doctors and private hospitals have capitalised for years on the health check-up craze of Hong Kong people by offering lucrative package deals on numerous diagnostic tests. Like the business model based on the principle of economy of scale touted by these private laboratories, they encourage people to take the more expensive packages, which often offer more tests than necessary.
As the Post said in its editorial, the marketing of such health checks by some private companies 'smacks more of pressure selling than medical ethics'.
But we can never protect all the fools in the world from parting with their money. As Hong Kong is a free market, a healthy dose of competition should always be welcome.
For the medical profession, the best way to take business away from these rogue 'health-care providers' is to develop patient trust. This way, instead of jumping at every chance to have a 'bargain' check-up, people would first discuss the benefits, and the necessity, with their doctor.
But trust is not going to be built if doctors carry out the same laboratory tests at a much higher fee - especially if the patient discovers that the main reason for the higher cost is because their doctor is taking 'kickbacks' - of up to 40 per cent of the fee - from the laboratory. There are other ways that private doctors can profit from health check-ups. Many people buy an insurance policy just to have a health check, by faking some vague symptoms and checking into a hospital.
This is tantamount to ripping off the insurance companies, and this cannot be easily accomplished without some collusion from their doctors.
Some doctors are enterprising enough to jump on the bandwagon, and start their own diagnostic centres offering health check-up services. Such entrepreneurial spirit is permissible, but it is considered ethical by western standards only with full public disclosure.
In the local medical community, disclosure of doctors' business interests to their patients is almost unheard of.
I am not saying that all private doctors profit from such schemes, but a significant number do.
Before condemning competitors for unprofessionalism and unethical practices, the medical community should get off its moral high horse and clean up its own house first.
Pocketing a handsome profit in an underhanded way, while stifling and criticising competitors, smacks of greed and hypocrisy.
Feng Chi-shun is a consultant pathologist at St Paul's Hospital
