SMC reminds doctors of ethical obligations amid concerns of ‘over-servicing’

The government body that regulates medical practitioners here on Monday (Mar 19) reminded doctors of their “ethical obligation” to charge fair and reasonable fees for services rendered.

  • The government body that regulates medical practitioners here on Monday (Mar 19) reminded doctors of their “ethical obligation” to charge fair and reasonable fees for services rendered.
  • A doctor must always place his patient’s best interests above his personal interests and any business or financial considerations …

For example, a doctor must not subject a patient to unnecessary tests or procedures “simply because (he or she) stands to benefit from the fees”.

“In the same vein, doctors should not conduct tests or provide treatment merely upon a patient’s request unless there is a clinical basis for doing so.

  • Senior Minister of State for Health Chee Hong Tat cited concerns with “over-consumption, over-servicing and over-charging….”.
  • It reiterated that doctors have a “duty to provide competent, compassionate and appropriate care to patients, based on a balance of evidence and accepted good clinical practice”.
  • “This duty also entails not over-charging and over-servicing patients for financial benefit. As members of the medical profession, doctors are held in the highest esteem by the public, and much trust is reposed in them.
  • Doctors “should not need to be reminded how to carry out our work ethically, charge reasonably and make good medical judgements … It is disappointing that doctors have to be reminded to do the right thing.”






Late wife’s advice to ‘date’ daughters changed his life, says chairman of Centre for Fathering

Richard Hoon says making the effort to connect with his three daughters changed his life, as he pays tribute to his late wife for raising their children right.


Published  6:30 PM, OCTOBER 21, 2017

Updated 8:55 PM, October 22, 2017

SINGAPORE – My late wife always had a huge influence on my parenting philosophy as a dad, which helped me enjoy an extremely close relationship with our three girls. One of the earlier things she advised me to do — when the girls were in their teens — was to ‘date’ my daughters individually.

I was hesitant at first because it would mean having to spend thrice the amount of time with them — precious time I did not have as I needed to focus on my business to support the family. But after my wife asked me several questions and hearing my own responses, I realised I only knew my daughters superficially. I didn’t know who their teacher was or what their favourite books were.

So, I started doing simple things together with each of my girls. It could be taking walks in the park, watching movies and eating dinner together. As time wore on, I realised all that mattered to them was that I was available for them — my kids equated love with time.

Now that I’m 60, each of them are taking turns to ‘date’ me. A couple of months ago, my youngest daughter, Eve, told me to clear my schedule for my birthday because she was taking me out. For over 12 hours, we had lunch, watched a movie and had a candlelit dinner with a bottle of wine and just chatted. I was touched that she had applied leave to spend a day with her dad! Parents also equate love with time, too!

In early 2016, my wife was ill with breast cancer for six months. She was going in and out of the hospital, and we decided to bring her home, as we didn’t want her to be stuck in the hospital environment. So, we converted the family room into a fully air-conditioned room on the ground floor of our home to accommodate her hospital bed.

My two elder girls quit their jobs and moved back home — my eldest daughter was in Melbourne, while my second daughter was based in Sweden at that time — to care for their mother full time. When I saw my three girls in the room with her, I thought, life has reached a full-circle. There they were in the room, cuddling their mother as she lay on the bed totally dependent on their loving care.

My wife, who had lost all her hair by then, had to be intubated so that she could breathe because of her deteriorating condition. Her cancer had metastasised to her skin, so she had bandages all over her body and she had to wear diapers. Often, the girls would climb into her bed, sit next to her and hug her like she used to with them when they were babies. She had looked after them and tended to all their needs, and now, the roles were reversed because they had now become her caregivers. What a glorious sight to behold.

All three girls received training as caregivers, so that they would know how to inject medication and feed their mother. Each took turns to feed her, change her soiled diapers and wash her around the clock. I saw their unconditional love for their mum and I told my wife, even though she could not speak, that she had raised her children right. She smiled!

At around the time we moved my wife back home, my eldest daughter accepted a marriage proposal from her Canadian boyfriend. Because of my wife’s condition, they decided to solemnise their marriage in our home. We managed to hold the ceremony just a few weeks before she passed away. It was a simple ceremony attended only by immediate family and a small group of very close friends. We turned the living room into a chapel of sorts and got the bishop from our Methodist church to officiate at the wedding.

At one point, the bishop read out the marriage rites, “in sickness and in health, to have and to hold”. Right before he uttered the words “till death do us part”, he glanced over at my wife and me. He then told my daughter, “This is what it means. This is your commitment to each other.” My wife and I had been married for 36 years.

After the ceremony, they all surrounded and kneeled in front of their mum, kissing and hugging her. At the tea ceremony, my Canadian son-in-law called my wife “mum” for the first time. She actually could not drink the tea because she was intubated, but she did so because she was so happy and grateful that she could be present for the occasion.

Shortly after the wedding, we held a small party for about 30 guests in the house. My wife was tired, so she went back to her room. At my wife’s funeral, my son-in-law revealed in his eulogy that she had called him into her room during the party.

He said the first question she asked was if he was happy. He said that moved him to tears because he knew that she was in great pain and the first thing she cared about was, if he was happy. That, he felt, was the mark of a parent’s selfless love.

Now that she is no longer with us, there are times when I miss our banter. Without my spouse, I do recognise now that I may sometimes feel inadequate as a parent. After all, parenting is a team effort.

But I am grateful for all the good and bad times we got to spend with our children and as a family. I know that if I were to falter now with my adult children, they would be okay as their foundation had been well-laid.

I’m happy that in this life, I didn’t have to do many parenting retakes. At its defining moments, I had generally made the right calls. Can I still do better as a father? Certainly, and I hope to! Am I happy with what I’ve done? Seeing the results so far, yes….I have no regrets!”

Richard Hoon is the chairman of Centre for Fathering, and is father to Eve, 25, Ethel, 27, and Elizabeth, 29.



Beautiful, heart-breaking “love”  story. But the sad question we need to ask is — Do you have to die suffering that way? Is there no  better way to die from breast cancer?

Malaysian medium dies in wok during “human steaming” ritual

KUALA LUMPUR — A 68-year-old Malaysian medium died from heart failure and massive second-degree burns after he sat inside a large wok for about 30 minutes with a fire burning underneath.

According to The Star, Mr Lim Ba was performing the “human steaming” stunt on Monday (Oct 23) night during the Nine Emperor God prayer session at a Chinese temple in Kuala Sanglang, of Malaysia’s northern state of Kedah.

Devotees removed the cover after they heard erratic knocks from inside the wok, the news report said.

“By the time the ambulance arrived, my father had stopped breathing,” Mr Lim’s youngest son Kang Huai, 32, was quoted as saying.

Kang Huai said his father had undergone a heart bypass last year and was on medication for hypertension.

The news report said Mr Lim had been performing the stunt for more than 10 years despite objections from family members.

According to this daughter Wei Ling, 37, Mr Lim’s longest record for sitting inside the wok was 75 minutes.

In the same report, Federation of Taoist Associations of Malaysia (FTAM) president Tan Hoe Chioew said the ritual was not a normal Taoist practice and that it was more of a theurgy, or magic performance.

“This ‘steaming man’ ritual is rarely performed, and I dare not comment on what preparations are needed before you perform this.

“But in general, doing physical endurance stunts is not advisable,” he was quoted as saying. THE MALAY MAIL ONLINE

Adulteration of proprietary Chinese medicines and health products with undeclared drugs: experience of a tertiary toxicology laboratory in Hong Kong


Proprietary Chinese medicines (pCMs) and health products, generally believed to be natural and safe, are gaining popularity worldwide. However, the safety of pCMs and health products has been severely compromised by the practice of adulteration. The current study aimed to examine the problem of adulteration of pCMs and health products in Hong Kong.


The present study was conducted in a tertiary referral clinical toxicology laboratory in Hong Kong. All cases involving the use of pCMs or health products, which were subsequently confirmed to contain undeclared adulterants, from 2005 to 2015 were reviewed retrospectively.


A total of 404 cases involving the use of 487 adulterated pCMs or health products with a total of 1234 adulterants were identified.

The adulterants consisted of approved drugs, banned drugs, drug analogues and animal thyroid tissue.

The six most common categories of adulterants detected were nonsteroidal anti-inflammatory drugs (17.7%), anorectics (15.3%), corticosteroids (13.8%), diuretics and laxatives (11.4%), oral antidiabetic agents (10.0%) and erectile dysfunction drugs (6.0%).

Sibutramine was the most common adulterant (n = 155). The reported sources of these illicit products included over-the-counter drug stores, the internet and Chinese medicine practitioners.

A significant proportion of patients (65.1%) had adverse effects attributable to these illicit products, including 14 severe and two fatal cases. Psychosis, iatrogenic Cushing syndrome and hypoglycaemia were the three most frequently encountered adverse effects.


 In Hong Kong, Folk Remedies Are Sickening Patients



The Pursuit of Truth in Medicine

by Donnie Yance

This is a great article. Read it. Yance is right to warn us to be aware that there are a lot of untruths in the healing industry! Yes, on both sides of this great divide  — doctors and alternative healers!

For those don’t like to read long article, let me highlight what Yance wrote:

  • Pursuit of Truth requires being and listening, rather than doing and assuming; and slowing down rather than speeding up.
  • … the motive behind clinical research is not to prove “truth” but to have a drug or device approved by the FDA.
  • … while there is a tremendous scientific basis for the therapeutic benefits of plants and nutrients in healing, they tend to not be studied in the most widely-accepted, gold standard, rigorous method designed for drugs, yet that does not make them any less valid or “evidence based” in my opinion. In other words, “evidence based medicine” doesn’t always mean it is the right medicine or the best medicine and we need to look beyond and apply a multitude of lenses to discover this (i.e., truth).
  • … “truth” in the medical arena—including pharmaceutical drugs and various treatments—actually has little validity and can be more detrimental than doing nothing. The attempt to gain approval of a drug, device, or treatment method is not a pursuit of truth, but unfortunately, is often driven by self -interest, and lacks the necessary ingredient of wisdom.
  • When it comes to postulating truths about herbal and dietary medicine, the medical establishment is not only frequently incorrect and dogmatic, but often maintains a position that is opposite to the truth, especially when it comes to herbs.
  • Misinformation is rampant, and the internet has exacerbated the problem. … There is an abundance of bad information and a lack of wisdom and integrity to guide you towards the truth.
  • “The greatest obstacle to discovery is not ignorance – it is the illusion of knowledge” – Daniel Boorstein
  • Truth involves a willingness to accept that the natural and the supernatural coexist. But this is not the way of modern conventional medicine. As a result, the medical profession is painfully shortsighted and makes egregious errors, including making proclamations about health that prove to be incorrect.
  • When I was five years old, my mother was told, if they removed my tonsils, it would improve my health and reduce the incidence of sore throats and infections. It wasn’t too many years later that the standard-of-care regarding prophylactic removal of the tonsils was stopped, and the tonsils were recognized as an important part of the immune system. But it was too late for me, and for millions of other children who grew up in the 50’s and 60’s.
  • I am continually appalled by how much of modern medicine is not based in truth, and worse, is accepted without any evidence. For example, not so long ago, if you had a small hormonal positive breast cancer, the standard-of-care was a mastectomy with lymph node dissection, with a full course of high dose chemotherapy that included three agents, followed by tamoxifen therapy, regardless of your age. No one questioned this practice, or asked for evidence demonstrating that the protocol significantly enhanced life or improved quality-of-life. The sad truth is that the accepted protocol did not benefit the vast majority of women. A small percentage of women were helped, but many others were irreparably damaged by the treatment, and would have been better off with no treatment except for hormone inhibition.
  • Yet herbal medicine, used for thousands of years and documented in countless historical medical textbooks, folklore, and in many cases re-validated by modern medicine, is falsely accused of not being “evidence based.”
  • In the pursuit of truth, we must seek open-mindedness.
  • … confronting cancer … Success is measured by outcome, quality of life, and health care costs, which are the most important parameters.
  • “It’s what you learn after you know it all that counts.” – John Wooden


Air travel comes at a price: Slightly elevated risk of cancer

Radiation doses from body scanners and baggage X-ray machines at airport security checks are minimal, compared to actual radiation exposure from the flight itself.


In April, Mr Tom Stuker, 63, became the world’s most frequent flier, logging 18 million miles of air travel over the last 14 years.

If his travelling behaviour is typical of business fliers, he may have eaten 6,500 inflight meals, drunk 5,250 alcoholic beverages, watched thousands of inflight movies and made around 10,000 visits to airplane toilets.

He would also have accumulated a radiation dose equivalent to that of about 1,000 chest X-rays.


You might think the radiation dose comes from the body scanners and baggage X-ray machines.

But radiation doses from airport security checks are trivial.

The major source of radiation exposure is from the flight itself.

This is because at high altitude, the air gets thinner. The farther you go from the earth’s surface, the fewer molecules of gas there are per volume of space.

Thinner air means fewer molecules to deflect incoming cosmic rays – radiation from outer space.

In fact, it is the accumulation of radiation dose that is the limiting factor for the maximum length of manned space flights. Too long in space and astronauts risk cata- racts, cancer and potential heart ailments when they return home.

So, what would Mr Stuker’s cumulative radiation dose be and what are his health risks?

It depends entirely on how much time he has spent in the air.

Assuming an average flight speed of 550mph, his 18 million miles would translate into 32,727 hours or 3.7 years of flight time.

The radiation dose rate at typical commercial airline flight altitude of 35,000 feet is about 0.003 millisieverts per hour.

By multiplying the dose rate by the hours of flight time, we can see that Mr Stuker has accumulated about 100mSv dose of radiation.

The primary health threat at this dose level is an increased risk of some types of cancer later in life.

Studies of atomic bomb victims, nuclear workers and medical radiation patients have allowed scientists to estimate the cancer risk for any particular radiation dose.

Assuming that low doses have risk levels proportionate to high doses, then an overall cancer risk rate of 0.005 per cent per mSv is a reasonable estimate.

Thus, Mr Stuker’s 100mSv dose would increase his lifetime risk of contracting a potentially fatal cancer by about 0.5 per cent.

The question is whether that is a high level of risk.

Most people underestimate their risk of dying from cancer. Although the exact number is debatable, about 25 per cent of men ultimately contract a potentially fatal cancer.

Mr Stuker’s 0.5 per cent cancer risk from radiation should be added to his baseline risk – from 25 per cent to 25.5 per cent.

A cancer risk increase of that size is too small to measure in a scientific way, so it must remain a theoretical increase in risk.

If you want to know your cancer risk from flying, estimate your airline miles over the years.

If you have clocked 370,000 miles, you would have a 0.01 per cent increase in the risk of contracting cancer.

However, most people do not fly 370,000 miles, which is equal to 150 flights from Los Angeles to New York, within their lifetimes.

So, for the average flier, the increased risk is far less than 0.01 per cent.

List all the benefits that you have derived from your air travel, such as job opportunities, vacation travel and family visits, and look at your increased risk again.

If you think your benefits have been meagre compared to the elevated cancer risk, maybe it is time to rethink flying.

But for many people, flying is a necessity of life and the small elevated cancer risk is worth the price.


The surprising number of American adults who think chocolate milk comes from brown cows

Seven percent of all American adults believe that chocolate milk comes from brown cows, according to a nationally representative online survey commissioned by the Innovation Center of U.S. Dairy.

If you do the math, that works out to 16.4 million misinformed, milk-drinking people. The equivalent of the population of Pennsylvania (and then some!) does not know that chocolate milk is milk, cocoa and sugar.


For decades, observers in agriculture, nutrition and education have griped that many Americans are basically agriculturally illiterate. They don’t know where food is grown, how it gets to stores — or even, in the case of chocolate milk, what’s in it.