A 61-year-old Indian-origin family doctor with 35 years of experience has been reportedly suspended from practice for a period of three years by the Singapore Disciplinary Tribunal. The decision was taken on the grounds of improperly prescribing sedatives to seven patients from his clinic for more than a decade on a long-term basis.
Dr. Maninder Singh Shahi practiced at 81 Family Clinic, located in Marine Parade Central, at that time. It has been renamed Legacy Clinic since then. The Singapore disciplinary tribunal, in its rationale for the decision taken, accepted the Singapore Medical Council’s (SMC) submission for the suspension but rejected Dr. Singh’s plea for a reduction in suspension, citing the delay in prosecution.
Dr. Singh pleaded guilty to 14 charges of professional misconduct in relation to his actions from 2002 to 2016, a period ranging from seven to 13 years and eight months. He also failed to document his reasons for prescribing the hypnotic drugs repeatedly to one such patient. The charges levied on Dr. Singh include inappropriately prescribing benzodiazepines, zopiclone, or zolpidem, failing to maintain appropriate details of patients’ medical records, and failing to refer patients in a timely manner to the psychiatrist or medical specialist.
Benzodiazepines are used to treat conditions such as insomnia and anxiety, while zopiclone and zolpidem are non-benzodiazepines used for treating insomnia. The patient named P3 had consulted Dr. Singh 300 times for insomnia.
The SMC code of ethics and guidelines state that such medications need to be prescribed by doctors for short-term relief or intermittent use for a period of two to four weeks. Chronic benzodiazepine prescriptions are also required to be limited wherever possible. The SMC, in its argument, added that the long-term prescriptions of hypnotics by Dr. Singh exposed the patients to long-term dependency and tolerance to the medications, which in turn created a substantial potential for serious injury or harm for the patients.
Dr. Singh, in his mitigation, explained that his only intention in prescribing the hypnotics was to help patients and was not guided by any sense of greed or profit. He had also tried to refer three of his patients to a psychiatrist, but his patients were not keen on it. He then felt that it was important for his patients to be under his care so that he could monitor their condition and thus did not want to alienate them. He further added that he had run a busy clinic, seeing as many as 40–70 patients every day. He has since then been consulting patients only in the evenings, and the clinic is now primarily run by his daughter.
The Singapore Disciplinary Tribunal further noted that they have repeatedly emphasized that the main sentencing in cases involving prescriptions of benzodiazepine and non-benzodiazepine hypnotics is that of deterrence, given that such misconduct appears to be even more prevalent.
(Inputs from various sources)
(Rehash/Dr. Sushmita Ganguli)