MOH to revoke MaNaDr Clinic's licence after probe into short teleconsultations
The Ministry of Health (MOH) has issued a notice to revoke MaNaDr Clinic's licence after an investigation into its teleconsultations, some lasting under a minute. The clinic, operated by a Nasdaq-listed startup, is under further scrutiny as MOH refers 41 doctors to the Singapore Medical Council (SMC) for potential professional misconduct.
SINGAPORE: The Ministry of Health (MOH) has issued a notice of intended licence revocation to MaNaDr Clinic Pte Ltd, following an investigation into its teleconsultation practices, where some sessions reportedly lasted less than a minute.
MaNaDr is operated by Mobile-health Network Solutions, a local medical technology start-up co-founded by Dr Rachel Pui Pui and Dr Siaw Tung Yeng, and is listed on Nasdaq.
The ministry's findings have raised serious concerns regarding the quality and safety of clinical care provided to patients.
In a statement issued on Thursday (24 Oct), MOH said in addition to the revocation notice, the MOH will refer 41 doctors who conducted teleconsultations at MaNaDr Clinic to the Singapore Medical Council (SMC) for potential professional misconduct.
The investigations revealed that these doctors may have breached one or more of the ethical guidelines outlined by the SMC, particularly in relation to their duty of care, clinical evaluations, and documentation practices.
Locum Practitioners Violate Employment Terms by Conducting Teleconsultations While on Active Duty
Among the 41 doctors referred, 13 were locum practitioners who provided teleconsultations while also employed by public healthcare institutions or MOH Holdings.
These individuals breached their employment terms by undertaking external work and conducting secondary clinical activities without prior approval from their employers.
Notably, many of these doctors provided consultations while on active duty in their respective institutions.
Of the 41 doctors, five have since left the public healthcare sector. Of the remaining eight, seven have been dismissed, while one doctor, whose actions were deemed less severe, is facing disciplinary action.
Investigations Uncover Short Consultations, Multiple Medical Certificates, and Inadequate Documentation Practices at MaNaDr Clinic
The MOH's investigation, which began after a directive on 16 August 2024 to halt teleconsultations at MaNaDr Clinic, revealed concerning practices. Findings included:
- Short Teleconsultations: A significant number of consultations were notably brief, often lasting one minute or less, yet resulted in prescriptions and issuance of medical certificates (MCs). Such brevity raises alarms about whether these actions were founded on sound medical reasoning.
- Multiple MCs Issued: Some patients received several MCs from different consultations within a short time frame, including multiple instances within just 30 days.
- Poor Documentation: Patient case notes often contained information inconsistent with the brief nature of consultations, with some records being alarmingly sparse, potentially jeopardising continuity of care.
Based on these findings, the Director-General of Health has determined that MaNaDr Clinic Pte Ltd, the licensee for MaNaDr Clinic under the Healthcare Services Act 2020 (HCSA), is unable to provide outpatient medical services ethically and clinically, prompting the licence revocation notice issued on 24 October.
Upon revocation, MaNaDr Clinic will no longer be authorised to provide outpatient medical services via any of its approved modes of delivery, including at its permanent premises at 371 Beach Road City Gate #02-52, temporary locations, or through remote consultations.
MaNaDr Clinic has 14 days to respond to the MOH’s notice.
MOH Evaluates Dr Siaw Tung Yeng's Performance Following Investigation Findings
The ministry is also assessing the performance of Dr Siaw Tung Yeng, the Principal Officer and Clinical Governance Officer of MaNaDr Clinic, to determine his suitability for his roles in light of these findings.
MOH has reminded all doctors practising telemedicine to adhere strictly to the SMC's Ethical Code and Ethical Guidelines at all times.
The ministry views these breaches seriously and will take further action, including referrals to the SMC, against any practitioners found to have engaged in professional misconduct.
These findings will also factor into any future licensing matters under the HCSA.
To ensure compliance, the MOH will continue to monitor other licensed providers of outpatient medical services offering teleconsultations, taking necessary regulatory actions against those found to be in breach of the guidelines.
A review of MaNaDr’s official website, which remained accessible as of 24 October, shows that the platform was established by Dr Siaw and a group of doctors with extensive experience in healthcare, government policy, and information technology.
Notably, Dr Siaw has been a member of the National Telemedicine Advisory Committee (NTAC) as of 2015.
Launched in January 2017, the MaNaDr platform boasts a network of over 500 clinics and 700 doctors in Singapore, with plans to expand into Australia, Indonesia, India, and Malaysia.
According to the company’s website, MNDR stock price has plummeted since August 2024, dropping from US$1.13 on 1 August to US$0.51 by 23 October.
MNDR initially announced its IPO on Nasdaq with 2.25 million ordinary shares priced at US$4 each, and by 16 April, the shares had surged to US$18, marking a 350% increase and pushing the firm’s market capitalisation to US$612 million.
At the time, MNDR stated that it would use the IPO funds to enhance user engagement on MaNaDr through technologies like artificial intelligence (AI) and blockchain.
