by Khairunisya Hanafi
WHEN buying a property, it’s all about location, location, location. When seeing a GP, it turns out, it’s all about timing, timing, timing.
It doesn’t matter if your GP clinic is in a shopping mall or in an HDB block. When it comes to how much your consultation fees will cost, it boils down to how long is the visit, whether it’s during the day or night, and whether it’s a weekend or a weekday. There is really no standard to how much a GP can charge – and get this, some doctors might even charge more if you’re being difficult.
Over the past week, we went to 40 clinics all over Singapore to check how much consultation fees cost. We tried to see if clinics in shopping centres would cost more than those in HDB flats. We also wanted to know if consultation fees would cost more at different times of the day.
We found that location really doesn’t matter. Instead, time plays an integral part in the pricing of consultation fees. Patients are typically charged differently depending on the duration of their consultation. Doctors may also charge patients with extended fees should they go beyond the length of a long consultation.
For many clinics that we visited, we were told that the clinics’ consultation fees were ultimately determined by the doctors on duty.
Diagnosing the problem
We wanted to know what this range was, after new guidelines came out saying doctors must be reasonable in determining how much to charge their patients. This seemed to be an important point in the report as it noted the number of complaints over the past decade regarding poor communication between doctors and patients about the cost of fees.
Recently, a patient, finance officer Ms Adeline Kang, made a complaint to the Ministry of Health (MOH) that she had been overcharged at a family clinic. The 41-year-old was told that she had to pay $80 at Wee’s Family Clinic & Surgery in Whampoa for two medical conditions- stomach pains and a sore throat.
Dr Wee Chee Chau then clarified the matter in a forum letter to The Straits Times stating that there was a “miscommunication between the patient and the clinic assistant” and that a separate billing for two ailments was “definitely not the case”.
MOH investigated the matter and found that the consultation fee did fall “within the range of charges displayed there”. It however advised the clinic to review the way it communicates its charging practice to patients.
The updated guidelines had another point to make: It reminded doctors that because they’re performing a service, how much they charge must be equal to the amount of work done, or in the words of the report: “the fees that you charge must be fair and reasonable and commensurate with the work actually done”.
This updated code and guidelines will come into effect on Jan 1 next year.
From the 40 clinics we visited, we found a wide range of consultation fees: From as little as $14 to more than seven times, as much: $110 per visit. Here’s how it works out:
- Duration of consult
Of all the variables we found related to timing, this was the best indicator of how much a consult will cost. Shorter consults cost less, and longer consults more, obviously.
However, there was also a lot of variation as to how “short” exactly was a short consult. As many as 18 out of 40 clinics determined this duration to be about 10 minutes. But there was one clinic, Silver Cross Medical Centre at Holland Avenue, which felt that a consultation just under 30 minutes could still be considered short. Most other clinics would consider 30 minutes too long – even for a long consult.
As many as 18 out of 40 clinics determined a “short” consult was about 10 minutes.
As for long consultations, most cost $30 on average and was roughly pegged at 11 to 20 minutes. Again there was some variation, though not by much. Long consultations can go up to $50 for Greenlife Clinical Surgery in Sembawang and Kao & Tan Family in Jalan Membina. Patients’ complaints and medical assessments carried out are other considerations when pricing consultation fees.
We also found a handful of clinics which charged extended fees beyond the span of a long consultation. First Medical Centre in Stirling Road charges about $15 per 10-minute blocks for consultations exceeding 20 minutes.
At Tiong Bahru Medical Centre, $25 is charged for every additional 15 minutes. Phoenix Medical Group at Paya Lebar Square similarly charges $1 for every minute beyond a long consult.
There were also clinics which set fixed prices no matter the duration. Shenton Family Medical Clinic at Jurong Gateway Road charges $22 for both short and long consultations.
Raffles Medical at Causeway Point charges $36.35 and has not changed its price for two years. For Yim Medical Centre in Admiralty MRT, consultation fees are fixed at $25.
2. Weekday or weekend?
Another factor of timing that we found was whether it was a Monday-Friday consult, or a Saturday-Sunday consult. While many clinics we visited did not make this distinction, others went into the nitty-gritty of breaking down the timings of each day, pricing the fees at different rates.
For instance, the Singapore Family Clinic & Surgery situated at Woodlands Drive 70 charges patients from $23 in the day and about 10 per cent more in the evening. On weekends, patients can be charged as much as 22 per cent more than what they would pay on a weekday.
Other clinics, such as Healthway Tampines Central Clinic, charges about 7 per cent more for weekend consultations. Its weekend consults are about $28 and weekday consults are about $26 during office hours.
Think 7 per cent is too high? Well, we found that Raffles Medical in Sembawang increases its fees by more than 40 per cent during the weekends, going at $40 and above.
3. Other special hours
We also found that there are several doctors who impose surcharges on their patients after usual office hours. At Kao & Tan Family, its midnight surcharge is $50 on weekdays, while during the weekends it charges $76 for consultations after midnight. At Central 24-Hr Clinic in Clementi, patients are charged $110 for midnight consultations.
It’s ultimately up to the doctor
Apart from timing, to our surprise, we found that there was another factor: basically how much the doctor likes you.
Dr Siah Kim Bin from Teng Clinic in Stirling Road said some doctors also consider the “attitude of patients” when charging them. If a patient is “stuck up” or “rich”, chances are he or she will have to pay more. The clinic’s fees start at $20 for both short and long consultations. Previously priced at $15, Dr Siah said he raised prices mainly due to inflation.
Dr Lee See Chung from Shenton Family Medical Clinic, on the other hand, prefers to keep his fees affordable. His patient service officer, Madam Alice Cheah said: “Dr Lee doesn’t like to charge his patients too expensively… because he doesn’t like his patients to pay so much in medication and consultations.”
“Even though 11 minutes and above is a long consultation, so far we don’t charge patients that expensively,” the 34-year-old added.
The clinic, located at Tampines Street 21, charges its patients $18 for a short consultation. It last reviewed its fees in January this year, previously charging patients $15.
And of course, all these can be done because it’s really up to the doctors how much they wish to charge their patients – which is exactly the issue the medical council has been trying to address for years.
A chronic issue?
The sheer number of different ways a GP can charge is problematic as it gives no direct indicators for patients to gauge their consultation fees.
Actually, this issue has been in scrutiny for a while. In 2007, a guideline on fees was withdrawn due to concerns that it was infringing competition laws. Additionally, the Competition Commission of Singapore removed the listing of fees which doctors should charge in 2010 as they viewed the action as anti-competitive.
While pricing guidelines have since been removed, the Singapore Medical Association does have a recommended fee guideline for private doctors on its website. Nonetheless, general practitioners and family doctors are still empowered to set their own fees.
Additional reporting by Iffah Nadhirah Osman
Featured image by Sean Chong.
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