The way forward...

Categories: Singapore

The recent suspension of 2 Chinese sinsehs by the Traditional Chinese Medicine Board sheds some lights on the practice of Traditional Chinese Medicine (TCM) in Singapore. In the cases reported by The Straits Times August 26 2006 edition, both were fined and suspended for "illegally dispensing prescription and banned drugs and the other for importing prescription drugs without a license."

The drugs in the case of illegal imports are antibiotics and contraceptives pills brought in from a neighbouring country. This may seem trivial until one consider the risk of getting counterfeit drugs or contaminated drugs from unlicensed sources. There were many cases of liver disease after taking slimming pills that was either tainted or contained fenfluramine. The most well-known must be that of Singapore actress Andrea De Cruz who developed liver failure in 2003 after taking Slim 10 which contained fenfluramine. Fenfluramine had been banned by the FDA since 1997. The drug was able to be imported legally because it was classified as a supplements and not a prescription drug and hence need not go through the mandatory testing. Little was known that it was "spiked" with the banned drug. Thankfully this sad story had a good ending when her fiance, fellow actor Pierre Png donated half his liver for her, enabling her to survive the crisis; and in the process probably redefined the definition of love!

The case involving the illegal dispensing is more dangerous. In this case, the TCM practitioner "prescribed the herbal product called BGT to control blood sugar and obesity." However it was found to contain glibenclamide and phenformin. Both these drugs are used in the treatment of diabetes in Western medicine. Hence these medication should only be prescribed to a diabetic and not just for the sake of controlling blood sugar, which has little to do with obesity. Improper use of the medications can lower a person's blood sugar so much so that the person may lose consciousness and going into coma and death! On top of that phenformin had been banned for at least the last 25 years. This followed the findings that the drug was found to cause the blood to be too acidic, resulting in fits and death.

These were the very reasons why the Ministry of Health (MOH) sets up the TCM Practitioner Board in 2000. Through the years TCM has gained popularity with the population and the practice was not regulated. Anyone can open a shop and claim to be TCM-trained. This may create a situation where unscrupulous and unsafe practice being carried out by fly-by-night self-proclaimed TCM practitioners. The result will be exposure of the population to potential mishaps from such practices with no recourse to any protection in the form of law suits. With the set up of the TCM board, only qualified practitioners are licenced; with the Board empowered to mete out any punishment for treatment that is unscrupulous, unethical or detrimental to the patient.

The punishments meted out by the TCM Board is indeed timely and the right way to go because now patients' rights are protected and at the same time the practice of TCM can be elevated to a higher level. As a practicing doctor, the rise of TCM is not seen as a threat but more as a complimentary practice to Western medicine. However this can only be achieved if TCM practice is regulated so that there is enough confidence in accepting their diagnosis and treatment. This is clearly proven by the overwhelming response by Western-trained doctors to the first TCM series of lectures leading to a diploma certification. With the interactions between TCM and Western medicine, the patients will stand to benefit.

With the practice of TCM regulated, maybe the next sector to look into is that of beauty salon. Beauty salons had been known to prescribed antibiotics for their patients with acne. Some beauty salons also proudly advertised their laser skin treatment. Unfortunately, antibiotics use and laser treatment can only be carried by a trained-doctor. Not all skin condition is treatable with laser; some condition may actually worsen with the use of laser. When such unfortunate incident happens, there is nothing much anyone can do short of plastic surgery. Hence, in the same vein as TCM practice, maybe the beauty industry should set up a board to regulate themselves so that a few bogus ones will not affect the image of the beauty industry sector.