Use of false documents and fraud
It is an offence under Section 9(3) of the Prevention of Bribery Ordinance (POBO) for an agent to use any false, erroneous or defective receipt, account or other document with intent to deceive his principal even without accepting a bribe. Any person who obtains financial advantages by deception might also commit a fraud offence. Commitment of corruption or criminal offence in clinical practice will not only ruin the career of the doctor committing the crime but also impair the reputation of the medical profession as a whole.
Scenario 1 | Request for "sick" leave certificates
Dr G operates a clinic with many large corporate clients offering medical benefits to their employees. He is usually busiest on Mondays and the days after live broadcasting of football matches in the middle of the night. It is obvious that many "patients" from these companies actually do not like working after revelries on these special days and want "sick" leave on the following day.
Geoffrey, the account officer of one of the companies, was a regular "patient" visiting Dr G's clinic in the morning of these special days. One day, Geoffrey suggested a "win-win deal" to Dr G that he did not really have to show up at his clinic. Instead, he would simply tell Dr G about his "symptoms" over the phone. What Dr G has to do was just to issue a certificate to certify that Geoffrey was unfit for work and Geoffrey would collect the certificate when he passed by his clinic. Dr G could then save the time on consultation or diagnosis but still claim the consultation fee from Geoffrey's company. If Dr G accedes to this proposal, Geoffrey would further introduce the scheme to his colleagues. Should Dr G agree to the proposal?
Dr G would commit an offence of deception if he obtains by deceit consultation fees from Geoffrey's company by issuing false sick leave certificates to its staff without conducting any consultation or diagnosis. Moreover, Dr G and those staff joining the scam would also commit an offence of conspiracy to defraud.
Dr G should not agree to the proposal as a sick leave certificate can only be issued after proper medical consultation of the patient by the doctor. Dr G would also violate the Code of Professional Conduct of the MCHK (Oct 2022) which prohibits doctors from signing untrue, misleading or otherwise improper certificates. If Dr G is convicted of criminal offence of deception, he may face disciplinary action taken by the MCHK. He may also be found guilty of professional misconduct by bringing the medical profession into disrepute.
Scenario 2 | Arranging medical service for ineligible persons
Dr H was a general practitioner in private practice. At an alumni dinner gathering, Dr H mentioned about the high rate of colorectal cancer in Hong Kong and suggested his former schoolmates to get a body check for early detection. Knowing that Dr H has recently participated in the Colorectal Cancer Screening Programme as a Primary Care Doctor, the schoolmates indicated interest to join the Programme but some of them have not yet met the age requirement to be eligible for the Programme. They were discussing about using the name of their elder family members or friends to enroll in the Programme and then ask Dr H to follow up on their cases so that they could enjoy the screening service at no cost while Dr H could earn the government subsidies. Wasn’t it a good deal for Dr H?
Dr H should discourage his former schoolmates from doing so and refuse to participate in the scam as both Dr H and his schoolmates would commit an offence of conspiracy to defraud by providing medical services to ineligible persons to deceive government for subsidies.
Besides, Dr H might breach the Code of Professional Conduct of the MCHK (Oct 2022) by issuing documents containing statements or information which are untrue, misleading or otherwise improper. He would render himself liable to disciplinary proceedings taken by the MCHK.
As an enrolled Primary Care Doctor of the Colorectal Cancer Screening Programme, Dr H should also observe and comply with the terms and conditions set out in the Agreement for Primary Care Doctor under the Programme.
Doctors are required to prepare documents such as reports and certificates for a variety of purposes (e.g. insurance claim forms, payment receipts, medical reports, vaccination certificates, sick leave certificates). Doctors should always exercise their independent professional judgement and maintain the highest standards of professional conduct when handling or issuing various documents. To avoid falling into legal and ethical traps, doctors should:
- exercise care in issuing certificates, medical reports and similar documents on the basis that the truth of the contents can be accepted without question;
- make utmost efforts to perform their professional duties and services by means which are proper, fair and in line with the interest of their patients, colleagues and business associates;
- avoid placing themselves under any financial or other obligation to outside individuals or organisations that might influence them in the discharge of official duties; and
- deal honestly with patients and other individuals and should not allow their judgement be influenced by personal benefit.