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Chinese Medicine Council of Hong Kong
Newsletter of the Chinese Medicine Practitioners Board
Issue No.29 / December 2011
(English Translation)

Introduction

The status of Chinese medicine and its practitioners has been established since the enactment of the Chinese Medicine Ordinance (CMO) in July 1999.

In the past six years, under the leadership of Prof. WONG Ngar-kok, James, the former Chairman of the Chinese Medicine Practitioners Board (Practitioners Board), the Practitioners Board has contributed enormous effort in implementing the regulatory measures stipulated in the CMO. Their effort has significantly strengthened the confidence of the public in Chinese medicine. The five committees under the Practitioners Board have also been contributing in the matters related to registration, examination and discipline of Chinese medicine practitioners (CMPs).

I am greatly honoured to be appointed by the Secretary for Food and Health as the Chairman of the Practitioners Board. I hope, together with my counterparts, we can work together to safeguard the public health, to promote the professional standard of the CMPs, and to cultivate the spirit of self-regulation of the CMPs. Together we strive for the vitality of Chinese medicine.

It is my pleasure to welcome Ms FENG Jiu, Ms WAI Chu-ur, Ms TSE Man-yin, Mr CHAN Wing-kwong, Mr LUI Wai-keung, Prof. LEUNG Wing-nang, Albert, Mrs HU LEUNG Tze-wai, Jeanie and Dr MAK Sin-ping, the new members of the Practitioners Board.

It is also a pleasure to introduce the following committee Chairmen, appointed by the Chinese Medicine Council of Hong Kong (CMC), of the committees under Practitioners Board: Ms TSE Man-yin as the Chairman of Registration Committee, Ms WAI Chu-ur as that of Examination Committee, Mr LAU Yiu-fai, Ronald as that of the Committee on Assessment of Chinese Medicine Degree Course; as well as Mr TSOI Sheung-pan and Ms WONG Ling who continued to be the Chairmen of Disciplinary Committee of Chinese Medicine Practitioners and of Ethics Committee respectively. For the member lists of the Practitioners Board and the committees, please visit the CMC homepage (http://www.cmchk.org.hk)

It has been endorsed by the Practitioners Board that Ms WONG Ling, Mr LUI Wai-keung and Mr LAU Yiu-fai, Ronald to be appointed as the member of the editorial board of the Newsletter from the Practitioners Board (Newsletter), succeeding Ms YU Wun-pan, Grace, Mr TSU Sze-chin and Dr LAM Siu-wing, Andy, whose tenures in the Practitioners Board have been completed in September. On behalf of the Practitioners Board, I pay tribute to Ms YU, Mr TSU and Dr LAM for their contributions as the members of the editorial board in the past years.

This issue of Newsletter reports the work of the Practitioners Board in the past four months, including matters related to the CMP Licensing Examination, Continuing Education in Chinese Medicine for Registered CMPs (CME) and CMP disciplinary cases. A reminder about CMPs using the Internet for advertising is also included in this issue.

In case of physical examination is required, CMPs are reminded to ensure the presence of a female care assistant as best as possible, or to conduct the examination in a non-enclosed space.

Over 1,800 registered CMPs' practising certificates expired in late November this year. The majority of them has submitted the applications for renewal of their practising certificates and has fulfilled the CME requirements. The Practitioners Board urged all CMPs to maintain a high standard of practice by pursuing continue education which helps in excelling their profession.

Wish you all good health.

Mr WONG Kit
Chairman of the Chinese Medicine Practitioners Board

 

Number of Chinese Medicine Practitioners

At the end of November 2011, there were 6,408 registered CMPs, 68 CMPs with limited registration, and 2,747 listed CMPs.

 

Chinese Medicine Practitioners Licensing Examination

The Clinical Examination of the 2011 CMPs Licensing Examination was conducted in August 2011. A total of 401 candidates attended the Clinical Examination, and 190 candidates (47.4%) passed the Clinical Examination.

The Written Examination and the Clinical Examination of the 2012 CMPs Licensing Examination would be conducted in June and August 2012 respectively. The application period for non-listed CMP persons was from 15 September to 28 October 2011, whereas the deadline for submitting applications for listed CMPs and repeaters is 30 March 2012. The Practitioners Board has issued a letter to notify all qualified listed CMPs the enrollment period for taking the examination.

 

Renewal of Practising Certificates and Continuing Education in Chinese Medicine for Registered Chinese Medicine Practitioners

In accordance with section 76 of the CMO, a registered CMP must apply for a valid practising certificate before he/she is allowed to practise Chinese medicine in Hong Kong. The usual validity period of a practising certificate is three years. Before a registered CMP is issued with the renewed practising certificate, he/she must fulfill the requirements of continuing education in Chinese medicine, as determined by the Practitioners Board. From August 2011 to November 2011, 497 registered CMPs renewed their practising certificates.

According to Appendix V of the Handbook on System of Continuing Education in Chinese Medicine for Registered Chinese Medicine Practitioners, registered CMPs would be awarded CME points from participating in courses/programmes of CME subjects held by the accredited Mainland institutions. Subsidiaries of these institutions which would like to have their courses/programmes be accredited as CME courses/programmes, should submit application for the approval of the Practitioners Board. Otherwise, registered CMPs who attend the non-accredited courses/programmes would not be awarded any CME points.

 

Awarding Points of Continuing Education in Chinese Medicine through Reading the Newsletter

To encourage the CMPs to read the newsletter, the Practitioners Board has decided to introduce the CME Quiz to Registered CMPs. Ten questions, based on the content of the three issues of Newsletter of the year, will be published in the December issue every year. Registered CMPs may send the completed answer sheet attached to the Newsletter to their "CME administrator" within the specified time frame of one month for the assessment and record of the CME points that they can be awarded.

Two CME points would be awarded for successful attempt of six or more questions. The ceiling of CME points obtained through CME Quiz within each three-year cycle is 10% of the 60 CME points required in the same cycle, i.e. six points per cycle. The accumulated CME points obtained through CME Quize and other self-study activities should not exceed 30 points per cycle.

The CME Quiz is published for the first time in this issue. Registered CMPs may send the completed answer sheet to their CME Administrators by fax or by mail on or before 1 February 2012. After the assessment by the CME Administrators, two CME points would be awarded for successful attempt of six or more questions. No CME points would be awarded for any late submission of the completed answer sheet. The previous issues of the Newsletters were uploaded to the CMC homepage for reference by the CMPs.

 

Continuing Education in Chinese Medicine of Registered Chinese Medicine Practitioners

The Practitioners Board will conduct the fourth review of the CME system in early 2012. In accordance with the requirements of the system, all accredited CME Administrators and Programme Providers are required to submit their working reports for the period from 1 January 2009 to 31 December 2011 to the Practitioners Board by early 2012, for the latter to conduct the fourth review of the system.

 

Disciplinary Inquiry Conducted by the Chinese Medicine Practitioners Board

The Practitioners Board held disciplinary inquiries for five registered CMPs and two listed CMPs who were convicted of an offence punishable with imprisonment or breached the Codes of Practice 1 (COP) from August to November 2011. All CMPs were found guilty after inquiries.

The Practitioners Board ordered to remove the name of one registered CMP for six months, but suspend the application for 18 months and warn the CMP; to remove the name of another registered CMP for 12 months, but suspend the application for 24 months and warn the CMP; to reprimand and warn one registered CMP; to reprimand one registered CMP; and to warn one registered CMP. In addition, the Practitioners Board ordered to remove the name of one listed CMP and to record the result of inquiry of another listed CMP for future reference.

Summing up the above cases, the Practitioners Board reminds all CMPs to take note of the following issues.

It is stipulated in the COP that a CMP shall issue prescriptions which conform with professional standards and shall not prescribe excessive or inappropriate medicines. If a CMP prescribes inappropriately with excessive dosages or excessive number of medicines without referring to any therapeutic principles, treatment methods, treatment priorities, or against the principle by which medicines are combined, the treatment of the patients would be adversely affected.

The Practitioners Board noticed that there were CMPs failing in issuing prescription to their patients, or the issued prescriptions were written unclearly. The Practitioners Board reminds all CMPs that patient has the right to know clearly the details of the Chinese herbal medicines prescribed by the CMP. In case there is a medical incident, the medical professionals whom a patient is referred to can use the prescription to take follow up actions and ensure the well-being of the patient.

It is also stated in the COP that the writing on the prescription issued by CMP must be clear and easily recognised. The prescription must include the names of all Chinese herbal medicines applied; dosages of all Chinese herbal medicines; number of times for re-dispensing; method of usage of the medicines; name, address, contact telephone number and signature of the registered CMP and the issuing date of the prescription.

According to the Reference Guide on Issuance of Sick Leave Certificate by Registered CMPs, receipt of consultation should include patient's name, HKID number, diagnosis, consultation fee, the information about the clinic and the CMP, such as the clinic's name, address, telephone number, name and signature of the CMP who issues the receipt and its issuing date. If the case involves industrial injuries and that the CMP prescribes, uses or supplies Chinese herbal medicines or proprietary Chinese medicines to the patients under his/her care, the consultation fee and the medicine fee should be stated separately on the receipt.

The Medical Insurance Association of the Hong Kong Federation of Insurers has appealed to registered CMPs not to split receipts of consultation fees, so as to avoid contravening any criminal offences by aiding an insured member to get premium of consultation fees by cheating or fraud.

On the other hand, CMPs are recommended not to indicate the amount charged on prescriptions issued to patients when issuing receipts of consultation fees and prescriptions. This appeal is being made in order to prevent an insured member from submitting a prescription and receipt which are issued for the same service separately to different insurance companies, and thereby making a dual claim and profit. Making a dual claim is a violation of the principles of indemnity in medical insurance, i.e. an insurance policy indemnifies an insured member only to the extent of the amount of insured member has paid for each consultation.

Other than possible criminal liabilities, a CMP would also commit professional misconduct if it is revealed that he has aided an insured member to get premium of consultation fees by cheating or fraud.

1 Codes of Practice refers to the "Code of Professional Conduct for Registered Chinese Medicine Practitioners in Hong Kong" and the "Code of Conduct for Listed Chinese Medicine Practitioners"

 

Using Internet for Advertising

With the advancement of information technology, it is becoming more common for CMPs using the Internet for advertising. The Practitioners Board reminds all CMPs to read carefully and comply with section 6(2)(f) in Part 3 of the COP. The Practitioners Board will take disciplinary action against those CMPs who violate the COP.

The revised COP (2011 version) were distributed to all registered and listed CMPs in December 2010, and were uploaded to the CMC homepage.

 

Professional Conduct of Chinese Medicine Practitioners

There has been CMP being convicted by the court of indecent assault recently. Although the COP do not require the presence of care assistant while CMP is conducting physical examination on his/ her patient, in order to safeguard the interests of both the CMP and patient, the CMP should as best as possible, arrange the presence of a female care assistant while conducting physical examination on the patient. If the patient requests the absence of care assistant during the examination, the CMP should record this request on the medical record concerned.

 

The provisions related to the requirements for labelling and package inserts of proprietary Chinese medicines commenced on 1 December 2011

Sections 143 & 144 of the CMO commenced on 1 December 2011. The provisions 2 require proprietary Chinese medicines (pCm) to be labelled and to include package inserts which comply with the prescribed requirement as set out in sections 26 & 28 of the Chinese Medicines Regulation (the Regulation). The provisions aim at helping the general public to use pCm safely and appropriately.

When purchasing pCm which is for dispensing to patients, CMPs should pay attention to, apart from whether the product was registered (Registration number HKC-xxxxx, HKP-xxxxx or application serial number of HKNT-xxxxx are labelled on the outermost package of the registered pCm), as well as to whether the pCm labels and package inserts are provided as required by the law.

According to section 26 of the Regulation, a label on the package of a pCm shall include the following 9 particulars (at least in Chinese): (i)the name of the medicine; (ii)the name of the main active ingredients; (iii)its dosage and method of usage; (iv)its packing specification; (v)the name of the holder of the certificate of registration of the medicine; (vi)its expiry date; (vii)its registration number; (viii) the name of the country or territory in which the medicine is produced; and (ix)its batch number.

According to section 28 of the Regulation, the package insert shall contain 12 particulars (at least in Chinese) including the label particulars (i) to (v) mentioned above, the quantity of the main active ingredients; its functions or pharmacological action; its storage instructions; its indications, contra-indications, side-effects, toxic effects and the precautions to be taken regarding its use (if any).

2 The maximum penalty for contravention of the above provisions is a fine of $100,000 and two years' imprisonment.

 

Exemptions for Proprietary Chinese Medicines Compounded by Chinese Medicine Practitioners or in Accordance with Prescriptions Given by Chinese Medicine Practitioners

In accordance with section 36 of the Regulation, the requirements for labelling and package inserts shall not apply in pCm which is compounded by or under the supervision of a registered or listed CMP at the premises where he/ she practises, and only if, such pCm is being used for the purpose of administering or supplying to a patient under his/ her direct care.

In addition, exemption for labelling and package insert shall be given to pCm individually prepared or compounded by a responsible person of a licensed retailer of Chinese herbal medicines in accordance with a prescription given by a registered or listed CMP.

 

Labelling Requirements for proprietary Chinese medicines Entrusted by Chinese Medicine Practitioner to be Manufactured by Licensed Manufacturers

According to section 26(4) of the Regulation, pCm for internal and/ or external application that entrusted by CMP to be manufactured by licensed manufacturers for patient under CMPs' direct care is exempted from providing package insert. However, the following particulars (at least in Chinese) shall still be labelled on the outermost package.

  1. the name and address of the CMP;
  2. the name and address of the manufacturer who produces the medicine;
  3. its batch number;
  4. the date on which it is produced;
  5. its dose form;
  6. its packing specification;
  7. its expiry date;
  8. the name and quantity of each ingredient listed in the prescription;
  9. a statement containing the following Chinese text -
    "須按照中醫指示使用". If the statement is to be available in English also, the English text -"To be used only in accordance with the instructions of a Chinese medicine practitioner"; and
  10. if the pCm is for internal application or both internal and external application, a statement containing the following Chinese text-
    "只供中醫施用於或供應予獲開給本成藥的處方且是由他直接治理的病人". If the statement is to be available in English also, the English text - "To be supplied to a Chinese medicine practitioner solely for the purpose of administering or supplying to the patient to whom the prescription of this medicine is given and who is under his direct care". If the pCm is for external application only, statements containing the following Chinese text-
    "只供中醫施用於或供應予由他直接治理的病人" and "只供外用". If the statements are to be available in English also, the English text - "To be supplied to a Chinese medicine practitioner solely for the purpose of administering or supplying to a patient or patients under his direct care" and "For external application only".

CMPs should pay attention that if the pCm, be it self-manufactured or manufactured by manufacturers, is for sale in the market, the pCm should be registered by fulfilling the safety, quality and efficacy requirements and by complying with the requirements for labelling and package inserts of pCm. For the above content which the provisions of CMO and the Regulation are concerned, the ordinance and the regulation itself prevails. The above-mentioned provisions are available on www.legislation.gov.hk.

 

Health Manpower Survey

The 2011 Health Manpower Survey conducted by Department of Health has commenced. This survey aims at collecting information on the manpower and employment status of healthcare personnel practising in Hong Kong, which is essential for reference of health manpower planning.

The questionnaire has been distributed to all CMPs together with the previous issue of Newsletter. It is known that some CMPs have not returned the completed questionnaire yet, enclosed please find the reminder and questionnaire to all CMPs from Department of Health. Please return the duly completed questionnaire to the Health Manpower Unit of the Department of Health as soon as possible.

For further enquiry, please visit http://www.dh.gov.hk/tc_chi/statistics/statistics_hms/statistics_hms.html or contact Health Manpower Unit at 2961 8566.

 

Personal Data

All CMPs are requested to notify the Secretariat as soon as possible if there are changes in their registered address, correspondence address, practising address, telephone number, fax number and other personal data which have been previously reported to the Practitioners Board. Enclosed please find the form for notification of change of personal data. It may also be obtained from the Secretariat if needed.

 

Suggestions

Should you have any opinions regarding the contents of the Newsletter of the Chinese Medicine Practitioners Board, please send them to the Secretariat by post, fax or email, indicating "Newsletter of the Chinese Medicine Practitioners Board". All published Newsletters of Chinese Medicine Practitioners Board have been uploaded to the Council's homepage (http://www.cmchk.org.hk). CMPs are cordially invited to visit the above website.

 

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