This issue of Newsletter mainly reports the work of the Chinese Medicine Practitioners Board (PB) in the past 4 months, including conduction of the Chinese Medicine Practitioners (CMPs) Licensing Examination, renewal of practising certificates and Continuing Education in Chinese Medicine (CME) for registered CMPs, updating the list of accredited "CME Programme Providers", announcement of results of the disciplinary inquiries conducted by the PB, and uploading of the Disciplinary Order of the PB on the homepage of the Chinese Medicine Council of Hong Kong (CMCHK).
To engage our concern to the recent incidents of dispensing medicines adulterated with western medicines to patients by CMPs, a relevant topic is covered in this issue of Newsletter. In addition, the requirements applicable to the use of Internet for practice advertising by CMPs as specified in the Codes of Conduct (Codes)1 for Chinese Medicine Practitioners are also published. All CMPs please pay attention to these requirements and follow the Codes.
The practising certificates of about 1 400 registered CMPs expired in the end of June this year. Most of the registered CMPs have already met the requirements of CME and applied for renewal before their practising certificates expired.
The PB takes this opportunity to remind all registered CMPs that if they have submitted their application for renewal of practising certificates and duly paid the prescribed fee, even if they have not yet received the renewed practising certificates before their original practising certificates expire, they are deemed to have obtained the practising certificates under section 80 of the Chinese Medicine Ordinance (CMO), until their application for renewal of the practising certificates is approved or refused by the Registrar.
However, the PB noted that a small number of the registered CMPs only submitted their application for renewal several days before their practising certificates expired or even after their practising certificates expired. As it takes time to process application and verification of documents, all registered CMPs are requested to submit their renewal application early before their practising certificates expire.
Besides, all universities and relevant organisations are requested to pay attention to the valid period of the CMPs with limited registration under their employment. Application for renewal of limited registration should be submitted as early as possible if the CMPs with limited registration are expected to continue to perform clinical teaching and research in Chinese medicine, or it will constitute illegal practice if they continue to perform the above work after expiry of the limited registration.
All CMPs can also obtain the information about the medical professional and public health from this issue of Newsletter, including the Chinese medicine practitioner sub-directory of the Primary Care Directory of the Department of Health and information about the World Health Organisation seeking the advice of health experts on the International Classification of Diseases.
I wish you good health and happiness in daily life!
Mr WONG Kit
Chairman of the Chinese Medicine Practitioners Board
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"
At the end of July 2012, there were 6,398 registered CMPs, 67 CMPs with limited registration and 2,743 listed CMPs.
The Paper 1 and Paper 2 of Part I Written Examination of the 2012 Chinese Medicine Practitioners Licensing Examination were conducted on 12 June (Tuesday) and 14 June (Thursday) respectively. The Clinical Examination (Part II) was conducted from 1 August (Wednesday) to mid-August. A total of 323 candidates sat for the Written Examination, of which, 11 candidates were absent from the examination and 239 candidates (74% of candidates) passed the examination.
The PB will publish the Candidates' Handbook for the 2013 CMPs Licensing Examination and disseminate the details in September 2012. Please watch out for the announcements in the CMCHK homepage (www.cmchk.org.hk).
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 3 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 PB. From April to June 2012, 1,198 registered CMPs renewed their practising certificates. All registered CMPs must report promptly to their "CME Administrators" their new CME cycles, required CME points and the valid period of their practising certificates.
In accordance with the CMO, if a registered CMP practises Chinese medicine without obtaining a valid practising certificate over a period exceeding 6 months since the expiry of his/her practising certificate, the PB may act in accordance with section 56(1)(d) of the CMO to order removal from the Register the name of that registered CMP.
The PB has approved with effect from 12 April 2012, to accredit "Hospital Authority (CME-PP0031)" as an accredited Programme Provider under the System of CME. There are now a total of 27 CME Programme Providers accredited by the PB. CMPs are encouraged to read the appendix of this Newsletter or to visit the CMCHK homepage for the latest list of accredited CME Programme Providers and the contact details of "Hospital Authority".
The PB held disciplinary inquiries for 4 registered CMPs who were alleged breaching the Codes and/or convicted of an offence punishable with imprisonment from April to July 2012. 3 CMPs were found guilty after the inquiries. The PB ordered to remove the name of 1 registered CMP for 12 months, but suspend the application for 24 months, and warn the CMP; to remove the name of another registered CMP for 7 days, but suspend the application for 3 months; and to reprimand and warn 1 registered CMP.
Summing up the above cases, the PB reminds all CMPs to take note of the following issues.
It is stipulated in s5(2) in Part 3 of the Codes that a CMP should adopt treatment methods on the basis of principles of the traditional Chinese medicine in prescribing Chinese herbal medicines or proprietary Chinese medicines, and in using traditional therapeutic apparatuses or other innovative therapeutic apparatuses developed with the incorporation of Chinese medicine theory; and shall not use other professional treatment methods as regulated by laws concerning those other medical and healthcare professions.
Recently, the number of cases about CMPs prescribing herbal cream which contains western medicine to patients has been increasing, the PB would like to remind all CMPs that a CMP should not prescribe any Chinese herbal medicines or proprietary Chinese medicines which contain Western medicines to his patient when practising Chinese medicine. The PB is of the view that CMPs should have a thorough understanding of the regulations of practising Chinese medicine as stated in the Codes and understand the medicines which can be prescribed by CMPs under the CMO.
In addition, in order to provide safe and good medicines to patients, CMPs should buy medicines from licensed Chinese medicine traders with good reputation and should not buy medical products from unclear and unreliable source.
As CMPs prescribing herbal cream which contains Western medicines to patient has an adverse effect on the image of the Chinese medicine profession, the PB would like to remind all CMPs to observe relevant regulations stated in the Codes at all time, i.e. a CMP should adopt treatment methods on the basis of principles of the traditional Chinese medicine in prescribing Chinese herbal medicines or proprietary Chinese medicines and shall not use other professional treatment methods (e.g. medical practitioners). If any CMP is convicted for similar case, the PB will process the case seriously in accordance with the procedures stipulated under the CMO.
According to s2(5) in Part 3 of the Codes, CMPs should make medical referrals when necessary, and the registered medical professionals to whom a patient is referred should be able to provide the required treatment according to the diagnosis. The PB reminds all CMPs to make appropriate referral of patients when necessary and choose the medicines or apparatus that best serve the medical interest of patients according to their independent professional judgment.
CMPs should not issue professional documents or certificates which are untruthful or misleading. Also, according to the Reference Guide on Issuance of Sick Leave Certificate by Registered CMPs, CMPs should not issue sick leave certificate with a date different from the actual date of consultation. Other than possible criminal liabilities, a CMP would also commit professional misconduct if it is revealed that he has issued any untruthful or misleading professional document or certificate.
According to the Codes, if a CMP has been convicted of an offence punishable with imprisonment (irrespective of whether a prison term is imposed or not), he/she must report to the PB immediately. He/she should quote the case number, date of conviction, venue, offence and minute of adjudication to the PB. If the CMP fails to report to the PB immediately after being convicted of an offence, the PB will take disciplinary action according to the established procedures.
With the advancement of information technology, it is becoming more common for CMPs to use Internet for practice advertising. The PB reminds all CMPs to read carefully and comply with s6(2)(f) Part 3 of the Codes. The PB will take disciplinary action against those CMPs who violate the Codes.
According to the Codes, only the following information may be published on an Internet website:
name of the registered / listed CMP, and (where appropriate) the names of his partners, assistants or associates in the practice;
gender of the registered / listed CMP;
language(s)/dialect(s) spoken by the registered / listed CMP;
applicable to registered CMPs - Chinese title of "香港中醫藥管理委員會註冊中醫", "香港中醫藥管理委員會註冊中醫師, "註冊中醫"or "註冊中醫師" or English title of "registered Chinese medicine practitioner of the Chinese Medicine Council of Hong Kong" or "registered Chinese medicine practitioner" with one of the streams of practice "General Practice", "Acupuncture" or "Bone-setting" put in a bracket at the end of the title; applicable to listed CMPs - Chinese title of "中醫" or "中醫師" or English title of "Chinese medicine practitioner";
academic titles and practising qualifications allowed by the PB. Academic titles and practising qualifications that could be exhibited must follow the restrictions set out in Appendix I of the Codes;
emergency service and emergency contact telephone number by the registered / listed CMP;
address(es) of the clinic(s);
consultation hours; and
According to s158 of the CMO, a proprietary Chinese medicine (pCm) is not required for registration if such pCm is being used for the purpose of administering or supplying to a patient under a CMP's direct care. To foster the best usage of Chinese herbal medicines issued by the CMPs to the patients under his or her direct care and to meet the appropriate standards of practice, the Chinese Medicines Board has compiled the Practising Guideline for Retailers of Chinese Herbal Medicines. This Guideline covers the aspects of personnel, premises, scope of business, keeping of records, processing of herbal medicines, preparing or compounding preparations, and dispensing single Chinese medicine granules for prescription. This Guideline has also been uploaded to the CMCHK homepage.
It is stipulated in the Codes that a CMP must be professionally responsible to his/her patient. The prescriptions issued by the CMP should conform with professional standards. Moreover, all issued prescriptions should include the name and dosage of all Chinese herbal medicines.
CMPs must be professionally responsible for the Chinese medicines prescribed directly or by dispensers under their supervision to patients under the CMPs' care. If a CMP has done something which has fallen short of the standards of conduct expected among his professional colleagues, it could be regarded as professional misconduct, the PB and the Disciplinary Committee may take disciplinary action against the CMP.
Recently, the PB has received enquiries from the media about the disciplinary inquiries conducted. Taking into consideration that the public has the right to know the details of the disciplinary cases, releasing the judgment of cases may be a way to educate the public, increase the professional standard of CMPs and enhance the transparency and creditability of the inquiries held by the PB, the PB has decided in April 2012 to upload the gazette notice and judgment onto the CMCHK homepage for 6 months for those disciplinary cases which were punished with removal of name, with or without suspension, and reprimand after the appeal period and without any appeal lodged. Any names of people appeared on the judgment other than the CMP concerned should be concealed. For those less serious cases which were punished with warning letter and put on record for future reference (for listed CMPs only), the PB will decide for each individual case whether to upload the judgment and gazette notice, if any, to the CMCHK homepage (www.cmchk.org.hk).
The Primary Care Directory (the Directory), a web-based directory containing personal and practice-based information of primary care professionals of various disciplines in the community, facilitates the public to search for their own primary care providers. The doctor and dentist sub-directories were launched in April 2011, and the CMP sub-directory is planned to be launched in October this year. The Department of Health (DH) sent invitation letter to all CMPs in Hong Kong on 18 April and 8 August 2012. The CMP sub-directory will contain background, qualifications and practice-based information of enrolled CMPs to help the public identify suitable CMPs. Please find below detailed information for CMPs who are interested to apply for enrolment in the Directory.
The Directory will be installed with a search function, which enables the public to find a CMP based on their own selection criteria such as practice location, clinic opening hours, types of services provided, etc. Those already having their own CMPs can also find updated information about their CMPs in the Directory.
All CMPs practising in Hong Kong, including registered CMPs, CMPs with limited registration and listed CMPs under the CMO, with self-declared commitment to the provision of directly accessible, comprehensive, continuing and co-ordinated person-centred primary care services are eligible for enrolment in the Directory. By enrolling in the Directory, CMPs' personal and practice-based information can be readily available to the public. CMPs could also update their information easily on-line, e.g. changing their clinic opening hours during public holidays or adding new services that are available in the clinic.
In order to promote and maintain the quality of services provided by primary care providers listed in the Directory, CMPs enrolled in the Directory must demonstrate that they are pursuing continuing education in Chinese medicine.
DH will promote the Directory through different channels, including posters, leaflets, advertisements in internet, etc in October 2012.
CMPs can apply for enrolment in the Directory through one of the following methods -
To enrol online by accessing the enrolment platform of the Directory at www.pcdirectory.gov.hk.
To enrol by means of the application form. DH sent an invitation letter to all CMPs in Hong Kong on 18 April 2012. Please refer to the attached application form and return the completed form together with Hong Kong Identity Card copy and/or photo to the Primary Care Office, Depatment of Health by fax or by post.
If you would like your information to be available in the Directory upon its launching, please submit your application on or before 31 August 2012. For enquiries, please contact the Primary Care Office (Tel no.: 3576 3658, Fax no.:3583 4549, email address: firstname.lastname@example.org).
As the Directory is a web-based directory to facilitate medical service provider, including CMPs, and the public to search for information, and not for practice advertising, type of medical service provided and the related fees can be uploaded in the sub-directory and not limited by s6(2)(f) Part 3 of the Codes regarding information to be published on an website. Notwithstanding this, the PB would like to remind CMPs joining the sub-directory that all information and academic qualifications being uploaded onto the directory should be true and accurate and in compliance with s6 Part 3 of the Codes. If any CMP violates the Codes, Disciplinary Committee and the PB will take disciplinary action according to the established procedures under Chinese Medicine Practitioners (Discipline) Regulation and the Codes.
In May this year, DH received a complaint concerning a CMP who was suspected of prescribing a cream, adulterated with undeclared western medicine, to his patients. DH launched an investigation and found that, after analysis, the seized cream contained a number of western medicines that were controlled under the Pharmacy and Poisons Ordinance (Cap. 138). These controlled medicines included steroid and drug used for treating fungal infection. Improper use of the cream could lead to serious side effects.
Further investigation revealed that the CMP purchased the cream from a Mainland internet company, and would supply to his patient after preparation. The CMP claimed he had believed that the cream contained only Chinese medicines.
According to the Pharmacy and Poisons Ordinance, unauthorised sale or possession of Part I poison and unregistered pharmaceutical product are illegal. The maximum penalty for each offence is HK$100,000 and 2 years imprisonment upon conviction. Moreover, any person who sells a drug intended for use by man but unfit for that purpose may have contravened Section 54 of the Public Health and Municipal Services Ordinance (Cap. 132), and the maximum penalty of this offence is HK$50,000 and 6 months imprisonment. If a CMP was convicted of the above-mentioned offences, enforcement agencies would also refer the information to the PB for consideration of disciplinary actions.
All CMPs are reminded to be more vigilant and better manage the medicines that they use and supply. All CMPs must obtain their medicines from credible suppliers, and provide to patients with medicines that are effective and safe. CMP shall refrain from purchasing medicines with unknown ingredients or dubious source from market or through internet, since these medicines may not have been evaluated by suitable authority or may contain undeclared ingredient. The safety, quality and efficacy of these products are not guaranteed and may threaten the health of users. In addition, the use of those products hurts not only the reputation of that particular CMP, but also the public's confidence in Chinese medicine. Moreover, criminal and disciplinary proceedings could be brought against those involved.
The Western Pacific Regional Office (WPRO) of the World Health Organization (WHO) launched the "Regional Strategy for Traditional Medicine in the Western Pacific (2011-2020)" on 7 May, 2012, in Hong Kong. The launching ceremony was attended by about 150 international experts from 15 countries or regions, and other local stake holders.
Recognising that significant developments have been made and new challenges have also emerged for traditional medicine in the past decade, the strategy is designed to steer traditional medicine development in the Western Pacific Region into the next decade. The launching ceremony is followed by a two-day meeting which aims at sharing best practices in ensuring safety, quality and efficacy for the use and practice of traditional medicine in the region, as well as to discuss priority actions to implement the strategy.
WHO invites, for the first time, health experts' input for 11th International Classification of Diseases (ICD). One of the new features of this revision is an independent chapter (Chapter 23) on traditional medicine.
The beta version of the ICD-11 version was released for open consultation in May 2012 of through a wiki-type online platform. It is expected that the final version of ICD-11will be released in 2015.
The ICD is the gold standard for defining and reporting diseases and health conditions. It allows the world to compare and share health information using a common language and hence, also the foundation for the identification of health trends and statistics globally. Receiving input from health experts will greatly improve the representation from current medical practice and create insight from a broader diversity of medicine.
As WHO's Collaborating Centre for Traditional Medicine, the Chinese Medicine Division of DH encourages our local experts in this field to contribute their valuable advice.
Please visit the following websites for more information.
The Expert Panel on HIV Infection of Health Care Workers (Panel) set up under the DH serves to assess and advise on the need of job modification of HIV infected health care worker, including CMPs, and lookback investigation. Attending doctor of HIV infected health care worker is required to make anonymous referral to the Panel, which will be examined on a case-by-case basis with all information treated in strict confidence. As of June 2012, the Panel has assessed 25 cases.
The Panel considers it necessary to keep health care professionals abreast of the subject of HIV infection and health care workers, and would like to stress herewith 3 points: (a) the importance of adherence to standard infection control practices to minimise the risk of transmission of blood-borne pathogens including HIV in health care settings; (b) the need for attending doctor of infected health care worker to submit referral for assessment; and (c) the health care workers' duty of care to patients and the need to seek HIV testing, care and treatment as appropriate if they have reason to believe they have been infected with HIV or at risk of infection.
For referral or questions relating to the Panel, please contact the Panel Secretary, Dr. KH Wong, at 3/F, Wang Tau Hom Jockey Club Clinic, 200, Junction Road East, Kowloon, Hong Kong, Tel: (852) 3143 7289; Fax: (852) 2780 9580.
The PB has lost contact with the following listed CMPs based on the information of their telephone numbers and addresses.
The PB appeals to the following CMPs for contacting the Secretariat of the CMCHK (Tel. No.: 2121 1888, Fax No.: 2121 1898) as soon as possible. If other CMPs have contact with them, please notify them of the above.
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 PB. The form of Change of Personal Particulars of CMPs can be obtained from the Secretariat or downloaded from the CMCHK homepage.
Should you have any opinions regarding the content of the Newsletter, please send them to the Secretariat by post, fax or email, indicating "Newsletter of the Chinese Medicine Practitioners Board". All published Newsletters have been uploaded to the CMCHK homepage (http://www.cmchk.org.hk). CMPs are cordially invited to visit the above website.
Chinese Medicine Council of Hong Kong
Room 2201, 22/F, Wu Chung House, 213 Queen's Road East,
Wanchai, Hong Kong
Enquiry telephone: (852) 2121 1888
24-hour enquiry system: (852) 2574 9999
Fax Number: (852) 2121 1898
E-mail Address: email@example.com
Service Hours: Monday to Friday: 9:00 am to 5:30 pm
Closed on Saturdays, Sundays and Public Holidays