This issue of the Newsletter mainly reports on the progress of work of the Chinese Medicine Practitioners Board ("CMPB") in the past four months, which includes the Chinese Medicine Practitioners Licensing Examination, matters related to renewal of practising certificates and Continuing Education in Chinese Medicine ("CME") for registered Chinese medicine practitioners ("CMPs") and findings of disciplinary inquiries. Some requirements under the Codes1 are also highlighted in this issue for the attention of CMPs.
In accordance with the Chinese Medicine Ordinance ("CMO"), if registered CMPs practise Chinese medicine without valid practising certificates for a period exceeding six months since the expiry of their practising certificates, the CMPB may order removal from the Register the name of those registered CMPs. All registered CMPs are hereby reminded to take note of the validity of their practising certificate and submit a renewal application to the CMPB in a timely manner.
With regard to disciplinary inquiries, CMPs are specifically reminded not to dispense western medicines. They should also observe the requirements stipulated in the CMO and the Codes, namely standards on prescribing medicines, information in prescriptions and proper keeping of medical records, reporting court convictions to the CMPB, issuance of sick leave certificates, and change of name of CMPs or use of alias in their practice etc.
Answers of the 2018 CME Quiz for awarding CME points through reading the Newsletter are attached to this issue for CMPs' reference.
On behalf of the CMPB, may I wish all CMPs all the best and good health.
Ms WONG Yu-yeuk
Chairman of the Chinese Medicine Practitioners Board
1The Codes refer to the Code of Professional Conduct for Registered Chinese Medicine Practitioners in Hong Kong and the Code of Conduct for Listed Chinese Medicine Practitioners.
The application for sitting the 2019 CMPs Licensing Examination for non-listed CMPs was closed at the end of October 2018 and that for listed CMPs and repeaters was closed on 29 March 2019.
The Paper 1 and Paper 2 of the Written Examination of the 2019 CMPs Licensing Examination will be conducted on 4 June and 6 June 2019 respectively. In the event of bad weather, the examination on 4 June and 6 June 2019 will be postponed to 10 June and 12 June 2019 respectively. The Clinical Examination is scheduled to be held between 1 August and Mid-August 2019.
Candidates should receive the admission forms and the Guidelines for Candidates one week prior to the examination. They may contact the Secretariat of the Chinese Medicine Council of Hong Kong ("CMCHK") at 2121 1888 if they do not receive the above-mentioned documents on time.
As at 15 March 2019, there were 7,406 registered CMPs, 35 CMPs with limited registration and 2,603 listed CMPs.
Pursuant to section 76 of the CMO, registered CMPs must hold valid practising certificates before they are allowed to practise Chinese medicine in Hong Kong. The usual validity period of a practising certificate is three years. Registered CMPs should fulfill the CME requirements prescribed by the CMPB before they can renew their practising certificates.
The CMPB will issue letters to notify the registered CMPs concerned of the arrangements for the renewal of their practising certificates about three months in advance of the expiry dates. To ensure timely processing of renewal application and update of the expiry date of the practising certificate on the CMCHK homepage, the CMPB hereby appeals to all registered CMPs to follow the advice in the notification letter and submit the application along with the prescribed fee at least six weeks before the expiry of the practicing certificate.
From 16 November 2018 to 15 March 2019, 239 registered CMPs had their practising certificates renewed. All registered CMPs who have their practising certificates renewed should report promptly to their CME Administrators their new CME cycles, required CME points and the validity period of their practising certificates.
The CMPB hereby reminds that:
if a registered CMP has decided not to renew his current practising certificate, he must stop practicing Chinese medicine upon expiry of the certificate. Otherwise, he will contravene section 76(1) of the CMO.
in accordance with section 56(1)(d) of the CMO, if registered CMPs practise Chinese medicine without valid practising certificates for a period exceeding six months since the expiry of their practising certificates, the CMPB may order removal from the Register the name of those registered CMPs.
To encourage CMPs in reading the Newsletter, the CMPB endorsed in 2011 the introduction of the CME Quiz. Ten questions, based on the content of the three issues of the Newsletter of the year, will be published in the December issue every year. Two CME points would be awarded if successful attempt of six or more questions.
The correct answers of the 2018 CME Quiz are attached to this issue of Newsletter at Appendix I for CMPs' reference. The 2019 CME Quiz will be published in the December issue of the Newsletter (issue no. 53) this year.
It is specified in the Application Form for "Registration as Registered Chinese Medicine Practitioner and Practising Certificate" that registered CMPs must provide their practising address as the registered address. For those who practise at more than one location, their principal practising address should be provided as the registered address.
In accordance with section 52 of the CMO, registered address shall be recorded in the Register of CMPs. The CMPB and the Registrar shall publish in the Gazette from time to time the list of listed CMPs and the names, registered addresses and qualifications of all registered CMPs listed in the said Register in accordance with sections 90(6) and 53. Such information will also be published in the website of the CMCHK.
If registered CMPs fail to acknowledge within 4 months after the date of despatch the receipt of a registered letter addressed by the CMPB to them at their addresses recorded in the Register, then the CMPB may consider ordering the removal of their names from the Register in accordance with section 56(2) of the CMO.
To ensure that members of the public can verify the qualifications of CMPs from the Gazette or the website of the CMCHK, both registered and listed CMPs are required to update the CMCHK on their practising addresses. CMPs who wish to change their personal particulars should complete the form, namely "Change of Personal Particulars of Chinese Medicine Practitioners", enclosed at the Appendix II, and send it to the Secretariat of the CMCHK (Address: Room 2201, 22/F, Wu Chung House, 213 Queen’s Road East, Wan Chai, Hong Kong / Fax no.: 2121 1898/ E-mail: firstname.lastname@example.org).
The CMPB held disciplinary inquiries from 16 November 2018 to 15 March 2019 on three registered CMPs and one listed CMP who were convicted of offences punishable with imprisonment and/or alleged breaching the Codes. The registered CMPs and listed CMP were found guilty after inquiries. Upon inquiry, the CMPB reprimanded and removed the name of two registered CMPs for 6 months but with a suspension of 24 months; and removed the name of one registered CMP for 3 months but with a suspension of 24 months. In addition, the CMPB put the decision for one listed CMP on record for future reference.
Summing up the above cases, the CMPB reminds all CMPs to take note of the following issues.
As revealed in a recent disciplinary case, the procedures of thread embedding acupuncture performed on a patient by a CMP were found improper, causing infection in the patient which led to sustained painful swelling and inflammation. Consequently, the CMP failed to fulfill his professional responsibilities to the patient. The CMPB urges all CMPs to stay vigilant and exercise special care when treating patients to avoid harm to patients or serious medical incidents.
According to the provisions of section 2 of Part 3 of the Codes, CMPs shall be professionally responsible to their patients. They should explain patiently to patients their medical conditions, methods of treatment and the precautions in taking drugs. They should diligently improve their professional knowledge and skills, so as to maintain high professional standards in providing medical service to patients. If the CMPB considers that a CMP, in the course of conduct of his profession, has conducted himself in a way which has fallen short of the reasonable standards of conduct expected among his professional colleagues, the CMP may have contravened the above-mentioned provisions of the Codes.
Chinese Medicine Practitioners Must Not Prescribe Western Medicines
Illegal sale or possession of Part 1 poisons are criminal offences under the Pharmacy and Poisons Ordinance (Cap. 138), and offenders are liable on conviction to a maximum fine of $100,000 and to imprisonment for up to 2 years on each count. Moreover, illegal sale and possession of antibiotics are prohibited under the Antibiotics Ordinance (Cap. 137), and offenders are liable for conviction to a maximum fine of $30,000 and to imprisonment for up to 1 year on each count.
Under the Codes, CMPs are required to prescribe Chinese herbal medicines ("Chm") or proprietary Chinese medicines ("pCm") to patients on the basis of principles of the Traditional Chinese Medicine. The CMPB considers that CMPs must know clearly the ingredients of the medicines prescribed to patients, be conversant with the professional requirements stipulated in the Codes, and have a thorough understanding of the medicines allowed to be prescribed by them under local laws. In this connection, CMPs are required to deal with reputable licensed Chinese medicine traders and prescribe medicinal products which are safe and effective for treating patients. They must not purchase Chm or pCm with unknown ingredients or from doubtful sources whilst they should keep the receipts in order to trace the sources of the Chm and pCm. All CMPs are also specifically reminded that in accordance with section 158(6)(a) of the CMO, the requirements for pCm to be registered and a person who manufactures pCm to apply for a manufacturer licence in pCm may be exempted for pCm compounded by or under the supervision of a CMP at the premises where he practises if, and only if, such pCm is being used for the purpose of administering or supplying to a patient under his direct care. Yet, CMPs are still rested with the professional responsibility to ensure the safety, quality and efficacy of the pCm compounded.
CMPs prescribing herbal medicine which contains western medicine to patient not only violates the laws and endangers public safety, it also has an adverse effect on the image of the Chinese medicine profession. The CMPB would like to restate that all CMPs should observe relevant regulations stated in the Codes at all time, i.e. CMP should adopt treatment methods on the basis of principles of the Traditional Chinese Medicine in prescribing Chm or pCm and shall not use any western medicines. If any CMP is convicted for prescribing medicines adulterated with western drug ingredients, the CMPB will process the case seriously in accordance with the disciplinary procedures stipulated under the CMO.
Standards on Prescribing Medicines
It is stipulated in the Codes that a CMP shall issue prescriptions which conform with professional standards and shall not prescribe excessive or inappropriate medicines. If the prescriptions were found against the principle by which medicines are combined or compatibility of Chinese medicine principle or a CMP prescribes inappropriately with excessive dosages or excessive number of medicines without referring to any therapeutic principles, treatment methods, treatment priorities, the treatment of patients would be adversely affected. If the CMPB considers a CMP has not provided adequate treatment to his patients according to their medical conditions or conducted himself in a way which has fallen short of the reasonable standards of conduct expected among his professional colleagues, the CMP may have contravened the above-mentioned provisions of the Codes and the CMPB will take disciplinary actions in accordance with the Codes.
Furthermore, all CMPs must make safety their first priority in prescribing medicines especially when toxic Chinese herbal medicines are prescribed. They should draw reference to the recommended drug dosages stated in the Pharmacopoeia of the People’s Republic of China, and closely monitor for any adverse reactions of patients. CMPs should also give medical instructions in clear written form to ensure that their patients can understand and follow their instructions in preparing and consuming the Chinese medicines. CMPs should also inform their patients of the known possible side effects of the prescriptions, and ask them to seek medical advice promptly if they experience any illness after taking the prescribed medicines.
Information in Prescriptions and Proper Keeping of Medical Records
The CMPB is concerned that some CMPs have failed to list in their prescriptions all necessary information, including the names and dosages of all Chinese medicines; instructions such as methods of preparation and administration of the medicines as well as number of times for re-dispensing; name, address, contact telephone number and signature of the CMP; and issuing date of the prescription, etc. It is also stipulated in the Codes that a CMP should maintain personal medical records for his patients. Personal medical records should include the patients' names, gender, consultation dates, contact details, symptoms, diagnosis and treatments applied.
Once again, the CMPB wishes to draw the attention of all CMPs to the fact that a patient has the right to know clearly what Chinese medicine is being prescribed for him. In case of a medical incident, a patient’s prescription, as well as the medical records maintained by the CMP, can further be used for immediate investigation and follow-up treatment in the best medical interests of the patient. It is therefore stipulated in the Codes that CMPs must maintain and provide such information relating to the patient as the diagnosis, medicine prescribed and treatment. The CMPB cannot stress enough the importance of compliance with the above requirements in respect of proper maintenance of patients’ medical records and issuing prescriptions. Rigorous action will be taken according to disciplinary procedures in case of violations.
Reporting Court Convictions to the CMPB
According to the Codes, if a CMP has been convicted of an offence punishable with imprisonment in Hong Kong or elsewhere (irrespective of whether a prison term is imposed or not), he/she must report to the CMPB within 28 days, specifying the case number, date of conviction, venue, offence and sentence. If the CMP concerned fails to do so, the CMPB will take disciplinary actions in accordance with the Codes.
Issuance of sick leave certificates
Registered CMPs are medical professionals with legal status. Sick leave certificates issued by registered CMPs are legally recognised under the Employment Ordinance, which was amended in the end of 2006. The CMPB has compiled "Reference Guide on the Issuance of Sick Leave Certificates by Registered CMPs" (the Guide), which includes diseases commonly encountered by CMPs in Hong Kong and the respective recommended number of days of sick leave, and acts as a general reference for registered CMPs on the issuance of sick leave to be fallen into reasonable standards of conduct expected among their professional colleagues. CMPs should issue appropriate sick leave certificates on the basis of their personal professional judgment and the particular circumstances of individual patients. If any discrepancy between an issued sick leave certificate and the Guide that leads to a complaint against a registered CMP, the registered CMP concerned has the responsibility to explain how he/she has exercised professional judgment in issuing the respective sick leave certificate and the relevant circumstances.
The CMPB reminds all CMPs not to issue professional documents or certificates which are untruthful or misleading when issuing sick leave certificates and receipts of consultation fees; otherwise, the CMPB shall handle the case strictly in accordance with the disciplinary procedures specified under the CMO.
Change of Name of CMPs or Use of Alias in their Practice
CMPs must make sure that their name as recorded in the list/Register of CMPs is used when they practise Chinese medicine, or otherwise they may contravene the Codes and even be investigated by the Police for suspected illegal practice of Chinese medicine.
The CMPB hereby reiterates that CMPs who wish to use an alias in their practice should apply to the Immigration Department ("ImmD") for alias registration and submit the Certificate of Registered Particulars for the CMPB's approval before using the alias. CMPs who have completed the alias registration may use their name as recorded in the list/Register of CMPs and/or their alias in their practice. As for CMPs whose application for alias registration is still being processed by the ImmD, they may only use their name as recorded in the list/Register of CMPs or list their alias alongside their name as recorded in the said list/Register.
CMPs who have been notified by the CMPB of the requirement for alias registration but have not yet filed an application to the ImmD should complete the registration within 12 weeks from the date of notification. CMPs who continue to use their alias in their practice without completing the alias registration may be subject to disciplinary procedures.
Besides, for CMPs who have changed their name, please bring along the original of their deed poll and proof of identity to the Secretariat of the CMCHK for change of personal particulars as soon as practicable.
In the past six months, the CMPB, despite repeated attempts, was unable to reach some of the CMPs (name list is at Appendix III) via the addresses and phone numbers they provided. The CMPB now calls on those CMPs to update their contact information with the Secretariat of the CMCHK as soon as possible. Should other CMPs be in contact with them, please remind them to provide their latest contact information to the Secretariat.
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 CMPB. The form of Change of Personal Particulars of CMPs can be obtained from the Secretariat or downloaded from the CMCHK homepage (http://www.cmchk.org.hk).
Should you have any opinions regarding the content of the Newsletter, please send them to the Secretariat of the CMCHK by post, fax or email, indicating "Newsletter of the Chinese Medicine Practitioners Board". All published Newsletters are 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
Telephone number: (852) 2121 1888
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