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I read with concern the report that the Ministry of Health (MOH) has taken action against private specialists for overtreating, overclaiming, or claiming for procedures that were not done ( , Aug 5). The doctor-patient relationship is unique and often considered to be a sacred one. At its core are trust, empathy, and confidentiality – principles enshrined in the Hippocratic Oath, which underscores a doctor’s commitment to prioritise a patient’s welfare, practise medicine with compassion, and uphold the highest ethical standards. However, this relationship is also characterised by information asymmetry, where doctors possess significantly more medical knowledge than their patients. This imbalance creates opportunities for potential dishonesty and makes it difficult for patients to discern false claims. Given that many patients rely on their health insurance to cover the bulk of medical expenses, they are less likely to question their doctor’s decisions or claims, trusting that the doctor is acting in their best interest. This dynamic further complicates the authorities’ efforts to uncover dishonest practices, as distinguishing between intentional overtreatment and defensive medicine can be challenging. Revoking a doctor’s ability to make insurance and MediSave claims for six months may be insufficient to deter such offences. Elective procedures can often be postponed, and urgent care can be transferred to another affiliate. In contrast, fraudulent claims made against SkillsFuture were met with more severe consequences. It is hence crucial to impose stricter penalties, given the gravity of the breach of trust involved in dishonest medical practices, which undermines the very essence of the doctor-patient relationship. There is a need to send a strong deterrent signal to the healthcare profession. This will set the precedent required not just to maintain the integrity of the already fragile health insurance system, but to maintain trust in our healthcare system and protect the sanctity of the doctor-patient relationship.