SMC ECEG: What the Ethical Code Means for Your Clinic's Marketing

If you are a doctor in Singapore, you have probably read the SMC Ethical Code and Ethical Guidelines at some point. Most doctors read it for the clinical content: consent, confidentiality, relationships with patients.

The advertising section gets less attention, and that is where marketing decisions go wrong. A clinic hires an agency, the agency writes copy the way it would for any consumer brand, and a doctor ends up with their name on material that falls short of the professional standard they are personally accountable for.

This guide walks through what the ECEG says about advertising, where it overlaps with the Healthcare Services Act rules and how to brief marketing work so it holds up. It is written for clinic owners and practice managers as much as for doctors, because they are usually the ones commissioning the work.

What is the SMC ECEG?

The ECEG is the Singapore Medical Council's statement of the ethical standards expected of registered doctors. The 2016 edition, which has been in force since January 2017, is accompanied by the SMC Handbook on Medical Ethics, which explains the guidelines in more depth.

The ECEG is addressed to individual doctors, not to clinics or companies. That distinction matters for marketing. Your clinic's licence and its advertising sit under the Healthcare Services Act. Your personal professional conduct, including what is said about you and your practice, sits under the ECEG. Both apply at the same time, and meeting one does not guarantee you meet the other.

What standards must medical advertising meet under the ECEG?

Section G of the ECEG deals with advertising, and it starts from a permissive position. Doctors can validly provide information about their services to help people make informed healthcare choices. The catch is that the information must meet a high standard.

The SMC Ethical Code lists twelve standards that medical advertising and information in the public domain must meet: factual, accurate, verifiable, not misleading, not unduly persuasive, no extravagant claims, not sensational, not enticing or alluring, no financial inducements, not laudatory, not comparative and not disparaging.

Read that list as a copywriter would and you will see the problem. Most consumer marketing is built on exactly the things the ECEG rules out. Emotional hooks, superlatives, comparisons with competitors, urgency and offers are the standard toolkit. For a Singapore doctor, they are off the table.

What the ECEG does allow is neutrally toned, objective information about your SMC registered qualifications, experience, areas of practice and expertise in procedures. That is a narrower lane, but a workable one. Clear, specific, factual content about what you do and who it suits is compliant, and it is also what a thoughtful patient is looking for.

Can Singapore doctors use testimonials or before and after photos?

No, not in advertising.

The ECEG says testimonials are subjective and must not be used in advertising on any media where the doctor has any control over the content. It also says doctors must not ask or induce patients, or anyone else, to write positive testimonials about them in any media. That second part catches review campaigns, incentivised review requests and "leave us five stars" cards at reception.

Before and after images are ruled out too. The ECEG states that doctors must not use "before" and "after", or even "after" images or information, for medical advertising in the public domain, because anecdotal cases create unjustified expectations of results.

The clinic side has its own version of the testimonial rule. Under the Healthcare Services (Advertisement) Regulations, a licensee must not display, publish or disseminate a review, testimonial or endorsement about its licensable healthcare service, subject to narrow exceptions. The MOH has also said that paid reviews are not allowed.

For aesthetic and surgical practices, this removes two of the most common marketing assets in other markets. Content has to earn trust through explanation instead: what a procedure involves, who it is and is not suitable for, what recovery looks like and what the risks are.

That is not a weaker position than it sounds. Patients researching a procedure want to understand it before they book. A clinic that answers their real questions clearly, with a named doctor's qualifications beside the content, gives them a reason to trust the practice that a testimonial never could. It also gives search engines and AI tools something substantial to reference, which a gallery of photos does not.

Are discounts and special offers allowed under the ECEG?

Generally, no. The ECEG says doctors must not offer financial inducements such as free or discounted examinations or treatments, outside legitimate health promotion activities that are not commercial. It also rules out luring patients through time limited special offers, tie ups with unrelated commercial entities such as credit cards, and gifts or other material incentives. Medical services and products must not be offered as prizes or gifts in any context.

That covers a lot of standard promotional mechanics. Launch pricing, bundle deals, "first consultation free" and "this month only" campaigns all need a hard look before they go anywhere near a doctor's name.

The ECEG also addresses the emotional register of advertising. It must not induce ill founded fear or insecurity about health or longevity, play on self esteem, or generate dissatisfaction with body image or physical attractiveness. It rules out glitz, glamour, famous locations and associations with celebrities or the entertainment and fashion world. For aesthetic clinics, that is a direct constraint on creative direction, not just on copy.

How does the ECEG apply to social media?

The ECEG is clear that the content of advertising matters more than the medium. The same standards apply to an Instagram post, a TikTok video or a Facebook ad as to a printed brochure.

It goes further on method. The Code says some methods may be unacceptable if they are intrusive or aggressive, and it lists unsolicited emails, individually addressed messages, viral distribution of advertising through social media and telemarketing among them. So a clinic's social strategy needs to think about how content spreads, not just what it says.

There are personal conduct rules too. Doctors must not initiate social media relationships with patients, and if they are active on social media, their personal exposure must not diminish their professional standing. Confidentiality applies online as well: the ECEG warns against allowing patient information to be disseminated through carelessness or participation in social media.

Educational content is where doctors have the most room. The ECEG supports doctors giving talks, interviews and writing articles to raise public awareness of health issues, provided the information is objective and any unsolicited information about your practice meets the advertising standards. Images, case studies and props used to explain a procedure must be for educational purposes, not to exaggerate results or imply a guarantee.

How should a clinic brief its marketing agency?

Give the agency the rules before it writes a word. Most compliance problems start with a brief that asks for "engaging" or "persuasive" content without saying what that means for a Singapore doctor.

1. Share the ECEG advertising section and the HCS (Advertisement) Regulations with anyone producing content, and name the doctors whose conduct is on the line.
2. Ban testimonials, reviews, before and after images, offers, urgency and comparative claims in the brief itself.
3. Ask for educational content built around procedures, suitability, recovery and risk.
4. Require a doctor to review any content that describes clinical outcomes or their qualifications.
5. Check creative direction, not just copy. Imagery that signals glamour or celebrity can breach the ECEG even with compliant words.

Want a second opinion on whether your clinic's marketing meets the SMC standards? Talk to our team and we will walk through it with you.

Frequently asked questions

Does the ECEG apply to clinic staff who are not doctors?

The ECEG binds registered medical practitioners. Nurses, therapists and marketing staff are not directly subject to it, but a doctor whose name or practice is promoted can be held to its standards for that content.

Can patients leave reviews on Google about our clinic?

Patients can post their own reviews on third party platforms. What the rules restrict is the clinic reproducing them, soliciting them or rewarding people for them.

Is it acceptable to say a doctor is a specialist?

Only if the title reflects the doctor's actual registration. The ECEG allows information about SMC registered qualifications and expertise, and rules out anything that could mislead the public about them.

Can we mention prices on our website?

Factual pricing information is different from a discount or inducement. Keep it factual and complete, with no framing that turns it into a promotion.

Is the ECEG being updated?

The SMC announced a review of the ECEG and Handbook, and the 2016 edition remains the version listed on its website. Check the SMC site before relying on any specific guideline, because wording can change.

References

• Ministry of Health. (n.d.). I currently have paid reviews in various media. What should I do if paid reviews are not allowed under HCSA? Ask.gov.sg. ask.gov.sg

• Healthcare Services (Advertisement) Regulations 2021 (Singapore). sso.agc.gov.sg

• Singapore Medical Council. (2016). SMC ethical code and ethical guidelines (2016 ed.). isomer-user-content.by.gov.sg

• Singapore Medical Council. (n.d.). Ethical code and ethical guidelines and handbook on medical ethics. smc.gov.sg