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    Issue 16

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    Diagnosis issues drive GPs’ claims

     
    Mel Yee Headshot

    Melissa Yee

    BPsych (Hons), MPsychol (Org)

    Research and Evaluation Manager

    Avant
     
    Diagnosis issues main image

    One in 10 GP members had a complaint or claim raised about their care in 2018-19. While the GP’s care was found to meet the standard expected in the majority of matters, facing an allegation is often stressful, even if your care is appropriate.

    GP diagnosis chart 1

    Our analysis^ shows diagnosis, doctor behaviours and medication are the main types of issues for GPs. Diagnosis issues are the most common, accounting for 23% of GP claims and complaints. Of these diagnosis issues, four in five were allegations of a missed or delayed diagnosis. These primarily related to issues during:

    • initial assessment, for example, failure or delay in referring for appropriate diagnostic testing, inadequate examination, failure to heed patient complaints or symptoms, or failure or delay in referring to specialist/hospital admission.
    • testing and results, for example, incorrect interpretation of results
    • follow-up including failure to follow up tests or action test results.

    One in five diagnosis issues were allegations of a misdiagnosis. These centred on issues during the initial assessment stage, such as inadequate examination or a failure or delay in referring for appropriate diagnostic testing.

    A thorough history and physical examination, appropriate and timely referrals, and effective use of follow-up and recall systems can help reduce your risk of a diagnosis-related complaint or claim.

    GP diagnosis chart 2

    Medication issues are common

    Medication-related allegations are also common for GPs. These were primarily related to inappropriate prescribing of drugs of dependence and other prescribing issues including refusal to prescribe, contraindicated medication and inappropriate dosage change or cessation.

    These types of allegations were also more likely to fall below the expected standard of care compared to other types of matters. Specifically, 56% of matters relating to prescribing drugs of dependence did not meet the standard of care expected (compared to 37% for matters overall).

    Useful resources

    Diagnosis-related claims
    Missed or delayed diagnosis
    Visit the Avant Learning Centre

    ^This is a retrospective review of routinely collected and coded data and is based on over 4,500 matters involving Avant GP members across Australia. All matters were indemnified and closed over the five-year period from July 2014 to June 2019.

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