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    Issue 16

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    A stitch in time ...

    Dr Patrick Clancy

    Dr Patrick Clancy

    MBBS, FRACGP, MHlth&MedLaw

    Senior Medical Adviser, Advocacy, Education and Research

    A stitch in time main

    Doctors strive for the best standard of care for their patients and often go the extra mile, but unwanted things happen. You face a range of medico-legal challenges and whether big or small, you may need good and timely advice to provide the best care.

    Big medico-legal issues may make the news headlines, but smaller, everyday issues are more likely, and can turn into bigger issues. There’s something to be said about the adage a ‘stitch in time saves nine’. That’s why managing issues early on is important. Addressing smaller medico-legal issues can resolve the situation quickly and minimise the chance of them turning into a complaint or a claim against you.

    It may be tempting to let something slide or cover a mistake up, but it’s important for doctors to take corrective action and if appropriate, to apologise for any adverse events. This can prevent small problems from becoming bigger problems.

    More doctors seeking assistance

    In 2020, we received more than 28,000 calls from doctors and practice staff for medico-legal advice – a 10% increase compared with the previous year. Responding to members’ issues relating to COVID-19 has been a factor, but the steady increase over the years indicates the growing frequency of instances where doctors need support.

    Of course, if things move on, we are also there for the big issues, from court cases to regulatory complaints and coronial matters, when everything can be on the line.

    A stitch in time graph

    Most common medico-legal issues

    The chart shows the breadth of issues for which members seek our help. The top medico-legal area resulting in regulatory complaints and compensation claims that were finalised over four years related to procedural/surgical issues (21%). This could be seen as the leading risk in medicine, where we know things will occasionally go wrong. Diagnosis matters (19%) is another area that could be viewed as a leading risk, where failed or delayed diagnosis at the initial assessment stage are the common issues.

    These two areas account for over a third of claims, with the remainder arguably being much more in doctors’ control. Doctor behaviours alone account for 20% of claims and commonly relate to communication issues and boundary transgressions.

    Medication issues, particularly relating to prescribing, as well as management/treatment concerns including treatment plans and the ongoing assessment of patients, are not as common. They are, however, areas where simple, small errors can readily occur.

    Medicine and patients are complex, and being a doctor isn’t easy. Having access to advice and support on medico-legal issues, whenever you need it and no matter what the situation, can really help and prevent problems from escalating.

    * Claims about management/treatment issues include patient management or treatment concerns other than primarily procedural/surgical or medication concerns.

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