Complaints to regulators drive psychiatrists' medico-legal matters

Dec 21, 2016

Why do psychiatrists seek Avant’s support? Our data provides some clues and our experts offer insight into which matters are becoming more prevalent and why.

Avant has over 70,000 members and insures more than half of all doctors in Australia. Our size means we handle a broad range of medico-legal matters across the country and have extensive claims data to draw upon. Our scope of work allows us to attract the very best medico-legal experts across every relevant matter of law and jurisdiction and offer our members unparalleled defence. Looking at the new cases managed in the 2015–16 financial year highlights the different challenges doctors face across each specialty. Here we look at your area of practice and highlight the matters we have helped our members with last year.

The number of psychiatrist members has increased over the last four years, however we have accounted for this increase by looking at cases per 1,000 members. Our data shows that one in seven psychiatrist members had a claim last financial year.

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Complaints to regulators remain high

Avant supported more than 750 cases for psychiatrists in the last four years. Last year, 83% of these were complaints to regulatory authorities or coronial matters. Although the frequency decreased slightly, the proportion of matters relating to complaints to regulators is higher for psychiatrists than any specialty with the exception of ophthalmologists. Conversely, civil compensation claims are extremely rare and lower than other specialties. Unlike surgical patients, psychiatrists’ patients are unlikely to suffer a physical injury which commonly leads to a civil compensation claim. Instead, the complaint path is taken either through a regulatory body or to the employer.

For example, we supported a psychiatrist member after a patient made a complaint to AHPRA alleging that the member had discriminated against them. The patient had been referred to the psychiatrist by their GP for anger issues. A court hearing was also pending in relation to the patient and domestic violence. As the psychiatrist did not handle medico-legal assessments, they declined to see the patient and recommended that the GP make a medico-legal referral to another psychiatrist. The patient claimed that the referral was for psychological treatment which was unrelated to the court hearing and they were not seeking a reference for the court, nor a medico-legal assessment.

Communication issues are a key cause of complaints, as noted by the NSW Health Care Complaints Commission in its 2016 Annual Report: “although clinical care remains the largest allegation category, complaints about doctor-patient communication have increased more significantly than other categories, highlighting the importance of the doctor-patient relationship”. The Avant Learning Centre has plenty of tips and advice on improving communication. You might also like our article When personality disorders threaten the doctor-patient relationship.

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Coronial cases increasingly common

Psychiatrists are the speciality group most likely to be supported by Avant for coronial matters, which increased 18% in the last year. This is largely a reflection of the profile of patients managed by psychiatrists. According to the Australian Bureau of Statistics1, suicide rates have increased 16.5% between 2013 and 2015. This may be one driver of the increased request for Avant’s support, with more psychiatrists being involved in coronial investigations. Our coronial expert, John Kamaras, Avant Law, also believed that the trend was being driven by psychiatrist members having become more educated on the importance of contacting Avant earlier for assistance with preparing coronial statements during coronial investigations.

In a common scenario, we recently helped a psychiatrist member draft a report for the coroner after they treated a patient for depression who subsequently committed suicide six months later. The psychiatrist had prescribed an anti-depressant medication to the patient and arranged a pre-admission assessment to an adolescent treatment facility. The member had provided follow-up and encouraged the patient's family to readmit the patient to the treatment facility. While a doctor’s involvement is usually not contentious, there are a number of implications psychiatrists need to be aware of. Read our recent article on protecting your interests and our factsheet The coroner and you for useful tips on dealings with coroners. View our handy quick-reference guide on your state’s requirements for reporting a death (taken from one of our handbooks found on the members’ portal The whole truth: responsibilities when providing evidence).

 

If you have any comments or questions on this article please email editor@avant.org.au. For more information on these matters please visit the Avant Learning Centre or, if you require immediate advice contact the Avant Medico-legal Advisory Service on 1800 128 268.

1Australian Bureau of Statistics (3303 Causes of Death, 2015)

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