Significant rise in calls from surgeons for advice about employment issues

Jun 21, 2017

Have you ever wondered what type of medico-legal issues your colleagues grapple with and require urgent advice on? Analysis of calls to our Medico-legal Advisory Service (MLAS) highlights the subjects surgeons contact us on.

Last year, our advisory service received more than 14,000 calls from specialist members – with over 1,800 coming from surgeons.# It’s unsurprising the service was rated as our most highly valued service by members in our 2016 annual member survey.

There were 545 calls per 1,000 members to our advisory service from surgeons last year, above the average for Avant members and an increase of 2.5% on previous years^.

Across all surgeon members#, plastic surgeons are the most frequent users of our advisory service, with almost eight calls per 10 plastic surgeon members last year, up 13% on previous years.^ Psychiatrists were the second most frequent users of the MLAS, followed by ENTs, obstetrician and gynaecologists, and orthopaedic surgeons, respectively.

So what are surgeons calling about?

Calls relating to complaints against surgeon members are the most common matter, accounting for one in five calls. This was followed by medico-legal issues relating to clinical treatment (one in four calls) and medical records (one in 10 calls), respectively.



Calls regarding employment issues on the rise

The topic with the largest increase in call frequency is employment issues (up 43%^). The increase for ophthalmologists was particularly large, up by 168%^, though calls from ENTs on employment matters were also markedly up (71%^).

Common issues include changing practices or starting a new practice, dealing with staff such as redundancies, termination and performance management, hospital contract queries and workplace conflict, for example, managing bullying, harassment or disruptive behaviours.

Disciplinary and informal complaints

The most common reason for all surgeons calling the MLAS regarded complaints made against them, both formally and informally (where the complaint has not been made to a regulatory authority). These calls increased in frequency by 13%^.

This was reflected in our claims data which shows that 46% of all surgeon claims related to complaints made to regulatory authorities in 2015–16. Last year, our advisory service received 372 calls from surgeon members related to complaints about them. This trend was reflected across all specialties with calls relating to complaints about doctors being the most common issue last year ­– increasing in frequency by 7%^

Disciplinary complaints include conduct, performance and health impairment concerns referred to regulatory bodies and commonly relate to dissatisfaction with treatment outcomes and communication issues for surgeon members.

‘In our experience, if given the opportunity, addressing a direct patient complaint promptly can resolve many concerns before they are escalated to the relevant authority,’ Ruanne Brell, a Medico-legal Advisor with Avant’s MLAS said.

You should contact Avant if you think the issue is serious or you are unsure what to do, even if the complaint seems trivial. For tips on how to manage difficult patients, download our factsheet.





Doctor-patient relationship calls on the rise

Calls to our advisory service by surgeons regarding patient relationships also accounted for one of the largest percentage increase in calls, up 32%.^ The frequency of calls from ENTs in relation to patient relationships increased by 35%^, followed by general surgeons and ophthalmologists, which were up 32%.^  

Common issues relate to managing difficult patients and advice on terminating doctor-patient relationships.



Useful information

To help manage the difficult situations surgeons may face, we have a wealth of useful information on our website. Download our When patients complain handbook for information on how to deal with and resolve patient complaints.

For more information on open disclosure complete our eLearning course or download our factsheet Open disclosure: how to say sorry.  

Understand your responsibilities – read our factsheet Providing medical records to a third party.

Doctors can find information on many of the issues members call us about on our website. Our MLAS can be contacted via email medicolegalenquiry@avant.org.au or if you require immediate advice, call 1800 128 268.

Our advisory line is staffed by a dedicated team of medical advisors, solicitors and claims managers to provide members with personalised support – available 24/7 in emergencies. In response to the increased calls from members, we have expanded our advisory service to have more experts dedicated to providing advice and support across our state offices. They are part of the largest medico-legal advice team of any MDO in Australia.

^ The increase is for 2016 over the average of the past three years.

# Includes all surgical specialities.

What do you think is driving our MLAS call trends?

We value your comments and we would love to know what factors you think are responsible for driving the call trends highlighted in this article. Contact the editor@avant.org.au with your thoughts.

Disclaimer: This publication is not comprehensive and does not constitute legal or medical advice. You should seek legal or other professional advice before relying on any content, and practice proper clinical decision making with regard to the individual circumstances. Persons implementing any recommendations contained in this publication must exercise their own independent skill or judgment or seek appropriate professional advice relevant to their own particular practice. Compliance with any recommendations will not in any way guarantee discharge of the duty of care owed to patients and others coming into contact with the health professional or practice. Avant is not responsible to you or anyone else for any loss suffered in connection with the use of this information. Information is current only at the date initially published.

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