Why patients decide to take action against doctors

By many measures, healthcare has never been safer: it is a safer time to have a baby or an anaesthetic or indeed a better time to have a heart attack, and yet as a GP you are more likely to be sued than ever before. Kirsty Plowman reports

As a GP, you will be confronted with a full range of medical, psychological and socio-economic challenges. Witnessing and treating these issues will keep your mind sharp and enhance your knowledge and skills. This rewarding profession offers variety and the practice environment provides you with a strong sense of community.

Despite the advantages of working in general practice, Medical Protection analysis shows that a full-time GP (outside of Scotland) is expected to be twice as likely to receive a claim as they were just seven years ago¹. Worryingly, over a typical career, the average full-time GP could now expect to receive two claims against them if our recent experience is indicative of the continuing future environment for claims against GPs².

The cost of claims can be considerable with damages alone reaching six figure sums not infrequently. Additionally, Medical Protection has seen a number of high value claims each year which have exceeded £1m and even up to £5m.

What are the common causes for claims?

• Failure or delay in diagnosis: 50% of diagnosis delays in primary care relate to surgical conditions, 32% to medical and 18% to obstetrics/gynaecology.
• Prescribing/medication issues: Of the prescribing errors, the most frequent involved a contraindicated drug (most commonly antibiotics), followed by choosing the wrong drug (for example, unsuitable choice of antibiotic for wound infection) and selecting the incorrect dose of the correct drug (most commonly opiates).
• Failure to assess adequately: This is particularly important when delivering unscheduled or out-of-hours care, where inadequate assessment led to the greatest number of indefensible cases.
• Surgical issues: The most common problems arising from minor surgical procedures carried out by GPs included burns from cryotherapy and nerve damage following excisions of skin lesions³.

What outcomes are patients seeking?

The majority⁴ of patients who take medicolegal action are not solely driven by the notion of financial compensation. Patients who take action do so for the following reasons:

• To find out what happened and why;
• To receive an acknowledgement, acceptance of responsibility and an apology;
• To enforce accountability;
• To correct deficient standards of care;
• Financial compensation for accrued and future costs.

What impact will a claim have?

An incident arising from a claim could lead to other problems such as:

• A referral to the General Medical Council (GMC);
• An inquest;
• Health implications including stress and anxiety.

Why be a member of Medical Protection?

It is a GMC requirement for doctors to have indemnity cover. In Good Medical Practice (2006) it states: “You must take out adequate insurance or professional indemnity cover for any part of your practice not covered by an employer’s indemnity scheme, in your patients’ interests as well as your own.”

Membership provides access to expert advice and support together with the right to request indemnity for complaints or claims arising from professional.

Membership of Medical Protection provides the right to request indemnity for claims arising from professional practice. In addition, membership also offers the opportunity to request assistance with other potential medicolegal jeopardy arising from your professional practice, including:

• Patient complaints;
• Ethical dilemmas;
• Disciplinary investigations;
• GMC investigations;
• Criminal investigations;
• Category 2 work;
• Coroner’s inquests;
• Good Samaritan acts worldwide.

Find out more

• To improve your skills and knowledge, book onto one of our educational programmes including workshops such as Mastering your Risk, Mastering Adverse Outcomes and Achieving Safer and Reliable Practice.

For advice and support, call our medicolegal helpline on 0800 561 9090.

References

1. Medical Protection Press Release 19 February 2015
2. Medical Protection Press Release 12 February 2015
3. Medical Protection Casebook September 2011
4. Bismark et al 2011 & 2006, Friele & Sluijs 2006, Vincent et al 1994

Please note: Medical Protection does not maintain this article and therefore the advice given may be incorrect or out of date, and may not constitute a definitive or complete statement of the legal, regulatory and/or clinical environment. MPS accepts no responsibility for the accuracy or completeness of the advice given, in particular where the legal, regulatory and/or clinical environment has changed. Articles are not intended to constitute advice in any specific situation, and if you are a member you should contact Medical Protection for tailored advice. All implied warranties and conditions are excluded, to the maximum extent permitted by law.