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Dr Liz Meyer
Medical Legal Consultant
Medical Protection Society in South Africa
Dr Liz Meyer
Medical Legal Consultant
Medical Protection Society in South Africa
HOW TO AVOID GETTING
INTO TROUBLE
HOW TO AVOID GETTING
INTO TROUBLE
8 October 20088 October 2008
PROFESSIONALISM:PROFESSIONALISM:
PROFESSIONAL:PROFESSIONAL:
WORTHY OF A PROFESSIONAL
PERSON, SKILFUL OR COMPETENT.
THE HEART OF MEDICINETHE HEART OF MEDICINE
The relationship a healthcare professional
establishes with a patient during a clinical encounter
THE IDEAL RELATIONSHIPTHE IDEAL RELATIONSHIP• Empathy “I could be you”
• Control “A person not merely a patient”
• Trust
• Communication
• Patient expectations
PROFESSIONAL MEDICAL PRACTICE
PROFESSIONAL MEDICAL PRACTICE
Make the care of your patient your first
concern
Treat patients as individuals, respect their
dignity and do not discriminate
Patients are people who need you!Patients are people who need you!
WORK IN PARTNERSHIP WITH PATIENTS:
WORK IN PARTNERSHIP WITH PATIENTS:
Listen to them
Give them information in a way they can understand
Respect their rights to reach decisions with you
The times they are a’ changing:
The times they are a’ changing:
Shift from “doctor knows best” to patients’ rights, autonomy and expectations
Reduced clinical freedom: MHC, Protocols
The Death of Paternalism in UK medicine
PROVIDE A GOOD STANDARD OF PRACTICE
AND CARE
PROVIDE A GOOD STANDARD OF PRACTICE
AND CARE
Keep knowledge and skill up to date
Recognise and work within the limits of your competence
Seek APPROPRIATE help early
MANSLAUGHTER
There have been a series of these cases in SA many related to giving wrong drug/wrong patient/wrong dose. Pleading inexperience does not protect you in law.
“there can be no excuse for a medical man, even though just setting out on his career … if he does not know the dose or the uses …” S v Mkwetshana 1965
If he doesn’t know he must consult
MANSLAUGHTER
Failure to call specialist
“I’m not a monkey” Says doctor to husband who was urging him to call a specialist…..
The patient exsanguinated, retained placenta
The Dr was convicted and sentenced to 2 years (suspended on appeal) S v Nel 1988
What is a good doctor?What is a good doctor?
By marrying the applied scientist & the medical humanist
By marrying the applied scientist & the medical humanist
BE HONEST AND OPEN AND ACT
WITH INTEGRITY
Act without delay if you have good
reason that patients may be
at risk.
Rodney Ledward & Richard NealeRodney Ledward & Richard Neale
Disgraced Gynaecologists (UK)Disgraced Gynaecologists (UK)
“Fastest gynaecologist” in the SE. 7 Hyst / am
Pressurized patients into private treatment & into unnecessary operations
Removed ovaries without discussion or consent
Surgical incompetence, eg:hyst, cut both ureters & repaired without urologist, perforated bladder, post op bleeding, ordered tests & left, but uncontactable
198 Claims for damages, dozens already settled
Rodney Ledward
Rodney Ledward
‘The profession has got rid of a first class consultant, I say that with no conceit whatsoever, looking in the mirror, feet on…’
‘I have no regrets. I’m a perfectly capable gynaecologist…I’ve done a first class job & had my errors like everyone else’
‘Mr Ledward is conceited, deluded….and breathtakingly arrogant. I Bogle, Chairman BMA
Ask for help early & follow professional advice
Never abuse your patients’ trust in you or
the public’s trust in the profession
Make sure your examinations are appropriate
Beware of personal body contact
Don’t bury your head in the sand!
CALL the MPS