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