Following a significant increase in medical negligence claims and complaints, an MPS survey of nearly 700 South African private GPs has found that 58% are practising defensively.
The survey reported in the new MPS publication for South African GP members, Practice Matters, shows that 76% of GPs are very aware of a significant growth in medical negligence claims and complaints, with 58% saying they have changed the way they practise as a result.
Other findings of those who responded to the survey include:
- 65% conduct more investigations as a result of increased complaints and higher value claims
- 67% now refer more patients for a second opinion
- 29% have a lower threshold for removing patients from the practice list
- 61% choose to stop dealing with certain conditions or procedures
Dr Graham Howarth, Head of Medical Services in Africa says: “MPS has seen a 30% increase in the frequency of medical negligence claims reported in South Africa between 2007 and 2011. It is therefore not surprising that doctors are practising defensively to reduce their risk of receiving a complaint or claim. However over-cautious doctors are unlikely to reduce the rate of negligence claims. Most claims arise not because of substandard care, but because of a failure in communication between the doctor and patient.”
A positive aspect of the survey’s findings was that 86% of the doctors who said they practise defensively keep more detailed records, and 83% are more careful to ensure that follow-up arrangements are in place.
Dr Howarth continued: “If a claim for clinical negligence is brought against a doctor, they will be asked why they did or did not do something. A defence will not be based on the number of tests they did, but the clinical reasoning behind their actions. As long as a doctor can look back and justify their decision in accordance with a responsible body of opinion, they are safeguarding their practice.
“A good rule of thumb is to remember the HPCSA’s advice that all doctors should always regard concern for the best interests or well-being of their patients as their primary professional duty.”
Strategies to reduce the risk of complaints and claims include:
- Communicating effectively with patients
- Having robust systems for follow-up
- Being open about risk
- Providing an appropriate standard of care
- Ordering investigations based on a thorough clinical history and examination
Notes to editors
- The MPS survey of South African private GPs took place in 2012
- http://www.medicalprotection.org/southafrica/practice-matters/issue-1