Wednesday, November 17, 2010

Agog over abject madness

This week the medical [1] and non-medical [2] media have been agog over this research article [3] in the 15 November MJA. Titled ‘Perceived practice change in Australian doctors as a result of medico-legal concerns’, it’s the survey responses of 2,999 Australian doctors. The findings are startling: due to the risk of medico-legal proceedings (i.e. being sued or complained about), 32% of responders are considering reducing their work hours, and 40% are considering early retirement. Naturally those who had personal experience of medico-legal proceedings were more likely to contemplate this action. Some 65% of the responders had such experience, with 14% having a current matter at the time of the survey. I’m one of this 14%. I have been since May 2008 [4]. Also the fear of medico-legal proceedings is driving health care costs up: 43% of responders said they referred more patients, and 55% said they ordered more tests. I appreciate society needs checks and balances. But the current situation’s nothing short of abject madness. And it’s a vicious cycle: the more doctors who reduce or stop work due to medico-legal proceedings against them, the greater the pressure placed on the remaining doctors. And thus they’ll be at increased risk of having medico-legal proceedings brought against them. The solution? I don’t know. But reducing the involvement in medicine of politicians, bureaucrats and lawyers would be a great start. Will it happen? Don’t answer that – it’s a rhetorical question.

1 comment:

Geoffrey Brittan said...

In difficult economic times, lawyers are more inclined to accept cases, particularly civil actions that they would reject during better times. It isn't entirely their fault; patients are more quick to seek financial redress too.

It's also a consequence of the cynicism of our age. Individuals don't trust the explanation they have been given; they suspect a conspiracy to keep the truth quiet.

You and I can recall a time when milk was delivered to your home daily, when people trusted the news on the telly and believed Walter Cronkite, when the government wouldn't lie. The watershed moment may have been the assassination of John Kennedy; the suspect government investigations, lost evidence, the impossible bullet that stopped in air and changed direction. Those of us born after the war were changed forever whether or not we realize it.

Lost in our malaise, is an appreciation for people who work with life and death decisions; doctors, firefighters, police, ambulance attendants. Decisions made in seconds are debated for months afterwards.

I have particular respect for the 14%, that group with whom you count yourself, who have the courage to work despite the pressures.