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Practising in the Facebook world

MPS Medical Director Dr Rob Hendry warns of the challenges facing the healthcare profession in keeping pace with the information age

Medicine has always been quick to adopt and adapt new technologies and many advances in care have been due to utilising advances made in other branches of science.

As we enter the new information age, the phenomenon of social networking is changing the way doctors interact with their patients and wider society. Traditional boundaries between private and professional life are becoming blurred and the potential for members to inadvertently fall into medicolegal traps is increasing.

Professional bodies around the world have recognised both the potential for the good that social networking technologies offer and also the risks for the unwary.

Tweeting to one’s friends after a bad day at work or posting details of what you got up to at a party at the weekend on Facebook can often be seen by patients, colleagues and managers. When comments are posted on the blogosphere all control is lost and they are less private than remarks made on the back of a postcard.

Professional bodies around the world have recognised both the potential for the good that social networking technologies offer and also the risks for the unwary

The laws of defamation apply to comments that may have been originally designed to amuse your friends or written in the heat of the moment, but which end up being widely circulated just as much as more traditional channels of communication.

In the UK, the General Medical Council has recently published guidance on social media, which states that where doctors identify themselves as doctors in publicly accessible social media, they should also identify themselves by name because any written material by authors who represent themselves as doctors is likely to be taken on trust. This places an onus on doctors to be thoughtful in what they write.

The full impact of new social media technologies will inevitably develop over the coming years. It is important that the way in which the public can become engaged and informed about health issues is not inhibited. However, the regulation of the profession’s use of new media opportunities may struggle to keep up with the pace of technological change and diverging social expectations of the profession.

MPS has always believed that our approach to indemnity allows us to provide the most flexible and adaptive support to our members, especially during times of rapid change in the world of medicine.

Ireland GP conferenceSave the date: MPS GP Conference 2013

This September sees the return of MPS’s General Practice conference – Spotlight on Risk – to Dublin, following last year’s sell-out event.

The programme will include:

  • MPS’s claims experience in Ireland
  • Top risks in general practice
  • Competence assurance
  • Patient safety and patient experience
  • Doctors in the dock.

There will also be a host of interactive workshops focusing on medicolegal dilemmas from the MPS caseload, medical records, challenging interactions with patients, and incident reporting.

The details of the event are:

  • Date: Thursday 12 September 2013
  • Venue: Irish Management Institute (IMI), Sandyford Road, Dublin 16

There is a nominal registration fee for attendance at the conference, with discounts for MPS members and practice staff. Registration is now open and details are available on the MPS website at www.medicalprotection.org/ireland/education-and-events.

summary report of the 2012 event is also available on the website; alternatively, to receive a copy, email publications@mps.org.uk with your request.

Patient ownership of decisions

Patient expectations and ownership of their treatment decisions are commonly at the heart of complaints and litigation. Patients who are well-informed and highly engaged when deciding between treatment options are placed in a stronger position to take ownership of the final treatment decision and outcomes.

The concept of ‘shared decision-making’ includes clearly communicating the pros and cons of treatment options and continuing to engage the patient, end-to-end, in the decision-making process. Shared decision-making is both good practice and good risk management.

MPS’s Mastering Shared Decision Making workshop

MPS’s Mastering Shared Decision Making workshop explores the specific skills that doctors require in adopting shared decisionmaking. Participants will learn techniques that can be used in practice to assist in reducing their exposure to complaints and litigation. Take control of your professional development and attend this workshop free of charge – a benefit of your MPS membership.

Shared decision-making is both good practice and good risk management

Hand hygiene compliance improves

The latest HSE national hand hygiene audit carried out in 44 acute hospitals found improved compliance compared with the previous survey. Overall compliance at 84.3% is just short of the 85% target for 2012.

While the improvement is very welcome, the HSE has set an ambitious target of greater than 90% compliance by the end of 2013

The compliance for different healthcare workers found doctors achieved 71% compared with nurses and midwives who achieved almost 89% compliance. Auxiliary staff scored 84%.

Dr Kevin Kelleher, HSE Assistant National Director, Health Protection, commented: “While the improvement is very welcome, the HSE has set an ambitious target of greater than 90% compliance by the end of 2013. We must continue to work to improve our hand hygiene to all staff. Particular emphasis will be placed on hospitals and medical staff who had a low level of compliance.”

Self-medication: a note from MPS

Doctors have long been warned about the pitfalls of prescribing for yourself in non-emergency situations: a lack of objectivity means you are not assured of safe and appropriate decision-making.

Worse still is stealing medication from your hospital or practice stores. It has recently come to the attention of MPS that the attitudes of both the law and medical regulators are hardening against medication theft, even common drugs such as paracetamol. Once seen as a fairly trivial matter, stealing medication has been seen by MPS to be treated as a criminal investigation.

The Medical Council says, in paragraph 51.2 of its Guide to Professional Conduct and Ethics for Registered Medical Practitioners: “If you become ill, you should seek advice and help from another doctor rather than treat yourself. Even as a doctor, you should have your own general practitioner.”
The attitudes of both the law and medical regulators are hardening against medication theft, even common drugs such as paracetamol

Abortion legislation due

The government has said that it will legislate by July 2013 to allow abortion to be performed in limited circumstances in the Republic.

It announced in December that its preferred option for giving effect to a 1992 court judgment on abortion was a combination of legislation and regulation. The decision follows the recent publication of the report of an expert group tasked with advising on how to respond to a ruling of the European Court of Human Rights that found that Ireland had failed to provide for abortion in circumstances where a mother’s life was at risk.

The Institute of Obstetricians and Gynaecologists welcomed the government’s decision on the form of action to be taken. “The implementation of this judgment by way of legislation with regulations is also our preferred option, a decision that we reached following an in-depth review of the details provided by the expert group,” it said in a statement. “This option is, in our opinion, the best way to protect women and health professionals, and it also allows for the necessary flexibility to cater for future advances in obstetrics.”

It announced in December that its preferred option for giving effect to a 1992 court judgment on abortion was a combination of legislation and regulation

Medical Council fills vacancies

Following a ballot of doctors on the medical register, five contested vacancies for medical members of the next Medical Council have been filled. The doctor who attracted the highest number of votes was Dr Audrey Anne Dillon, who secured the seat reserved for non-consultant hospital doctors.

Health Minister Dr James Reilly will now nominate five lay members to the 25-member Council

Dr Ruaidhri O’Hanlon, a GP in Drogheda with 1,377 votes of the 2,883 ballots cast, attracted the highest number of votes in the category for doctors working in primary care. In the section devoted to pathologists and radiologists, consultant radiologist Dr Sean Curran secured the vacancy.

Consultant obstetrician and gynaecologist Dr Colm O’Herlihy had a narrow victory over his colleague Dr David Walsh for the obstetrics seat, while Dr Anthony Breslin pipped Dr Ailis Quinlan for the public health medicine vacancy. The sixth vacancy for medical practitioners was filled by Dr Bairbre Golden, who took the anaesthetics division unopposed.

Health Minister Dr James Reilly will now nominate five lay members to the 25-member Council. The remaining vacancies will be filled by various bodies specified in the 2007 Medical Practitioners Act.

DNR guidelines drawn up

The Health Service Executive’s Director of Quality and Patient safety has formulated new guidelines on do not resuscitate (DNR) orders, which will be implemented across the health service.

DNR orders cover areas such as when to offer cardiopulmonary resuscitation (CPR) in certain clinical situations. The lack of regulation was highlighted in a nursing home report published by the Health Information and Quality Authority (HIQA) earlier this year.

The new guidelines have been developed as part of a national policy on consent

It found that some patient files had been marked DNR but without evidence that the issue had been discussed with the resident, their relatives or the health professionals involved in their care. The new guidelines have been developed as part of a national policy on consent.

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