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News and opinion

Under the influence

MPS Medical Director Dr Rob Hendry reminds doctors of their unique opportunities to influence and inspire those working around them

Doctors are often surprised how influential they are within their teams and organisations. The things they do and say and the way they conduct themselves is increasingly being recognised as central to effective healthcare.

Most medical care is now delivered by teams rather than by individual healthcare professionals working in isolation. When teams work well the results can be spectacular, but when teams are dysfunctional, patient care can suffer. Stories in the press about “failing hospitals” are, in fact, often actually about failing teams.

Sadly at MPS we frequently see members getting into difficulties with their employers and their regulators, not because of their lack of specialist knowledge or poor technical skills, but because of the way they interact with their colleagues.

When relationships break down in healthcare teams not only do things go wrong more often, but when they do the impact on everyone involved is usually much greater.

One of the characteristics of being a professional is taking responsibility for one’s actions. Often, choosing to turn a blind eye to problems within a team can lead to problems becoming magnified and intractable.

Product liability and MPS

Issues with product liability have made the headlines in a number of countries around the world recently – notably the DePuy metal on metal hips in South Africa and Ireland, and the PiP breast implants in the UK. These issues arose from faulty products, where normally responsibility lies with the manufacturer or supplier of the product.

However, in both cases, attempts were made by claimants to include surgeons in the claims – in the DePuy hips case, the justification given was that the surgeons had failed to properly fit the prostheses; with the PiP implants, the insolvency of the manufacturer was the motivation for involving the surgeons in the claims.

In both situations, whilst MPS is not providing an indemnity for product liability, MPS is supporting members with these cases by doing whatever is possible to prevent the development of litigation targeting clinicians, when other more appropriate sources of compensation (the manufacturer or supplier) are no longer available.

In the meantime, members can take steps to protect themselves in the event of a claim for product liability, by retaining documentation relating to:

  • Evidence of purchase.
  • Where possible, the serial number of the item in question – it can be used as evidence of the batch of goods obtained.
  • Terms and conditions.
  • Express warranties and guarantees.
  • Instructions and packaging.
  • Correspondence regarding product specification and any alteration.
  • Where whole goods are transported by an external logistics company, relevant contracts/terms/correspondence.
  • Complaints history relating to product and similar products (if relevant).
  • Order forms, emails, faxes.

Clinicians should also take care regarding any verbal statements made to patients regarding a product. Statements that erroneously imply a lifetime guarantee, for example, can make a clinician liable in the event of a related allegation or claim.

Save the date for Ethics 4 All 2013

Registration for our annual ethics event – Ethics 4 All – is now open!

The event provides an opportunity for members to examine ethical challenges and enable attendees to obtain CME/CPD points for the ethical component of their professional development. Ethics 4 All has been running for the past five years, and last year more than 2,500 delegates attended across three locations.

In 2013 we are delighted to be hosting three events:

DURBAN

  • Sunday 1 December 2013 (morning event)
  • Venue: Southern Sun Elangeni Hotel
  • In conjunction with KZNMCC
  • Chaired by Dr Mzukisi Grootboom, Chairperson, South African Medical Association (SAMA)

PRETORIA

  • Monday 2 December 2013 (evening event)
  • Venue: CSIR International Convention Centre
  • In conjunction with Ampath
  • Chaired by Professor Martin Veller, Professor and Head, Department of Surgery, University of Witwatersrand

CAPE TOWN

  • Wednesday 4 December 2013 (evening event)
  • Venue: Cape Town International Convention Centre (CTICC)
  • In conjunction with PathCare
  • Chaired by Dr Mark Sonderup, Vice Chairperson, South African Medical Association (SAMA)

The programme has been developed to cover core bioethical and medicolegal issues, based on feedback from last year’s events. The 2013 programme will include:

  • Walking the Ethical Tightrope – Falling Foul of Ethics – Trends in Complaints and Claims; MPS Claims Experience in South Africa; Common Problems
  • Ethics of Managed Healthcare Resources – Squeeze on Private Health; Undercover Reporting and Distributive Justice
  • Adverse Events in Healthcare and the Ethics of an Apology – The Importance of Being Open; Raising Concerns; Professionalism and Criticising Colleagues
  • Mastering Shared Decision Making to include: Unreasonable Patient Demands; Appropriate and Informed Choices about Treatment; Patient Decision Making; What Leads to a Complaint or Claim; and the Principles of Consent.

Dr Graham Howarth, MPS Head of Medical Services (Africa) says: “Set against the backdrop of an adverse claims environment and increasing complaints to the HPCSA, providing support and guidance to doctors about ethical issues by way of these conferences is both timely and fulfils a key educational need.

“We know that issues surrounding ethics and professionalism can be challenging for doctors to navigate and, although we’re here for doctors when things go wrong, we very much want to help them get it right.”

The events are free of charge for MPS members. A full copy of the conference programme can be found here.

For more information about Ethics 4 All please contact: stacey.mack@mps.org.

MPS Update: Contract queries

MPS has recently been contacted by a number of members regarding contracts that they have been asked to sign by private hospitals or clinics where they carry out medical practice.

Members have highlighted clauses within the contract requiring them to indemnify the hospital or clinic against any losses that might occur in relation to their clinical practice. Whilst MPS cannot advise members on their individual contractual liabilities, we have seen examples of contracts requiring particularly broad and potentially unclear indemnities from doctors and other healthcare professionals.

MPS recommends that any doctor entering into a contractual relationship with a hospital or clinic ensures that he or she takes advice from a lawyer or other appropriately qualified professional.

MPS membership is designed to indemnify members against claims arising from their professional practice, including clinical negligence claims and regulatory matters

MPS membership is designed to indemnify members against claims arising from their professional practice, including clinical negligence claims and regulatory matters, but it is not intended to meet liabilities arising from commercial contracts.

More information about the benefits of MPS membership can be found in the members’ handbook.

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