News and opinion
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
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.
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.
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.
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
Singapore: SMC responds to complaints criticism
The Singapore Medical Council (SMC) has responded to criticism over its handling of complaints against practitioners. Earlier this year, the Registrar of the SMC wrote to all medical practitioners to outline the SMC’s position; read the letter at www.healthprofessionals.gov.sg.
Malaysia: Patients criticised over medical errors
Self-prescribing by patients, and a refusal to follow prescribed dosages from doctors, play a major role in medical errors in Malaysia, according to the president of the Malaysian Medical Association (MMA).
Datuk S R Manalan said that patient safety had to be a combination of input from both doctor and patient, and patients should not be reticent in questioning doctors if they struggle to understand their medication plan. He said: “[Patients] may lessen their dosage because the medicine is too costly or they don’t want to take antibiotics. It could be that they add on medication because their neighbour or family member is also taking it.
[Patients] may lessen their dosage because the medicine is too costly or they don’t want to take antibiotics
“If they do this, it upsets the management plan that the doctor has drawn up and errors can crop up. There are also those who are afraid to ask their doctors because they do not understand. In a country like Malaysia, language can be a barrier. They need to ask if they do not understand.”
Malaysia: Data link-up for public hospitals
The Health Ministry has announced plans to electronically link all public hospitals and clinics, as part of a data-sharing initiative.
It is hoped that the system will enable a smooth transfer of patient records between different institutions
Health Minister Datuk Seri Liow Tiong Lai said the system, which is currently being developed and is expected to be ready in a year, will connect 142 hospitals and more than 1,000 clinics. It is hoped that the system will enable a smooth transfer of patient records between different institutions.
Mr Liow said: “They will be able to share data, which will improve their services tremendously. Currently, the hospitals and clinics operate on a closed system, under which even the Putrajaya Hospital cannot communicate with the Serdang Hospital.&rdquo
Hong Kong: Digital paper scores award success
Each year MPS and the Hong Kong Academy of Medicine (HKAM) jointly organise the Award for Patient Safety. The award aims to encourage medical professionals to promote the subjects of patient safety, risk management, medical ethics and quality and professional standards.
The winner of the 2012 MPS-HKAM Award for Patient Safety was Dr Lo Wing Kee for his paper The Use of Handheld Digital Devices at the Bedside to Reduce Medication Errors. A plaque and cheque for HK$20,000 was presented to Dr Lo by the HKAM’s Professor Ignatius Yu at a ceremony last December.
Further information on the award, including judging criteria, can be found at www.hkam.org.hk. Details of the 2013 award are set to be announced this year.
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. Most patients highly value the decision-making process.
Shared decision-making is both good practice and good risk management
- 96% of patients want to be offered choices and asked their opinions in clinical decision-making (Chung, 2011)
- 58% would prefer a greater level of involvement than they experienced (Stewart, Abbey et al, 2004).
Failing to meet patient expectations can cause patients and their families any number of emotions, ranging from mild disappointment to extreme distress and anger. This is the reason shared decision-making is a fundamental communication technique for proactively managing your risk and patient satisfaction.