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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.

MPS Associates – here to help

Associates are a group of MPS members who can provide peer support. They will treat everything in the strictest confidence and if you need medicolegal advice you will be referred to a specialist medicolegal adviser or one of our expert panel lawyers. Over the next few issues of Casebook we will be allowing readers to get to know our Associates a little better – beginning this issue with Hong Kong.

Dr Loretta Chan (GP) 
MBBS, FHKAM (Family Medicine), FHKCFP, FRACGP, DCH (Ireland), DPD (Wales), PDipComPsychMed (HK), PG DOM (CUHK)

I am a family physician working in the private sector, and I also actively participate in the Hong Kong College of Family Physicians, where I am serving as the Council member from 2011 to 2014.

Email: lorettachanwy@gmail.com

Dr Danny Lee (Consultant General Surgeon) 
MBChB (CUHK) 1991, with distinctions in Paediatrics and Surgery, FRCS Ed (General Surgery) 1998, FHKAM (Surgery) 1998, MD (CUHK) 2005, LLM (Medical Law ) 2009, Juris Doctor JD 2011

I am currently a private surgeon working mainly in the areas of minimal invasive surgery and gastrointestinal endoscopy. I liaise and participate in MPS-related activities in Hong Kong and provide professional support to MPS members; I am also an accredited presenter of risk management workshops organised by MPS Educational Services. I received medical training both in Hong Kong and the USA. I have previously worked at the Department of Surgery, Prince of Wales Hospital, the Chinese University of Hong Kong, where I developed a longstanding interest in medical teaching, research and publication. I also studied law in my leisure time. I hold two postgraduate law degrees and in the medicolegal area, I have developed particular interests in medical communication, clinical risk management, and patients’ rights and dispute resolution.

Email: dannywhlee@gmail.com

Dr John Low (Consultant Anaesthetist) 
MA (Oxford University), BMBCh (Oxford University), FRCA, FHKCA, FANZCA, FHKAM (Anaesthesiology)

I have been in the specialty of anaesthesia for 36 years. I am an instructor for the “Course on Safe Sedation” by the Hong Kong College of Anaesthetists, as well as an instructor for the St Paul’s Hospital Airway Workshop for Residents. I have also pioneered venous arterial ECMO (extra-corporeal membrane oxygenation) in the private sector in Hong Kong, and was instrumental in introducing critical incident reporting in the major private hospitals in Hong Kong. My spare time hobbies include film-based photography and scuba diving.

Email: johnmlow@usa.net

Dr David Wong (Consultant Plastic Surgeon) 
MBBS(HK) 1982, FRCSEd 1987, FCSHK 1990, FRACS 1992, FHKAM 1993, LLB(Lond) 2004, LLM(Lond) 2008, PCLL (HK) 2007

I work in the Division of Plastic Surgery, Department of Surgery, Prince of Wales Hospital, Shatin, NT, Hong Kong. Other offices I hold include: 

  • Honorary Clinical Associate Professor, University of Hong Kong and Chinese University of Hong Kong 
  • Training Programme Director and (ex-) Secretary of the Board of Plastic Surgery, Hong Kong College of Surgeons.
  • Chief Examiner in Plastic Surgery Exit Examination, Hong Kong College of Surgeons. 
  • President, The Hong Kong Society for Plastic, Reconstructive & Aesthetic Surgeons 
  • Associate, Medical Protection Society since 2012 
  • Co-opt member, Working Group on Differentiation between Medical Procedures and Beauty Services, Steering Committee on Review of Regulation of Private Healthcare Facilities, Department of Health, Hong Kong.

I have also written more than 50 journal articles and a book, Legal Issues for the Medical Practitioner.

Email: sywong@surgery.cuhk.edu.hk

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