Assessing litigation risks in patient-doctor interactions at Helen Joseph hospital

Abstract

Introduction: Medical malpractice lawsuits continue to be filed at an alarming rate, with billions of dollars being paid out across the globe. Most of these claims, defendable or not, are settled out of court. These uncontrolled medical claims continue to push up the costs of medical liability insurance, which in turn pushes up the cost of health care. These pressures are felt most by the "high risk" specialties namely, Obstetrics and Gynaecology, Neurosurgery and Orthopaedics. South Africa has not escaped the wave of medico-legal lawsuits, and may be headed towards greater challenges than its first world counterparts. With the introduction of the new Consumer Protection Act, and having one of the world's most enlightened constitutions, makes the South African medical fraternity an easy target. Litigation involving South African orthopaedic surgeons suggests that the majority of claims filed are due to poor patient-doctor interaction, accounting for 13.35% of all claims. Methodology: A prospective study conducted at Helen Joseph Hospital 2014. Using a tailored patient satisfaction questionnaire, post operative orthopaedic patients were able to give insight into their satisfaction regarding their personal patient-doctor interactions. Each question was correlated to an area of patient-doctor interaction, that in the past had led to litigation. This was used to asses which areas of patient-doctor interactions were lacking in a typical resource starved state hospital. Results: Nearly 20% of patients are considering legal action at point of discharge, with no demographic data playing any significant role in this decision. All areas of patient-doctor interactions showed a significantly lower score, in those considering litigation versus those who were not. The two highest risk areas were related to doctor availability and consent taking. This study emphasizes the importance of proper communication between doctors and patients in preventing litigation, and the need for doctors to focus on improving their individual doctor-patient relationships.