What are the key causes of complaints against doctors? NMC elaborates
New Delhi: The primary cause of complaints against doctors is the communication gap between them and patients or their relatives, the National Medical Commission (NMC) has recently highlighted in its first publication of e-book titled "Professional Conduct Review - Lessons from Case Archives".
Medical Dialogues had earlier reported about the launch of the e-book by the apex medical regulator. Altogether nine (9) case archives have been discussed in Volume I. In respect of each and every case, the book has discussed different topics including- Communication Between Doctor and Patient's Relatives, Allegation of Wrong Diagnosis Leading to Delay in Treatment, Specialty Practice-Without Adequate Qualification/Training, Clinical Drug Trial and Role of Registered Medical Practitioners, Elective LSCS done by a General Surgeon Leading to Maternal Death, General Surgeon doing Hysterotomy, Documentation of Surgical Procedure, Misrepresentation of Qualification and Alleged Overcharging by a Medical Practitioner, Life-Threatening Events: A Dilemma for Patient Family.
For each of the cases, the book elaborates on different aspects such as the keywords, context/category, abstract, summary of the case, discussion, decision of State Medical Councils or NMC Ethics Board, lessons learned from the case, take-home message, etc.
In its e-book, the NMC's Ethics and Medical Registration Board (EMRB) suggested that doctors often don't sufficiently explain diagnosis and treatment plans. The most common cause of complaints against doctors is communication gap with patients and their relatives, the National Medical Commission (NMC) has said.
In most instances, doctors fail to explain to the patients and their relatives about diagnosis, treatment plan, etc. in spite of their good intentions, the NMC's Ethics and Medical Registration Board (EMRB) said in an e-book on "Professional Conduct Review - Lessons from Case Archives".
"Then there is the issue related to patient's understanding of constraints of the hospital system, they don't understand duty shifts of doctors and expect the same doctor to be available 24x7 for their patient, especially in corporate hospitals," the NMC said.
The patients feel dejected when they don't find the behaviour of a doctor up to their expectations. Doctors too feel that patients have no right to complain unless there is harm, the NMC has mentioned.
The commission has further stated that apart from known causes of litigation against doctors like problems related to communication consent and medical records, etc., a new problem faced is fixing responsibility when the treatment is done by a team of doctors.
A doctor may attend only for a consultation and will not own responsibility for the rest of the treatment protocol, the NMC pointed out.
The problem of understanding with respect to differentiation of ethics, conduct and negligence exists even among experts. They sometimes go too deep into legal aspects of ethical problems by citing earlier court cases, that essence of the problem at hand is lost, the book highlighted. The book also referred to the Clinical Establishment Act 2010, according to which all professional charges and hospital charges should be displayed and made known to the patient before the treatment is initiated.
Overcharging is an unethical practice and registered medical practitioners must avoid exploitation of patients during emergencies or otherwise, the NMC said. All payments should be billed and receipts provided by individual doctors or hospitals, as the case may be. Every registered medical practitioner should establish a firm written contract with a hospital or clinical establishment regarding his terms of employment or association for the purpose of consultation, admission, and/or operation as a temporary/ permanent/ visiting doctor.
All modalities of payment by the patient should be decided and approved in advance and receipts should be provided, it further stated.
In the words of Dr. Yogender Malik, Editor of the booklet and Member of the Ethics and Medical Registration Board and Head Media Division at NMC "This pivotal E-Book comprises comprehensive case studies adjudicated by seasoned professionals in their respective domains. Drawing from real-life examples, it sheds light on professional errors and their consequences, offering valuable lessons to stakeholders, particularly medical practitioners. The aim is to enhance awareness, mitigate professional errors, and safeguard patients from potential ethical lapses."
As an appellate body EMRB, NMC has been hearing cases of misconduct and passing judgments. The need to disseminate the learnings from the complaint cases against Doctors (RMPS) was felt right from the beginning. The thought was shared with the Board and a group of experts was formed. They worked very hard, going through hundreds of pages of each case, and summarizing them without losing the essence of the case and the message. There were apprehensions regarding the identity of doctor and patient, but anonymizing solved this problem, the release by NMC mentioned.As an appellate body, the Ethics and Medical Registration Board of the NMC has been hearing cases of misconduct and passing judgments.
The case studies in the book show that it is very difficult for a patient to differentiate between ethics, conduct and negligence.
