Summer Salad

January/February 2009

GPs’ concerns about medicolegal issues

How it affects their practice

Volume 38, No.1, January/February 2009 Pages 66-70

Louise Nash

Merrilyn Walton

Michele Daly

Maree Johnson

Garry Walter

Elizabeth van Ekert

Simon Willcock

Chris Tennant

Background

General practitioners’ concerns about medicolegal issues have been shown to influence the practice of medicine. This research looks at GPs’ beliefs about medicolegal issues and how medicolegal concerns affect their practice.

Methods

A descriptive comparative design was used. A cross sectional self report survey was sent to 1239 GPs, 566 responded (46% response rate). Responses were considered as a group, and then comparisons were made between those who had experienced a medicolegal matter and those who had not. This data was sourced from surveys and medicolegal insurer records.

Results

General practitioners with previous medicolegal experiences were more likely than their colleagues to report believing the law required them to make perfect decisions and that medicolegal factors made them consider early retirement from medicine. They were also less likely to believe that inadequate communication is a factor in most complaints. More than half the GPs reported having made practice changes due to medicolegal concerns in the following areas: test ordering (73%); specialist referrals (66%); systems to track test results (70%); and communication of risk to patients (68%). Other changes were reported less frequently.

Discussion

This study found that GPs’ concerns about medicolegal matters impact on their practise of medicine. While greater awareness of medicolegal issues may lead to positive impacts, the negative impact of their concerns is that some changes arise from anxiety about medicolegal matters rather than from the exercise of good clinical judgment.

General practitioners’ concerns about a potential complaint, inquiry or lawsuit influences their practise of medicine in potentially positive ways such as developing audit procedures and better patient explanations; but also negatively such as increased prescribing of drugs, referrals and diagnostic testing.1–9 These impact on the quality and cost of health care.

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Correspondence afp@racgp.org.au

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