Elizabeth van Ekert
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.
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.
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.
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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