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At the heart of general practice since 1960

Most GPs practise defensively to avoid complaints, survey finds

By Gareth Iacobucci

Almost three quarters of doctors are practising defensively to avoid complaints and claims, according to a survey by the Medical Protection Society.

The MPS surveyed more than 670 of their members to see whether a rising fear of complaints and claims is leading doctors to change the way they practise medicine.

The survey found that 71% of respondents practise defensively to avoid complaints and claims, with 66% of these citing potential media criticism of the profession as a contributory factor. Over three quarters of respondents said they noticed their colleagues practising defensively.

The results showed more than a quarter of respondents chose to stop treating certain conditions, and performing certain procedures, to prevent complaints and claims.

The organisation warned that doctors who practise defensively may order more investigations, change their prescribing habits or avoid certain procedures to help protect themselves rather than to further the patient's diagnosis.

Dr Stephanie Bown, MPS director of policy and communications, said: 'In our experience, many claims originate not because of substandard care, but because of poor communication between the doctor and the patient.

'Medicine is not risk free. As a doctor you cannot always guarantee a successful outcome for your patient, but if you have managed your patient's treatment appropriately and communicated effectively from the beginning, and documented this, it will reduce the risk of the patient bringing a successful complaint or a claim.'

Dr Bown added: 'MPS is only too aware of the extensive negative coverage given by the media to healthcare professionals and this can lead doctors to practising defensive medicine. However, doctors must always do what is best for the patient and be prepared to justify their actions.'

One positive finding from the survey was that almost two-thirds of the doctors who did practise defensively to avoid complaints and claims said they kept more detailed records, with half saying they were more careful to ensure that follow-up arrangements were in place.

Dr Bown said: 'The risks of being sued are much lower than you may believe - doctors should not let their fear of being sued affect the way they deliver care. As long as a doctor can look back and justify any treatment decisions in accordance with best practice, then their business and reputation will be safeguarded. This is why it is so important to keep quality notes; so that the clinical reasoning behind any decisions can be demonstrated and understood later.'

Other findings from the survey include:

• 49% of respondents had a complaint against them

• 12% had a claim of negligence

• 11% had had an adverse finding following investigation

• More than 50% of those felt the finding was unjustified, however 64% changed their practice

• More than 70% were most concerned that a complaint could lead to an investigation, yet only 5% had been investigated

Dr Stephanie Bown

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