Alfred Dawes | Why are medical negligence claims on the rise?

It is hard to turn on the TV or scroll through a social media feed without confronting another heart-rending tale of the loss of a loved one at one of our public hospitals. The tragedies that tug at our hearts more likely involve a child or a pregnant mother. These occurrences are becoming all too prevalent and, unfortunately, given the status quo, there will be many more to come.

Accompanying the stories are accusations of negligence by grieving relatives. The knee-jerk reaction is to call for blood and that someone has to pay for what went wrong. But, often, there is more than meets the eye in these unfortunate incidents and it is seldom the actions or inaction of one practitioner that results in the loss of a life. Rather, it is like a plane crash, where a series of unfortunate events, that may or may not include negligent actions, causes the disaster.

During my stint as senior medical officer at the Savanna-la-Mar Public General Hospital, I was often the facilitator of meetings with families who had lost loved ones while undergoing medical care. The upset relatives would immediately attribute negligence as the cause of death. In about 90 per cent of the cases, there was no negligence involved. What they conflated with negligence was poor customer service. A rude or abrupt encounter that precedes a death will always be viewed as negligence.

Dots that need not be connected will be by the angry mind, and fault and blame cast where it need not be. Even if the delay in definitive treatment was caused by the family doctor who failed to refer on in a timely manner, as long as they are congenial and have an existing relationship with the family, they will be spared their wrath. It is the doctor or nurse who did not rush immediately to the far-too-gone patient who will get the blame. In many instances, the healthcare worker invites this upon themselves with the way they interact with patients.

CUSTOMER SERVICE

When staff morale is low, the first thing that goes is customer service. That is the experience of managers and customers alike. With borderline intolerable working environments and frustrations from working without the proper tools and treatments, healthcare workers suffer from chronic low morale. Not to excuse the boorish behaviour of some staff. But, when one is subjected to a high stress environment where everyone is important, the chances of snapping increase.

Studies have shown that, when subjects viewed a short video clip without audio of an interaction between a doctor and patient, they could identify quite accurately which doctors were most likely to be sued, this, irrespective of their outcomes. Negligence claims are more likely to arise if the patient or relative does not like you or your demeanour. Healthcare workers ought to be reminded of this when they go about their work. Listening to and taking time to communicate with patients and relatives, being empathetic and compassionate, goes a long way in reassuring them that you are doing your best for them. If things go awry, it is best to be forthright and honest. Complications happen. It is how you relate that will make the difference between trauma for yourself and those under your care or none where negligence never occurred.

Communication policies ought to be standard for all hospitals. There are too many complaints about relatives trying to get information on the status of their relatives unsuccessfully. Medical staff should avail themselves during visiting hours or be reachable by phone within reasonable limits. Poor communication is the number one complaint of users of the public health system, and it needs to be addressed urgently.

LACK OF RESOURCES

In instances where the system genuinely fails, it may be because of a lack of resources and not meet the legal standard for negligence. After all, any expert given a basket to carry water would have acted the same in those circumstances. Not having timely results to make a clinical decision, or being overwhelmed with patients and not being able to review a patient in time, can have disastrous consequences. Even more distressing is the situation where a diagnosis is made and treatment cannot be initiated or continued because of resource constraints.

This may range from no medication or blood products available to no operating time. I have seen cancers recur in the months after surgery it took to obtain the pathology reports needed to initiate chemotherapy, and death watches on patients bleeding out while awaiting the arrival of blood from another hospital. It is the system that caused the death of those patients but, as with the pothole that damages your front end, who do you sue?

It would be remiss of me not to touch on negligence caused by human error or wilful commission. As more doctors are trained from the many medical schools that have proliferated over the last 20 years, the number of substandard physicians graduating will increase.

The practice of medicine is exactly that. It never gets perfect, and supervision, guidance and consultation with peers are needed until the day of retirement. The training of medical students and postgraduate residents will undergo greater scrutiny in the coming years, as the pendulum has swung too far on the intake side, subordinating quality to quantity in the rush to fill the needs of the health sector. The price of human lives and suffering is too costly for this to be ignored.

Dr Alfred Dawes is People’s National Party member of parliament candidate for SE St Catherine and shadow spokesman on health and wellness. Follow him on Twitter @dr_aldawes. Send feedback to columns@gleanerjm.com and alfred.dawes@gmail.com.