MEDICAL NEGLIGENCE AND THE LAW- AN ANALYSIS : Day 5

27 January, 2018

SOME DO’S
  • Mention the date and timing of the consultation
  • Qualifications on the prescription
  • Name, age, sex and address of the patient
  • In complicated cases, record precisely history of illness and substantial physical findings
  • Mention the condition of the patient in clear language
  • Name of the drug should be written clearly along with correct dosages
  • Space whether prognosis was explained
  • Mention allergies and additional precautions
  • In case of deviation from standard care, mention reasons
  • Train staff in the art of simple yet transparent record keeping
  • Train members in judicious use of high technology investigative procedure, laying reasonable protocols wherever possible
  • Establish grievance Redressal cell or committee
  • Written consent of the patients / relative / attendant especially, involving special risk in the treatment.
  • Reasonable knowledge, skill and care exercised.
  • Listen attentively. Look carefully, ask questions intelligently.
  • Always face the patient. Do not stare, especially female patients.
  • Ask the patient to come back for review on the next day, if you are not sure about the diagnosis/ treatment.
  • Mention “diagnosis under review” until the diagnosis is finally settled.
  • In complicated cases record precisely history of illness and substantial physical findings about the patient on your prescription.
  • Record history of drug allergy.
  • Write names of drugs clearly. Use correct dosages.
  • Always advise the patient not to stop taking a drug suddenly which is required to be tapered before it is stopped.
  • Remember major drug interactions.
  • Mention if patient/ attendant are/ is under effect of alcohol/ drugs.
  • Adjust doses in case of a child/ elderly patient and in renal or hepatic disorders.
  • In case of chronic ailments, mention treatment to be taken immediately in case of an emergency. For example, a patient on anti-epileptic treatment should be advised to take an injection of diazepam when convulsions occur.
  • Mention where the patient should contact in case of your non-availability/ emergency.
  • If you are not sure what disease a patient has after a thorough workup, get a consultation.
  • Whenever referring a patient, provide him with a referring note.
  • In case of emergency/ serious illness, ring up the concerned doctor in the patient’s presence in hospital casualty.
  • Update your knowledge and skill from time to time.
  • Update not only your own knowledge and skill, but also that of your staff.
  • Update the facilities and equipment according to prevailing current standards in your area.
  •  Preferably employ qualified assistants. If not available, impart proper training and skill at your or some appropriate centre and obtain a certificate for the same.
  • The period for the responsibility of the surgeon extends to and includes the post-operative care.
 
 
SOME DON’TS
  • Whenever you receive a notice under CPA, do not ignore or disrespect Court
  • Maintain the doctor-patient confidentiality
  • Always give complete information to the patient regarding the issue and the treatment etc
  • Do not write Ayurvedic/homeopathic/unnani formulations
  • Do not adopt experimental method in treatment
  • Don’t prescribe/ administer a drug which is banned, e.g. Analgin
  • Don’t under-prescribe: dose is too small, length of treatment is too short.
  • Never talk loose of your colleagues, despite intense professional enemy.
  • Don’t do anything beyond your level of competence.
  • Competence is defined by your qualification, training and experience.
  • Don’t give a drug parentally if it can be given orally. There may be some exceptions.
  • When you are not sure what and why to do. Consult your senior/ specialist/ colleague.
  • Don’t refuse the patient’s right to know about the hospital rules, regulations and hospital charges.
  • Don’t refuse if the patient/ attendants want to leave against medical advice (LAMA). It is their right. Document this properly.
  • Never avoid a call for help from a nurse on duty at night. A genuine emergency may be there.
  • Don’t hesitate to extend your condolences and sympathies to the bereaved persons.
  • Not to issue death certificates unless you have yourself verified it.
  • Don’t give untrue, misleading or improper reports, documents, etc.
  • Do not leave a patient unattended during labor

Read Day 4 Here
Read Day 3 Here
Read Day 2 Here
Read Day 1 Here