For your safety, avoid these common pitfalls:
- Anaesthesia should be administered only by qualified anaesthetists and not by the surgeon themselves
- Insist on written proof of a specialist consultation instead of relying on the verbal statement of patient.
- Giving advice on telephone, messages and email should be avoided, except in case of grave emergencies.
- In case of an on-table complication or change of the agreed course of action during surgery, the surgeon/doctor must himself/herself inform the relatives and not communicate through a team member, anaesthetist, nurse or any other person.
- Short forms/abbreviations that are not universally accepted and are capable of being misinterpreted should be avoided.
You have right to refuse treatment when:
- The patient seeks discharge in the absence of the in-charge doctor or expresses lack of confidence in substitute doctor.
- The patient insists on a request that is medically contraindicated.
- The patient is not willing to pay fees (admission can be withdrawn).
- Necessary infrastructure or proper consultants are not available.
Precautions while taking Consent
- One doctor, must fill consent form in one sitting, if possible without changing the pen.
- Different consent is required for anaesthesia and surgery.
- Consent must state name, dose and type of anaesthesia.
- In case of multiple procedural options, the patient’s consent must be taken for all options –different consent forms for different procedures.
- Separate consent must be taken for blood transfusion.
- If the patient is illiterate/not well versed in English, it is advisable to explain all information in a language known to the patient and get the consent form attested by an independent witness who understands the form.
- In case is doubt regarding patient’s capacity, it is advisable to take the signature of a near relative.
- Risk, benefit and alternative shall be explain and mention in consent form.
- Investigation reports must always be in writing except in emergencies.
Advice or Prescription
- Avoid asking a patient to purchase medicines, disposables, implants, etc. from a particular chemist/dealer only.
- Avoid referring patient to a facility/hospital, which can cause conflict of interest like your own private clinic.
- Standard instruction cards about pre- and post-intervention precautions should be issued in English or even local language.
Procedures, transfers and emergencies
- While transferring a patient, the sender must mention the reasons for transfer and condition during transfer while the receiver must record the condition on arrival.
- In case the doctor or Institute is not comfortable/competent in attending to an emergency patient, legal duty involves selecting a proper hospital/doctor for transfer, providing all facilities for transfer, providing proper care, and managing the patient during the transfer.
- In any emergency, procedural formalities must be put aside and patient must be provided treatment first.
- In case of difference in opinion with other doctor, the principal surgeon should personally remain present during the surgery. Maintaining Records and Preventing Legal action
- When legal action is anticipated, doctor is advised to re-order test or seek opinion from another doctor/hospital/lab and document the second professional opinion/test result.
- It is mandatory to preserve the medical records of a deceased patient for a period of three years.
- It is advisable to send the dead body for post mortem rather than not sending it, if a medico legal problem is foreseen.
- In case the patient makes a request for his/her medical reports, it should be provided within 72 hours.
- In case of an act of violence, cite the Medicare Act: In case of an act of violence, cite the Medicare Act:
- Any act of violence against doctors/hospital staff or any act of damage to a hospital/clinic is prohibited under the Medicare Service Persons and Medicare Service Institutions (Prevention of Violence and Damage to Property) Act.
- Sensitize your patients and their relatives about this Act by displaying the poster related to the Act in your Hospital/Clinic OPDs and waiting rooms – you can download the poster from medical protection act.
- In case of any act of violence against you, lodge an FIR with the nearest police station under the Medicare Act and not as physical assault Under this Act.
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