Opinion

Healthcare: Ill-considered allegations have tremendous impact on doctors

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By Dr Hlombe Makuluma

Patient care and doctor well-being are being undermined by the high number of ill-considered cases brought against medical practitioners in South Africa.

Statistics from the Health Professions Council of South Africa’s (HPCSA) 2022-2023 annual report reveal of the complaints brought against healthcare professionals, just 9% were referred by the HPCSA, to a profession conduct committee.

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In the build-up to National Doctors’ Day on Thursday, it’s important to highlight the impact that ill-considered allegations have on the healthcare sector. The doctor-patient ratio is about 0.31 doctors per 1 000 patients. In this context it is patients who end up paying the price of hasty and sometimes unjustified legal recourse against healthcare professionals.

Following ill-considered allegations, some doctors stop practicing or reduce their scope of practice, fearing future litigation, further exacerbating SA’s critical doctor shortage.

Others become defensive and push up healthcare costs unnecessarily by performing tests aimed at mitigating their medico-legal risks. This is costly, especially to the patient.

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The threat of patients reporting doctors to the HPCSA, or demanding compensation or, in the worst cases, laying criminal charges, can also take a massive toll on the mental wellbeing of healthcare professionals.

A condition known as medical malpractice stress syndrome (MMSS) has been recognised as affecting medical professionals who are subjected to litigation.

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This disorder, which includes severe anxiety and depression and physiological changes relating to immune and endocrine functions, speaks to the often negative impact that allegations can have on doctors.

In the medical fraternity, the doctor-patient relationship is considered a fundamental ethical principle.

The relationship is based on trust, which gives rise to doctor’s ethical responsibility to place patients’ welfare above his/her own self-interest or obligations to others, to use sound medical judgment on patients’ behalf, and to advocate for their patients’ welfare.

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Ill-considered litigation negatively affects this relationship.

I’d like to urge South Africans to openly discuss their grievances with their treating doctor before reporting the practitioner or taking legal action.

Only as a last resort

Legal action should be a last resort, pursued only after all other channels of communication and conflict resolution have been thoroughly explored.

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It’s essential to recognise that litigation is not only costly, but also time-consuming, intricate, and emotionally draining for both parties involved.

By fostering open dialogue and understanding between patients and healthcare professionals, we can mitigate unnecessary legal proceedings and uphold the integrity of our healthcare system.

Patients must also remember that litigation may not provide satisfactory answers to their objectives of taking legal action.

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Other than the undue stress it causes to both the patient and doctor involved, unwarranted legal action creates unnecessary bottlenecks within the regulatory processes, potentially slowing down the review of deserving cases.

While the HPCSA has acknowledged the delays and inefficiencies within their processes, they are actively dedicated to making improvements.

Medical care cannot guarantee perfect outcomes and it is important to understand that medical care inherently involves certain risks.

It is also essential to recognise that less-than-ideal outcomes or unexpected complications do not automatically indicate negligence.

Our courts have cautioned against the natural human inclination to attribute blame when an innocent party is injured. This underscores the importance of distinguishing between adverse outcomes and genuine negligence.

Doctors’ Day on Thursday is an opportunity for South Africans to recognise the growing challenges that face South African doctors.

It is also an opportunity for each of us, as patients, to foster open and direct communication with our doctors to safeguard a robust healthcare system in our country.

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Published by
By Dr Hlombe Makuluma