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Tips to avoid trouble…
An article for physicians by physicians
Originally published September 2008
IL0830-2-E

Of interest to all physicians

This is the fourth in a series of articles based on observations by Medical Officers at the CMPA who communicate with members on a daily basis. The content is simple yet the issues arising from each may be complex.

These tips are intended as suggestions to assist physicians in their practice. Read on to discover how you might reduce your risk of medico-legal difficulties.

Tip #10 – Be careful with your telephone advice

Before giving telephone advice, be satisfied you have obtained enough information to be confident the advice is appropriate.

With the passage of time, medical information you have received or advice you have given over the telephone may be difficult or impossible to recall.Whether you have given the advice to other professional colleagues or directly to patients, appropriate documentation of the discussion will be important should your advice ever be called into question.

Consider having a system in place to make it easier to document your advice.

Tip #11 – Be aware of high-risk times in your workplace

End of day, end of shift, end of week, and at the time of any planned or unplanned absence are all high-risk times for a patient to “slip through the cracks.” Harm may result if there is uncertainty about who is responsible for providing the care when a particular physician is unavailable.

It is important that the transfer of care and delineation of responsibilities be communicated effectively and documented appropriately.

Tip #12 – Consider your level of competence and comfort

Knowingly providing care outside your level of expertise when alternatives are available may lead to criticism. It is thus wise to ask yourself whether your personal level of skill and training is adequate for the particular clinical situation as it now exists.

As stated in the CMPA’s booklet, A Medico- Legal Handbook for Physicians in Canada, “…the physician has an obligation to refer the patient or to obtain consultation when unable to diagnose the patient’s condition, when the patient is not responding to treatment or when the required treatment is beyond the competence or experience of the physician.”

However, the clinical condition of any patient may evolve rapidly, and in an unexpected manner. As a result, unusual or life threatening circumstances, or the lack of immediately required resources, may require you, on occasion, to provide care for a particular patient that is beyond your usual clinical skills.