Year ending 31st December 2003

RESTRUCTURING OF THE BOARD

Tan Sri Dato’ Dr. Abu Bakar Suleiman joined the Board of MDM as Chairman on 26th June 2003.  Dr. Eddie Soo is now the Executive Director.  The Board of  MDM also welcomes Dato’ Dr. (Mrs.) S.T. Kew and Dr. Michael Tan as Directors.

MDM is beginning its third year in business.  We had a successful second year – there was no report of a claim and there was increase in membership.  We hope this trend will continue and  the subscription rates for 2004 have not been raised.  We will prudently monitor the local medical negligence claim scenario before making any consideration to increase the rates.

It is very disturbing to observe that fifty percent of the private practitioners in the country are practising without medical indemnity in the year 2003.  This is very alarming – it is akin to driving a motor car without insurance cover.  The situation exists because medical indemnity is not compulsory in this country.  It is pertinent to note that according to Fleming & Wiley¹, those doctors who are targeted in medical malpractice suits are not the incompetent, the unskilled or the careless.  In fact, some of them are the most highly regarded physicians in U.S.A.  Medical indemnity cover is important for all practising medical practitioners to ensure that their medico legal interests are looked after and also to ensure that patients have recourse to compensation as a result of adverse effects of medical treatment.

CONTINUING MEDICO-LEGAL EDUCATION
                                                                                                                                             
The directors of MDM have been travelling outstation to discuss  “How To Avoid Medico-legal Problems” and “Informed Consent”.  MDM would like to work to improve the doctors’ understanding of medical negligence.  MDM hopes to address this issue by conducting frequent seminars.  Members are encouraged to attend and discuss issues of concern in these areas with MDM experts.

Dr. Richard Veerapen and Dr. Eddie Soo were invited speakers at the Asia Business Forum’s  “ MEDICO-LEGAL CONFERENCE “  held on 9th and 10th October 2003 at the Sheraton Towers Hotel, Singapore.  Dr. Richard Veerapen spoke on “Failure To Warn”.  Dr.  Eddie Soo spoke on “Case Study – Challenge and Triumph Involved In Forming A Local Medical Defence Organisation (MDO)”.

Dr. Richard Veerapen also conducted a one-day workshop on 8th October 2003 on “Handling Adverse Medical Events - Principles and Practice” which covered the Classification and Definitions of Adverse Events,  Communicating Adverse Events and Errors to Patients and Relatives and Role Play sessions whereby participants were provided with case histories and scenarios involving adverse medical events, providing them opportunities to experience the difficulties and stresses encountered during interaction between aggrieved patients and relatives and hospital representatives.

MEMBERSHIP

The membership has increased substantially.  Institutional medical practitioners at the Universiti Kebangsaan Malaysia and Universiti Putra Malaysia are strong supporters of MDM.  The year 2004 will be a very busy year for MDM as it expects its membership to grow substantially in view of the increased subscription rates of  a foreign-based medical defence organisation.  These high rates probably do not reflect the local medical negligence claims scenario.  To date, MDM is proud to record that the service provided is second to none.  “WE ARE HERE WHEN YOU NEED US”.  Members who had queries and problems will attest to this.  The most important factor is that you can talk to your medical colleague and peer. 

PATIENT-DOCTOR COMMUNICATION

The lack of patient-doctor communication amongst doctors appears to be one of the main causes of complaints.  This frequently results in a medical negligence suit.  Beckman² and colleagues studied 45 depositions of transcripts of plaintiffs in settled malpractice suits, focusing on the question of why these plaintiffs decided to bring malpractice actions.  They found that 71% of the depositions revealed problems with physician-patient communication in four areas :

(i) perceived unavailability;
(ii) devaluing of the patient’s or family’s views;
(iii) poor delivery of medical information;
(iv) failure to understand the patient’s perspective.

MDM will arrange a course on “Patient-Doctor Communication” in the year 2004.  Due notice will be given.  MDM members will get a discounted rate.  The speakers will be from a neighbouring country.

Miscommunication sometimes leads to “allegations of molest”.  Always use a chaperone while examining a patient of the opposite sex.  When breast examination or P.V. or P.R. examination is to be performed, one should obtain an informed consent.  Enclosed are relevant portions from MMC’s Guidelines to Good Medical Practice.

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Tan Sri Dato’  Dr. Abu Bakar Suleiman
Chairman

References:
¹Fleming & Wiley
  www.medscape.com/viewarticle/466793
²Beckman, Markakis, Schuman et al:  The Doctor-Patient Relationship And Malpractice:  Arch. Intern. Med. 154:  1365,   1994