An overview of medical protection with Dr Ming-Keng Teoh
The ever evolving aspects of medical practice, along with changes in a society’s economy, demographics and technology, present ever greater challenges doctors today must be prepared to deal with. MIMS Doctor talked to Dr Ming-Keng Teoh, Head of Medical Services-Asia, Medical Protection Society (MPS), on how Medical Protection Society can assist doctors and other healthcare practitioners in making their practice worry-free and ultimately providing the highest standard of care for their patients.
MD: What does medical protection entail? What are its goals?
Teoh: Our organization, the MPS, was set up by doctors to support and protect doctors and other healthcare practitioners in their professional practice. We help them navigate through an increasingly complex medicolegal world and help them resolve problems and disputes early, ultimately aiming to avoid problems, improve professional practice and patient safety.
MD: How do doctors and patients benefit from medical protection?
Teoh: Because professional support and services are provided by medical professionals who understand what it is like to practice as a clinician and are trained in the medicolegal field we can provide much more relevant and effective support. Together with the support of lawyers, risk managers and other professionals, we can bring all their expertise within MPS to support members if, for example, there are complaints or mishaps.
MD: What are the common causes of complaints or litigations usually dealt with by doctors who have consulted the MPS before?
Teoh: Most of the complaints come from adverse outcomes arising from treatment, or simply from poor communication. Patients’ unrealistic or unmet expectations are also important factors, so these must be managed well. When taking consent, we have to make sure that patients understand not only the benefits but also the risks that may arise from the treatment or procedure. Other problems we can assist doctors with include medical council complaints, disciplinary actions within institutions, criminal investigations or coroner’s inquest. When a claim or complaint arises from professional practice, doctors can request advice and assistance including legal representation and an indemnity for legal costs and damages in accordance with their membership.
MD: How do interactions between doctors themselves create problems that give rise to patient complaints or litigations?
Teoh: We emphasize that medical treatment involves teamwork, where communication skills are very important. Referrals are important aspects of how doctors interact amongst themselves. Medical recordkeeping is a very important area which involves adequate recording of instructions of care, follow-up and the progress of patients.
A lot of complaints also arise from careless remarks from doctors themselves. For instance, if a patient experiences a complication after undergoing treatment with doctor A, the patient should go back to doctor A to have it resolved. But if he goes to doctor B and doctor B makes a careless remark without understanding or awareness of the facts, then this can cause distress to the patient who may misconstrue that doctor A should have done something different. Often, despite the best treatment and when everything was done to a reasonable standard, mishaps can still happen in medical care. Patients need to be able to understand that.
MD: There would be some inevitable instances where undesirable reactions arise from patient management. How should such problems be resolved to ease the patient?
Teoh: Adverse outcomes happen not because of the doctor’s or the hospital’s mistakes. When these do arise, we need to ensure that clinicians are confident to be open to the patients and show compassion. Instead of withdrawing and being defensive, it is important to act professionally and show humility and care for the patients. Patients would not complain if they can understand the situation, and can believe that their doctor has done his best and can continue to have faith in their doctors.
Another point is that sometimes patients will come complaining of something, but in fact there is an underlying problem in that complaint. For example, they are unhappy for being rushed by the doctor or for the lack of care from the doctor’s side, but they point out something else as the complaint. We must be trained to identify the patient’s true concerns. We need to give patients the confidence on how they can voice out these grievances so as to have early resolution and prevent these grievances from becoming complaints, which would be costly and can be traumatic for clinicians.
MD: What are some services doctors can avail from the organization?
Teoh: We have a whole range of professional services to provide for doctors’ needs, including medicolegal advice, membership services and risk management. We also have MPS associates who are local doctors from different specialties to provide support and reassurance when a member needs to speak to a sympathetic clinician for support and sharing. In addition, we organize courses and workshops for members on topics such as managing mishaps, managing difficult interactions, how to take consent, and providing shared care, to name a few. We also provide medicolegal seminars and courses based on lessons learned from cases where doctors have sought our assistance. Casebooks, regular publications for members and online learning modules are available on our website.
MD: Are there any other professionals in the healthcare sector who can seek your advice?
Teoh: We also offer membership for nurses, physiotherapists, dietitians, professional bodies, regulators, and dentists. We also interact with key stakeholders such as medical councils, ministries of health, professional societies and colleges, and hospitals.
MD: How do you help doctors who decide to practice or train overseas?
Teoh: Being an international organization operating in several countries such as New Zealand, Australia, the UK, Ireland, Singapore, Malaysia and Hong Kong, we have a policy that if a doctor wishes to participate in humanitarian work overseas for natural calamities, for example, we can extend our membership or protection for the specific period when they are away. The same holds true if a doctor is overseas for attachment or training, or if they are invited overseas to demonstrate a new product or technique in a conference or workshop. Members should inform MPS if they wish to practice in a different territory. They should also, of course, ensure they are registered with the relevant regulatory bodies in order to be able to practice in their chosen country.
MD: A medicolegal conference was held recently in Hong Kong. Do you host these meetings often? What are the usual agendas of these meetings?
Teoh: The themes of these meetings are usually based on issues local doctors are currently facing. The recent meeting we conducted in Hong Kong was about looking forward to the future of medical practice in Hong Kong. Topics included the impact of societal and demographic changes, new technology and social media on medical practice, and the different medicolegal issues arising from these. We were fortunate to have our finance and risk director speaking at the meeting about medicolegal risk management based on our experience globally.
MD: Do you have any parting comments for our readers?
Teoh: At MPS, we care about attaining the highest professional standards so that patients can be treated with safe and better care. We protect and support the professional interests of thousands of members in Hong Kong and are truly passionate about supporting doctors and ensuring their security and peace of mind.