A report prepared by the Centre for Primary Care Research in Dublin on behalf of the Royal College of Surgeons in Ireland (RCSI) has found that most compensation claims for primary care negligence are for missed or delayed diagnoses.
The “The Epidemiology of Malpractice Claims in Primary Care: A Systematic Review” – published recently in the British Medical Journal – was compiled by a team lead by Dr Emma Wallace with the objective of identifying where the focus should be targeted in future risk management systems and educational strategies for primary healthcare workers.
The report found that the most common reason for compensation claims for primary care negligence were claims against GPs and front-line doctors in hospitals for the missed or delayed diagnosis of cancer – specifically colon cancer, breast cancer, lung cancer and cancer of the female genital tract – medication errors (administration errors and prescription errors) and, in medical negligence compensation claims for children, the failure to correctly diagnose appendicitis and meningitis.
Dr Wallace – who is herself a GP – acknowledged that compensation claims for primary care negligence were not the ideal tools against which to measure adverse events in primary care environments, but commented that when medical negligence claims are made against GPs and front-line doctors, the medical practitioners against whom the claims are made often experienced increased stress levels – reducing their effectiveness, and placing more patients at risk of a misdiagnosis or medication error.
The report also highlighted that GPs are more commonly practicing defensively because of the risk of litigation if they make a mistake and consequently referring a higher proportion of patients to consultants rather than make a diagnosis themselves. This unwillingness to make – and act on – the diagnosis of a cancer can lead to patients´ conditions deteriorating unnecessarily and ultimately put more pressure on an under-resourced Irish health service.
Dr Wallace hoped that her team´s “review” provides an insight into the nature of adverse events in GPs surgeries and hospital outpatients departments and the reasons for them happening, which would reduce the number of compensation claims for primary care negligence in Ireland and have the knock-on effect of improving the standard of primary care provided.