Apollo Hospital fined 5 lakh: “Doc, Talk less, write more”.Doctor save yourself by “documenting the communication”


Doctors are trained to treat patients and  that is they keep on  doing. But in today’s era that is not enough. They are expected to examine, investigate, diagnosis , treat correctly   and communicate to the family or patient. Everything should be speedy and  financially suitable to the patient’s expectations. Even if that is done, the things do not end here. Doctor need to document, what has been  communicated to the family.  It is hard to believe that  doctor at a hospital like Apollo,  who really did well to diagnose a disease like SLE and still did not communicate. Yes, news item mentions that in file that  there was no evidence of communication. Doctors still behave like doctors and do not treat patient as consumer. Usually , doctor trust their patients  and there is lot of verbal communication takes place. Verbally they sympathize, communicate  and  tell many things which are not documented as a routine.

The Delhi State Consumer Commission, in its judgment, made it essential for a hospital to disclose to the patients or their attendants, the line of treatment and the potential risks involved in it.
The judgment came in connection with the death of a 23-year-old student, who died during a treatment at  Indraprastha Apollo Hospital in 2004.

Many times patients are sincere enough to admit to  verbal  communication. But sometimes when  during ongoing  medico legal lawsuits, a feeling  of revenge prevails  or as guided by lawyers, patient  may not admit  to the verbal communication.  Specially if verbal communication is not documented in file.

How to  save yourself  by  “documenting  the communication”

  • examine, investigate, diagnosis , treat correctly and communicate
  • Make a note of plan of treatment and prognosis, and communicate to patient or attendants.
  • Sign yourself and ask the patient or nearest relative to sign.
  • It is not uncommon that relative will refuse to sign. In that case just write a note and mention that attendant refuses to sign.
  • It is also a common issue that after listening to everything, relative will say that he does not understand or will ask his uncle or aunt. These are difficult moments and commonly happen. Just make a note of everything. Besides it wastes crucial time.
  • Can use camera for communication in difficult cases.
  • Never rely on verbal communication. It has little value.  Commonly people refuse to admit verbal communication, and will say that they were not told anything.

As time for everything is limited in life, be it treatment, communication, consent or documentation. So message is clear for doctors. “Talk less and write more”. You will be judged by documents after many years. Therefore,  do save the patient, but save yourself also.

 

 

4 thoughts on “Apollo Hospital fined 5 lakh: “Doc, Talk less, write more”.Doctor save yourself by “documenting the communication”

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  1. Even if you write that patients attendant refused or didn’t sign and you continue to treat the patient another problem will arise, until they sign Ur consent don’t treat the patient and write why not treatment started. Yes true it’s a fashion to slap doctors on face instead of paying them or rewarding them for their undoubtedly the utmost devotion for betterment of human race.

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  2. Thank you. Can you please delete my 1st comment as it got posted twice? We need to have a paradigm shift in communication, counseling and informed consent process whereby the patient is able to make a choice on which therapy to choose. Quite a preparation and trained resources would be required to make a design & implement such a system effectively within the health care delivery system.

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  3. The title itself is eluding. Most issues can be avoided with right communication at right time not just while seeking informed consent. Verbal consent is sought as a mere “yes”/ “No” , especially when patients’ relatives are under stress & are not actually listening or partaking in the informed decision making for their treatment strategy. Though verbal communications play a critical role, ‘that which is not documented is not done’ continues to hold true. Recently, in clinical trials, audio-video recording method has been mandated in the Pharma world & can be inculcated as a process in NABH hospitals. It’s not only safety of doctors that’s to be safeguarded, ultimately life of a patient too remains of supreme importance!

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    1. Thanks. I corrected the heading, by a comma. Here I mean is that if court agrees that treatment is not faulty than why fine? If no harm done, warning or suggestion can be enough. It is just a fashion to punish doctors.

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