The conference
Dr Cutbush attended the MIGA medicolegal conference in February 2017.
Medicolegal conferences cover the areas where clinical practice meets the law: consent, documentation, open disclosure when something goes wrong, and the obligations that surround all three. For a surgeon these are not peripheral matters, and keeping current with them is part of practice.
What informed consent actually involves
Consent for an operation is a process rather than a signature on a form. It means setting out what is wrong, what the available options are including not operating, what the proposed procedure involves, what the recognised risks and complications are, and what the operation is intended to achieve as distinct from what it cannot achieve. It also means giving the patient the opportunity to ask questions and the time to consider the answers before deciding.
The legal standard in Australia requires that the information given takes account of what this particular patient would want to know, which is why the discussion differs from one person to the next. A manual worker, an overhead athlete and a retired patient with another medical condition may all need the same operation explained quite differently. Documentation of that conversation matters because it records what was discussed and agreed. Individual results vary.
Open disclosure and continuing professional development
Open disclosure is the practice of telling a patient promptly and openly when something has not gone as planned, explaining what happened and what will be done about it. It is an expectation of Australian medical practice rather than a matter of individual preference, and the conferences run by medical indemnity organisations spend time on how it is done well.
Attendance of this kind also forms part of continuing professional development. Specialists registered in Australia are required to undertake and record ongoing education each year, and that requirement covers more than surgical technique. It includes the ethical, legal and communication aspects of practice, audit of a surgeon's own results, and review of adverse events. Conferences run by indemnity providers are one of the recognised ways of meeting that part of the obligation, and they also give a picture of where problems commonly arise across the profession, which is more useful than learning the same lessons case by case.
Related information
- Our consultation page, explaining how appointments work
- The surgery FAQs, covering what is discussed before an operation
- Shoulder surgery
- Rehabilitation