Medicolegal concerns are affecting how Australian doctors practise medicine, according to an article published in the Medical Journal of
Dr Louise Nash, coordinator of the postgraduate course in
Psychiatry and Master of Psychiatry at the New South Wales Institute of
Psychiatry, Sydney, and co-authors conducted a survey of Australian doctors to
explore the perceived impact of medicolegal concerns on how they practise
medicine, and to compare doctors who have experienced a medicolegal matter with
those who have not.
Dr Nash said that medicolegal concerns can prompt changes to
the practice of medicine that could be beneficial and detrimental to patient
The study identified a link between changes in doctors'
practice of medicine and medicolegal concerns. Forty-three per cent of doctors
indicated that they referred patients to specialists more than usual, 55 per
cent stated that they ordered tests more than usual, and 11 per cent stated
that they prescribed more medications than usual due to these concerns.
Concerns for medicolegal issues led to 33 per cent of
doctors considering giving up medicine, 32 per cent considering reducing their
working hours, and 40 per cent considering early retirement. These proportions
were all significantly higher for doctors who had previously experienced a
medicolegal matter compared with those who had not.
Respondents also reported improved communication of risk to
patients (66 per cent), increased disclosure of uncertainty (44 per cent),
development of better systems for tracking results (48 per cent), better
methods for identifying non-attendees (39 per cent), and better methods for
auditing clinical practice (35 per cent).
Dr Nash said that targeted training in patient safety and
medicolegal aspects of medical practice would help doctors to be better
informed and to better understand how such issues influence their judgement and
The Medical Journal of Australia
is a publication of
the Australian Medical Association.