By the way, a disclaimer: If you are reading this years after it has been posted, and you are the legal practitioner of a client who is currently suing me for something, then please note that all this is not to be taken seriously. I repeat: I AM JUST JOKING! Also, if you are a medical student reading this, and you do decide to take this seriously, YOU DESERVE TO HAVE SOMEONE SUE THE PANTS OFF YOU, YOU DOUCHE. AND IF YOU ARE READING THIS WHILE CLASS IS GOING ON, THEN STOP READING AND START LISTENING!
Key Medical Issues
Mistaking Left vs Right
We've all done it - mistake the left for the right or the right for the left. Hell, I did it during my driving test all those years ago. If I can turn left when some guy asks me to go right, imagine what I could do with an orthopaedic drill, a bone chisel, and a human body that's been anaesthetised! Such a tragedy can be easily avoided with a thick, black permanent marker. When that poor sucker that's going under the knife walks in, don't shake hands or say hi to him/her. There are more important things to be done first. Get the marker out and draw a giant star on whichever leg needs to be operated on. You can even be creative and draw or write something on there. "Say goodbye to this leg" is not recommended.
Confidentiality
Confidentiality
What goes on in the consult room, stays in the consult room. You wouldn't want your doctor disclosing your current STI track record would you? Confidentiality is like the house sewerage pipes - break it, and you're in deep shit. You can omit names, but the world is tiny. If you mention "a 56 year old female", chances are, some guy 400 metres away will hear you and know exactly who you're talking about. Avoiding this is pretty simple - just shut the hell up in public. But what about those "secure" medical records? They always ends up in the wrong hands. So what do you do? Do what the crims do. Burn the evidence. At the end of every consult, take those notes you've been writing diligently and burn them in front of your patient's eyes. Nothing says "it's OK. Your secret's safe with me" better than burning paper.
Medical Negligence
Negligence is the technical legal term for "a huge cock-up". There are endless ways of achieving this. Such ways include administering the wrong drug, letting the patient fall and fracture a hip when you get them out of bed, injecting into a vein when you're not supposed to, and somehow causing someone to go blind when you're inserting a scope up their rectum. Best way to avoid such cock-ups? Five words: Let the nurses do it. Face it, future and current doctors. You might be there to make the decisions and boss people around, but when it comes to "hands on" work, you have as much dexterity as a seven month old baby. The nurses completely own you on most procedural work, so just admit your shortfalls and let them do it. It's not being lazy, it's called "doing what's best for your patient". The plus side is, if something goes wrong, the lawyers won't be coming after you. Win!
Relationships with clients
Relationships with clients
Falling in love with your patient is a huge no-no. No matter how hot your patient is, no girl is worth your medical career. (Exceptions to this rule can be found here, here, and here.) It's hard to avoid such feelings though. You're stuck in a small room all day, and you meet so many people. And with all that stress you're exposed to, it's hard to keep those emotions in check. You need reminders. And what better reminder than a picture of your significant other. Plaster her picture everywhere in your consult room, but that picture shouldn't be one of her smiling or else it's like she's saying "go on, I approve of your infidelity!" No, those pictures should have her looking at you with an angry "if you cheat on me, I'm going to take away most of your money" face. That should be enough to stop you from cheating on her.
Sexual assault
The sexual assault lawsuit is complicated. Well, for males at least. When a male doctor does something unlawful with a female patient, then that lady will rightfully see it as sexual assault. Yet when a female doctor does something unlawful with a male patient, then that guy will usually see it as a fantasy coming true. Regardless of such gender differences, sexual assault is indeed a very serious issue. There is, however, one major problem with tackling this subject. You see, there is just no way around it. I don't know about you, but you can give me all the warning you want. It still won't make a finger up the anus, a poke of my breast, or an alarmingly-thicker-than-the-hole-it's-supposed-to-go-into sized tube up the urethra any less traumatic. Face it, men. There is one absolute with becoming a doctor in today's litigation happy Western society: You are eventually going to get sued for sexual assault at some time. It doesn't matter how innocent you are, it will still happen. So what do we do? Simple! Get to know your medical board! It's the board that decides whether to pass your case up to the courts, so act early and neutralise it before it gets there! Humans are a very subjective species. Medical boards are full of humans. Logic thus says, medical boards are subjective. Use it to your advantage. Find someone, who knows someone's friend, who knows someone's aunty, who knows someone's brother, who knows someone's cousin, who knows someone's best friend, who knows someone on the board. Then buy him wine, or her some flowers. Nothing influences passing judgement on someone more than "Hey I know that guy! He's alright!"
Informed Consent
It is not enough to simply ask the patient, "Is it OK for me to go ahead?" You must ensure that the patient has been disclosed all the relevant information and results regarding the tests that led you to the proposed management, as well as details regarding the actual proposed management. You must inform them of the potential benefits of this management, as well as the potential risks involved. Following this, you must then tell them of the probabilities that the aforementioned benefits and risks would occur. You must then ensure that they are aware of all other treatment options that are available to them. Whilst giving all this information, you must ensure that you haven't coerced them into making a decision, and that their final choice is not confounded and is free from bias. Somewhere along the line you must make sure that they are still with you, and haven't gone insane with information overload. If they are still there, you must then ensure that the patient is competent to make the decision themselves. This may involve various tests of mental and psychological stability. Should they not be competent enough to make an informed decision, their next-of-kin, or court-appointed "decision-maker" needs to be soughted. Once an informed decision is made, and consent is gained, you must then obtain written documentation as evidence that the consent process is completed. This often requires you to find a pen of some sort and the patient to read about seven pages of size 4 font writing. Good luck to you if the patient doesn't read English. Once all this has been completed, it is likely about 2:21am in the early morning, and the practice has been closed for the past five hours.
Basically, what I'm saying is, learn to become a 24 hour doctor in order to accommodate all the informed consent requirements.
Basically, what I'm saying is, learn to become a 24 hour doctor in order to accommodate all the informed consent requirements.
