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Old 11-08-2022, 09:58 AM
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Would like some genuine advice from seniors here. (Can be hospital or polyclinic)
Can I check how much are doctors protected medicolegally while working in public institutions? (Both from a junior doctor and senior doctors - fp/consultant point of view)

I recently read that a gp got suspended for missing diagnosis of TB (apparently xr got changes and he dismiss it as pneumonia and didn't follow up) Also noted few years back a private paediatrician got suspended for missing Kawasaki disease (apparently symptoms are atypical).
Just wondering if the same thing happen in a public, how protected are we as doctors. (Of course I don't know the details of the exact cases, info are from smc website)

Context: personally I am mopex in ops currently, I can tell you for sure our seniors don't vet through all the cases we see. Similarly previously mopexing in gs, we don't clear all clinic cases with consultant. (IM no clinic work to be fair so reg sees everything inpatient so safer)

just wondering if a similar thing happen to us (e.g missed tb/cancer or didn't give appropriate follow up for cases that should be followed up), will we be backed or protected by the institution? And I guess same thing apply if one becomes a senior (either as consultant or senior FP in ops), will we be protected if we missed a serious diagnosis by missing or not following up on an investigation result?

Just wondering as I am seriously worried that no matter where I go, I cannot gaurantee that i wont make mistakes, and of course we all know some mistakes are more serious than usual...
TBH when u work in a institution, the level of protection is far better.
For starters, internally they try to help you. It then becomes a case of M&M where u face the music. Terrible to be there, but tahan ,zone out for 2 hours and then ok liao.
Trust me, i have been there.

When did u last see a institution doctor individually kenna censured in public? Even in the case of the missed lung cancer at changi hospital , only hospital got fined.

Also , know the difference between SMC censure vs court. Medical insurance doesn't cover SMC censure and fines.

The TB case if u go and read, the GP also anyhow la.

He go modify the notes 2 months after the visit after knowing he is in trouble. When asked for account of the visit , he say cannot remember much, but then was question how come cannot remember much can still modify the notes 2 months later, kenna trap.
In a case of my words vs your words, the assessor need to balance who is likely to be telling the truth. They caught him in a compromising situation and choose not to believe him.
Its like NSF come in geng MC, history at the start and bottom don't match. Poor NSF didnt know the smiling polyclinic doctor ask those innocent question got meaning one...

Piang ey, lousy notes vs fake notes, i rather have lousy notes.

His defense rest entirely on his premise that he is treating for pneumonia but then he was caught telling the employer better dont be TB , if not troublesome. That means he knew it could be TB liao and choose not to act on it and instead treat for pneumonia.

Also he pre-filled the domestic helper form

Its not the first TB case that is missed la and not the first one that is report, i tell you. His was brought all the way up because at the initial screening stage, things are missing and he was stubborn. If he admit to the mistake , maybe suspend 1 to 3 month or a fine, case close. take the few month as a unpaid holiday. Want to win go all the way, sure die, now name splash big big, 15 months suspension plus a few years of uneasiness.

If he had documented 'properly', he can probably get away.
private GP get lazy , think no one will see the notes anyway.

so always document, document and document.
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