Indexing Title: NALUDINOs Medical Anecdotal Report [06-09]

MAR Title: Rapport

Date of Medical Observation: September 2006

Narration:

I recently operated on a 50-year-old man. He suffered a gunshot to his right flank after being ambushed by a group of unknown assailants. He had multiple colonic injuries. With the approval of the consultant and the guidance of my senior resident, I performed my very first colon resection.

After the operation, I immediately briefed the wife regarding the condition of her husband. I explained to her the possible complications of the injuries he received. Deep inside I was hoping they were able to understand what I was trying to communicate.

I was able to establish good rapport with the relatives of the patient. Every now and then, I would appraise them of the condition of the patient. Unfortunately this meant that I would be the one bringing them news of a deteriorating patient.

When the time of death was already imminent, I was confronted by two persons whom I have never met before. They were voicing out comments which were quite provocative. They were implying that we mismanaged their patient. For a while, I was quite concerned that they would convince the relatives to file a medico legal suite against us.

For a few days, I was what you would describe a restless surgeon. I was waiting for bad news, someone to tell me that someone had pressed charges against me.

Then one day, I saw the brother of the patient at the ward. He was waiting for me. He approached and we had quite a conversation about the events that had just transpired. Indirectly, he said to me that I should no longer worry about it. The family had already accepted the fact and that they are already moving on. I offered him all the help I could give in the processing of the claims of the family. He held out his hand and we had an agreement. That night I was finally able to sleep well.

Insights (Physical, Psychosocial, Ethical) (Discovery, Stimulus, Reinforcements):

In this day and age, the public has become more aware of their “rights” as patients. Thus we are seeing more cases of malpractice suits being filed against health practitioners. What should we do to protect ourselves from these complications? Short of avoiding the practice of medicine can we do anything to prevent the occurrence of such legal problems?

Establish good rapport. That is what our consultants have been trying to teach us since day one. If we are able to establish a good relationship with the patient and those around him we have a more than adequate chance of avoiding a medico-legal suit.

Even if we did everything by the book, and by some stoke of luck something unfortunate happened to the patient, we run the risk of being charged. Conversely, even if we did commit a “mistake” in the management of the patient but we somehow established good rapport, the chances of them filing a case against us would be lesser than if we failed to establish a goof relationship.

Often, we take into consideration our patient-doctor relationship and assume that everything is alright until the unfortunate happens. As doctors we must not let this happen, for the patient’s sake and for ours.