Medical Malpractice in Health and Social Care
Medical Malpractice in Health and Social Care
Gosport War Memorial Hospital Case Study
In modern-day healthcare industries throughout the world, different incidences or claims of medical malpractice have far-reaching financial, social and psychological effects on both patients, as well as healthcare service providers at every level. It can be argued that a range of malpractice suits critically gives rise to a predominant level of negative publicity and loss of staff to cause untold and unprecedented damage to a healthcare institute like a hospital, as well as clinical practitioners. Considering the grave concerns related to such professional and ethical issues related to health and social can profession, this report attempts to investigate the extent to which a particular situation can damage the reputation of an organisation. In order to develop relevant ideas, the paper has selected the issue surrounding medical malpractice at Gosport War Memorial Hospital in the 1990s to come up with planned solutions regarding recovery of damaged reputation of a healthcare setting.
The reported incidence of medical malpractice at Gosport War Memorial Hospital in the 1990s caused 456 elderly patients lost their lives, leading families of these patients to file malpractice suits against the senior medical practitioner, Dr Jane Barton. Families of the patients who died due to medical negligence and professional misconduct have been fighting for over 20 years to bring the doctor to face criminal charges, leaving the former health minister, Jeremy Hunt to issue a public apology in June 2018. As discussed by (Bogner 2018) medical malpractice in a hospital or any other healthcare setting occurs when a doctor or other healthcare professional commits an act of negligence or omission, thereby causing serious injury to a patient. The act of medical negligence occurs in multiple forms, commonly including errors in treatment, diagnosis, aftercare and healthcare management to give rise to ethical dilemmas across the entire health and social care profession. There is a significant difference between medical malpractice and medical negligence, where the former refers to a breach in care duties by a healthcare provider or a medical facility and the latter involves a mistake by the medical practitioner in treating a patient to cause significant harm (Shanafelt and Noseworthy 2017). It is not always possible for medical practitioners to prevent a bad outcome or be able to save a life but they have a specific duty of care, which suggests their commitment to comprehensive patient care. The element of ‘intent’, hence, creates the difference between malpractice and negligence in the medical context.
The scenario reflected in the case study related to Gosport War Memorial Hospital clearly points out intentional involvement of doctors, nurses, pharmacists and other medical professionals, as the main accused, Dr Jane Burton along with other staff knew that the process of providing opium drugs increased the risk of causing harm to the patients. The particular incidence, therefore, caused significant damage to the reputation of the hospital, leading this report to analyse the effects from three primary perspectives discussed throughout the subsequent sections.
The incidents of medical malpractice have over the years become a much complex topic in the profession of healthcare system due to continuous evolution and growing controversies surrounding different incidences. Although it appears that the effects of malpractice mainly apply to doctors, patients and lawyers, any such cases of malfeasance constitute significant pressures to all healthcare providers at all levels, especially to those individuals positioning in the management or leadership of the organisation. Similarly, the effects of such medical malpractice have damaged the reputation of the healthcare facility known as Gosport War Memorial Hospital, where the impact can be observed from multiple perspectives, which are discussed in the subsequent paragraphs.
First issue the hospital faced is related to discrepancies in the managerial roles, which cost the hospital to lose its reputation and make payments in millions. The roles of senior executives and managers have become highly complicated given the strong level of pressure on different healthcare organisations to conform to the required standards and providing safe and effective care to service users. Managers are mostly responsible for enabling smooth flow of hospital’s operations to ensure protection from adverse events and situations to patients, as well as staff. However, in case of Gosport War Memorial Hospital, a significant gap in management roles and responsibilities can be observed, leading its doctor to prescribe opioid drugs to entire 456 elderly patients throughout the 1990s, which resulted in their death. The situation caused agitation among the families of patients, which led them to file lawsuits with the intention of bringing the doctors and other healthcare professionals to face criminal charges for their misconducts. As suggested by Park et al. (2016), it is one of the fundamental responsibilities for the managers to implement a systematic medical framework within the hospital to ensure effective handling of different types of legal risks while enabling elimination of risks factors associated with administrative services. The study further concluded that managers are the ones who need to educate all nurses and other practitioners of the hospital regarding preventive strategies, as well as ways to improve patient services. Considering the case of Gosport Hospital, such duties and responsibilities were missing in the senior management, leading it to adopt an unwavering attitude and providing no attention on recommendations of nurses and pharmacists of the healthcare organisation.
The second issue is related to the particular approach adopted by the senior management of the hospital, which led to the increased controversies and damaged reputation of the healthcare facility. The oblivious approach of senior managers has subsequently caused significant damage to reputation of Gosport War Memorial Hospital. A wide number of elderly patients had died due to medical malpractice, a situation, which could have been prevented if there was a systematic healthcare framework in place. In order to establish standard coping strategies to manage medical disputes and malpractice lawsuits, roles played by the managers are important for developing more responsible efforts (Bunting Jr and Groszkruger 2016). In this case, there should be a Medical Dispute Mediation Committee in place within Gosport Hospital to enable establishing a highly compliant medical support system and development of a specialised workforce to eliminate the chances of any professional misconducts such as medical malpractice or negligence. With the increasing levels of expectations related to healthcare services, more and more lawsuits are filed since medical disputes have gone far beyond simple dissatisfaction of medical consumers. Damage to the reputation of Gosport Hospital, as a result, was significant as awareness related to consumers’ rights, as well as expectations for monetary compensations and access to information on medical technology, have increased on a year-on-year basis.
Customers or Patients
The first issue is related to growing cost of the healthcare services, causing significant worries for patients from different paths of life. It is principally discussed in the previous section that medical malpractice or incidents like professional misconduct are likely to increase the cost of healthcare. In the modern society, where a large proportion of the population still finds it difficult to afford high-quality, best and safest medical treatment and attention, claims and controversies surrounding malpractice are known as the leading cost to escalate the cost of overall healthcare services, thereby exerting more pressure on patients, as well as the industry (Popescu 2015). From the context of malpractice insurance premiums, which are consistently rising and differing drastically in terms of boroughs and medical speciality, doctors and physicians of Gosport Hospital, driven by the pressure of rising premiums, may decide to move to a feasible location with more manageable costs. Such a scenario would create more troubles for the patients, as they will have limited access to best healthcare professionals. As access to healthcare is becoming increasingly limited in many areas with substantially high malpractice premium rates, it is highly likely that Gosport Hospital may find it difficult for the delivery of high quality, standard healthcare services to patients visiting the facility.
The second issue is related to unwillingness among physicians, causing them to overlook the need of providing necessary care services to patients. As families of 456 patients had won the legal battle in respect of the lawsuits filed against the doctor and other involved parties, it was a damage to the reputation of not only the hospital but also the entire healthcare industry. Where former health minister recently had to issue a public apology to families of 456 patients, Dr Barton, the physician primarily accused of the medical malpractice, had to resign from her position in 2009. Such circumstances may cause further dilemmas for the potential patients, as physicians and practitioners of Gosport Hospital prefer to practice ‘defensive medicine’, a euphemism for instructing additional tests and procedures that are not necessary for providing effective care but provide protection against claims of medical malpractice and negligence (Reschovsky and Saiontz‐Martinez 2018.). Failure to comply with the promise of delivering safe and effective care, thus, can gradually harm the reputation of Gosport Hospital while creating rising concerns for patients.
The Industry or Sector
The first issue is related to the growing liability costs involving medical malpractice affecting effective delivery of healthcare services while degrading industry reliability. The significant growth in liability costs associated with medical malpractice has the potential to degrade the delivery of healthcare in the United Kingdom. Frakes and Jena (2016) significantly observed that the overall scenario related to medical malpractice over the years had caused significantly higher rates for malpractice insurance premiums, making physicians to pay more while affecting the size and composition of the entire physician workforce. The impact of such a situation adds further concerns for Gosport Hospital, as it needs to think about managing its workforce, consisting of doctors, nurses, pharmacists and other staff while coping up with the devastating consequences of numerous lawsuits filed by families of elderly patients died due to medical malpractice. The study of Saini et al. (2017) found out that the loss of key staff, as well as negative publicity involving the lawsuit claims, result in an unprecedented level of damage to the hospital or medical clinic. As for the case of Gosport Hospital, such a dilemma will cause significant damage to the delivery of effective care to patients while misplacing trusts among patients to the entire healthcare industry.
The second issue is related to the growing costs associated with malpractice insurance premiums, affecting overall performance of the healthcare industries. While rapidly rising rates of malpractice premiums have become a growing concern for physicians, policymakers and general public, the modern scenario has garnered significant woes for the entire healthcare industry. Where claims related to multiple lawsuits increased the cost and affected the delivery of comprehensive healthcare services, the incident related to the former health minister apologising to the families of 456 patients did untold damage to the reputation of not only Gosport Hospital but also the entire healthcare industry. The effects of malpractice have become substantial on doctors and other healthcare professionals, as lawsuits rarely involve insurance companies and lawyers resolving the matter. Malpractice lawsuits filed by the families of 456 patients spanning over two decades caused significant stress on the life of healthcare professions making them quitting medial practices, affecting performance of hospital and damaging reputation as a high-quality healthcare provider (Popescu 2015).
Based on the overall explanation, it is clear that the claims or incidents of medical malpractice not only have a far-reaching impact on the financial areas of a healthcare organisation but also affects patients, healthcare providers and other members from various aspects related to both social and psychological perspectives. Continuously growing costs regarding the liability of medical malpractice have the substantial potential to affect the comprehensive delivery of healthcare services to the patients of different needs and specifications. It is also importantly observed through the analysis that size and composition of the entire physical workforce of a country may become affected due to the growth in malpractice payments, which often result in considerable increase in malpractice insurance premiums for physicians. The overall assessment essentially signifies that the growing possibility of losses caused by malpractice liability may also encourage physicians from different levels of health and social care profession to practice defensive medicine, i.e. defensive decision-making, which is not necessarily the best option for a patient’s treatment.
Concerning the scenario reflected throughout the assessment, the growing requirement of useful solutions can be observed to strike a proper balance in the profession and improve physician-patient relationships from multiple aspects. In order to reduce the chances of medical malpractice and prevent its damaging impact on the organisation’s reputation, the following recommendations can be considered:
Clear and effective communication serves as the foundation to build and maintain a healthy doctor-patient relationship, which is the most important driver for providing best and safest care to service receivers (Hall et al. 2016). No matter the degree of talent, education and experience the physician has, no other element is as important as communication in avoiding malpractice. The incident of medical malpractice at Gosport Hospital could have been evaded if there was a suitable communication process in place between Dr Jane Barton and other nurses and pharmacists involved in the delivery of care to 456 patients.
While effective communication skills lie at the core to avoid malpractice claims from the interpersonal perspective, proper documentation skills play an important role from administrative context. In order to recount a certain circumstance and justify the actions of physicians and other professionals involved in the practice, explicit and unambiguous documentation can come in handy (Renkema, Broekhuis and Ahaus 2014). The particular process also helps the healthcare organisation by removing the burden of incurring unnecessary expenses in the form of payouts while keeping its reputation intact in the particular field of operation.
Lastly, it is recommended to the healthcare provider to develop a succinct understanding of legal guidelines and requirements, especially regarding the medical malpractice laws, which tend to differ from one state or territory to another. Any revisions in the regulations must be acknowledged to develop a highly compliant healthcare system in line with the professional standard. It not only helps the organisation to avoid any claims of medical malpractice but also gradually elevates its reputation in the particular profession.