The impact of litigation on obstetricians and gynaecologists

Abstract

Seventy-five per cent of senior obstetricians and gynaecologists (47/63) in the North Thames (West) Region had been involved in litigation. They reported that difficulties with professional relationships and team working is at the heart of much injury to patients, particularly supervision of junior staff and communication between staff and patients. Other common concerns were inadequate record keeping, the use of locums and transient staff and out-of-date equipment. There was little indication of defensive medicine but the effects of litigation on individual doctors was disturbing in a proportion of cases. Many felt distressed and personally attacked, some considered giving up medicine. The human costs, often overshadowed by the concern with financial costs, are great. Clinical risk management strategies must be developed to counter the risk factors identified. Training in communication skills, particularly in helping dissatisfied, distressed or injured patients, is urgently needed. Consideration should be given to formal support or counselling for staff involved in serious obstetric incidents.