Compensation claims and complaints insights - general surgeons

Summary: Members asked us for more information about compensation claims and complaints to regulators. In response, the following is a retrospective review of routinely collected data.

Monday, 15 August 2022

Graph showing 6 bodies and 1 is highlighted.

Avant general surgeon members had a matter raised about the provision of their care.

Five year average FY2017-FY2021

Data source: matters indemnified FY2017-FY2021

The types of matters Avant assisted general surgeons with included:

Pie graph showing data for matters idemnified FY2017-FY2022. 45% regulatory complaints, 32% claims for compensation, 10% employment disputes, 8% coronial, 5% other (including Medicare)

Regulatory complaints and compensation claims against general surgeons related to:

68% procedural / surgical issues, 9% practitioner behaviour, 9% diagnosis, 7% consent, 8% other.

The nature of procedures commonly seen in procedural/ surgical matters

procedures on the digestive system (excluding bariatric surgery) (51%). Laparoscopic surgery (24%). Bariatric surgery (21%). Hernia procedures (19%).

(% out of total procedural/surgical matters shown)

The stage of care during which procedural/surgical issues occurred

19% pre-operative (e.g. improer selection of surgical procedure).60% Intra-operative (e.g. poor surgical performance).21% Post-operative (e.g. poor post-operative performance; delay/failure to diagnose complication).

Assessment of the care provided

General surgeons were assessed to meet the standard of care in procedural/surgical matters more than in other matters.

Procedural/surgical matters - 72% met the standard of care; 28% were below standard.Other matters - 57% met the standard of care; 43% were below standard.

Other matters

Allegations relating to practitioner behaviour included: failure to communicate results, inappropriate communication or disrespectful behaviour with a patient and boundary issues.

Allegations relating to diagnosis included: failure or delay in diagnosing a condition or a misdiagnosis.

Allegations relating to consent included: inadequate discussion about risks involved and not obtaining consent for specific treatments or procedures.

Key points

  • Procedural/surgical issues were the primary sources of complaints and claims for general surgeons. 
  • 51% of procedural/surgical allegations involved procedures on the digestive system (excluding bariatric surgery).
  • Other common procedural/surgical allegations arose with laparoscopic surgery and bariatric surgery. 
  • General surgeons were more likely to meet the standard of care expected in matters relating to procedural/surgical issues compared to other matters.

The above retrospective review is of routinely collected and coded data. Our review is based on 336 regulatory complaints and compensation claims involving Avant members who are general surgeons across Australia. All matters were closed over the five-year period from July 2016 to June 2021 (FY2017-FY2021).

Glossary

  • General surgeons are classified as those who hold FRACS or equivalent recognised qualification in general surgery.
  • Claims refers to claims for money, compensation and civil claims.
  • Complaints relates to formal complaints to regulators.
  • Matters include claims, complaints, coronial cases and other matters such as employment disputes and Medicare.
  • Employment disputes are matters where Avant defends members against complaints or supports members to resolve employment issues.
  • Medicare matters include Medicare investigations and audits.

Resources

If you receive a claim or complaint, contact us (avant.org.au/MLAS) on 1800 128 268 for expert medico-legal advice on how to respond – available 24/7 in emergencies.

For any queries on this analysis, please contact us at research@avant.org.au.

Disclaimers

IMPORTANT: Avant routinely codes information collected in the course of assisting member doctors in medico-legal matters into a standardised, deidentified dataset. This retrospective analysis was conducted using this dataset. The findings represent the experience of these doctors in the period of time specified, which may not reflect the experience of all doctors in Australia. This publication is not comprehensive and does not constitute legal or medical advice. You should seek legal or other professional advice before relying on any content, and practise proper clinical decision-making with regard to the individual circumstances. Persons implementing any recommendations contained in this publication must exercise their own independent skill or judgement or seek appropriate professional advice relevant to their own particular practice. Compliance with any recommendations will not in any way guarantee discharge of the duty of care owed to patients and others coming into contact with the health professional or practice. Avant is not responsible to you or anyone else for any loss suffered in connection with the use of this information. Information is only current at the date initially published.

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