Claims insights: general surgeons

Monday, 15 Aug 2022
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.

1 in 6*

Avant general surgeon members had a medico-legal matter raised about the provision of their care, each year (* five-year average).

Data source: matters indemnified FY2017-21

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)

Main issue in claims and complaints

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

The nature of procedures commonly seen in procedural/surgical matters

Description% of procedural/surgical matters
Procedures on the digestive system (excluding bariatric surgery)51%
Laparoscopic surgery24%
Bariatric surgery21%
Hernia procedures19%

The stage of care during which procedural/surgical issues occurred

  • Pre-operative (19%) e.g. improper selection of surgical procedure
  • Intra-operative (60%) e.g. poor surgical performance
  • Post-operative (21%) 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 and is based on matters involving Avant general surgeon members across Australia. All matters were closed over the five-year period from July 2016 to June 2021 (FY2017-21).

Glossary

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

Resources

For medico-legal advice, please contact us here, or call 1800 128 268, 24/7 in emergencies.

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

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.

Download claims insights



Back to top