New resource targets medico-legal drivers of low-value care

New online learning is now available from NPS MedicineWise under the Choosing Wisely Australia initiative. The online module and an upcoming webinar will help support clinicians understanding of legal risks and defensive practice.

According to Australian and international research, doctors’ fear of legal liability is frequently reported as a driver of ‘low value care’.

A Choosing Wisely survey in 2018 (summarised in the 2018 Choosing Wisely Annual Report) found that half of general practitioners and over one-third of specialists reported fear of litigation as a driver for ordering unnecessary care. General practitioners report unnecessary test ordering and specialist referrals due to medico-legal concerns.

A recent Australian research project on medico-legal aspects of low value care involved in-depth interviews with medical practitioners. The results revealed that fear of criticism from peers and superiors is a powerful influence on defensive practice.

Lead author, Professor Nola Ries, Faculty of Law, University of Technology Sydney says improving clinicians’ understanding of the law and their awareness of the risks of low value care is important to counter defensive practice.

An on-line learning module - Medico-legal risks and low-value care - has been designed based on material developed by Professor Ries.

“Defensive practice occurs when clinicians provide services, such as tests, treatments and referrals, mainly to reduce their perceived legal or reputational risks,” says Professor Ries.

“But providing services that offer little or no benefit to patients is problematic. It exposes patients to the risks of avoidable harm, including cascades of tests and procedures, hospital-acquired complications and extended hospital stays. This can increase the chance of complaints or litigation, especially when patients feel they didn’t receive adequate explanation about their options.”

Using clinical scenarios based on actual court and legal tribunal decisions, the education module covers core legal knowledge to help practitioners avoid low value care and recommends communication strategies to improve patient consent and decision-making processes.

This activity is relevant to all health professionals. It is approved for 2 points (CPD Activity) under the RACGP CPD Program for the 2020-2022 triennium.

Join the Choosing Wisely Webinar on 6 April 3:00pm-3:30pm AEST where findings from the in-depth interview research and key features of the online learning module will be presented.

Choosing Wisely Australia, with forty-seven Australian health professional colleges, societies and associations as members, is facilitated by NPS MedicineWise. It is part of a global campaign encouraging a national conversation about reducing unnecessary tests, treatments and procedures. Reducing unnecessary care can improve patient care and reduce harm, while freeing up resources for more high-value care.