Shakuntala Memorial Hospital, Mumbai, India.
Acta Neurochir Suppl. 2023;130:221-224. doi: 10.1007/978-3-030-12887-6_27.
There is a sea change in the scenario of medical practice, manifested in a serious trust deficit between patients and doctors and an exponential rise in malpractice litigation. This has given boost to the practice of defensive medicine by doctors. Neurosurgery is considered to be a high-risk branch of surgery in terms of potential for medicolegal issues. It is inevitable that as a response to these changes, we should identify the potential problem areas and adopt measures to deal with them. Practicing ethical, rational, and evidence-based medicine can minimize medicolegal problems. It is suggested to avoid treating patients beyond one's competence. In this review, the concept of negligence is defined, and the common allegations and causes of litigation in neurosurgical practice are identified. The importance of keeping meticulous patient records in preventing medicolegal problems is emphasized. The value of obtaining informed consent and operation-specific consent is highlighted. It is advised not to overpromise the results of treatment. The roles of effective communication and display of empathy toward treated individuals are important factors in averting litigation by them. Communication failure results in breakdown of the doctor-patient relationship. The protective value of professional liability insurance to deal with potential problems is stressed. Finally, the practice of "jousting," or bad-mouthing a colleague, is strongly condemned, as it can provoke malpractice litigation.
医学实践的格局正在发生重大变化，表现在医患之间严重缺乏信任，医疗事故诉讼呈指数级增长。这促使医生采取防御性医疗措施。神经外科被认为是潜在医疗法律问题的高风险手术科室。因此，作为对这些变化的回应，我们应该识别潜在的问题领域，并采取措施加以应对。践行伦理、理性和循证医学可以最大限度地减少医疗法律问题。建议避免治疗能力之外的患者。本文定义了疏忽的概念，确定了神经外科实践中常见的诉讼指控和原因。强调了详细记录患者病历以预防医疗法律问题的重要性。强调了获得知情同意和针对特定手术的同意的价值。建议不要过度承诺治疗效果。有效的沟通和对治疗对象表示同理心的作用对于避免诉讼是重要因素。沟通失败会导致医患关系破裂。强调了专业责任保险在处理潜在问题方面的保护价值。最后，强烈谴责“争吵”或诋毁同事的行为，因为它可能引发医疗事故诉讼。
