Patients should be confident that they, along with their doctor, have decided to conduct a surgery or to take medication with possible side effects; thus, in the event of an unfavorable outcome of the treatment the results are more likely to be perceived as associated risks, not as negligence of the physician. Errors in relationship between doctors and patients are not rare in medical practice; reducing their number can be achieved by relationships of trust, based on the achievements of modern medical science, compliance technologies and high level of staff.
As a rule, the causes of conflict on the basis of dissatisfaction of patients of treatment are:
- low quality of medical services as a result of non-compliance examination and diagnosis of diseases of organs and systems before the start of treatment and lack of control measures on its stages (non-compliance of the rules of medical manipulations);
- failure to comply with deontological principles caused by the lack of well-established relationship with the patient
- failure to achieve positive results or failure to comply with the principle of patient information;
- deficiencies in the maintenance of medical records, not allowing to judge the completeness and structure of diagnostic, treatment, control and rehabilitation measures.
Importantly, according to polls, conducted among medical negligence solicitors, more than 54% of the legal cases (non-lethal) were initiated by the patients that were completely dissatisfied with the services the doctors provided.
Of course, not all the grievances and complaints of patients are groundless, especially if they are related to errors in physician-patient relationship (especially the ones that caused some damage to the health). Thus, among the claims in London Greater Area, over 20% are submitted by people with psycho-emotional disorders, and most of the court cases due to objective complexity of the treatment of pathologies which the patient suffers from. Our assessment of claims against physicians is generally consistent with European experience.
At the same time health care workers do not take into account and/or not use the factors that could protect them in cases of justified and unjustified claims. Doctors of all specialties without exception, even the forensic doctors, unfamiliar with the legal framework of medical care, should know and follow the rules of informing patients and conducting medical documentation, which should create the necessary evidence base during a forensic medical examination.
Previous trials of conflicts show that the mere implementation of good professional practices is not enough to solve the complex health care problem. Therefore, along with the correct choice of treatment, proper execution of all the necessary professional procedures, organisational elements that ensure solving the main problem – the provision of adequate high-quality patient care with an adequate result, should be included in the algorithm of mandatory medical actions. These elements are the rules of patient information and medical records. As analyses show, their absence aggravates the process of compulsory cooperation and mutual understanding between doctor and patient, often turning into an independent source of conflict.