Under the banner of ‘Bringing us together’, SASUOG recently hosted its annual conference where Dr Bettina Taylor was invited to speak about EthiQal’s claims experience relating to obstetric and gynaecological ultrasound examination.
Aligned with global trends, EthiQal recognizes the importance of sharing claims information as this gives medical professionals insights into potential vulnerabilities in their practices, with an opportunity to safeguard against these. Vulnerabilities include the risk of a claim arising, but also the potential inability to defend a claim successfully despite having acted reasonably.
To highlight specific trends and risks, Dr.Taylor presented findings from a structured claims review, as well as anecdotal reports from EthiQal’s in-house team of legal and clinical professionals who are in direct daily contact with practitioners.
The systematic data analysis included claims information spanning more than two decades and was a follow-up to research published previously in the South African Medical Journal under the title ‘Retrospective, observational study to identify determinants of claims against O&Gs in SA’s private sector’ (S Afr Med J 2021; 111(7):661-667).
Anecdotal experiences were drawn from the full team at EthiQal that provides medicolegal advice, defends claims together with other experts at law firms and engages practitioners proactively where medicolegal vulnerabilities are identified in the context of underwriting and claims management processes.
Points noted included the following:
- Need for equipment that meets minimum quality standards in terms of imaging.
- Back-up of images, in the form of paper or electronic copies, to protect against potential deletion or corruption of images stored on the hard drive of the ultrasound machine.
- Treatment deferment where images are inconclusive. Depending on the clinical context, further diagnostic steps could include repeat ultrasound, referral to a more experienced or equipped colleague or performance of additional tests.
- Benefits of recording limitations of scans performed – taking into consideration scan type, as well as practitioner’s competency levels – as discussed with patients.
Documentation of fetal anomaly screening offered to patients, together with reasons for decline, where applicable.