Psychiatrists, among scholars that fewer claims received, as indicated by experts during the 20th National Congress of Psychiatry Legal.
-almost 80 per cent of complaints received in the care services to the patient are, according to experts, by lack of information and/or communication between doctor and patient. Of these complaints received, less than 2 per cent correspond to psychiatry. Professionals gathered at the annual scientific meeting of the Spanish society of Legal Psychiatry, which has just closed in Palma de Mallorca, have also confirmed that a high percentage of these claims are in internal complaints solved with a reasoned explanation by the service to the patient. ”
Barcelona, 2011-June as Teresa Távora, head of the service to the patient of the Hospital General Universitario Gregorio Marañón, Madrid, the main reasons that lead to patients or their relatives to making a complaint are related with the disagreement with assistance; disagreement with the organization or standards; the request for a change of specialist and the problems in relations with other patients ”. Teresa Távora insists on the idea that many of these complaints are usually dealt with good information and communication which prevents that they become proprietary claims (which represent an economic compensation). Claims which go in this category are usually associated with an unconformity with discharge of the patient, problems by not entering it or incidents during the income ”, indicates Távora.
In this context the Technical Director Willis Iberia Juan González PeñÃn health responsibility, notes claims in psychiatry are less than 2% of all them that arrive to the insurer. Also, González PeñÃn confirms that though few complaints received by the psychiatric practice, 42% of these are by death and 58 per cent, for injuries; These include moral damage, the psychological damage, injuries, side effects of medication or damage ”.
To communicate, an essential tool
The communication is the key tool for conflict management ”, drew Távora. For that reason believes that in the training of doctors, communication – which currently is an optional subject – should be compulsory; I would avoid many problems for the future ”, says the expert.
In this same vein insists Javier Sánchez Caro, responsible for the area of bioethics and health law for a Ministry of health of the community of Madrid, which has also participated in the twentieth Congress of the Spanish society of Legal Psychiatry (SEPL). The doctor-patient communication, knowledge address information for the physician and the relationship of trust established between the two is very important. Is trafficking of a key element that carried well can save an error, but poorly managed is the gateway to claim ”. Sánchez Caro also clarifies that ” psychiatry is a specialty of humanistic dyes so it is relatively easy to establish a good relationship and communication between the professional and the patient, is for this reason that the claims in this medical field are exceptionally ”. In this aspect Távora Yes highlights that some of these are extremes that often, the patient makes the claim is in a phase of acute crisis so these complaints do not always have a solid and coherent basis ”.
Diego Gracia, Professor of history of medicine and bioethics from the Complutense University of Madrid, who also spoke at the scientific meeting of the SEPL shared view with Sánchez Caro and Távora: when the doctor-patient communication is good does not tend to produce claims; However, if this is bad you can reach the complaint while clinical practice is correct ”, says grace.
This expert in bioethics stresses, like Távora, that one of the basic points to advance the patient-doctor relationship is the training. continuous training is essential to acquire skills and have tools to manage conflict situations ”. Some conflicts which have increased, according to grace ” since that has been the patient participate increasingly in decision-making about their health ”. The Professor says that the rules have changed. The relationship between doctors and patients have horizontalizado so now, both can give their reasons and decide. There is more than one point of view and that means that most conflicts can be generated ”. In the same subject insists Gonzalez PeñÃn which ensures that users increasingly are more sensitive and require a higher quality of care, know their rights and have clear before any damage derived from a clinical performance must be compensated; PeñÃn Gonzalez also points out that now patients are demanding that a few years ago, but sometimes they claim no actual results ”.
Also, Willis Iberia representative ensures they have detected an increase in claims over the past three years. Some of the reasons which have contributed to this are, according to González PeñÃn, as well as a greater healthcare demands by the patient, the existence of a greater number of patients associations and the economic crisis ”.
Also this expert also stated that everything can be a positive reading and which can be drawn in this case is that claims require to improve the quality of care. They are a source of information that brand always areas for improvement and indicates which are the main reasons for dissatisfaction in patients ”.
Tutoring of the MIR
Training for future doctors, as experts say is an important point to prevent problematic, that is why the SEPL Congress devoted one of its meetings to discuss and analyse the formation of internal resident doctors (MIR) and the relationship between them and the tutor during his period of training.
Javier Sánchez Caro says it’s a relationship that must be from more to less oversight and monitoring to measure the period of training which passes ”. The head of the unit of bioethics and health law, Ministry of health, community of Madrid explains that the training system of the MIR requires a professional practice scheduled, supervised, monitored and had the charge to go, as progress has been made in training, increasing the autonomy and the confidence of the resident to make this completely autonomous ”. This guarantees, according to Sánchez Caro, which the resident doctor learn while working and not vice versa. It is a model based on the transmission of knowledge, so that the work would not be the main ”. It pursues this, adds, is that during his training MIR knows how to anticipate situations of risk, and also, to acquire the necessary tools to help you avoid them. ” opinion that also shares Teresa Távora, future physicians must learn to communicate; Learn to say things will greatly facilitate your daily practice ”, concludes Távora.
Organized by the Spanish society of Legal Psychiatry, this 20th Edition of the Congress National Legal Psychiatry has met, during three days, in Palma de Mallorca, to more than 300 professionals in the field of Psychiatry, as well as judges and lawyers of recognised prestigeresponsible for patient care and insurance services.
