Physiotherapists indemnity & liability insurance

Guild Insurance regularly analyses claims data to understand factors contributing to claims and complaints.  This analysis has highlighted a trend where claims involve treatment by at least two practitioners within the same profession.  This finding led Guild Insurance to explore why a patient seeing more than one practitioner may lead to a claim arising and what can be done to prevent this. 

Why would a patient see a second practitioner?               
Common reasons include: 

• some practices operate in a way where the treatment of patients is shared between practitioners
• patients may change practices over time, such as when they’ve changed work location or moved to a new home
• a patient may require an urgent appointment and can’t get in to see their usual practitioner so chooses to see another
• a patient is unhappy with the treatment they’ve received and therefore chooses to go elsewhere for a second opinion or further treatment.

What leads to complaints?

Not all situations where multiple practitioners are involved in treatment will lead to issues arising.  However, the following highlights what commonly leads to patients complaining.

• The second treating practitioner provides differed treatment and the patient feels they’ve received greater benefit from this new treatment.  This can lead to the patient feeling the previously received treatment wasn’t appropriate and a waste of time and/or money.  They may also feel this inappropriate treatment exacerbated their condition.
• The second treating practitioner may make a comment questioning the treatment provided by the other practitioner, suggesting to the patient (sometimes inadvertently) that the initial treatment was incorrect.

How can this be avoided?

• Don’t make comments to a patient judging the treatment another practitioner has provided. It’s possible that the clinical situation you’re seeing is not exactly the same as what the first practitioner saw. Also, if the patient has told you what the diagnosis and treatment was, it’s possible they might be wrong due to their lack of clinical knowledge. Making even what you see as a small or insignificant comment to a patient regarding the choice and quality of treatment provided by another practitioner could be enough to encourage that patient to make a complaint or a demand for compensation.
• If you’re seeing a patient for the first time, be careful to not fall into the trap of simply relying on the patient telling you what their regular treatment entails or just relying on previous clinical notes. You need to have a thorough understanding of the patient’s condition and how it may have changed over time. Only then can you decide what care will be most appropriate.
• If you’ve taken over the treatment of a patient from a colleague whose notes are insufficient, you may need to spend some time doing further assessment before continuing with their ‘usual’ treatment. It’s advisable to engage the patient in a positive conversation on why you’re doing that to manage their expectations.
• Managing patient expectations from the outset is vital. Make patients aware of what to expect from their treatment; they won’t want surprises. The more they understand about their treatment and likely outcomes, the less likely they are to be dissatisfied and look elsewhere for treatment.
• Building relationships with patients is an important element in running a successful practice.Get to know your patients and give them a reason to trust you and come back to you.
• Where appropriate, contact your patients after treatment. If you expect them to be in some pain or discomfort following treatment, they may appreciate you making contact to check how they’re feeling. If your patient hasn’t returned for a follow up appointment, call them to find out why. This gives you the opportunity to discuss any concerns they may have about their treatment.
• Patients can become frustrated with ongoing costs of treatment, especially if they aren’t seeing the benefit they’d expected. Always be open and upfront about the cost of treatment. And where possible, let them know how many appointments you anticipate they’ll need to treat their condition.
• When you’ve been treating a patient over a long period of time, continue to keep your communication with them up to date and professional. Never assume they have a complete understanding and continue educating them on positive lifestyle habits.
• Avoid offering refunds or free treatments in the event of a poor or unexpected outcome. This may be seen by the patient as an admission of responsibility or liability and they may expect that discounted or free treatments will continue. Always contact Guild Insurance on 1800 810 213 before offering any form of compensation to a patient.
• Documentation is vital! The key to dealing with a dissatisfied patient who’s considering making a claim or complaint against you is your accurate clinical records. If your work is being questioned by a patient, another practitioner or your regulator, you’ll need a record of the facts behind your decision making.
• And finally, always maintain a high level of professional and appropriate behaviour, both when treating patients and anytime you’re communicating and interacting with them. This not only reflects well on you, it can also improve the public perception of your profession.