After an error, there are times when immediately stopping treatment not best: CMPA

The Canadian Medical Protective Association (CMPA)1 read with interest the article published in the June 17, 2022 issue of the Medical Post entitled, “What to do when a treatment goes wrong?” by Claire Immega and Harpreet Dosanjh. We know the Medical Post has previously published articles by these authors, including “Sign on the dotted line: What you need to know about consent and waiver forms” (January 28, 2022) and “No complaints: 6 tips for preventing disciplinary actions” (December 1, 2021). We expect some of the comments in the articles by Immega and Dosanjh may create confusion among the medical profession, given they are not consistent with the CMPA’s advice to physicians. For example, the article “What to do when a treatment goes wrong?” advises physicians to “immediately stop treatment” if a problem arises. The CMPA generally takes a more principles-based approach when providing advice, taking into account the particular patient’s needs and the physician’s obligations in the circumstances. While removing oneself as most responsible physician may be appropriate in some circumstances, this does not imply “stopping treatment”. Stopping treatment is not generally an appropriate response to a patient safety incident (unless the treatment itself is the cause of the harm). The safety and wellbeing of the patient must be paramount. For example, the CMPA’s publication “Disclosing harm from healthcare delivery: Open and honest communication with patients” emphasizes attending to the patient’s clinical needs and seeking to improve the patient’s existing clinical condition. This publication also discusses the importance of maintaining an open, honest dialogue with the patient and provides a roadmap for disclosure. Read: College complaints on the rise: Better communication can help, CMPA says The Immega and Dosanjh article “What to do when a treatment goes wrong?” also recommends that physicians report to their “insurer if they have concerns about a possible regulatory complaint or lawsuit.” The article further suggests that admitting liability “can void your professional liability insurance.” While this advice is relevant for physicians who maintain liability protection through an insurance company, it is not applicable to those physicians who are CMPA members. The CMPA provides medico-legal assistance and liability protection to more than 105,000 physicians in Canada. Because the CMPA is a mutual defence organization and not an insurance company, it does not require its physician members to report situations that may give rise to legal proceedings in advance of requiring assistance. Read understanding the CMPA mutual membership model to learn more about the CMPA’s membership model. CMPA members who experience medico-legal difficulties, such as medical negligence claims or medical regulatory authority (college) complaints, can request CMPA assistance. CMPA assistance will not be declined due to an admission of liability, and our physician advisors are always available to provide guidance and support to physicians faced with patient safety incidents, including in relation to acknowledging responsibility for harm. Whenever physician members encounter medico-legal difficulties relating to the practice of medicine, they are encouraged to contact the CMPA for case-specific advice. The CMPA also has publications on a variety of medico-legal issues that are available online at www.cmpa- acpm.ca. Dr. Lisa Calder is the chief executive officer of the CMPA. References: The CMPA is Canada’s largest national medical association for doctors. As part of the CMPA’s commitment to assist members in reducing their medico-legal risk and to contribute to improvements in the safety of care, the CMPA provides risk management advice on a number of different issues related to the practice of medicine. This advice is delivered in various forms, including through the CMPA’s education sessions, workshops and publications.

After an error, there are times when immediately stopping treatment not best: CMPA

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