Articles and Case Studies

It’s Beginning to Look a Lot Like Christmas

07 Dec 2012

Our Medico-legal Advisory Service receives over 3000 calls a year. The team discuss some of the dilemmas MDA National Members may face over the festive season.
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Q. I have just received a subpoena to give evidence in a compensation case. I will be away for four weeks over Christmas and won’t be in Australia for the hearing.Can I ignore the subpoena?

A. You should never ignore a subpoena. If you cannot comply with the subpoena due to pre-planned travel outside the state/country, contact the issuing party immediately. It may be possible for you to provide your evidence in writing, via the telephone or by video conference. If your evidence is vital to the case, the parties may agree an adjournment until your return.

Q. A patient I have treated for a number of years has recently separated from her husband. Last week she sent me a Christmas card suggesting we catch up for a drink. I know my patient is very distressed at present – how do I decline without causing her embarrassment?

A. It is always complex and difficult when a patient starts to show interest in becoming friends (or something more) outside the doctor/patient relationship. If you do not feel comfortable having the conversation in person, you could send a polite letter to the patient, pointing out that the Medical Board of Australia has strict guidelines in respect of doctor/patient boundaries.1 At MDA National we have experience in assisting Members with this difficult situation and would be happy to assist in preparing you for the conversation with the patient and/or drafting a response.

Q. I have a six year old patient who comes in with her mum. On Christmas Eve, the mum brings the child in with swimmers ear. I prescribe ear drops, and mum mentions it is dad’s turn to have the child on Christmas Day. She has asked me to write a letter saying the child is sick and needs to stay in her care. Should I write the letter?

A. Young patients who are the subject of custody arrangements need to be managed carefully. Even though you may only see one of the parents regularly, it is important that you are not seen to advocate for one party over another. You should always use your clinical judgement and keep in mind the best interests of the child. If dad is equally able to administer the drops and care for the child on Christmas Day, you should decline the request. Family disputes are highly emotive and any decision you make which may alter court ordered custody arrangements should be clinically justified.

Q. A new patient came in on 2 January requesting a First Medical Certificate for a workplace injury sustained on 24 December. She has been off work since the accident and has asked me write 24 December as the date the certificate was issued. She had trouble making an appointment over Christmas and wants her sick leave reimbursed. What should I do?

A. You can enter the date of injury as advised by the patient, which in this case is 24 December, if you reasonably believe the information provided to you by the patient is true. When it comes to signing and dating the certificate, you should write the date that the certificate was actually completed and issued to the patient, which is 2 January. If you sign and date the medical certificate as the patient has requested, and the insurer later requests a copy of the patient’s medical records, it will be clear that you did not see the patient on 24 December, and this could lead to a complaint and disciplinary action against you.2


1 Sexual Boundaries: Guidelines for Doctors. Available at: www.medicalboard.gov.au/Codes-Guidelines-Policies.aspx

2 Section 8.8 Good Medical Practice: A Code of Conduct for Doctors in Australia. Available at: www.medicalboard.gov.au/Codes-Guidelines-Policies.aspx

Anaesthesia, Dermatology, Emergency Medicine, General Practice, Intensive Care Medicine, Obstetrics and Gynaecology, Ophthalmology, Pathology, Practice Manager Or Owner, Psychiatry, Radiology, Sports Medicine, Surgery
 

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