Dr Rob Walters
Previous MIPS Clinico-Legal Adviser
Recent implications by some GP after hours providers that the patient's usual GP bears the responsibility for the follow up and communication of any investigation results to the patient, arising from tests ordered by that after hours provider is incorrect and dangerous.
Fundamentally, whoever orders the investigation bears the prime responsibility for following up the results of that investigation and the transmission of the results and significance of same to the patient. Whilst clearly it makes sense to request that the patient should also seek the results after explaining the importance of doing so, it will not be a sufficient defence should they fail to do so, or fail to attend a follow-up appointment.
Obviously any doctor subsequently treating the patient and who is aware of investigations having been performed, should also seek and discuss those results and explain their significance and any subsequent management that might be required.
All of this of course raises the issue of notification/‘follow up’ systems both within and external to a medical practice/hospital.
Whilst the advent of electronic notifications from pathology/radiology providers direct to practices, is certainly an improvement on the old paper based system, it also brings with it certain risks of significant results being filed on a patient's records without being given due attention.
A documented ‘follow up system’ is required with a strong focus on risk management.
RACGP Standards recommend that a ‘follow up system’ ensures that:
- all received test results and clinical correspondence (eg reports from other healthcare providers) relating to a patient's clinical care are reviewed
- clinically significant tests and results are followed up with the patient
- patients are made aware of the seriousness of not attending a follow-up
- patients are made aware of who is responsible for communicating with whom about results and when this is to occur.
The same principles of course apply to specialist practice as well.
Should members have any queries related to these issues they are advised to contact MIPS for advice on 1800 061 113.