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RE: Do Medical Administrators owe a duty of care to patients for their management decisions?

Professor Loh’s article published in the April 2016 edition of the Quarterly, is a useful and succinct review of the current legal position for medical administrators.  I agree that we should be accountable for our decisions, and that patient safety is a key function of medical administration, but I also feel that there are some key differences between the decisions clinicians make and those made by medical administrators.
Clinicians often make decisions solely regarding the patient they are currently treating.  Their duty of care is clear.  Medical administrators, on the other hand, have to balance the individual needs of a patient, with the competing demands of the system, budgets and waiting lists.  This broader view of the healthcare system may mean that some decisions, which should and need to be made, are not in the best interests of a particular patient.  Are we then in breach of our duty of care to that patient?
For example, how does a medical administrator’s duty of care apply when a high cost drug is refused or a service withdrawn?  The viewpoint of medical administrator is often of the whole hospital or system and they may see that the funding for this drug may bring greater advantages if carefully spent elsewhere.  Is this a breach in the duty of care owed to this patient and are we responsible for the resultant harm?  It could certainly be argued (as stated in Professor Loh’s final paragraph) that this management decision will have a direct impact on patient care. 
As leaders and healthcare advocates, the application of direct duty of care to the patients within the hospital is perhaps contentious, but really underlines the care medical administrators must take in making management decisions.  This, of course, is already well known, and extensive consultation is usually undertaken when the correct course of action is not apparent. 
This article suggests to me is that we all need to be more aware of the personal risks that our decisions may bring.  Perhaps the college could provide further education around record keeping practices to aid in any defence or justification of decisions made as well as a continued commitment to provide up to date legal information as supplied by Professor Loh in this article.
Dr Nigel Fellows
RACMA Candidate


Last Updated on Thursday, 29 June 2017 11:15