Sara Sreih, medicolegal consultant at Medical Protection, details how she and the dedicated medicolegal team support members every day.

As a medicolegal consultant (MLC) in the Asia team at Medical Protection, our days are varied and challenging. Our roles span both the medical and legal fields, and we combine our expertise to assist doctors with the investigative processes they face. 

We handle a range of cases, such as complaints, Medical Council investigations, inquests, and criminal investigations, as well assisting with ethical dilemmas that doctors may find themselves involved in. In order to assist  members, we can instruct and work closely with lawyers – and a barrister when appropriate.

Quite often, there has been an adverse outcome at the heart of a case – some patient dissatisfaction or even patient death – and on top of having to deal with the stresses of this, the doctor may then have to navigate a difficult medicolegal process with their job, reputation or even licence to practise at risk. Often while still going about their day-to-day clinical practice. 

Unfortunately, the reality is that a single incident or complaint can result in multiple processes – what we call multiple jeopardy. The clinician may also have additional concerns about potential adverse publicity through the press or social media that might surround a case. This can be incredibly difficult for the doctor, and we aim to ease this burden. 

Having been through the process of medical training and practising clinically, we have insight into the significance of this on a doctor, and it is a privilege to be in a position to support fellow clinicians in what can be an incredibly difficult time. With the potential impact that such processes can have on wellbeing, we try our best to support our members, and are able to direct members to our free and confidential counselling service, as well as work with our press team to manage any press attention. 

As well as managing our own caseload, we also provide input into the management of cases handled by our colleagues, such as other MLCs and case managers within the team. We have a range of clinical backgrounds (such as general practice, anaesthesia, surgery, internal medicine, and psychiatry) and a range of different experiences through our work in various jurisdictions. Complex cases are discussed so that the relevant input can be sought to achieve the best outcome for our members. 

Our claims in Hong Kong are managed by claims managers and claims assistants. Our claims managers are all qualified solicitors with a background in practising medical negligence law and they manage these claims with support from medicolegal consultants and panel lawyers. As MLCs, we review the medical records, witness statements, and any expert reports received, and work jointly with the claims manager to review the prospects of success and formulate an appropriate strategy.

Medicolegal consultants also provide advice over the phone. Medical Protection provides a telephone advice line that is available to members, allowing them to contact us at any time with a medicolegal query or ethical dilemma arising from their clinical practice. This means we are able to respond to queries in a timely manner, especially if the matter is urgent – which in some cases we may need to resolve immediately. 

Although we are clinicians, we are not able to provide clinical advice as a clinical colleague would when consulted. We advise members on their professional obligations and relevant legislation so that the doctor can understand the medicolegal landscape they must navigate. We also use our knowledge and experience to provide practical suggestions that may be of assistance.

Being an international organisation means that we have an extensive understanding of medicolegal issues from various jurisdictions and means we can share our knowledge with colleagues and other parts of the business. We are able to identify trends and potential issues that might arise from changes in law and advancements in the clinical field. Regarding COVID-19, we were able to understand what difficulties clinicians might face in other parts of the world as the pandemic spread across the globe. 

We are able to respond quickly, but also proactively, to make sure that members have the relevant medicolegal resources available to them, such as the Risk Prevention webinar series on telemedicine. Just as clinicians learn from their cases, we are keen to identify lessons from our cases and share these with members. As MLCs, we are also involved in writing articles for the press, our website and Casebook, our bi-annual print publication, and delivering interactive webinars. 

We want to ensure our members have the tools to improve patient safety and manage their medicolegal risk from the outset, avoiding any complaints, incidents or claims arising in the first place.