Group decisions in oncology: doctors' perceptions of the legal responsibilities arising from multidisciplinary meetings.
There is growing consensus that multidisciplinary meetings (MDMs) are the optimal means of arriving at a comprehensive treatment plan for cancer patients. However, if a patient was grieved by a decision made by an MDM and wished to recover damages, the courts would find all involved consultants responsible for decisions related to their area of expertise. The aim of this study was to assess (i) whether doctors participating in oncology MDMs are aware that they are individually accountable for the MDM decisions and (ii) whether MDMs are conducted in a way that reflects this individual responsibility. A 35-question survey was developed and peer reviewed. Doctors attending MDMs in four Australian tertiary-care hospitals were invited to respond. One hundred and thirty-six responses (91% response rate) were received from 18 MDMs across 4 hospitals. Only 48% of doctors believe they are individually liable for decisions made by the MDM. This awareness was greater for an MDM where the patient attends, than in those that were 'discussion only' (58 vs 37%; P = 0.036). Seventy-three per cent stated they would like further education about their legal responsibilities in MDMs. Thirty-three per cent of doctors feel that the MDM discussion environment is suboptimal and radiation oncologists are significantly more likely to hold this view. Even though 85% of doctors have disagreed with the final MDM decision in an important way at some time, 71% did not formally dissent on those occasions. Doctors should be made aware of the legal implications of their participation in MDMs. A greater awareness of these responsibilities and improved team dynamics should optimize patient outcomes while limiting exposure of participants to legal liability.
Sidhom
M A
MA
Liverpool Hospital Cancer Therapy Centre, Sydney, New South Wales, Australia. mark.sidhom@sswahs.nsw.gov.au
Poulsen
Mg
M
D001291:Attitude of Health Personnel; D001315:Australia; D003625:Data Collection; D003657:Decision Making; D007722:Health Knowledge, Attitudes, Practice; D007258:Informed Consent / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data; D016365:Liability, Legal; D008495:Medical Oncology / Q000706:statistics & numerical data*; D010348:Patient Care Team / Q000331:legislation & jurisprudence*; D028701:Patient Rights / Q000331:legislation & jurisprudence*; D010819:Physician's Role; D010817:Physician-Patient Relations; D011361:Professional Competence / Q000706:statistics & numerical data