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When a healthcare professional receives a request for records or, even more concerning, an email from the Health Professions Council of South Africa (HPCSA) with a letter of complaint, the first thought for a Medical Protection member should be: “How do I ask Medical Protection for help?”
While this may seem like a straightforward question, the reality is that in situations where attorneys are pressuring the member or a patient is persistently contacting them, it’s understandable that the specific information Medical Protection needs to assess the request for assistance properly might not be immediately considered. However, providing us with the relevant information as soon as possible, ideally from the outset, enables us to assist you more effectively.
With that in mind, we have outlined a basic guide below on the information required by Medical Protection to consider a member’s request for assistance.
Medical Protection aims to make the process of requesting assistance as straightforward as possible. Members can reach out through the following methods:
Phone Number: 0800 014 780 Availability: 24/7 for general medicolegal advice in emergency situations. Process: Members can call directly. After confirming their identity with contact details, date of birth, email address, case reference, specialty, or home address, general advice will be provided. For case-specific requests, members are often asked to email detailed information to Medical Protection for thorough consideration and expert discussion. Note: If a practice manager or receptionist calls, Medical Protection must request the member to make contact directly to ensure confidentiality and ensure compliance with POPIA and GDPR requirements.
Steps: 1 - Go to the ‘Contact’ tab. 2 - Scroll down to the ‘Medicolegal advice’ option. 3 - Select the ‘Submit query’ tab. 4 - Download and complete the form, then email it to Medical Protection.
Addresses: medical.rsa@medicalprotection.org casemanagement@medicalprotection.org.za Instructions: Members should use their email address to ensure identity verification. If a member wants a receptionist or practice manager to handle correspondence, they must explicitly state this via email. A plan on handling normal and abnormal results is needed. Even normal results may lead to further action, let alone abnormal ones.
By following these steps, members can ensure their requests are handled efficiently and confidentially
To ensure the correct member is identified and to maintain the confidentiality of any shared information, Medical Protection requires at least three of the following identity checks for all queries:
Medical Protection membership number
Email address
Phone number
Cell phone number
Address
Specialty
Medical Protection telephone reference (provided when calling the Medicolegal Advice line)
Medical Protection case or claim reference number (provided when a file has already been opened regarding the request for assistance)
Please ensure that the information provided matches what has been given to Medical Protection’s Membership department. Since some details may change over time, it’s advisable to provide more than three of the above items for identification purposes, just to be sure.
If this information is not supplied, Medical Protection will need to verify the member’s identity by asking them to confirm three or more of the above items before assistance can be considered and a case can be opened.
The remaining information needed for assistance will be categorised based on the types of matters Medical Protection handles for its members.
For members in a limited membership grade, which requires them to be involved in private practice for a limited number of hours per week or to have an income from private practice below a certain threshold, for instance, the assigned case handler will contact the member to verify that they are practicing within their grade limitations.
Advice requests are any inquiries where a member seeks medicolegal guidance or recommendations on their next steps. To provide assistance, Medical Protection requires the following information:
Summary of the advice needed: A brief description of the advice required and the reason for the request. For example: “I need advice on how long to store records, as I have heard that the HPCSA has recently changed its guidance on this matter.”
Patient information (if applicable): If the request involves a patient, please include the dates of first and last contact with the patient, along with the patient’s initials and year of birth.
Providing this information helps Medical Protection to offer precise and relevant guidance.
Report matters include the following scenarios:
Adverse Incident Reports: When something may have gone wrong during patient management or a patient experienced a complication, and the member wants to inform Medical Protection in case medicolegal action is pursued.
Claims-Made Adverse Incident Reports: For members in a claims-made membership, notifying Medical Protection of any matters with potential medicolegal risks as soon as reasonably possible.
Requests for Records: From patients or attorneys, whether made orally or in writing.
Requests to Attend Hearings or Act as a Witness in legal matters.
Requests to Prepare a Report regarding the member’s clinical involvement with a patient.
To consider providing assistance, Medical Protection needs the following information:
Dates of first and last contact with the patient.
Patient’s initials and year of birth.
Brief summary of the member’s involvement with the matter.
Correspondence: Any communication the member has had with the patient, the patient’s family, or their attorneys regarding the matter.
Additional documents: Any other documents the member feels are necessary for Medical Protection to consider, such as a draft report for review.
Please note that patient medical records should not be sent to Medical Protection initially. These will be requested if and when they are needed.
Complaint matters involve any request for assistance related to an expression of dissatisfaction with a member’s clinical practice. This classification applies whether the complaint is delivered directly to the member or via a third party, such as the member’s employer or practice. However, if the complaint is addressed to the HPCSA, it will be classified as a Regulatory matter, which will be discussed later.
For complaint matters, Medical Protection requires the following information to consider providing assistance:
Copy of the complaint: If the complaint is made orally, a summary of the complaint will suffice.
Regulatory matters include any correspondence between the member and the HPCSA, such as complaints, investigations into the member’s practice, or investigations into alleged impairment.
To consider providing assistance, Medical Protection requires the following information:
Correspondence: A copy of any correspondence received from or sent to the HPCSA.
Patient involvement (if applicable):
Patient’s full name and date of birth.
Any correspondence with the patient, the patient’s family, or their attorneys regarding the matter.
Additional documents: Any other documents the member feels are necessary for Medical Protection to consider.
Draft response: If an explanation is required, the member may send a draft response for consideration by Medical Protection.
Providing this information helps ensure that Medical Protection can offer the most effective assistance.
These matters involve situations where a patient or their authorised representative demands reimbursement or compensation for alleged harm caused by the member’s management or involvement in the patient’s care. This includes cases where the member has received a letter of demand or a summons. It also covers situations likely to evolve into a claim, such as when a patient indicates they seek compensation, like in cases of dental damage caused by an anaesthetist.
To consider assistance, Medical Protection requires the following information:
Legal documents: A copy of the summons, letter of demand, or any other legal documents issued to the member.
Once Medical Protection receives an email from a member, they aim to respond within two to five working days, unless immediate assistance is required. The most crucial step in any medicolegal matter is to involve Medical Protection as soon as possible and respond promptly to requests for further information to avoid delays. Failing to seek assistance or respond promptly can escalate a simple complaint into an HPCSA complaint, fine, or a claim where a judgment is made without Medical Protection’s expertise, potentially affecting the resolution’s fairness.