The Medical and Dental Practitioners Disciplinary Tribunal is usually organised by the Medical and Dental Practitioner Investigating Panel (MDPIP) of the Medical And Dental Council Of Nigeria (MDCN). MDCN is the regulatory body for the medical, dental and alternative medicine professions in Nigeria.
Early in the month of June 2022, a series of pending cases reported across the country for disciplinary actions was examined by the panel during the 3-days tribunal in Abuja. Click here to watch the proceedings of day 1, day 2 and day 3. However, during the different sessions, here are some observations, commendations and recommendations to be considered.
The setting and arrangement of the tribunal: Being composed of experts from all involved fields and subspecialties in medicine and healthcare management, the cross-section examination process by the tribunal was largely robust. With the likes of Prof. Osibogun (Public health physician), other consultants (pathologists, Obstetrician and Gynaecologists, head of medical services) and legal representations – which is highly commendable.
However, the long standing position of doctors under interrogation and some derogatory intonation used during the interrogations could be critically worked on for a better ambience for the doctors. Likewise, removal of case file from the possession of the doctor at the point of interrogation, which is being used as backup and to crosscheck facts could be reviewed.
Attendance: Overall, this was impressive. As the tribunal was filled to its capacity mostly (with council members, participants representing both parties involved in the medico-legal case and witnesses), and there was online participation as well. However, more publicity could help with more participation, improve attendance and even get the attention of stakeholders.
In the course of the proceedings, items or factors noted to affect the trend and outcome of each case, were observed to include the following:
Documentation: Most of the exhibits presented and evidence referred to were sworn affidavits, case notes, investigation results, treatment plans, discharge notes/summaries detailing patient’s state of discharge, discharge medications, working or definitive diagnoses (pre-Op, intra-Op and post-op) and so on.
This goes to show that proper documentation, records and case note keeping cannot be overemphasised. Also as important, is the prompt provision and availability of these listed documents for defence. Likewise, ensuring that documents or documentation are not contradictory. Because they are thoroughly examined line by line, tallying dates, times, vital figures and every detail in between.
Communication: This is another important observation, as a lot of issues wouldn’t have come up or could have been resolved with effective interpersonal communication between the doctor, managing healthcare team, patient, and patient’s relatives. Also, inter and intra professional communication among healthcare providers involved in the management of patients has proven very important. This helps to query investigation results, seek second opinions on diagnosis and treatment plan, and appropriately escalate issues to qualified (sub)specialists for expert management.
Constant update of Doctors profile on MDCN portal: A significant lapse on the side of most doctors being reprimanded by the tribunal is their failure to update their knowledge, skills, new certifications or levels on the MDCN site. This is a way of informing the council of your proficiency in your area of expertise. If this is not done, it is assumed its non-existent. Therefore, even if a doctor is indeed trained to render a particular service or carry out a procedure, if its not duly registered and updated with the council, such qualification is not regarded by the council.
Employing the services of experts in Private Practice: This should and must always be done the proper way, as it was noted that expertise management in Private Prcatice is commonly carried out inappropriately. The proper ways recommended to get experts involved in patient management are usually through employment, referral or locum.
Furthermore, following these 3-days sessions, feasible synergy is needed between the legal arm (lawyers) and medical practice for smooth identification and viable prosecution of a medical negligence. Likewise, explicit processes and rules must be stated as guidelines for involved witnesses to give evidence to the best of their knowledge and the council’s, to avoid bias and time wasting. Clear instructions and invitation messages must be sent to every representation, which must be time bound with stated sanctions.
Also, health seeking behaviour, perception and expectation of patients, patients family and the general public must be well managed by the healthcare team, especially by medical doctors.
Finally, for charges to be brought to prosecution or cases reported for any form of medical malpractice by a medical doctor; a petition in affidavit form must be written and addressed it “The Secretary, Medical and Dental Practitioner Investigating Panel, Plot 1102, Cadastral Zone B11, Off Oladipo Diya Road Behind Prince and Princess Estate, Kaura District, Abuja, Nigeria”.