Medical Council seeks to protect doctors

The Medical Council of Thailand has granted 30,000 doctors nationwide the right to turn down patients in non-emergency cases, and also offers protection to doctors who treat patients to the required standard, a source said yesterday.

The move followed a growing number of criminal and civil lawsuits filed against doctors.

In the "medical facts" announcement number 46/2549 issued on November 30, the council stated that, "some times in the medical treatment procedure, unwanted circumstances occur despite sufficient caution and care by the medical profession and that shall be regarded as a force majeure".

For the patients' benefit, the medical profession could refuse to treat those who were not in a life-threatening condition and that medical professionals who followed the standard medical procedures shall be entitled to rights and protection from unjust accusations.

The announcement also stated the work burden, a hospital's limitations, the physical and mental condition of the doctor, as well as the environment, might affect results and the efficiency of treatment.

Patients who cover up the true nature of their symptoms and related information along with failing to follow a doctor's advice can affect diagnosis and treatment, it said.

Meanwhile, former secretary-general of the Medical Council of Thailand Pinit Kullavanijaya yesterday said the "medical facts" announcement was to explain the rights of doctors to the public.

"It is not intended to counteract patients because a doctor's duty is to be good and treat patients the best they can. We've worked on this for nearly four years with many drafts as we wanted to get it right," Pinit said.

He said the right to turn down patients was for their benefit as some doctors may not be expert in a certain disease and might feel another doctor has the required knowledge.

Pinit said his visits around the Kingdom during the past four years found that doctors were overwhelmed by patients and that 86 per cent of doctors had less than one minute to attend to a patient, while patients had very high expectations of doctors.

Meanwhile, Suwat Thianthong, a deputy permanent secretary at the Public Health Ministry, has been assigned to oversee the drafting of a regulation to protect the medical profession from being sued.

The Nation

Medical council move attacked by victims' network

The Network of Victims of Medical Malpractice objected Wednesday to a Medical Council plan it believes will allow doctors to deny patients treatment in non-emergency cases.

Members of the network laid a mock funeral wreath for the council and carried banners condemning it.

"It's clear the Medical Council protects doctors rather than patients," network chairwoman Preeyanant Lorsermwatthan said.

A recent council announcement called "Facts about Medicine" said that for the "benefit of patients, medical practitioners may refuse to treat patients who are not in need of immediate treatment and not in life-threatening condition but must give proper recommendations or make proper referrals".

Council secretary-general Dr Pinij Kulavanich explained the announcement was for the benefit of patients as well as doctors.

"Read the announcement carefully and you will understand," he said, adding the council had not protected doctors for unsound reasons.

"But we should provide justice for doctors, too. In some areas, a single doctor has to take care of 100 patients in a very limited time," he said.

Pinij said the council would consider an amendment at its next meeting.

In a related development, Leena Jang Foundation chairwoman Leena Jangjanya complained to the Public Health Ministry that her 86-year-old mother suffered a broken kneecap as a result of alleged malpractice by an unlicensed doctor. who she identified as Chudej Chuenchom.

The Nation

MEDICAL TREATMENT

Council board stands by controversial directive

Non-emergency cases should only be handled during office hours, it repeats

The Medical Council's executive board yesterday stood by its controversial decision to allow doctors the right to refuse treatment in non-emergency cases. Critics have claimed the move is unfair and aims to simply protect doctors from malpractice lawsuits.

At a news conference yesterday the council rebutted widespread criticism of the move, published in a recent announcement.

"There's nothing legally binding or anything that affects human rights or the rights of patients in this announcement," council president Somsak Lohlekha said.

The controversial directive says doctors can refuse to treat patients whose lives are not in danger. It said that complications in cases where sufficient caution was exercised by doctors should be considered a "force majeure" - an unforeseeable event not preventable by due care.

The council also said medical services suffered from limited facilities, the emotional and physical condition of practitioners and their environment.

Somsak insisted the announcement informed people, the news media and others of the facts about the limits of medical treatment.

"The Medical Council has spent more than four years preparing this announcement. It's for the benefit of patients," Somsak said.

The directive reads "for the benefit of patients medical practitioners may refuse to treat patients who are not in need of immediate treatment and not in a life-threatening condition but must give proper recommendations or make proper referrals".

The council said yesterday doctors were now advised to transfer patients to better-equipped facilities if they were not specialised in a particular illness or procedure. If doctors did this they were protected from negligence claims.

Council secretary-general Dr Pinij Kullawanich said it would continue to inform patients of the news.

Somsak said the full council would tomorrow consider how to deal with growing criticism of the move. "It's possible further explanation will be made to clarify the content of the announcement or wording could be changed to avoid further misinterpretation," he said.

The council noted doctors had been fined and jailed for negligence in cases where patient death or disability resulted, mainly from untreatable existing disease or disability.

In addition, some diseases like dengue fever did not present obvious symptoms in their early stages and, therefore, proper diagnosis was possible only after the onset of symptoms.

However, Rural Doctors Association chairman Kriangsak Wacharanukunkiat suggested the council could remove clauses from the directive about refusal of treatment and protection from unfair litigation.

The council's executive board said yesterday doctors were exhausted and lacked rest because of the government's universal-healthcare scheme. Tired doctors could make mistakes, it said.

The board called on Public Health Minister Mongkol na Songkhla to ensure proper working conditions for doctors or show responsibility.

"Problems can be prevented if the government ensures sufficient medical services. Non-emergency cases should be treated during office hours only," the council said.

Duangkamon Sajirawattanakul

The Nation

If a Doctor refuses to treat peeps here they might be better off!

They wont refuse to treat Farangs of course.....wonder why?