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Medico-legal aspects of exercise prescription

Dr. David KanM.A. (Medical Law), M.B.B.S., B. Med. Sci. (Hons)

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Stages in exercise prescriptionStages in exercise prescription

• Pre-exercise assessment.

• Advice regarding exercise regime.

• Monitoring progress.

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Legal issuesLegal issues

(1) Requisite training and expertise.

(2) Seek specialist advice if necessary.

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Legal issuesLegal issues

(3) Duty of care to exercise reasonable skills.

(4) Provide proper advice.

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Legal issuesLegal issues

(5) The negligent patient – check patient’s ability to comply with exercise regime.

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6. Communication/informed consent6. Communication/informed consent

• Obtaining “consent” from who?

• Need to discuss:-

- indication

- details of exercise regime

- potential risks

- prognosis with or without exercise.

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6. Communication/informed consent6. Communication/informed consent

• A legal hurdle?

• Establishing good rapport and managing patient’s expectation.

• check patient’s understanding

• use of information leaflets

• proper documentation - ? Consent form ?

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7. Keep good medical records7. Keep good medical records

Importance of keeping good records:

“The quality of medical records is a direct reflection of the quality of medical practice. To achieve and maintain a high standard of medical practice, proper medical documentation is essential …

… all doctors have a responsibility to maintain clear, accurate, adequate and contemporaneous medical records of their patients. Systematic record keeping helps in ensuring patients’ problems are followed and properly looked after”

Section 1.1.2 of the Medical Council Code of Conduct

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7. Keep good medical records7. Keep good medical records

• Need to record outcome of assessment, details of discussions etc.

• Different types of records.

• Your “best friend or worst enemy”.

• Does it assist you in reconstructing events without relying on memory?

• Citing approved abbreviations only.

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Richards Butler

Plaintiff’s solicitors

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