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Legal complaints for missed melanomas double in a decade

Medico-legal experts have warned that UK GPs urgently need extra training to spot melanomas if they are reduce the growing number of legal cases brought against the profession.

The Medical Defence Union (MDU) – reported in GP online magazine – has called for GPs to receive better training to improve early diagnosis and referral of melanoma in the light of a rising number of legal complaints. Cases brought against medical professionals for missing or incorrectly diagnosing the disease have doubled in just a decade.

The MDU, which handles legal complaints, received on average seven melanoma-based claims per year between 1996 and 2000, but for the period 2008-2012 this figure jumped to 15. 85% of cases were against GPs. The MDU also recommends

that GPs who have missed a melanoma diagnosis offer a ‘full, honest and timely response’, including an apology, in an effort to help prevent the matter escalating into legal action.

Because they are frequently the first point of call, and responsible for making an initial diagnosis and referring patients on, GPs are especially vulnerable to complaints of this kind.

Dr Michael Devlin, MDU head of professional standards and liaison, is quoted as saying: “Melanoma is especially challenging, because without adequate training and experience, diagnosis can be difficult. Therefore, we encourage doctors to seek further training if required and to work in-line with national and locally-agreed guidelines.

“If things do go wrong, particularly if the outcome is poor or unexpected, we recommend an explanation, an apology and action to fix the problem, if possible. A full, honest and timely response may prevent the matter from escalating into a claim. It’s important to talk to your medical organisation as soon as you are aware of a potential problem.”

Per Hall, Clinical Director at Check4Cancer and a pioneer in the early detection of melanoma, comments: “Melanoma is relatively rare (14 per 100,000 population) but is still the sixth most common cancer in the UK, killing over 2,000 people a year – more than road traffic accidents. Its early detection is the key to improving survival or even achieving cure. The challenge faced by General Practitioners is that they are, by definition, not specialists – but with cancer incidence increasing across the board, it is more important than ever that they are properly equipped to recognise initial danger signs in the short time they have with patients.

“This not only means knowing what to look for, but understanding when individuals are at higher risk due to factors such as fair skin, a family or personal history of skin cancer, genetic predisposition (dysplastic naevus syndrome) or immunosuppression due to drugs or other illnesses. Ultimately, the issue here is not protection of GPs against legal action, but preventing cancer – and we can all play our part in that, by being aware of risk factors ourselves and understanding the dangers of sun exposure. Increasingly, employers are also offering skin cancer checks as benefits or as part of a one-off wellbeing campaign, many of which are implemented by Check4Cancer. All our checks are carried out by specialist staff with hospital experience of melanoma. With the holiday period upon us I would encourage anyone worried about this issue to discuss it with their GP and perhaps take it up with their employer as well.”

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