Monitoring Of Prostate Condition

Health and Disability Commissioner Anthony Hill today released a report finding a general practitioner (GP) in breach of the Code of Health and Disability Services Consumers’ Rights (the Code) for failing to provide appropriate care and services in relation to a man’s prostate condition.

Mr Hill said the report highlighted the importance of conducting appropriate and timely investigations and communicating test results to patients.

The man had a long history of elevated prostate-specific antigen (PSA), and had had his PSA level monitored since 2005 to check for prostate cancer. A urology specialist recommended that the man undergo a yearly follow-up of PSA and digital rectal examinations (DRE), and to return to the service if his PSA result went above 10.

The man first saw the GP in January 2015, and had consultations with him until September 2018. The GP did not perform a DRE at any of the consultations with the man. In September 2018, the GP received the result of the man’s PSA test, which showed a PSA level of 10.3. He did not tell the man about the result, nor did he refer him to a specialist. The man transferred to a different medical practice and was only informed of his 10.3 PSA result when he saw a new GP in April 2019.

Mr Hill considered that the GP was in breach of the Code for not conducting any DREs, not setting up recalls for DREs, not asking the man to return for a DRE following the high PSA result in September 2018, not recording his treatment plan and the abnormal PSA result in his clinical notes, and not using the recall system correctly. The GP was also found in breach of the Code, as he did not disclose the raised PSA result to the man promptly or discuss with him a treatment plan.

Mr Hill recommended that the GP apologise to the man, arrange an independent audit of his patient recalls/reminders, and undertake further training on communication and informed consent, and that the Medical Council of New Zealand consider whether a review of the GP’s competence is warranted.

The full report for case 19HDC00803 is available on the HDC website.

© Scoop Media