The project “Scripta Manent: Better Healthcare Arising from the Way in Which Medical Opinions are Provided to Patients”, which Fabrizio Esposito will be responsible for, aims to study the consequences of the lack of an obligation by doctors to issue written opinions regarding patients’ health in Portugal legislation. In fact, under Portuguese law, medical opinions are given orally, unless the patients explicitly ask for them in writing – a right that is not known by the general population and, therefore, which remains largely unused. Such a right is, furthermore, only established in the Regulation on Medical Deontology, in article 44, paragraph 1.
The default in Portugal, being oral medical opinions, may bring nefarious consequences to patients. This project discusses the possibility of such phenomenon leading to a higher number of undertreated patients, who are convinced by their doctors, through oral arguments and the use of medical buzzwords, that a given treatment or exam is needed. Furthermore, the fact that opinions are given orally brings additional difficulties when a patient wants to compare different medical opinions to decide on what to do, as technical terms of what was mentioned tend to be forgotten. Consequently, said patient will be inclined to seek the opinion of a third or fourth expert, wasting time, energy and money to do so. Furthermore, this can also have an impact on competition between medical institutions – competition that, if functioning well, would push them to offer better medical support and services – as doctors can (and most of the time, do) recommend only specialists from the same health group, framing it as the “only” or the “better” choice. Finally, and in general terms, an oral opinion is always harder to sustain in court, when trying to construct a case of medical liability, which leaves many patients vulnerable to doctors’ malpractice with regard to ill-advised opinions given.
With this in mind, it is important to look at specific data regarding the activity of both doctors and patients, to evaluate if the previously mentioned concerns are relevant in practice. Such evaluation will, then, concern both the health care system of Portugal and of different countries, with different regulations regarding medical opinions – so that conclusions can be drawn through their comparison.
However, publicly available data – like OECD and Eurostate databases, or even national databases – is not deemed enough for this investigation, as they are mostly incomplete, since patients do not always understand they are victims of the concerns described. Therefore, such research requires patient-level uniform data, meaning data that is complete with regard to a specific range of patients and their experiences.
Better Healthcare Arising from the Way in Which Medical Opinions are Provided to Patients
