What is a medico-legal adviser?
A medico-legal adviser (MLA) is the interface between the doctor and the legal process, handling a wide variety of files ranging from general advice through to claims, complaints, regulatory issues, inquests and criminal investigations.
In ‘project managing’ cases, we liaise with the doctors involved, instruct solicitors and barristers as necessary and oversee the overall running of the case. All MLAs at Medical Protection are experienced doctors who have undergone further medico-legal training so they have an understanding of the members’ experience and are well-placed to advise them on the legal process.
What is your professional background and why did you want to become an MLA?
I finished my GP training in 2008 and moved to London from Sussex to gain experience in different roles, subsequently working as a locum in out of hours and in a number of salaried positions.
I have always had an interest in medical law, however it was as a result of a difficult time that a friend had experienced with a GMC case that encouraged me to apply for a job that I saw an MLA post advertised at Medical Protection.
I saw the direct impact it had on him and his personal life and I was also becoming increasingly aware of the pressures and challenges that doctors face in modern medical practice and I wanted to be able to help. I was shortlisted for the post and made it through the stringent interview process and almost five years later, I am still here.
Did you have to complete any extra study to be an MLA?
The learning curve when I started was steep and entailed a great deal of further study. After I joined, I completed a masters degree in medical law and ethics and also sat and passed the membership exams for the Faculty of Forensic and Legal Medicine. Both required a lot of work.
Like medicine, the law is always changing and it is important to keep knowledge up to date. At Medical Protection, we have weekly CPD sessions which help with this. This involves presentations on policy changes and guidance updates, or open discussions on specific topics.
What does the role entail?
There are many parallels between working as an MLA and as a doctor; however, as an MLA I am in a different type of consulting room providing expert advice to doctors who are now in the patient’s chair. Every case is different but you need to go through a process of considering its history, examination, investigation, diagnosis and, of course, what remedy is available.
The role is varied and draws on your knowledge of medicine, patients and the healthcare system. No two cases are ever the same.
You could be on the telephone advice line or looking through case reports one minute, and travelling across the country to attend meetings to support members the next. From representing doctors in court, to lecturing to doctors at healthcare conferences and meeting a wide range of doctors and regulators across primary and secondary care; there is no ‘typical’ day.
In many ways, being an MLA is similar to being a counsellor – doctors unsurprisingly find the investigation process extremely difficult, so we listen to their concerns, help them understand the situation and support them throughout.
As case handlers we have to be highly organised; as counsellors we must be patient and empathic, whilst retaining the objectivity necessary to offer what we believe is the best advice.
Do you still practice as a GP?
Yes, I still manage to keep up my work as a GP and supervise trainee GPs in the out-of-hours setting. I find this really enjoyable as I am able to provide trainees with valuable information about specific areas of risk in an already comparatively high risk environment.
Working at Medical Protection has also assisted in my development as a GP. It has opened my eyes to how doctors can be perceived by patients. I am now more aware of the medico-legal issues I deal with on a daily basis, such as the importance of good communication with patients, keeping accurate medical records and obtaining informed consent.
What advice would you give to GPs thinking about becoming an MLA?
If you are interested in a career as an MLA, it would be helpful to firstly complete specialist or GP training and get experience in that role.
An obvious interest in law and regulatory matters is also required and there are a number of courses which doctors can complete, such as the Faculty of Forensic and Legal Medicine’s Diploma in Legal Medicine. There is also a lot of writing and presenting involved so an excellent grasp of the English language and attention to detail is helpful.
Being an MLA presents unique challenges but can also be very rewarding, particularly when you have been able to successfully reassure and support a doctor going through one of the most stressful and difficult time of their lives, or when you obtain a positive result at the GMC or in court.
It is also a real privilege to work with the profession to help create a safer and more secure environment for patients.