GPs with double lives: Medico-legal advisers

For a lay person, the differences between medicine and law are stark. One involves speaking to people and tending to their maladies, while the other requires the interpretation and application of complex rules and regulations.
 
GPs Dr Sara Bird and Dr Owen Bradfield have a foot in both camps as medico-legal specialists who can integrate the two disciplines for stressed doctors facing legal issues.
 
Dr Bird is Executive Manager of Professional Services at MDA National and Dr Bradfield is the Chief Medical Officer at MIPS.
 
They spoke to newsGP about how being a GP underscores their current jobs and how the union of medicine and law underpins ethics.
 
For Dr Bradfield, books and television shows about law and crime fascinated him into studying a double degree in medicine and law.
 
‘In high school, I remember reading Patricia Cornwall and watching Silent Witness. For a long time, I have been interested in issues at the intersection of medicine, law, and ethics,’ he said.
 
Watching medical colleagues burdened by medico-legal claims also inspired him.
 
‘One issue I noticed early in my career was how fearful many doctors were of medico-legal claims and how this fear sometimes impacted on clinical decisions,’ Dr Bradfield said.
 
‘I also witnessed the personal and professional impact that legal claims and processes can have on doctors.’
 
Dr Bird had a more unexpected venture into the medico-legal field.
 
‘In the mid 1990s I started working in the Sexual Assault Service at Royal North Shore Hospital, where I had done my training as a medical student and junior doctor,’ she said.
 
‘For a few years, I continued to work part-time in general practice and also in the Sexual Assault Service. In 1998 I saw an advertisement for a medico-legal adviser at The Medical Defence Union.
 
‘I thought this would be a good opportunity to continue to work at the interface between medicine and the law.’
 
Dr Bird saw her sexual assault work as dealing with criminal law, whereas her role at the medical defence organisation could be an opportunity to explore the civil side of that interface.
 
‘In reality, I fell into the medico-legal field without really knowing what it involved,’ she said.
 
‘My career was definitely not planned, and it has followed unexpected paths.
 
‘I was a partner in a four-person general practice, taking over my mother-in-law’s practice, and had to leave the practice in the early 1990s when I moved to the US for my husband’s work.
 
‘But [were it not] for the move to the US, I think I would still be working in general practice.’
 
Looking back on her career, Dr Bird identifies the steep learning curve of becoming a medicolegal adviser, but says she was ‘extremely fortunate’ to be working alongside some wise and experienced advisers.
 
Both Dr Bird and Dr Bradfield worked as GPs as their experience in the legal field garnered momentum.
 
When the latter saw the stress of legal claims on other doctors, he acted and undertook extra training.
 
‘This inspired me to undertake a PhD at the University of Melbourne in which I further explored these issues,’ Dr Bradfield said.
 
He has now worked in general practice for eight years and in the medical indemnity insurance industry for more than a decade, but he is not done studying.
 
‘I am currently taking a break from general practice while I complete my PhD,’ Dr Bradfield said.
 
‘I was working in a lovely supportive practice in Sunbury, Victoria, before I left in March 2022 to complete a Fulbright Scholarship in the US at Stanford University’s Department of Health Policy.
 
‘I hope to return to general practice in the new year, once I have submitted my PhD.’
 
Dr Bird enjoyed working as a GP and recommends it to young doctors and medical students.
 
‘I loved the diversity of the work and the breadth of knowledge required as a GP,’ she said.
 
‘I loved having my “own” patients who saw me as the primary provider of their medical care.
 
‘The practice I worked in was a traditional, suburban group practice where we would sometimes be caring for three generations of the one family, and we shared all of the on call and weekend work.’
 
The doors general practice can open
Dr Bradfield credits his general practice training as providing a solid foundation from which to pursue other passions and careers, and highly recommends it for students or junior doctors looking to combine medicine with other interests.
 
‘There were many reasons why I chose general practice as a medical specialty,’ he said.
 
‘One significant positive was that I could train and work part-time, which has allowed me to develop and pursue my interest and experience in the medical indemnity insurance space.
 
‘I very much see my medical defence work as an important way of giving back to the profession that has given me so many opportunities.’
 
And when doctors need advice and support, Dr Bradfield says they want to speak to someone who can understand and solve their problem, irrespective of whether the problem is primarily legal, clinical, or administrative. This is where his diverse professional background comes to the fore.
 
‘I hope to make an important difference for doctors and the medical profession by advocating for fairer and kinder regulatory processes, and by better understanding how changes in healthcare systems and technology today might impact clinical risk and medical indemnity insurance tomorrow,’ Dr Bradfield said.
 
‘Working in general practice and in the medical indemnity insurance industry are both immensely rewarding careers. Being able to combine the two is a bonus.
 
‘While it is a privilege to assist my patients and the community when working as a GP, it is also an honour to be entrusted with supporting and assisting doctors when they are in their time of need.
 
‘This is what medical indemnity insurance is all about – helping those who help others, or caring for our carers.’
 
He also believes being a dual qualified doctor and lawyer greatly assists with communication and shared understanding
 
‘Much of what I do sometimes is translate legalese into medical jargon, and vice versa,’ Dr Bradfield said.
 
‘Indeed, I see my role at MIPS as very much bridging the divide between two great professions for the benefit of the medical profession and the administration of justice in Australia.’
 
Dr Bird still loves working in the field and echoes Dr Bradfield’s analogy to translation and interpretation.
 
‘A large part of a medico-legal adviser’s role involves being an interpreter – interpreting the medicine in a particular case for the lawyers, and the law for doctors,’ she said.
 
‘From the moment I started working as a medico-adviser, I loved the work and I still find it a challenging and immensely rewarding area to work in.’
 
Like any good adviser, Dr Bird finishes with simple but eternally important advice for GPs.
 
‘GPs don’t need to know the ins and outs of the law – they simply need to be able to identify the situations where they should obtain advice and support from their medical defence organisation,’ she said.
 
‘Understanding the ethical and professional behaviours that make us good doctors is invaluable in preventing medico-legal problems – and I wouldn’t be a good medico-legal adviser if I didn’t mention the importance of keeping good medical records!’
 
This article is part of a series about GPs with parallel careers. Anyone interested in telling their story is encouraged to contact filip.vukasin@racgp.org.au
 
Log in below to join the conversation.

alternative career law medicolegal