Choosing Indemnity Cover: Occurrence vs Claims-Made
The least interesting administrative decision you will ever make, and the one most likely to leave you personally exposed a decade after you stop operating.
8 min read
Blog stream
Professional Practice
Patient safety, consent, medicolegal practice, documentation and the systems surgeons work in.
27 articles, newest first.
The Coroner's Inquest: A Surgeon's Guide to Giving Evidence
A coroner's inquest is not a trial and cannot find you liable, yet it can be deeply exposing. Surgeons who find it hardest prepared for the wrong thing.
9 min read
Guidelines vs Protocols vs Pathways
Guidelines, protocols and pathways mean different things, including in court. Departing from a guideline is defensible with reasoning; a protocol is different.
8 min read
Safeguarding: Children and Vulnerable Adults in Orthopaedics
Safeguarding in orthopaedics: you need not be certain and are not the investigator. Concerns surface early, and the threshold to act is lower than most assume.
8 min read
Writing a Business Case for Equipment or a List
Surgeons lose these arguments by making a clinical case to a financial audience. The evidence that a new implant is better is necessary and nowhere near sufficient.
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Fitness to Practise: What Happens When a Surgeon Is Referred
Fitness to practise asks if you are safe to practise now, not whether you once erred. Knowing the stages and getting support on day one changes how it goes.
9 min read
Incident Reporting: What Happens After You Submit
Incident reporting: surgeons report far less than other staff, largely because nothing visibly happens. Where a report goes, and what makes one worth reading.
8 min read
Serving as an Expert Witness: Duties, Pitfalls, Getting Started
As an expert witness your duty is to the court, not whoever pays you. Experts get into trouble when they forget that or stray beyond their own practice.
9 min read
Run Charts and SPC for Surgeons
Run charts and SPC for surgeons: two bars cannot show change. Control charts separate real signal from ordinary noise, so you stop reacting to random variation.
8 min read
Never Events: Wrong Site, Wrong Implant, Retained Items
Never events in orthopaedics: wrong site surgery is the commonest, and orthopaedics has a large share of wrong-implant events. Why they occur, what stops them.
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Root Cause Analysis After a Serious Incident
Root cause analysis after a serious incident: there is rarely one cause, and England no longer mandates RCA. What replaced it, and how hindsight bias skews it.
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Duty of Candour: What It Requires and How to Do It Well
The duty of candour is a professional obligation and, above a threshold, a statutory one. The rules are clearer than most think; waiting to know more is wrong.
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Running an M&M Meeting That Changes Something
Most M&M meetings are a list of cases and a shrug. Those that change something share a structure, a classification and an actions register read out first.
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Capacity and Best-Interests Decisions in Orthopaedic Practice
Capacity is decision-specific, time-specific and presumed until disproved. The commonest surgical error is treating a refusal you disagree with as incapacity.
11 min read
PDSA Cycles That Actually Finish
Most surgical improvement projects die between the first measurement and the second. The reasons are predictable — and so are the fixes.
8 min read
Informed Consent After Montgomery: How Standards Differ Worldwide
Informed consent after Montgomery: disclosure is judged by the patient, not the profession. The legal test, how countries differ and how to consent well.
13 min read
What Clinical Governance Actually Is
Clinical governance is not a committee or training module. It is the accountability framework connecting audit, incidents, guidelines and appraisal.
7 min read
The Medico-Legal Duties of a Surgeon: A Global Overview
The medico-legal duties of a surgeon: negligence, consent, candour and regulation run on separate tests, and trainees have duties of their own. What applies.
11 min read
How to Write a Good Operation Note
The operation note is a legal and clinical record that matters. How to write clear, complete, defensible operative notes every time.
3 min read
Building Trust With Patients Quickly
How to establish trust with patients fast — in clinic, on the ward and before surgery.
10 min read
Cultural Competence in Surgical Practice
Why cultural competence improves care, and practical ways for surgeons to communicate across difference.
9 min read
How to Apologise Well When Something Goes Wrong
How a genuine, well-judged apology helps patients heal and protects trust when something has gone wrong.
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Writing Clear Referral and Clinic Letters
How to write referral and clinic letters that are clear, useful and reflect well on you.
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Mastering the Surgical Handover
How to give and receive a clear, safe surgical handover that protects patients and the team.
9 min read