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SUMMARY
Most physicians get sued at least once in their careers. Medical claims in dermatology are commonly due to misdiagnoses or errors during procedures.
Although dyschromia is an unavoidable risk after most dermatologic procedures, it is the leading cause of adverse outcomes resulting in claims. This highlights the importance of good communication.
Effective communication, risk management protocols, and other preventative practice measures should be implemented to minimize adverse events and avoid medicolegal complications.
Dermatologists should acknowledge that malpractice suits can occur. Appropriate legal measures should be taken to effectively navigate lawsuits.
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DON’T FORGET
Appropriate and clear communication is key to building patient rapport and minimizing adverse events and potential legal claims.
When appropriate, apologies should be well thought out and constructed with a formal rather than impulsive process.
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CLINICAL PEARLS
Checklists and protocols, including prebiopsy photographs, can assist with accurate biopsy site identification on the day of surgery and can minimize adverse events.
Implementation of root cause analysis peer review programs can help improve patient care, minimize errors, address adverse events, and provide protection against malpractice.
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PATIENT EDUCATION POINTS
Patients should engage in open discussion with their physicians for complete informed consent. Informed consent requires education on the risks, benefits, and alternative options of procedures, medications, and other medical therapies.
Patients should be encouraged to follow up as directed to ensure continuity of care, which can improve compliance and strengthen the physician-patient relationship.
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Medical professional liability is a risk that affects all specialties, including dermatology. A physician’s risk of getting sued, by age 65, ranges from 75% to 99% for low-risk and high-risk specialties, respectively.1 Dermatologists are not immune to litigation. Data between 1991 and 2005 revealed that the indemnity payment for dermatology was $117, 832.1 However, when comparing it with the more recent data from 2006 to 2015, the recovery per claim actually increased almost twofold to $238,145.2,3 A study found that dermatologists were only responsible for 1.2% of closed claims over a 20-year span (2006-2015).2 However, the net reduction of closed claims was lower in dermatology (2.5%) compared with other specialties (17.9%).2 Furthermore, if dermatologists comprise 1.4% of physicians, the number of claims is actually proportional to their representation of the physician population (1.2/1.4 = 0.86).2,4 Thus, it may be that dermatologists may actually be getting sued at a rate similar to other physicians.
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A review of claims between 2006 and 2015 revealed that procedural-based errors and misdiagnoses were the first and second most common issues resulting in claims, respectively. The most common adverse outcomes associated with claims were dyschromia followed by malignant neoplasms of the skin, most notably melanoma.2,5 There are many factors that affect malpractice trends. For example, female physicians and dermatologists practicing at institutions are less likely to be sued.2,...