The study “Medical Liability in Dermatology: Trends in Liability Claims Against Dermatologists from 1991-2015” by Kornmehl and colleagues recently published in JAMA Dermatology confirms that most malpractice cases against dermatologists are “abandoned, withdrawn or dismissed”. It also showed that there has been a net reduction of 29.2% in paid claims for dermatologists.
What is not clear is what are the reasons for these trends. This is important if we are to contribute to continuing to reduce medical liability for dermatologists. The authors indicate that disclosure and apology programs may be the answer. But, is this really the case? In fact, there is data that both support and contradict this contention. Another interesting fact is that Dyschromia is the most common outcome resulting in claims. This gives credence to the common statement by many malpractice specialists that poor communication is often the key factor leading to suits. Equally interesting is that misdiagnoses and errors that occurred during an operative or diagnostic skin procedure were the cause for the first- and second-highest number of claims, respectively. Yet, information as to what specific errors occurred was not clear and may also point to the importance of proper communication. Are these errors attributable to wrong-site surgeries or inadequate informed consent?
Finally, the authors noticed that dermatologists practicing at institutions had fewer closed claims. Does this mean that academic institutions are a better place to practice medicine? If so, would this reverse the trend of graduating dermatology residents seeking private practice opportunities over academic practice opportunities? My colleague Sailesh Konda and I have addressed many of these questions in our JAMA Dermatology editorial response to the Kornmehl article. But for those of you that have not yet seen that editorial or those that have seen it and still have questions, I will discuss this topic further at the upcoming Generational DermatologyTM Palm Springs Symposium to be held on March 22-25, 2018.
1. Kornmehl, H., Singh, S., Adler, B., Wolf, A., Bochner, D. A., Armstrong, A. W. Medical Liability in Dermatology: Trends in Liability Claims Against Dermatologists from 1991-2015. JAMA Dermatology.