Bryan Ma, Ye-Jean Park, Jing Han, Maharshi Gandhi, Michele Ramien, David Klassen, Laura Payant, Elaine Rose, Gary Garber, Mireille Probst, Jori Hardin
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Aggregate, anonymized data was reviewed and case outcomes, patient harm, and contributing factors were extracted.</p><p><strong>Results: </strong>Nearly one-fifth of all dermatologists who are CMPA members have been named in at least one medico-legal case between 2013 to 2022. A total of 396 civil-legal actions or College complaint cases involving dermatologists were closed at the CMPA during this timeframe. The most common patient allegations were deficient assessment (34%), diagnostic error (28%), and unprofessional manner (22%). Nearly half of patients experienced a harmful event, the majority of which were asymptomatic or mild. The most frequently identified contributing factors related to providers were poor clinical decision making (n = 73), lack of situational awareness (n = 67), and conduct and boundary issues (n = 59). Team factors included a breakdown of communication with patients (n = 124).</p><p><strong>Conclusions: </strong>Improved communication with patients for informed consent, treatment plans, clinical follow-up, and documentation of thorough clinical patient assessments can improve patient satisfaction and health outcomes, and mitigate dermatologists' medico-legal risk.</p>","PeriodicalId":15403,"journal":{"name":"Journal of Cutaneous Medicine and Surgery","volume":null,"pages":null},"PeriodicalIF":3.1000,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Medico-Legal Complaints Against Dermatologists: Data From the Canadian Medical Protective Association, 2013 to 2022.\",\"authors\":\"Bryan Ma, Ye-Jean Park, Jing Han, Maharshi Gandhi, Michele Ramien, David Klassen, Laura Payant, Elaine Rose, Gary Garber, Mireille Probst, Jori Hardin\",\"doi\":\"10.1177/12034754241275989\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Medico-legal complaints against physicians are a significant source of anxiety and could be associated with defensive medical practices that may correlate with poor patient outcomes. 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Nearly half of patients experienced a harmful event, the majority of which were asymptomatic or mild. The most frequently identified contributing factors related to providers were poor clinical decision making (n = 73), lack of situational awareness (n = 67), and conduct and boundary issues (n = 59). 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引用次数: 0
摘要
背景:针对医生的医疗法律投诉是焦虑的重要来源,可能与防御性医疗行为有关,而防御性医疗行为可能与患者的不良治疗效果相关。在加拿大,患者向监管机构和法院投诉皮肤科医生的情况鲜为人知:方法:加拿大医学保护协会(Canadian Medical Protective Association,CPA)对加拿大皮肤科医生的医疗法律投诉进行了调查:方法:查询加拿大医疗保护协会(CMPA)资料库,了解过去十年中涉及皮肤科医生的所有结案案例。对匿名的汇总数据进行了审查,并提取了病例结果、对患者的伤害和诱因:2013年至2022年期间,在所有皮肤科医生中,有近五分之一的CMPA会员至少在一起医疗法律案件中被点名。在此期间,CMPA共审结了396起涉及皮肤科医生的民事诉讼或学院投诉案件。最常见的患者指控是评估不足(34%)、诊断错误(28%)和态度不专业(22%)。近一半的患者经历过有害事件,其中大多数没有症状或症状轻微。与医疗服务提供者有关的最常见诱因是临床决策失误(73 人)、缺乏情景意识(67 人)以及行为和边界问题(59 人)。团队因素包括与患者沟通不畅(n = 124):结论:加强与患者在知情同意、治疗计划、临床随访和全面临床患者评估记录等方面的沟通,可以提高患者满意度和医疗效果,降低皮肤科医生的医疗法律风险。
Medico-Legal Complaints Against Dermatologists: Data From the Canadian Medical Protective Association, 2013 to 2022.
Background: Medico-legal complaints against physicians are a significant source of anxiety and could be associated with defensive medical practices that may correlate with poor patient outcomes. Little is known about patient concerns brought to regulatory bodies and courts against dermatologists in Canada.
Objective: To characterize factors contributing to medico-legal complaints brought against dermatologists in Canada.
Methods: The Canadian Medical Protective Association (CMPA) repository was queried for all closed cases involving dermatologists over the past decade. Aggregate, anonymized data was reviewed and case outcomes, patient harm, and contributing factors were extracted.
Results: Nearly one-fifth of all dermatologists who are CMPA members have been named in at least one medico-legal case between 2013 to 2022. A total of 396 civil-legal actions or College complaint cases involving dermatologists were closed at the CMPA during this timeframe. The most common patient allegations were deficient assessment (34%), diagnostic error (28%), and unprofessional manner (22%). Nearly half of patients experienced a harmful event, the majority of which were asymptomatic or mild. The most frequently identified contributing factors related to providers were poor clinical decision making (n = 73), lack of situational awareness (n = 67), and conduct and boundary issues (n = 59). Team factors included a breakdown of communication with patients (n = 124).
Conclusions: Improved communication with patients for informed consent, treatment plans, clinical follow-up, and documentation of thorough clinical patient assessments can improve patient satisfaction and health outcomes, and mitigate dermatologists' medico-legal risk.
期刊介绍:
Journal of Cutaneous Medicine and Surgery (JCMS) aims to reflect the state of the art in cutaneous biology and dermatology by providing original scientific writings, as well as a complete critical review of the dermatology literature for clinicians, trainees, and academicians. JCMS endeavours to bring readers cutting edge dermatologic information in two distinct formats. Part of each issue features scholarly research and articles on issues of basic and applied science, insightful case reports, comprehensive continuing medical education, and in depth reviews, all of which provide theoretical framework for practitioners to make sound practical decisions. The evolving field of dermatology is highlighted through these articles. In addition, part of each issue is dedicated to making the most important developments in dermatology easily accessible to the clinician by presenting well-chosen, well-written, and highly organized information in a format that is interesting, clearly presented, and useful to patient care.