From Harbor-UCLA Medical Center and the David Geffen Medical School at University of California, Los Angeles; Nova Southeastern University; and Litigation Management and Loss Control, Applied Medico-Legal Solutions Management Group.
Los Angeles, Calif.; Dallas, Texas; and Fort Lauderdale, Fla.
Plast Reconstr Surg. 2021 Jan 1;147(1):239-247. doi: 10.1097/PRS.0000000000007497.
The current status of the plastic surgeon in the medical liability spectrum and ways to avoid litigation are explored by using pooled national data from the Medical Professional Liability Association, private information from Applied Medico-Legal Solutions RRG, and a detailed literature search. The medical liability system in the United States costs $55.6 billion, or 2.4 percent of total health care spending. Plastic surgery accounts for 3.31 percent of reported claims and 3.16 percent of paid claims. Total payments for plastic surgeons represent 1.75 percent of the total paid for all specialties. Malpractice awards are relatively light for plastic surgeons. Nevertheless, they still have a 15 percent chance per year of being sued. However, 93 percent of cases will close with a dismissal or a settlement, and only 7 percent will go to trial. Of these, the plastic surgeon will prevail in 79 percent. Most importantly, 75 percent of all cases will result in no payment. To minimize the chances of a lawsuit, plastic surgeons should maintain excellent communication with their patients and participate in shared decision-making. They should take a leadership role and buy in to the performance of perioperative checklists, embrace patient education, and actively participate in Maintenance of Certification. They should be transparent in their dealings with patients by preoperatively declaring their policies on revisions, refunds, complications, and payments. Plastic surgeons must maintain complete and accurate medical records and participate in hospital-based programs of prophylaxis. They should be aware that postoperative infection is the single costliest adverse outcome and proactively deal with it.
当前，整形外科医生在医疗责任范围内的地位以及避免诉讼的方法，可通过使用医疗责任协会的全国性综合数据、应用医学法律解决方案 RRG 的私人信息，以及详细的文献检索来探索。美国的医疗责任制度耗费了 556 亿美元，占总医疗支出的 2.4%。整形外科占报告索赔的 3.31%和已支付索赔的 3.16%。整形外科医生的总支付额占所有专业支付总额的 1.75%。对于整形外科医生来说，医疗事故赔偿相对较轻。尽管如此，他们每年仍有 15%的被诉几率。然而，93%的案件会以驳回或和解结案，只有 7%会进入审判。在这些案件中，整形外科医生胜诉的概率为 79%。最重要的是，75%的案件不会支付任何费用。为了最大程度降低诉讼几率，整形外科医生应与患者保持良好的沟通并参与共同决策。他们应发挥领导作用，认同并参与围手术期清单的执行，接受患者教育，并积极参与持续认证。他们应通过在术前声明其关于修复、退款、并发症和支付的政策，与患者坦诚相待。整形外科医生必须保留完整、准确的医疗记录，并参与医院的预防计划。他们应该意识到术后感染是最昂贵的不良后果，并积极处理。
