Zhang Zach, Hawary Hassan El, Oxley Paul, Gilardino Mirko S, Arneja Jugpal S
Division of Plastic and Reconstructive Surgery, Department of Surgery, University of British Columbia, Vancouver, Canada.
Division of Plastic and Reconstructive Surgery, Department of Surgery, McGill University, Montreal, Canada.
Plast Surg (Oakv). 2024 Dec 5:22925503241300337. doi: 10.1177/22925503241300337.
Being named in a medicolegal complaint can be a lengthy process filled with uncertainties. Its current impact on Canadian plastic surgeons is unknown. We aim to review the impact of medicolegal complaints and provide advice for surgeons on how to prevent, minimize, and navigate through the medicolegal process. An anonymous survey was sent to registered Royal College of Physicians and Surgeons of Canada certified plastic surgeon members. The survey collected data on surgeon demographics (clinical status, gender, practice type, volume), medicolegal complaint history and outcome, impact on practice, and insights into the process. Surgeons with an inactive practice and invalid contact information were excluded. Out of 456 invited plastic surgeons, 100 responses were included, 73% were male, with an even distribution of practice types and years in practice. Most were Canadian Medical Protective Association (CMPA) members. A significant portion (62%) had been named in a medicolegal action, primarily related to treatment complications (42%) and poor outcomes/disease progression (34%). Factors associated with complaints were greater years in practice (<.01), and a higher annual volume of operating room cases (=.02). The duration of the medicolegal process varied, with the majority taking 1-2 years. Respondents predominantly agreed that CMPA provided adequate legal defence (83%, 53/64). However, most surgeons felt the process had a significantly negative impact on their mental health (75%, 48/64). After being involved in a complaint, many surgeons modified their practice pattern by increasing documentation/consent process (45%, 29/64), avoiding certain procedures (22%, 14/64), and avoiding care of high-risk patients (19%, 12/64). Despite legal resolution in favour of the physicians, the results of this survey indicate the medicolegal complaint process has a significant impact on plastic surgeons' practices, time, and mental health. Understanding the medicolegal process and outcome is crucial for risk mitigation.
被卷入医疗法律投诉可能是一个漫长且充满不确定性的过程。目前其对加拿大整形外科医生的影响尚不清楚。我们旨在回顾医疗法律投诉的影响，并为外科医生提供有关如何预防、最小化以及应对医疗法律程序的建议。向加拿大皇家内科医师与外科医师学院注册认证的整形外科医生会员发送了一份匿名调查问卷。该调查收集了有关外科医生人口统计学信息（临床状态、性别、执业类型、手术量）、医疗法律投诉历史及结果、对执业的影响以及对该程序的见解等数据。不活跃执业状态和无效联系信息的外科医生被排除在外。在456名受邀的整形外科医生中，有100份回复被纳入，其中73%为男性，执业类型和执业年限分布均匀。大多数是加拿大医疗保护协会（CMPA）的成员。很大一部分（62%）曾被卷入医疗法律诉讼，主要与治疗并发症（42%）和不良结局/疾病进展（34%）有关。与投诉相关的因素包括更长的执业年限（<.01）和更高的年度手术室病例量（=.02）。医疗法律程序的持续时间各不相同，大多数需要1至2年。受访者大多同意CMPA提供了充分的法律辩护（83%，53/64）。然而，大多数外科医生认为该程序对他们的心理健康有显著负面影响（75%，48/64）。在被卷入投诉后，许多外科医生通过增加文件记录/同意程序（45%，29/64）、避免某些手术（22%，14/64）以及避免治疗高危患者（19%，12/64）来改变他们的执业模式。尽管法律裁决有利于医生，但本次调查结果表明，医疗法律投诉程序对整形外科医生的执业、时间和心理健康有重大影响。了解医疗法律程序及结果对于降低风险至关重要。
