Dermatologists

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      What Dermatologists need to know about their Liability Coverage

      The medical specialty of dermatology has both surgical and non-surgical components, with subspecialties that include cosmetic dermatology, dermatopathology, immunodermatology, Mohs surgery, pediatric dermatology and teledermatology. The primary professional organization for dermatologists is the American Academy of Dermatology (AAD). Founded in 1938, the AAD has a membership of about 17,000 physicians.

      Dermatology is not considered a high-risk specialty by medical professional liability insurers, especially if the dermatologist does not perform surgical procedures, so rates for the specialty are generally modest, but premiums can vary widely for a number of reasons. Medical malpractice insurance rates are higher in certain states, particularly those without caps on non-economic damages, and are also generally higher in urban and litigious areas of the country. Dermatologists who spend more than 10 percent of their time in cosmetic practice can also expect to pay somewhat higher rates. Other details of the practice—such as previous claims, hours worked and number of patients seen per week—can affect the price of medical malpractice insurance for dermatologists. According to a survey from the AAD, most dermatologists have per occurrence coverage limits of $1 million, which is a standard amount in most states for medical professional liability policies.

      In recent years, across medical specialties, there has been a trend toward increasing use of office-based surgery. Dermatology is unique in that it has a more-established history of performing office-based procedures than most specialties. The most common procedure performed by members of the American Society for Dermatologic Surgery is skin cancer surgery. Most dermatologic procedures are assigned a low level of malpractice risk, and indeed the rate of serious complications is low. Dermatologic surgeons tend to operate alone, outside the hospital setting, so there is a comparative lack of data on the risks of dermatologic procedures.

      Though data on malpractice in dermatology is limited, available sources give some insight into common causes of malpractice suits against dermatologists. The content of two legal databases reveal that malpractice cases in the specialty can arise from all kinds of cases, with many cases resulting from the most common skin conditions. Melanoma is one of the riskiest diseases for dermatologists to treat, in terms of liability exposure. Other conditions that are responsible for an outsized number of claims against dermatologists are malignant neoplasmasms of the skin, acne, dyschromia and psoriasis. Dermatologists should take extra care with these risky conditions, and be sure to employ effective risk management techniques. One of the most important of these techniques is effective documentation. Records should be clear, thorough and standardized. Good documentation can be a deciding factor if there is an allegation of malpractice. Also important is communication. By being clear and avoiding misunderstandings, physicians can significantly reduce the likelihood of a lawsuit.

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      This write-up for Dermatologists was put together by Michael Matray, the Editor of the Medical Liability Monitor

      Necessary Resources for Dermatologists

      American Academy of Dermatology
      American Society for Dermatologic Surgery
      Medscape: Dermatology Articles
      Dermatology Atlas
      Dermatology Foundation
      Dermatology News from Medical News Today
      Dermatology Online Journal