A study of closed plastic surgery malpractice claims by The Doctors Company found that the three most common complaints against plastic surgeons were improper performance of surgery, improper management of the surgical patient (mostly related to improper management of surgical complications), and improper performance of the treatment or procedure (cases where the patient suffered from nerve damage, scarring, and other forms of disfigurement).
The Doctors Company notes that the allegation of Improper performance of surgery, which resulted in a whopping 49% of claims, “was often made when the outcome of surgery differed from the patient’s expectations” even if the patient’s record indicated they consented to risk of known surgical complication related to their care.
In fact, plastic surgeons cited communication as one of the top three factors that contributed to a patient’s injury, along with technical performance (wrong site, poor technique, etc.) and patient factors (like body characteristics and individuals who were non-compliant with follow up care).
Communication starts at the initial consultation. A significant amount of time should be spent with the patient and/or their family understanding expectations and being clear about whether surgery will reasonably meet the patient’s needs or desires. One practical solution that can be implemented right away with little cost is to provide procedure-specific brochures to patients. A study published in the Aesthetic Surgery Journal found that plastic surgeons who gave their patients these types of brochures were significantly less likely to be sued.
While non-compliance may be viewed as a patient factor, malpractice risk mitigation falls heavily on the surgeon. Patients are less likely to comply with follow up care if they receive inadequate information or if they fail to understand instructions, so clear communication is a critical factor post-surgery as well, along with robust follow-up communication policies and documentation of follow up care, referrals, and outcomes.
The same study in the Aesthetic Surgery Journal also found a significant negative correlation between participating in carrier-required medical malpractice courses on how plastic surgeons can avoid litigation and being sued.