Patient safety: Part I. Patient safety and the dermatologist.

UNLABELLED: Congress is grappling with ways to fund health care in the future. Much of the focus rests on paying physicians for their patients' outcomes, rather than the current system of payment for services provided during each visit. The years ahead will be years of change for American health care, with an increasing emphasis on the comparison of patient outcomes and measures of quality. Patient safety initiatives will be an integral part of the overall strategy to improve American health care. Part one of this two-part series on patient safety examines what we know about patient safety in dermatology, including data from medicolegal claims and published data on patient safety in the setting of office-based surgery. The article also focuses on how medical societies, payers, the US government, and the Board of Medical Specialties are responding to calls for accountability and improvements in patient safety. LEARNING OBJECTIVES: After completing this learning activity, participants should be able to identify risks to patient safety based on an understanding of the major causes of legal claims against dermatologists, use published patient safety data to improve the practice of office surgery, and be able to improve patient safety through an understanding of requirements for maintenance of certification.

Dermatology's malpractice experience: clinical settings for risk management.

BACKGROUND: Dermatologists need objective information that will help them make rational risk management decisions. OBJECTIVE: We asked, "What can be learned from the limited sources available regarding the clinical situations associated with malpractice litigation against dermatologists?" METHODS: We searched 2 legal databases, one jury verdict and settlement reporter, and reviewed and analyzed a major report from an association of physician insurers. RESULTS: A wide variety of clinical circumstances give rise to malpractice claims. Melanoma is still associated with high risk, and common conditions are associated with relative claim frequency. The clinical details currently available do not encourage optimal responses to reports of malpractice cases. CONCLUSION: Information that clinicians can use in their own risk management efforts can be derived from available sources, but more reliable objective data is needed.