Patricia A Carney1, Paul D Frederick2, Lisa M Reisch2, Stevan Knezevich3, Michael W Piepkorn4, Raymond L Barnhill5, David E Elder6, Berta M Geller7, Linda Titus8, Martin A Weinstock9, Heidi D Nelson10, Joann G Elmore2. 1. Department of Family Medicine, Oregon Health and Science University, Portland, Oregon; Department of Public Health and Preventive Medicine, Oregon Health and Science University, Portland, Oregon. Electronic address: carneyp@ohsu.edu. 2. Department of Internal Medicine, University of Washington School of Medicine, Seattle, Washington. 3. Pathology Associates, Clovis, California. 4. Department of Medicine, University of Washington School of Medicine, Seattle, Washington; Dermatopathology Northwest, Bellevue, Washington. 5. Department of Pathology, University of California, Los Angeles, California; Department of Pathology, Institut Curie, Paris, France. 6. Pathology, University of Pennsylvania, Philadelphia, Pennsylvania. 7. Family Medicine, University of Vermont, Burlington, Vermont. 8. Epidemiology and of Pediatrics, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire. 9. Dermatology and Epidemiology, Center for Dermatoepidemiology, Department of Veterans Affairs Medical Center, Providence, Rhode Island; Department of Dermatology, Rhode Island Hospital, Providence, Rhode Island; Departments of Dermatology and Epidemiology, Brown University, Providence, Rhode Island. 10. Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, Oregon; Department of Medicine, Oregon Health and Science University, Portland, Oregon; Cancer Prevention and Screening, Providence Cancer Center, Providence Health and Services Oregon, Portland, Oregon.
Abstract
OBJECTIVE: We sought to identify characteristics associated with past malpractice lawsuits and how malpractice concerns may affect interpretive practices. METHODS: We surveyed 207 of 301 (68.8%) eligible dermatopathologists who interpret melanocytic skin lesions in 10 states. The survey assessed dermatopathologists' demographic and clinical practice characteristics, perceptions of how medical malpractice concerns could influence their interpretive practices, and past malpractice lawsuits. RESULTS: Of dermatopathologists, 33% reported past malpractice experiences. Factors associated with being sued included older age (57 vs 48 years, P < .001), lack of board certification or fellowship training in dermatopathology (76.5% vs 53.2%, P = .001), and greater number of years interpreting melanocytic lesions (>20 years: 52.9% vs 20.1%, P < .001). Of participants, 64% reported being moderately or extremely confident in their melanocytic interpretations. Although most dermatopathologists believed that malpractice concerns increased their likelihood of ordering specialized pathology tests, obtaining recuts, and seeking a second opinion, none of these practices were associated with past malpractice. Most dermatopathologists reported concerns about potential harms to patients that may result from their assessments of melanocytic lesions. LIMITATIONS: Limitations of this study include lack of validation of and details about the malpractice suits experienced by participating dermatopathologists. In addition, the study assessed perceptions of practice rather than actual practices that might be associated with malpractice incidents. CONCLUSIONS: Most dermatopathologists reported apprehension about how malpractice affects their clinical practice and are concerned about patient safety irrespective of whether they had actually experienced a medical malpractice suit.
OBJECTIVE: We sought to identify characteristics associated with past malpractice lawsuits and how malpractice concerns may affect interpretive practices. METHODS: We surveyed 207 of 301 (68.8%) eligible dermatopathologists who interpret melanocytic skin lesions in 10 states. The survey assessed dermatopathologists' demographic and clinical practice characteristics, perceptions of how medical malpractice concerns could influence their interpretive practices, and past malpractice lawsuits. RESULTS: Of dermatopathologists, 33% reported past malpractice experiences. Factors associated with being sued included older age (57 vs 48 years, P < .001), lack of board certification or fellowship training in dermatopathology (76.5% vs 53.2%, P = .001), and greater number of years interpreting melanocytic lesions (>20 years: 52.9% vs 20.1%, P < .001). Of participants, 64% reported being moderately or extremely confident in their melanocytic interpretations. Although most dermatopathologists believed that malpractice concerns increased their likelihood of ordering specialized pathology tests, obtaining recuts, and seeking a second opinion, none of these practices were associated with past malpractice. Most dermatopathologists reported concerns about potential harms to patients that may result from their assessments of melanocytic lesions. LIMITATIONS: Limitations of this study include lack of validation of and details about the malpractice suits experienced by participating dermatopathologists. In addition, the study assessed perceptions of practice rather than actual practices that might be associated with malpractice incidents. CONCLUSIONS: Most dermatopathologists reported apprehension about how malpractice affects their clinical practice and are concerned about patient safety irrespective of whether they had actually experienced a medical malpractice suit.
Authors: David E Elder; Michael W Piepkorn; Raymond L Barnhill; Gary M Longton; Heidi D Nelson; Stevan R Knezevich; Margaret S Pepe; Patricia A Carney; Linda J Titus; Tracy Onega; Anna N A Tosteson; Martin A Weinstock; Joann G Elmore Journal: J Am Acad Dermatol Date: 2018-03-07 Impact factor: 11.527
Authors: Kachiu C Lee; Sue Peacock; Martin A Weinstock; Ge Alice Zhao; Stevan R Knezevich; David E Elder; Raymond L Barnhill; Michael W Piepkorn; Lisa M Reisch; Patricia A Carney; Tracy Onega; Jason P Lott; Joann G Elmore Journal: J Am Acad Dermatol Date: 2016-09-28 Impact factor: 11.527
Authors: Patricia A Carney; Paul D Frederick; Lisa M Reisch; Linda Titus; Stevan R Knezevich; Martin A Weinstock; Michael W Piepkorn; Raymond L Barnhill; David E Elder; Donald L Weaver; Joann G Elmore Journal: J Cutan Pathol Date: 2018-04-26 Impact factor: 1.587
Authors: Lisa M Reisch; Martiniano J Flores; Andrea C Radick; Hannah L Shucard; Kathleen F Kerr; Michael W Piepkorn; Raymond L Barnhill; David E Elder; Stevan R Knezevich; Joann G Elmore Journal: Am J Clin Pathol Date: 2020-10-13 Impact factor: 2.493
Authors: Caitlin J May; Michael W Piepkorn; Stevan R Knezevich; David E Elder; Raymond L Barnhill; Annie C Lee; Martiniano J Flores; Kathleen F Kerr; Lisa M Reisch; Joann G Elmore Journal: J Cutan Pathol Date: 2020-07-17 Impact factor: 1.587
Authors: Linda Titus; Raymond L Barnhill; Jason P Lott; Michael W Piepkorn; David E Elder; Paul D Frederick; Heidi D Nelson; Patricia A Carney; Stevan R Knezevich; Martin A Weinstock; Joann G Elmore Journal: Lab Invest Date: 2016-11-28 Impact factor: 5.662
Authors: Joann G Elmore; Raymond L Barnhill; David E Elder; Gary M Longton; Margaret S Pepe; Lisa M Reisch; Patricia A Carney; Linda J Titus; Heidi D Nelson; Tracy Onega; Anna N A Tosteson; Martin A Weinstock; Stevan R Knezevich; Michael W Piepkorn Journal: BMJ Date: 2017-06-28
Authors: Linda J Titus; Lisa M Reisch; Anna N A Tosteson; Heidi D Nelson; Paul D Frederick; Patricia A Carney; Raymond L Barnhill; David E Elder; Martin A Weinstock; Michael W Piepkorn; Joann G Elmore Journal: Am J Clin Pathol Date: 2018-08-30 Impact factor: 2.493