Malpractice Concerns, Defensive Medicine, and the Histopathology Diagnosis of Melanocytic Skin Lesions

Linda J. Titus, PhD; Lisa M. Reisch, PhD; Anna N. A. Tosteson, ScD; Heidi D. Nelson, MD, MPH; Paul D. Frederick, MPH, MBA; Patricia A. Carney, PhD; Raymond L. Barnhill, MD, MSc; David E. Elder, MBChB, FRCPA; Martin A. Weinstock, MD, PhD; Michael W. Piepkorn, MD, PhD; Joann G. Elmore, MD, MPH

Disclosures

Am J Clin Pathol. 2018;150(4):338-345. 

In This Article

Conclusions

In summary, we found that one in four pathologists reported that their interpretation of MSLs was influenced toward a more severe MSL diagnosis by malpractice concerns. Pathologists with more years of MSL experience were less likely to report the influence of malpractice concerns on their diagnoses. More than 95% of pathologists reported practicing at least one of four assurance behaviors, and those who did were more likely to be influenced toward a more severe MSL diagnosis by malpractice concerns. Past personal experience with an MSL-related malpractice lawsuit was not associated with self-reported upgrading of MSL diagnoses due to concerns about malpractice, although numbers were limited for this analysis.

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