Dermatologists are doctors who specialize in the skin. A dermatologist has expertise in the diagnosis and treatment of diseases and health conditions involving the skin, nails, and hair. Dermatologists primarily perform clinical examinations and order diagnostic lab testing on patients. Treatment by a dermatologist typically involves prescription medications and follow-up examinations and monitoring. However, dermatologists do perform some invasive procedures.
The medical malpractice attorneys at our firm do not deal with or see a large number of lawsuits against dermatologists. Compared to other types of doctors such as cardiologists or OB/GYNs, most dermatologists do not find themselves defending many medical malpractice lawsuits. When dermatologists are involved in medical malpractice it often involves procedural errors and delayed diagnosis of serious dermatology conditions like skin cancer.Education Requirements for Dermatologists
Dermatologists are specialist doctors. This requires a completion of medical school and earning a degree of Doctor of Medicine (M.D.). After med school dermatologists must complete a residency training program in the field of internal medicine or general surgery. The residency is then followed by a dermatology fellowship program. Like all doctors dermatologists must pass a medical doctor exam. Dermatologists who want to be designated as "board certified" must also pass an exam with the American Board of Dermatology and satisfy continuing educational obligations.
Dermatology fellowships offer education and training in various subspecialties within the dermatology field including cosmetics, phototherapy, lasers, and immunohematology. Some dermatologists carry the designation FAAD after M.D. in their credentials. This indicates that that they have been named a "Fellow" of the American Academy of Dermatology.What Does a Dermatologist do?
The vast majority of dermatologists practice in private small group or solo clinic offices. Dermatology practices often have no affiliation or attachment to a hospital because dermatologists are usually not involved in in-patient procedures or treatment. Although dermatologists do perform a variety of mildly invasive procedures, including surgical procedures, they are largely things that can be done in an out-patient setting rather than in a hospital.
Dermatology tends to be a high volume practice type similar to that of a primary care or family doctor. Dermatologists are skin specialists and the skin is the largest single organ in the human body. Skin conditions and diseases are very common and recent healthcare studies report that 42% of participating patients had gone to a doctor for a skin condition at some point. Most dermatology patients are referred by their primary care doctors.
The most serious disease that dermatologists are directly involved with treating is skin cancer which includes melanoma, squamous cell carcinoma and basal cell carcinoma. Skin cancer is one of the most common types of cancer affecting about 1 in 5 people during their lifetime. Just under 5 million people in the U.S. receive treatment for skin cancer on an annual basis and dermatologists are at the forefront of this.
Aside from skin cancer, dermatologists also treat patients for well over 3,000 different types of conditions and diseases affecting the skin. Some of the more common skin conditions and diseases that dermatologists specialize in treating include:
- Shingles (herpes zoster): a painful viral infection that attacks sensitive nerve endings in the skin and triggers a painful rash.
- Vitiligo: a disease in which the melanin in the skin is lost resulting patches of pigment and color loss in the skin.
- Dermatitis and Eczema: condition causing uncomfortable and even painful inflammation of the skin surface.
- Psoriasis: an autoimmune disorder that causes skin cells to grow too rapidly causing red, scaling looking skin.
For the most part, dermatologists treat patients with prescription medications and other non-invasive treatment methods. However, dermatologists do regularly perform certain invasive procedures and minor surgical. These procedures are usually done on an out-patient basis in the dermatologist's office. The most common dermatology procedures include:
- Skin Biopsy: this involves the removal of skin samples for pathology testing. Dermatologists frequently perform biopsies or suspicious spots on the skin to determine whether they are skin cancer.
- Excisions: dermatologists perform surgical excisions (removals) of spots or lesions on the skin. This can be done purely for cosmetic purposes or to treat skin cancer by removing cancerous lesions.
- Mohs Surgery: this is a special type of surgical procedure in which numerous thing layers of cancerous skin are continuously removed until a cancer free skin layer is reached. Dermatologists perform this procedure often for the treatment of basal cell skin cancer.
- Skin Grafts: dermatologists often take skin from one part of the body and apply it to repair another part of the skin or body.
- Liposuction: cosmetic dermatologists regularly perform a certain type of liposuction called tumescent liposuction to remove fat from the body.
Dermatologists do get sued for medical malpractice on a fairly regular basis - just not nearly as often as their counterparts in other medical specialties. JAMA Dermatol recently published a study on Medical Liability Claims Against Dermatologists. That study examined over 90,000 medical malpractice claims filed between 1991 and 2015 and found that only 2% of them were against dermatologists. This ranked dermatology as the specialty with the 6th lowest risk for malpractice.
The JAMA study reported a fairly high rate of dismissal or abandonment of claims against dermatologists. For those claims against dermatologists that were not dismissed or withdraw, the majority were resolved by settlement without a lawsuit. For the small handful of cases against dermatologists that went to trial, the plaintiffs lost over 64% of the time.
Most medical malpractice lawyers would probably assume that failure to diagnose is the most common type of malpractice claim against dermatologists. However, the study in JAMA found that this was actually not the case. Errors during a procedure (minor surgical errors) actually accounting for most of the malpractice claims against dermatologists. Misdiagnosis was actually a distant second, accounting for less than half as many claims. However, the JAMA study found that misdiagnosis claims against dermatologists had a much higher rate of success (45%) compared to procedural error claims (32%).Dermatologist Malpractice Verdicts and Settlements
Outlined below are sample case summaries from actual medical malpractice lawsuits against dermatologists that resulted in jury verdicts or publicly released settlements. These cases offer a glimpse into various situations which can lead to dermatologist malpractice.
- Plaintiff v Defendant (Massachusetts 2017) $1 million: Dermatologist diagnoses female plaintiff in her late 30s with squamous cell carcinoma (a common skin cancer). The pathology report showed that cancer cells had spread along the nerves (a condition called perineural invasion). Dermatologist performs a surgical excision of the site and tells plaintiff all cancer had been removed and there was nothing to worry about. Several months later she calls dermatologist complaining of pain around the excision site. Although this is a symptom of the cancer possibly spreading along the nerves, the dermatologist disregards the complaints and tells plaintiff to see her primary care doctor if the pain continues. She does see her primary care doctor after her neck becomes numb and he immediately sends her to the hospital. It is eventually discovered that the skin cancer cells had spread along her facial nerves causing the left side of her face to become permanently paralyzed with Bell's palsy. Plaintiff had to undergo multiple surgeries to help correct her facial disfigurement as well as chemo to treat the cancer. She sued the dermatologist for negligently failing to treat her skin cancer condition. Case goes to mediation and settles for $1 million.
- Parrot v Reizner (Wisconsin 2009) $500,000: Male patient was referred to defendant dermatologist for examination of a skin growth on the right side of his neck. The dermatologist diagnosed the lesion as benign and told him to come back if the lesion grew or changed. About 8 months later the patient came back and the lesion had grown and was crusted and bleeding. This time a biopsy lead the dermatologist to a diagnosis of advanced stage melanoma. Despite extensive treatment the patient died from the cancer within 2 years. Patient's wife brought a wrongful death action against the dermatologist alleging that he failed to properly diagnose the melanoma at the initial visit. Case was eventually settled for $500,000.
- Schmidt v Woodson (Nevada 2009) $540,000: Female plaintiff went to defendant dermatologist for treatment of a fungal infection in her nails. Dermatologist prescribes Sporanox. Plaintiff subsequently becomes pregnant and her baby is born with numerous birth defects including a webbed right finger, no third finder, and a shortened leg. Plaintiff sues dermatologist alleging that the birth defects were caused by the medication and that the dermatologist failed to warn her that the drug should not be taken during pregnancy. Case was settled for $540k.
- Doe v Dermatologist (2007 California) $725,000: Male plaintiff in mid-30s goes to defendant dermatologist for examination of lesion on his left check. A punch biopsy is performed and the lesion is diagnosed as dysplastic nevus (a benign mole). He undergoes a freezing procedure to remove the lesion. A year later the lesion has grown back and plaintiff sees another dermatologist and is diagnosed with malignant melanoma and gives plaintiff a long term survival chance of 25%. Plaintiff sues defendant dermatologist for misdiagnosing the cancerous legion as a benign mole.
- Jurinko v Mercincin (Pennsylvania 2005) $2.5 million: Male plaintiff in his late-50s presented to defendant dermatologist with a black spot on his nose. A dermatologist treats the spot with acid but does not take a biopsy. Plaintiff returned to the dermatologist a year later with the same black spot and this time a biopsy was taken but the pathology results came back normal. 5-years later the plaintiff was back in the dermatologist's office with the same black spot. Acid treatment was used to remove the spot but no biopsy is taken. The follow year plaintiff comes back and again no biopsy is taken. About 6 months later plaintiff is diagnosed with metastatic melanoma (stage III) and only a 25% chance of survival. Plaintiff sues the dermatologist for failing to perform further biopsies resulting in a 6-7 year delay in diagnosis of his cancer. A Philadelphia jury awards $2.5 million.
If you or a relative have a potential claim against a dermatologist for medical malpractice, the person injury lawyer at Miller & Zois have the experience and knowledge to help get the compensation you deserve. Call us at 800-553-8082 or reach out to us online.