Out-of-scope Cosmetic Surgery: A Review of Malpractice Lawsuits against Nonplastic Surgeons

Abstract

Background: The increasing patient demand for cosmetic surgeries and minimally invasive procedures has encouraged physicians without aesthetic surgery training accredited by the American Board of Medical Specialties to provide these services. This systematic review aims to determine the rate of out-of-scope practice in medical malpractice lawsuits involving cosmetic surgery or minimally invasive procedures performed by nonplastic surgeons. Methods: Our systematic review of the Westlaw legal database from 1979 to 2022 included 64 malpractice cases. Inclusion criteria were cosmetic surgeries or minimally invasive procedures in medical malpractice lawsuits not involving board-certified plastic surgeons. Out-of-scope was defined using the procedural competencies established by the American Council for Graduate Medical Education, the Commission on Dental Accreditation, and the Council of Podiatric Medical Education. Data on legal proceedings, provider credentials and board certification, surgical interventions, and legal outcomes were collected. Results: The majority of malpractice cases involving cosmetic surgeries or minimally invasive procedures occurred when providers were practicing out of scope (N = 34; 55.7%). The verdict was ruled in favor of the plaintiff (patient) in 34.4% of cases. Out-of-scope practice occurred most in family/internal medicine, no board certification, and obstetrics/gynecology (N = 4, N = 4, and N = 3, respectively). The most common allegation was permanent injury or disfigurement (N = 21; 21.4%). Plastic surgeons provided expert testimony 44.0% of the time. Conclusion: Our review of the Westlaw legal database suggests that the majority of nonplastic surgeon cosmetic malpractice cases may occur in the setting of out-of-scope practice.

Plastic Surgery: Beware the Candle Burning at Both Ends

“…33 Studies have consistently shown that non-ABMS certified physicians are more commonly revoked of their licenses and provide lower quality of care when compared with ABMS-recognized board-certified physicians, hence the importance and value lended to boardcertification. 30,31,34,35 The value of board-certification as a concept is acknowledged by the vast majority of respondents in this survey; unfortunately, the ability to create and title an unaccredited "board-certification" has allowed others to take advantage of the trust built by the establishment of the ABMS, at the same time bypassing their oversight. Additionally, the news is filled with reports of postcosmetic-surgery horror stories due to non-ABPS certified surgeons performing cosmetic procedures.…”

“…Additionally, the news is filled with reports of postcosmetic-surgery horror stories due to non-ABPS certified surgeons performing cosmetic procedures. [6][7][8][9][10][11]35 With a high percentage of participants in this study demonstrating a significant gap in knowledge regarding the scope of plastic surgery and an even larger gap in understanding the pathways leading to board certification, there is potential for confusion as patients seek the care of plastic surgeons, not knowing whether the providers they identify are in fact true plastic surgeons.…”