MedicalResearch.com Interview with:
Omar A. Ibrahimi, M.D., Ph.D
Connecticut Skin Institute
Founding Medical Director
Stamford, CT 06905
Medical Research: What is the background for this study? What are the main findings?
Dr. Ibrahimi: The delivery of healthcare in a efficient and cost effective fashion is one of the largest themes in medicine today. Malpractice lawsuits have steadily increased with the cost of healthcare delivery. Mohs surgery involves the surgical removal, the tissue analysis and the reconstruction of a skin cancer all in a single visit that bundles multiple procedures in a cost effective manner that is proposed to be the gold standard for treating certain skin cancers.
Information regarding malpractice involving Mohs surgery is lacking. The only previous study that has been done was a survey of Mohs surgeons looking at how many had been involved in lawsuits and the reasons for being involved. Our study examined a legal database to identify all the lawsuits involving Mohs surgery and skin cancer. We were surprised to find that the majority of lawsuits involved non-Mohs surgeons as the primary defendant, mostly due to a delay of or failure in diagnosis, cosmetic outcome issues, lack of informed consent, and a delay of or failure in referral to a Mohs surgeon.
Medical Research: What should clinicians and patients take away from your report?
Dr. Ibrahimi: Skin cancer is the most common cancer in the United States. Clinicians of all types, Dermatologists, Primary Care Physicians/Internists and Plastic Surgeons would benefit from coordinating care with Mohs surgeons to optimize the treatment of skin cancer. The American Academy of Dermatology has developed appropriate use criteria (AUC) for Mohs surgery that can help guide when Mohs surgery is an appropriate treatment option for a particular skin cancer. Patients should always have a discussion with their physician regarding what their treatment options are and the varying risks, benefits and side effects.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Ibrahimi: One of the benefits of Mohs surgery is that it offers the highest cure rate and has the potential to be extremely cost efficient due to bundling of the surgical removal and pathology. Larger studies looking at cost-effectiveness and quality of life scores for patients following Mohs surgery versus other treatment modalities would help further define the role of Mohs surgery in the treatment of skin cancers.
D’Souza LS, Jalian H, Jalian C, et al. Medical Professional Liability Claims for Mohs Micrographic Surgery From 1989 to 2011. JAMA Dermatol. Published online February 04, 2015. doi:10.1001/jamadermatol.2014.4495.
MedicalResearch.com Interview with: Omar A. Ibrahimi, M.D., Ph.D (2015). Study Examines Malpractice Risk Of Mohs Surgery For Skin Cancer MedicalResearch.com