Medical Malpractice Lawsuits.

The tenets of a lawsuit are a deviation from the applicable standard of care that caused an injury. Elements must be addressed, including duty of care, deviation or breach of the duty to care, evidence the breach caused injury, and the identification of associated damages. Steps include consultation by a plaintiff with the attorney, pertinent records and imaging studies, and a review of the material by an expert. A complaint is filed and served upon each party. The defendant(s) must respond typically within 20 days. The parties then engage in discovery. The case may be referred to mediation, trial settlement, or dismissal.

Insemination "Fraud": Potentially Criminal Actions in Reproductive Medicine.

Case law and statutory provisions ensure marital rules of paternity apply when artificial insemination is associated with the pregnancy. Virtually all jurisdictions in the United States provide for gamete donors to remain anonymous. Much of this has been challenged with access to donor information via 23 and me. A breach of trust and a number of lawsuits involving physician provider(s) have resulted. We provide case law examples related to artificial insemination and the identification of the sperm donor. Proposed future legislation to protect patients and offspring from harm in relation to the process of donor sperm inseminations is provided.

Are Apologies a Way to Reduce Malpractice Risks?

Apologies are a means of responding to a medical error. Explanation of information related to the episode often fills a need for the patient and family to feel adequately informed. There are pros and cons related to the apology. The American College of Physicians, the American Medical Association, and the Joint Commission of the Accreditation of Health Care Organization Hospital strongly encourage practitioners to disclose when an error or complication occurs. Apologies can be admissible in the courtroom and much of this is state dependent. An apology will be an integral part of the clinician's armamentarium.

Interdisciplinary Representation of Burn Surgery Journal and Society Leadership.

Burn care is a complex craft that requires an interdisciplinary approach. It includes a diverse array of specialty providers to provide holistic, specialized care to burn victims. This study aims to evaluate the diverse array of subspecialties involved in burn surgery journal and society leadership. A cross-sectional study was conducted in July 2019 by examining the characteristics of society and journal leaders. Current governance and committee members of the American Burn Association (ABA) and International Society of Burn Injuries (ISBI) were determined, as well as the editors of five major burn journals. Information gathered included occupation, advanced degrees obtained, and type of residency training. Of 384 editorial board members identified, 76% were physicians (n = 291), with specialties including burn surgery (n = 208, 54%) and anesthesiology (n = 22, 6%). Among nonphysicians (n = 78, 20%), 76% were medical researchers (n = 59), 8% physical therapists (n = 6), and 5% nurses (n = 4). Looking at ABA and ISBI governance (n = 29), 82% were physicians (n = 24). Nonphysician ABA and ISBI leaders were nurses (n = 2, 7%) and occupational therapists (n = 2, 7%). Of 467 identified ABA and ISBI committee members, half were physicians (n = 244, 52%). There was a wide array of nonphysician occupations among committee members, from nurses (n = 99, 21%), to occupational therapists (n = 25, 5%), and even firefighters (n = 6, 1%). Burn surgery journal and society leadership reflect the interdisciplinary nature of burn care by including an array of subspecialties. Yet, physicians tend to dominate academic burn leadership in comparison to other disciplines, highlighting the need for more nonphysician representation in leadership positions.

Racial and Ethnic Disparities Among Burn Surgery Leadership.

The underrepresentation of racial and ethnic minority groups has been well-documented in general and plastic surgery but not in burn surgery. The aim of this study is to evaluate current minority group disparities among burn surgery leadership. A cross-sectional analysis was performed. Burn surgeons included directors of American Burn Association-verified burn centers in the United States, past and current presidents of the American Burn Association, and editorial board members of five major burn journals (Journal of Burn Care & Research, Burns, Burns & Trauma, Annals of Burns & Fire Disasters, and the International Journal of Burns and Trauma). Surgeons were compared based on factors including age, gender, training, academic rank, and Hirsch index (h-index). Among 71 burn center directors, 50 societal presidents, and 197 journal editors, minority groups represented 18.3, 2.0, and 34.5%, respectively. Among burn center directors, the group classified collectively as nonwhite was significantly younger (49 vs 56; P < .01), graduated more recently (2003 vs 1996; P < .01), and had a lower h-index (9.5 vs 17.4; P < .05). There were no significant differences in gender, type of residency training, advanced degrees obtained, fellowships, academic rank, and academic leadership positions between white and nonwhite groups. When compared with the 2018 U.S. National Census, burn unit directors had a 5.1% decrease in nonwhite representation. Disparities in representation of ethnic and racial minorities exist in burn surgery despite having similar qualifying factors.

Gender Disparities Among Burn Surgery Leadership.

Gender disparities have been described in the plastic surgery and general surgery literature, but no data have been reported in burn surgery. The aim of this study is to determine gender disparities among burn surgery leadership. A cross-sectional study was performed. Burn surgeons included were directors of American Burn Association (ABA)-verified burn centers, past presidents of the ABA, and International Society for Burn Injuries (ISBI), and editors of the Journal of Burn Care & Research, Burns, Burns & Trauma, Annals of Burns & Fire Disasters, and the International Journal of Burns and Trauma. Training, age, H-index, and academic level and leadership position were compared among surgeons identified. Among the 69 ABA and ISBI past presidents, 203 burn journals' editorial board members, and 71 burn unit directors, females represented only 2.9%, 10.5%, and 17%, respectively. Among burn unit directors, females completed fellowship training more recently than males (female = 2006, male = 1999, P < .02), have lower H-indexes (female = 8.6, male = 17.3, P = .03), and are less represented as full professors (female = 8.3%, male = 42.4%, P = .026). There were no differences in age, residency, research fellowship, or number of fellowships. Gender disparities exist in burn surgery and are highlighted at the leadership level, even though female surgeons have a similar age, residency training, and other background factors. However, gender diversity in burn surgery may improve as females in junior faculty positions advance in their careers.