The top complaints of patients in aesthetic care: CMPA

Between 2019 and 2023, the Canadian Medical Protective Association (CMPA) concluded 644 medico-legal cases involving cosmetic procedures performed by physicians. In CMPA nomenclature, these treatments include “medical and surgical treatments performed for cosmetic purposes, which are not covered by a provincial health insurance plan or which are not performed for health reasons.”After analyzing these 644 cases, the organization that provides assistance to Canadian clinicians published a report entitled “Medico-legal risks and cosmetic procedures: what physicians need to know.” The objective is “to contribute positively to the safety of care. Medicine remains a risky profession. By drawing attention to the most frequent issues, we want to raise awareness among physicians by giving them support to reduce the risks associated with their practice,” said the executive director, learning of the CMPA, Dr. Armand Aalamian.Read: Top 5 most frequent misdiagnoses in primary care: CMPAUnsurprisingly, “the risk is greater in surgical specialties and for surgical procedures where complication rates are generally higher,” said Dr. Aalamian. Half of the 644 cases studied were plastic surgeons. This was followed by family physicians (15%), ophthalmologists (10%) and dermatologists (10%).The most frequently affected interventions by specialty: Plastic surgery (n=319)Breast augmentation or reductionAbdominoplastyBody remodelingFace liftBlepharoplastyRhinoplastyFamily medicine (n=101)Face liftHair transplantTreatment of varicose veins (laser, sclerotherapy)AbdominoplastyOphthalmology (n=65)Refractive keratoplasty (LASIK, PRK)BlepharoplastyFace liftEyebrow liftOtorhinolaryngology (n=41)Face liftRhinoplastyGeneral surgery (n=39)AbdominoplastyBreast augmentation or reductionDermatology (n=37)Face liftHair transplant The most commonly made complaintsThe CMPA report states that “the complaints reflect the fact that, from the point of view of the people being treated, a problem occurred during the provision of care. (They) are not always supported by the opinion of medical expertise.”For their part, medical experts tend to point out the following shortcomings:Inadequate informed consent processInadequate record keepingDeficient assessmentInadequate administrative proceduresInsufficient knowledge or skillsIllustrated in the report with a few concrete examples, “these five criticisms always come up,” observed Dr. Aalamian. “Regardless of medical specialties or type of intervention, these are the same cases that come up.”The frequency of complaints about consent underscores, he says, the importance of communication with the patient. “The most important thing is to have a real conversation with the patient to discuss their expectations, to show them what the risks of complications are and how realistic their expectations are.”In doing so, we avoid disappointments and limit the risk of complaints, mentions the administrative director of the CMPA.The other way to avoid prosecution is to conduct “a careful assessment, clearly identifying the patient's risk factors,” says the family physician by training. The CMPA report lists the main ones:ObesityComplications of previous surgeryFailure to follow medical instructions (such as the appearance of seromas in someone who does not restrict their activities after abdominoplasty)Complications of treatment or surgery:Infection, tissue necrosis, gangreneBreast asymmetry, capsular contracturesSeromasScarsThe document also highlights risk factors associated with the physician himself: insufficient knowledge or skills; inadequate decision-making process regarding care; suboptimal choice of medication; deviation from clinical procedures.

The top complaints of patients in aesthetic care: CMPA

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