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I'm Thinking About Retiring: A Survey Analysis Of Trends And Perceptions Of Legal Involvement Amongst Vascular Surgeons
Yun Ke Du, M.D., Matthew J. Dougherty, M.D., Keith D. Calligaro, M.D., Douglas A. Troutman, M.D.
University of Pennsylvania Health System, Philadelphia, PA, USA.
Introduction: The impact of malpractice litigation on vascular surgeons has rarely been studied, with most data remaining anecdotal. General medical surveys demonstrate that involvement in malpractice litigation has a deleterious impact on quality of life for physicians. Our study aims to examine the demographics of vascular surgeons involved in litigation and its effects on wellness and practice patterns.
Methods: Active SCVS (Society for Clinical Vascular Surgery) members were surveyed regarding involvement in litigation and opinions regarding the current vascular surgery medicolegal environment. After a four-week polling period, responses were anonymized and data analyzed in the standard statistical fashion (significance with p-value < 0.05).
Results: 104 responses were received from active SCVS members. The majority were male surgeons (n = 83, 80%) in practice for greater than 20 years (n = 45, 43%), with many practicing in an urban setting (n = 57, 55%). Seventy-two respondents (69%) reported being named in lawsuits. Compared to peers not named in lawsuits, surgeons were more likely to be male (p = 0.02), older than 50 (p < 0.00001), and in practice for greater than 20 years (p = 0.00002). They were also significantly more likely to consider retiring early secondary to the medicolegal atmosphere (p = 0.047). Respondents reported the following directly secondary to being named in legal proceedings: burnout symptoms (n = 54, 75%), distraction from patient care (n = 67, 93%), decreased engagement in academic pursuits (n = 40, 56%), and increasing documentation and testing for defensive purposes (n = 42, 58%).
Conclusions: This survey of current SCVS members demonstrates that older surgeons with longer experience are more likely to have been named in lawsuits due to length of practice. We show the concerning impact of litigation on vascular surgeons’ well-being, desire to continue practice, engagement in direct patient care, and time-consuming practice of “defensive medicine.” Societal support and young surgeons’ education regarding lawsuit involvement should be emphasized. Future work will aim to increase the power of survey data along with analysis of other variables such geographic location and perceived practice breakdown of endovascular and open cases.
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