Classification of plastic surgery malpractice complaints brought before the São Paulo Medical Board that were treated as professional-misconduct cases: a cross-sectional study

ABSTRACT BACKGROUND: Nowadays, there is an ethical and moral necessity to establish rules that govern professional attitudes and conduct. In the medical field, these rules are multifaceted, given the health consequences inherent to medical procedures. Ethics is an even more delicate subject when it comes to plastic surgery, since one of the aims of this particular medical specialty is esthetic improvement of the body. OBJECTIVE: To survey and classify São Paulo State Medical Board investigations of plastic-surgery complaints that were treated as professional-misconduct cases between 2007 and 2016. DESIGN AND SETTING: Cross-sectional study conducted in a medical council. METHODS: A total of 360 cases were reviewed. Among these, 8 (2.23%) were dismissed, 1 (0.27%) became an administrative lawsuit and 351 (97.50%) were treated as professional-misconduct cases. RESULTS: A breakdown of the complaints filed over the nine-year period showed that complaints concerning malpractice were the most common (28.43%), followed by those regarding medical advertising (24.19%) and poor doctor-patient relationships (10.39%). CONCLUSION: Overall, the number of complaints lodged decreased over the last two years reviewed, although complaints regarding malpractice and poor doctor-patient relationships increased by 10% over the same period. In order to further reduce the number of medical board investigations, the medical establishment needs to carefully review the medical training of students and doctors at every stage of their careers.

摘要
### 研究背景
当下，制定规范医护人员职业态度与从业行为的准则具备伦理与道德层面的必要性。医疗领域的这类准则具有多重维度，原因在于医疗操作本身会对患者健康产生固有影响。而就整形外科而言，伦理议题更为敏感——因为该医学专科的核心目标之一便是对人体外观进行美学改善。

### 研究目的
对2007年至2016年间圣保罗州医疗委员会受理的、被认定为职业失当行为案件的整形外科投诉调查开展统计与分类研究。

### 研究设计与实施场景
于医疗委员会开展的横断面研究。

### 研究方法
共计回顾360起案件。其中8起（2.23%）不予受理，1起（0.27%）转为行政诉讼程序，剩余351起（97.50%）被认定为职业失当行为案件。

### 研究结果
对这9年间提交的投诉进行细分后发现，医疗事故类投诉占比最高（28.43%），其次为医疗广告类投诉（24.19%）以及医患关系不佳类投诉（10.39%）。

### 研究结论
整体而言，在所回顾的最后两年中，投诉总量呈下降趋势，但医疗事故与医患关系不佳类投诉的数量同期上升了10%。为进一步减少医疗委员会受理的调查案件数量，医疗行业需对医学生及医生职业生涯各阶段的医学培训进行审慎审视与优化。