Risk Management for Dermatologists
Risk Management for Dermatologists
Dermatology practice often involves unique risk management challenges. Understanding these risk factors and the strategies to mitigate them can help dermatologists deliver optimal care while reducing professional liability exposure.
Pathology follow up and specimen management
Ensuring that pathology results are received, reviewed, and communicated to patients in a timely manner is essential. The foundation of effective pathology management is a tracking system that follows specimens from when they’re taken until the patient has been notified of results. This requires developing protocols to ensure specimens are labeled and stored appropriately, using EHR flags or tickler systems to track pending results, assigning staff members to monitor outstanding reports, and establishing clear timeframes for when results should be expected.
Practice protocols should specify how results will be reported to patients, whether by phone call, letter, or patient portal message.Critical or unexpected findings demand urgent attention, and practices should consider requiring dual verification before communicating high-risk results.
Document patient notification in the medical record with the date, method, and content of the discussion. Weekly audits of pending reports can help catch any that may have fallen through the cracks.
Patient engagement is equally important. Patients should understand at the time of biopsy when to expect results and how they’ll be contacted. Encourage patients to call or send a message through the portal if they have not heard within the expected timeframe.
Scheduling and follow-up
Patients lost to follow-up represent a significant liability risk. While EHR reminder systems can flag patients due for follow up, staff can also be assigned to monitor compliance and reach out to patients. Protocols should specify different approaches for scenarios such as post-procedure checks, routine surveillance, or chronic condition management.
A proven approach is scheduling follow-up appointments before patients leave the office, accompanied by clear written instructions about timing and purpose. Automated appointment reminders via text, email, or phone reduce no-shows, while priority scheduling ensures urgent follow up can be accommodated quickly.
Documentation that’s specific — such as noting “return in 3 months for skin check” rather than simply “follow up” — makes expectations clear. When patients miss critical appointments and fail to respond to routine contact, it may be necessary to send a certified letter to document attempts to provide care.
Photography and image documentation
While clinical photography serves important diagnostic and documentation purposes, it requires careful attention to privacy and consent. Written consent should specify all intended uses of photographs, with separate consent required for clinical documentation versus teaching or promotion. Any use beyond the original scope requires re-consent, and consent documentation should be clearly noted in the medical record. 1
Technical standards help to ensure images are clinically useful. These standards can include consistent protocols for distance, lighting, and angles; inclusion of anatomical landmarks and measurement markers when appropriate; and capturing both contextual and close-up views of lesions.Use file naming conventions to help protect patient identity.
Privacy protection is paramount. HIPAA regulations statet hat images must be stored in encrypted systems, with access limited to authorized personnel. Clinical images should never reside on personal devices or unsecured cloud storage. When images are used for teaching or promotion, identifying features should be removed. 1
Medication safety
Dermatologists prescribe medications with significant risks, from isotretinoin to immunosuppressants, making medication safety systems essential. Electronic prescribing with drug interaction checking and allergy alerts can catch potential errors before they reach patients. Maintaining accurate medication lists and conducting reconciliation at each visit ensures prescribing decisions are based on complete information.
High-risk medications require standardized monitoring protocols. For isotretinoin, methotrexate, biologics, and other potent therapies, checklists ensure required baseline and follow-up testing occurs.2 Patient education should include risks, side effects, monitoring requirements, and pregnancy prevention for teratogenic drugs. Teach-back methods can help confirm that patients understand the risks and benefits oftheir medications.
Cosmetic procedures
Patients seeking cosmetic procedures may have heightened or even unrealistic expectations of what can be achieved by their dermatologist. Because the cost of these therapies is often born solely by the patient, there may be less tolerance for anything that does not go as planned. Any complication may be met with a higher degree of anxiety, anger, or disappointment. Therefore, it is helpful to discuss realistic outcomes when obtaining informed consent.
During this discussion, emphasize that every patient’s experience and outcome will be their own. Ensure that the patient understands that follow-up procedures or new therapies may be necessary to achieve the patient’s long-term goals or to address potential complications. 2
A thorough informed consent discussion can help lessen anxiety, increase trust, and improve understanding if a complication occurs. Several studies have shown that patients are less likely to file a claim against a physician with whom “they have developed a trusting and mutually respectful relationship . . . even when patients have experienced considerable injury as a result of a ‘medical mistake’ or misjudgment.” 2
Sources
- Henry K. Guidelines for medical photography under HIPAA. Accountable HQ. August 17, 2025. Available at https://www.accountablehq.com/post/guidelines-for-medical-photography-under-hipaa. Accessed March 2, 2026.
- Mayo Clinic. Cosmetic surgery. June 21, 2024. Available at https://www.mayoclinic.org/tests-procedures/cosmetic-surgery/about/pac-20385138. Accessed March 19, 2026.
Disclaimer
Dermatology practice often involves unique risk management challenges. Understanding these risk factors and the strategies to mitigate them can help dermatologists deliver optimal care while reducing professional liability exposure.
Pathology follow up and specimen management
Ensuring that pathology results are received, reviewed, and communicated to patients in a timely manner is essential. The foundation of effective pathology management is a tracking system that follows specimens from when they’re taken until the patient has been notified of results. This requires developing protocols to ensure specimens are labeled and stored appropriately, using EHR flags or tickler systems to track pending results, assigning staff members to monitor outstanding reports, and establishing clear timeframes for when results should be expected.
Practice protocols should specify how results will be reported to patients, whether by phone call, letter, or patient portal message.Critical or unexpected findings demand urgent attention, and practices should consider requiring dual verification before communicating high-risk results.
Document patient notification in the medical record with the date, method, and content of the discussion. Weekly audits of pending reports can help catch any that may have fallen through the cracks.
Patient engagement is equally important. Patients should understand at the time of biopsy when to expect results and how they’ll be contacted. Encourage patients to call or send a message through the portal if they have not heard within the expected timeframe.
Scheduling and follow-up
Patients lost to follow-up represent a significant liability risk. While EHR reminder systems can flag patients due for follow up, staff can also be assigned to monitor compliance and reach out to patients. Protocols should specify different approaches for scenarios such as post-procedure checks, routine surveillance, or chronic condition management.
A proven approach is scheduling follow-up appointments before patients leave the office, accompanied by clear written instructions about timing and purpose. Automated appointment reminders via text, email, or phone reduce no-shows, while priority scheduling ensures urgent follow up can be accommodated quickly.
Documentation that’s specific — such as noting “return in 3 months for skin check” rather than simply “follow up” — makes expectations clear. When patients miss critical appointments and fail to respond to routine contact, it may be necessary to send a certified letter to document attempts to provide care.
Photography and image documentation
While clinical photography serves important diagnostic and documentation purposes, it requires careful attention to privacy and consent. Written consent should specify all intended uses of photographs, with separate consent required for clinical documentation versus teaching or promotion. Any use beyond the original scope requires re-consent, and consent documentation should be clearly noted in the medical record. 1
Technical standards help to ensure images are clinically useful. These standards can include consistent protocols for distance, lighting, and angles; inclusion of anatomical landmarks and measurement markers when appropriate; and capturing both contextual and close-up views of lesions.Use file naming conventions to help protect patient identity.
Privacy protection is paramount. HIPAA regulations statet hat images must be stored in encrypted systems, with access limited to authorized personnel. Clinical images should never reside on personal devices or unsecured cloud storage. When images are used for teaching or promotion, identifying features should be removed. 1
Medication safety
Dermatologists prescribe medications with significant risks, from isotretinoin to immunosuppressants, making medication safety systems essential. Electronic prescribing with drug interaction checking and allergy alerts can catch potential errors before they reach patients. Maintaining accurate medication lists and conducting reconciliation at each visit ensures prescribing decisions are based on complete information.
High-risk medications require standardized monitoring protocols. For isotretinoin, methotrexate, biologics, and other potent therapies, checklists ensure required baseline and follow-up testing occurs.2 Patient education should include risks, side effects, monitoring requirements, and pregnancy prevention for teratogenic drugs. Teach-back methods can help confirm that patients understand the risks and benefits oftheir medications.
Cosmetic procedures
Patients seeking cosmetic procedures may have heightened or even unrealistic expectations of what can be achieved by their dermatologist. Because the cost of these therapies is often born solely by the patient, there may be less tolerance for anything that does not go as planned. Any complication may be met with a higher degree of anxiety, anger, or disappointment. Therefore, it is helpful to discuss realistic outcomes when obtaining informed consent.
During this discussion, emphasize that every patient’s experience and outcome will be their own. Ensure that the patient understands that follow-up procedures or new therapies may be necessary to achieve the patient’s long-term goals or to address potential complications. 2
A thorough informed consent discussion can help lessen anxiety, increase trust, and improve understanding if a complication occurs. Several studies have shown that patients are less likely to file a claim against a physician with whom “they have developed a trusting and mutually respectful relationship . . . even when patients have experienced considerable injury as a result of a ‘medical mistake’ or misjudgment.” 2
Sources
- Henry K. Guidelines for medical photography under HIPAA. Accountable HQ. August 17, 2025. Available at https://www.accountablehq.com/post/guidelines-for-medical-photography-under-hipaa. Accessed March 2, 2026.
- Mayo Clinic. Cosmetic surgery. June 21, 2024. Available at https://www.mayoclinic.org/tests-procedures/cosmetic-surgery/about/pac-20385138. Accessed March 19, 2026.
Disclaimer
Want to save this article for later?
Download the full issue as a PDF for future reference or to share with colleagues.
Subscribe to Case Closed to receive insights from resolved cases.
You’ll receive two closed claim studies every month. These closed claim studies are provided to help physicians improve patient safety and reduce potential liability risks that may arise when treating patients.
Related Resources
Discover more insights, stories, and resources to keep you informed and inspired.
