Monday, August 6, 2012

Authority and Responsibility of Physicians in Skin Surgery

Development of knowledge and medical technology often unexpected speed and direction, either as a result of discoveries in the field of technology equipment (medical instrumentation) or due to the discovery in the field of molecular technology. Consequently the rise of new skills to hold a special medical services that use science and new technologies, including skin surgery (dermatosurgery).

Surgical skin is not a new specialization, at least until recently; but only one group of specialized studies and genital skin. Development of skin and venereal specialization toward skin surgery is still reasonably be justified by taking the analogy of "eye surgery" or "ENT surgery ', of course along the land is still in the skin.

Noteworthy is that any and expertise towards the development of any iptekdok if based on the development and oriented to the interests of patients can be justified. However, by "entry" into the field of cosmetic skin surgery resulted in a collision with a plastic surgery specialist who has been in previous employment, though not equal true.


In the medical profession, the existence of overlapping competencies between the various specialist areas are very reasonable as a result of differences in the formation of specialized grounds or reasons. Most of specialization was established by organ system (eg, nerve, eye, cardiovascular, obstetrics-gynecology, etc.), partly based on the location (ENT, internal medicine, etc.), by way of working (surgery, radiology), based on age-specific (pediatrics), by function (forensic); so it is not impossible a certain function is handled by more than one specialization. It is no secret that hypertension can be handled by SpPD (nefrolog) or SpJP; cancer treated by SpBOnk, SpR, SpPD; HNP is handled SpS, SpBO and SpBS; or head and neck as a land with a few specialists. Lately Medicine also "divided" according to organ systems, such as gastroenterology, endocrinology, etc.

In terms of medikolegal, should be assessed competence, authority, and responsibilities. First of all need to be assessed, whether surgical skin is a new competence requiring specific authority or merely the use of technology? Similarly, if the word "surgery" on a surgical skin giving the sense that the skin of a surgical competence should also have basic surgical competence as taught in the PPDS-I of surgery? The second question has to be considered inherent to the first question. The next question is related to the field of cosmetics, namely whether the doctor foretell the result?

If it is true that skin surgery is a competence that requires special authority, it must be agreed to establish a program of education or training and certification specifically for that issue. And certification program should be introduced and should be "accredited" by the Assembly of the College of Medicine, and thus invalid as a new skill. Or in other words mean that the competence and authority and legal expertise has been recognized by the medical world as a peer-group. Furthermore, the responsibility involved in any skin surgery follow all general rules on the responsibilities as described above.

If the right doctor promise certain cosmetic outcome, either implicitly or explicitly, it means the doctor is also liable for the failure of treatment performed. Pre-action communication is good, honest, clear and complete information is necessary in order to avoid any malpractice claims.

Finally, an understanding of the responsibilities of doctors in the field of law should not be used as barriers in implementing and developing the profession, but rather used as a trigger for always trying to achieve and maintain the highest standards of service quality.

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