by unqualified non-physicians. These non-physicians did not possess the necessary licenses or certifications, had no verifiable credentials, or lacked the training to perform the service. Non-physicians with inappropriate qualifications performed 7% of the invasive procedures that physicians did not perform. It should be noted that guidelines used for analysis included those considered “relevant Medicare requirements, state laws and regulations.” Guidelines of relevant medical societies such as those of the American Academy of Dermatology and the American College for Mohs Micrographic Surgery and Cutaneous Oncology were not used.

If Mohs surgery is being provided by some of the above-identified poorly trained non-physicians, such treatments may or may not be legal – they certainly are unethical.

References

1. Furrow BF, Greaney TL, Johnson SH, Jost TS, Schwartz RL. Liability in health care Law. 3rd ed. St. Paul: West Publishing Co; 1997.

2. Hyams AL, Shapiro DW, Brennan TA. Medical practice guidelines in malpractice litigation: an early retrospective. J Health Polit Policy Law. 1996;21:289–313.

3.Lamont v. Brookwood Health Service, Inc., 446 So.2d 1018 (Ala.1983)

4.Gannon v. Elliot, 19 Cal.App.4th 1 (1993)

5. Frost CA, Green AC. Epidemiology of solar keratoses. Br J Dermatol. 1994;131:455–64.

6. Ackerman AB. Solar keratosis is squamous cell carcinoma. Arch Dermatol. 2003;139:1216–7.

7. Glogau RG. The risk of progression to invasive disease. J Am Acad Dermatol. 2000;43:S23–4.

8.Prevalence and Qualifications of Non-Physicians Who Performed Medicare Physician Services. OIG Report, OEI- 09-06-00430, August 2009.

Summary: Introduction

•It is important for physicians to be aware of their legal responsibilities and to gain a foundation in medical-legal perspectives.

I.Reyter • T. Nino • A. Torres (*)

Department of Dermatology,

Loma Linda University School of Medicine, Loma Linda, CA, USA

e-mail: abelt@aol.com; cmorrill@llu.edu

46.1Introduction

Over the course of a career in dermatology, a physician will encounter the legal system in many ways. Thus, it is important for a doctor to preemptively become aware of his or her legal responsibilities and develop a framework for understanding critical legal issues in medicine. Unfortunately, this information is typically not covered in most medical school curriculums, and physicians are tasked with learning the information on their own, often in no formal or organized manner. Occasionally, confusion over legal issues and responsibilities leads to fear