Policies

One of the main issues in Medico-legal arena is the differentiation of a medical complication from an adverse result that is caused by the physician’s malpractice. While healthcare workers are held responsible for malpractice, it is accepted that they will not be responsible for complications.

A medical intervention is bound to be complicated at any phase of the procedure. Some of these complications may be related to the patient’s existing medical problems such as occurrence of a hematoma (blood collection in the surgical field) in a hypertensive patient despite use of correct anti-hypertensive medications throughout the peri-operative period. This would be called as a complication as the physician did his best to control the situation but the unfavorable result was inevitable. If this happens in a case where the patient’s preoperative hypertension is known by the physician but ignored and not addressed then that may be called a malpractice.

Every surgical intervention has its own specific risks and complications. These should be well explained to the patient before the operation. The patient should be aware of these risks and should give consent to the physician to proceed with the selected treatment method. This informed consent is collected from the patient before the surgery. This should be in his/her own language or should be translated to the patient by a professional translator.

The mainstream idea among health care workers is that an unfavorable result is classified as a complication if it is listed in the informed consent, with the condition of all possible precautions have been taken and warnings have been done.

In aesthetic surgery some medical complications may arise from patient incompliance with the physician’s advices. A classical example is keeping on smoking despite the surgeon’s strict tobacco ban which should start couple of weeks before the surgery. This may cause tissue necrosis or suture breakdown after surgery and may be categorized differently than other complications when it comes to find a financial solution for correcting the unfavorable result.

In our practice we value patient safety as a priority and take the following precautions:

• We do a thorough preoperative evaluation
• If there is any general medical problem we ask for further evaluation by a specialist
• If the present medical problem creates a significant risk for the patient we decline the treatment
• If the preoperative problem needs to be corrected before the surgery (such as advanced varicose veins) we suggest the patient to have an operation to treat these, first.
• We remind the patient preoperatively about cessation of smoking, or certain medications and vitamins (in relation to the planned operation).
• If something is not clear we schedule a zoom conference with the patient to have the physician talk

Should a complication occur during or after a surgery, we help our patients to come out of this difficult situation in any case, however, the financial aspects of this additional medical procedures will differ according to the cause of the complication:

1. If this is a complication listed in the informed consent list and happened despite all bona fide efforts of both the patient and the physician, then the patient pays the hospital fees + travelling/ accomodation fees (if the complication has occurred after the patient’s return, or should be fixed after certain amount of healing time) and the plastic surgeon fees are waived. However, if other specialities has to be involved for the treatment of this complication, the patient pays for those physicians fees.
2. If this is a complication resulted by the malpractice of the physician (this has to be validated) then the physician pays for all.
3. If the complication is related to the patient’s in compliant behavior (this has to be validated as well), then the patient pays for everything.
4. The patient may buy an aesthetic surgery insurance from Turkey before he/she arrives and the complications related hospital, travel, hotel, accompanying person expenses are paid by the insurance during the first 6 months of surgery (the amount paid and the coverage may change according to the type of the insurance).