Principles and Fallacies in Medical Appraisal: Focusing on Gastroenterology Cases

Medical appraisal has emerged as a medico-social problem. There are more medical appraisal errors than expected. Physicians are trained in the process of scientific thinking, and then can make a medical appraisal error. Medical appraisal requires both legal knowledge and medical experience. Medical appraisal is neither commentary nor advice for the best ideal medicine. The ideal medical practice described in textbooks and the implementation of the guidelines are different from the medical reality. Medical appraisal should reflect the real-time changing medical field. Medical appraisal experts must consider the level of medical care at the time the incident occurred, the facility, region, environment of the medical institution, and the patient's underlying disease, sequelae, and complications. Since the medical appraisal doctor conducts a retrospective analysis with all the data and time to review, it should be kept in mind that the medical appraisal may differ from the judgment of the actual medical field. Medicine is an evolving but limited science because it is the youngest science. For the fairness of medical appraisal, the medical professionalism and appraisal education of medical appraisers are essential. The Korean Medical Practice Review Authority was established in 2019 led by the Korean Medical Association. The appraisal education program was implemented to strengthen the expertise of appraisers and to develop appraisal skills. The medical field, especially gastroenterology, is the most common subject of medical appraisal. The principles and errors of medical appraisal were reviewed by focusing on the gastroenterology appraisal cases.