AAEM Shames Plaintiff's Witnesses

docB said:

Has anyone else seen this?
http://www.aaem.org/aaemtestimony/
I think it's great but let's call it what it is. They are trying to shame plaintiff's witnesses. They are cloaking it in a less inflamatory term of "remarkable testimony."

Like I said I think it's great but is it ethical? I'm sure lots of lawyers (plaintiff's lawyers) would say it's not.

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Personally, I don't think there's any problem with commenting on stuff that's in the public record. I note that they only have one case after a year and a half.

They are not the only ones. ACEP has a review process through the medical ethics committee. I gather that a letter may be sent to members who give egregious testimony and membership pulled.

Probably the toughest on paper is the Texas Chapter's process. They have had discussions with the Texas Medical Board. They may refer cases to the board after discussion. The reason that it's potentially tough is that the TMB considers expert testimony as the practice of medicine and discipline might go up to pulling a license. My understanding is that the chapter has had only reviewed one complaint so far, and chose not to refer it.

Maybe egregious testimony isn't as common as we think.

BKN said:

ACEP has a review process through the medical ethics committee. I gather that a letter may be sent to members who give egregious testimony and membership pulled.

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One of our attendings is a lawyer who specializes in consulting for medical malpractice cases. He told me how one law firm is a member of ACEP for the sole purpose of being able to report emergency physicians who give questionable expert testimony. From what he said, an ACEP bylaw only allows one ACEP member to file complaint against another.

Interesting idea...

ACEP's one case is also a CVA/TPA case with almost equally ridiculous testimony by a different "expert" I realize this could be interpreted as intimidation but in cases this ridiculous it seems more like a public service. It means "experts" who say totally stupid stuff will at least be discredited, which ought to end their utillity as experts.

I like the links to the original complaint and the letter to the expert. He hasn't responded yet.

Question: Are you aware that Genentech, the company that makes the drug, is the one that sponsored the study?"

Answer: "I'm not aware of that. I'm sure they've probably provided the TPA, but I'm not, I'd be surprised if they paid for the entire study."

Comment: Genentech did. Surprise!

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Sounds like someone at AAEM has a sense of humor.

I think if you don't exaggerate and take your job as an expert and not an advocate seriously you don't have anything to fear from exposure. Its interesting to read the transcript of the whole testimony. I don't think his testimony is anywhere near as egregious as the ACEP case. I learned a few lessons.

Always document an actual NIH stroke scale

Always document time of onset and why you believe that time or why you can't document a time?

Always document why you didn't give TPA

I think that these a$$holes need to be exposed. They are a huge part of the malpractice problem and if they are rattling off this BS, then they need to be called on it. Kind of like registering sex offenders for public knowledge.....

docB said:

Interesting article from one of the throw-away journals. They are basically calling BS on a plaintiff's "expert" who is apparently (per the magazine) a professor at Northwestern. He makes some remarkable assertions about ankylosing spondylitis. Anyway, here's the link:

http://www.epmonthly.com/index.php?option=com_content&task=blogcategory&id=1&Itemid=3

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Yeah i read that article. Honestly i can't remember the last time I dx ankylosing spondylitis. Maybe its the patient population I see in urban DC.... and I think the first disease I learned about in medical school was an OMT cervial disease.

Q

I actually have worked with this guy and he's a very experienced very competent ER doc. And he's a nice guy. I believe his intention really was to act as the patient's advocate and he's got the background to have an informed opinion on the matter.

But like I have said before, I would never act as an expert witness against another doc, just because the system is so screwed up. I really think it's this culture of jackpot justice we have over here (I'm not talking about this case in particular) in the U.S. that's leading to our current healthcare crisis.

I was talking about the TPA case, not the AS case. That second case about AS is absolutely ridiculous.

docB said:

Interesting article from one of the throw-away journals. They are basically calling BS on a plaintiff's "expert" who is apparently (per the magazine) a professor at Northwestern. He makes some remarkable assertions about ankylosing spondylitis. Anyway, here's the link:

http://www.epmonthly.com/index.php?option=com_content&task=blogcategory&id=1&Itemid=3

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The numbers that he quotes do seem completely made up. However it is true that spinal fractures in those with AS are very unstable. They certainly are associated with a high likelihood of spinal cord injury.

This is exactly what we need. Going after hte lawyers is fruitless. They control Congress, they control the legislatures, we cant win in a direct fight against them.

But we have one trump card, and that trump card is that every lawsuit must have a plaintiff "expert" to back up the case.

Plaintiff expert ****** get paid many more hudnreds of dollars per hour more for whoring themselves in court compared to treating patients, regardless of specialty.

Thats why the ATLA (American Trial Lawyers Association, I refuse to call them by their new name, the American "Justice" Association) has a monthly journal in which 90% of the ads are DOCTORS WHORING THEMSELVES OUT AS EXPERT WITNESSES.

Take a look at the back of that ATLA journal and witness hte hundreds of prostitutes who will say anything to get those fat lawyer consult fees.

Every plaintiff and defendant expert testimony should be reviewed by professional associations and if its flawed, they should lose their specialty affiliation.

The simple thing to do with this is define (rightly so) giving expert testimony as the practice of medicine. This would then require the expert to be licensed in the state in which they are practicing, i.e. offering testimony. It would then be regulated by the state medical board and subject to disciplinary action.

The testimony would be reviewed, much like any other complaint of medical misdeed, by the board and action could be taken, up to and including license revocation in that state. As anyone who has applied for a license knows, one of the 50 million questions we have to answer is whether we've ever had disciplinary action or license revocation.

BKN mentioned that Texas has done this. I know we've talked extensively about doing it but didn't think that we'd yet accomplished it. Of course, it may have happened during my intern year when I was only vaguely aware that life existed outside of the hospital.

Take care,
Jeff