Re: Frontline: outrageous expert testimony

[Dr...@aol.com]

The troubling trend is that there is a downward spiral in membership in organizations like the Tennessee Medical Association and the local medical societies.

Some of it is due to the backlash from the AMA's support of medical care reform (the Affordable Care Act or a.k.a Obamacare.) Too many physicians have either withdrawn from organized medicine as they feel it does not represent their own interests.

What happens when the shrinking pool from which reliable experts are to be drawn is no longer likely to yield viable candidates?

 

Thanks

Bob Dimick, MD

Chairman of the Board, Nashville Academy of Medicine

Nashville, Tennessee 

[Judge Thomas]

In response to Bob's e-mail, if there is no organization to whom a
trial judge can go for recommendations, we are in deep trouble. I
would like advice from anyone on how to appoint an independent expert
if there is no organization for recommendations.

Neil

[Arnold Cohen]

I appreciate the comments.
How to select an independent evaluating expert who will give an opinion that is not biased for either the defense or plaintiff.
Very interesting question.
I don't think membership in an organization is the answer. Membership in ACOG or any other organization does not mean you will give an unbiased opinion since all the expert witnesses for both the defense and plaintiff probably are members of the specialty specific organization.

Getting a doc from an academic medical center with a residency is one way that comes to my mind. It is not fool proof but since that person needs to practice evidenced based medicine, he/she would be more likely to render an opinion based on the evidence rather than personal opinion that may be biased.
I would even go further the person who give an opinion and that opinion should be reviewed by the chairman of the department since the chair has some impetus to have his/her department be perceived as honorable.
If the opinion is approved by the chair then I would say that it is unbiased and useful.

Just my opinion. I have proposed this before but it didn't stick

Here is an example of this.

Arnie

Remember- Sign all Verbal orders in PeriBirth.
Also-Wash your hands

Arnold W. Cohen, MD
Chairman
Department of Ob/Gyn
Albert Einstein Medical Center
215-456-6993
coh...@einstein.edu

This message is intended for the use of the person or entity to which it is addressed and may contain information that is privileged and confidential, the disclosure of which is governed by applicable law. If you are not the intended recipient, or the employee or agent responsible to deliver it to the intended recipient, you are hereby notified that any disclosure, copying, or distribution of this information is strictly prohibited. If you have received this message by error, please notify the sender immediately to arrange for return or destruction of these documents.

[dpriver]

I agree with Bob that organized medicine is not going to be the long
term answer to the question of how one finds credible independent
experts. I believe there is another way (which I have submitted
before), and that is the development of a certification process for
expert witnesses, just like for other specialty areas within medicine.
There's no doubt that it would be a monumental effort to establish
such a program (and you can be sure there would be vociferous
opponents amongst those who would have the most difficulty becoming
certified). Imagine, if you will, the advantages that such a program
would offer: first and foremost the elusive feature called
accountability; decertification would be a penalty with teeth. Second,
the powerful advantage that an attorney would have in pointing out to
a jury that his expert is certified while his opponent's is not. Would
there be any law firms that would risk going to court without a
certified expert? I doubt it. Thirdly, Neil would have near absolute
certainty that a certified independent expert he selected would be
credible. As I'm sure everyone will agree, the devil will be in the
details. But I can't think of a group more qualified than FACT to
begin the process of brainstorming how such a board certification
process could be initiated. Your comments are welcome and hope
everyone is having a pleasant summer.
David

> > Nashville, Tennessee- Hide quoted text -
>
> - Show quoted text -

[lbamdjd]

This is an interesting policy, Arnie. The only prior one of which I
had been aware was Wake Forest; it is not nearly as comprehensive but
at least does inject some element of accountability into the process
(not to mention a "Dean's Tax"). I rather like this approach, with
one caveat: has anyone educated these faculty about what is ethically
and legally required of a medical expert witness? Or could a panel
of faculty be applying an "ivory tower" or "counsel of perfection"
view of the standard of care to cases involving community
practitioners in limited circumstances? I think if there is one thing
members of this group could reasonably assist with, it is providing
education to institutions and organizations that are supporting the
provision of experts. I have done this sort of thing for AAOS, ACR,
ACS, and NCMed Society and a number of EM groups and it was very well
received. Part of the training of course involves how to avoid
various types of bias usually inherent in the contracting process.
People who want to do the right thing and really want the proper tools
with which to proceed seem to be extremely grateful. Louise

On Jul 7, 9:55 am, "Arnold Cohen" <Cohe...@einstein.edu> wrote:
> I appreciate the comments.
> How to select an independent evaluating expert who will give an opinion that is not biased for either the defense or plaintiff.
> Very interesting question.
> I don't think membership in an organization is the answer. Membership in ACOG or any other organization does not mean you will give an unbiased opinion since all the expert witnesses for both the defense and plaintiff probably are members of the specialty specific organization.
>
> Getting a doc from an academic medical center with a residency is one way that comes to my mind. It is not fool proof but since that person needs to practice evidenced based medicine, he/she would be more likely to render an opinion based on the evidence rather than personal opinion that may be biased.
> I would even go further the person who give an opinion and that opinion should be reviewed by the chairman of the department since the chair has some impetus to have his/her department be perceived as honorable.
> If the opinion is approved by the chair then I would say that it is unbiased and useful.
>
> Just my opinion. I have proposed this before but it didn't stick
>
> Here is an example of this.
>
> Arnie
>
> Remember- Sign all Verbal orders in PeriBirth.
> Also-Wash your hands
>
> Arnold W. Cohen, MD
> Chairman
> Department of Ob/Gyn
> Albert Einstein Medical Center
> 215-456-6993

> cohe...@einstein.edu

>
> This message is intended for the use of the person or entity to which it is addressed and may contain information that is privileged and confidential, the disclosure of which is governed by applicable law.  If you are not the intended recipient, or the employee or agent responsible to deliver it to the intended recipient, you are hereby notified that any disclosure, copying, or distribution of this information is strictly prohibited.  If you have received this message by error, please notify the sender immediately to arrange for return or destruction of these documents.
>

>  Chairman Review Process -EVMS.doc
> 39KViewDownload

[lbamdjd]

Neil, as a person very involved in organized EM, I naturally would
want to suggest that you not forget specialty societies in those cases
where it is clear what sort of expert is needed. At least one
specialty organization, I believe it was the American Association of
Chest Surgeons, had an expert witness program where it suggested
experts when queried. However, if I think of my own organization
(ACEP), I don't know how staff would respond if asked by a judge for a
list of neutral experts, as there is no precedent. And we are
probably the rule rather than the exception in this regard. It
wouldn't hurt if others on this list who are active in their specialty
associations pushed for this type of program to be promoted. It
shouldn't be too difficult, if a society has for example, a Speaker's
Bureau, those members who are identified as experts for the purpose of
speaking about a particular issue would naturally be likely candidates
for expertise in court cases. But I'm speaking from a national
perspective. There aren't too many state or local specialty societies
except chapters of national organizations. An individual judge such
as yourself would have to be very lucky to find a state chapter
organized enough to have even a Speaker's Bureau. But it is
absolutely true that membership in AMA and state medical societies is
becoming less and less common as these groups are seen as having less
and less relevance compared with specialty societies.

Here's a novel idea, though. How about asking state bar associations
for recommendations for neutral medical experts? Since so many
lawyers seem to hate neutral experts and covet their own personal
stable of favorites, if they respond at all it might really be with
those who have shown frustrating neutrality!