www.SickOfLawsuits.org Web Chat
Dr. David Priver
June 23, 2006, 3:00 pm ET
Dr. Priver: Welcome to today’s Sick of Lawsuits Web chat and thank you to all those who have joined us. I’ll be taking your questions on an issue that has become all too familiar in recent years: expert witness testimony and junk science in our courts and the impact they have on our healthcare system. As a practicing OB-GYN in California and a member of the Coalition and Center for Ethical Medical Testimony, I have been involved with these issues for many years and have helped develop ethical standards for expert witness testimony. I’m looking forward to talking to you about all this and more during our chat today, and with that I’ll take the first question.
Jeb, Dallas, TX: Haven't courts adopted guidelines and limits on expert testimony to limit “junk science”? Doesn't California have limits on liability?
Dr. Priver: Yes, California does have limits and they've been very helpful. Courtroom guidelines also exist, but they're not always valuable because they depend upon judges to enforce them. With all due deference, judges are not always medically trained. We need physicians to be involved in this process.
Robert, DePere, WI: American trial lawyers seem to escape any censure from those agencies (state bars, the American Bar Association, etc.) which are supposed to review the quality of attorneys work. Some of the most memorable acts of pseudoscience have been committed in the Dow-Corning and asbestosis cases, but the complaints of MDs and scientists carry almost no weight for state and Federal government. How can we best reform the disciplinary agencies for these attorneys?
Dr. Priver: As a physician, I can't determine what the legal profession should do to discipline its members. However, I'm hoping that there can be a cooperative system developed between the two professions whereby a code of ethical behavior can be created to which we can all sign-on.
Cheri, Port Hadlock, WA: Is there a central location where current ethical standards and/or sanctioning mechanisms regarding medical expert testimony can be seen?
Dr. Priver: Unfortunately, there is not a central location for ethical standards. That's what my organization, Coalition & Center for Ethical Medical Testimony, wishes to address. We're hoping to create a standard code which will apply in all locations and will be accepted by both experts and attorneys. That way, what's ethical in New York is also ethical in Florida, etc..
There is, for example, much debate about whether a retired physician should give testimony. We hope to sit down with our legal brethren and work out reasonable solutions to questions like that. I would encourage the audience to sign onto our Web site (www.ccemt.org) and learn more about what we're doing.
Kate, Valencia, CA: A congressional committee has held hearings in the past few months about the fraud in asbestos and silica cases. What do you think the outcome will be of the hearings?
Dr. Priver: Hard to tell what Congress will do, but what I'm hoping is that this travesty will encourage medical organizations, such as the American College of Radiology in this case to hold their misbehaving members accountable for what they've done, which is to give our profession a black eye. We need to encourage expert accountability.
Anne, Ithaca, NY: I have heard that different medical societies have their own standards for their members testifying in lawsuits. Are these standards enforced? Do you think we’ll ever have all expert witnesses held to the same standard?
Dr. Priver: That's a great question! I was hoping someone would ask it. There is no widely accepted standard for ethical testimony. This is, to a large extent, why CCEMT exists. We are hoping to solicit widespread participation in the creation of a standardized code of ethics which will enable both the legal profession and the medical profession to interact smoorthly.
Sandy, Versailles, IN: Do Americans know that these lawsuits are not only effecting doctors but also effecting Americans bottom line by increasing doctors fee's and hospital and drug cost? I think if we informed Americans more to this reality they wouldn't be so ready to take them to court over everything.
Dr. Priver: I suspect most people do not realize how much it costs the system to have frivolous suits filed. As an OB/GYN physician myself, I recognize that we probably run more tests and do more costly procedures to avoid claims that we didn't do "all we could have" to avoid an adverse outcome. Thie money has to come from somewhere, and I'm sure overall medical costs in this country have gone up substantially because of this problem.
The best current estimate is that we spend $50 billion a year in "defensive medicine" in this country. In other words, it's money that does not go to make anyone healthier. It's purely wasted. I don't think we can afford this.
Jim: How is a poor lay jury to decide the truth behind the technicalities that each side of a case will present with their opposing "expert witnesses" who are testifying for big bucks?
Dr. Priver: I agree this is a major problem. The fact is it can be impossible for a lay jury to know where the truth lies when experts are being hired to present their client's best case. The answer, I think, lies in creating a system where physicians review testimony given by fellow physicians. It's a concept we call "peer review'. We've used it for many years to review the quality of care provided at the bedside. I think it should also be applied to behavior in the courtroom as well.
George: I hear that most physicians in Florida are now "going bare." How does that strategy play out with regard to physician retention and recruitment in that state?
Dr. Priver: Going bare is not a good solution, but I do recognize the desperation that might lead a physician to do that. The problem is that going bare will expose a physician's colleagues and hospitals to having to accept more risk. Courts will often permit a plaintiff to go after a deep pocket, i.e. get money from a defendant who was minimally involved in a case. None of us feel comfortable working with a physician who is bare because it increases our own risk.
Dr. Priver: That will be our final question for today. I thank all of you for your participation. Let me encourage that we continue this fruitful dialogue on www.sickoflawsuits.org and/or www.ccemt.org. I look forward to working with all of you toward a workable solution to this problem.