| At the
2002 ASA Annual Meeting in Orlando, Florida, the
House of Delegates approved sweeping Bylaws revisions
designed to more specifically establish grounds
for adverse action by ASA against a member and to
put into place defined procedures pursuant to which
such action could be taken.
Since that time, the medical professional liability
situation has continued to deteriorate. Current
projections by the American Medical Association
place 18 states in what is classified as a crisis
situation where there are significant problems with
the availability and affordability of medical liability
insurance.
At the ASA Board of Directors interim meeting on
March 1-2, 2003, in Chicago, Illinois, the Board
of Directors approved Report 412-1.1, “Expert
Witness Testimony,” in an attempt to further
the actions of the 2002 ASA House of Delegates and
to address one aspect of the continuing medical
liability crisis. Report 412-1.1, which I submitted,
lays out the path to be followed for developing
a process by which ASA may, in the event of a complaint,
evaluate the expert witness testimony given by an
ASA member. As I pointed out in my “Administrative
Update” in the February 2003 ASA NEWSLETTER,
it is envisioned that the ASA process will mirror
that of the American Association of Neurological
Surgeons, which has withstood a court challenge.
This report requests action by two ASA committees
and the ASA Section on Fiscal Affairs.
The Committee on Bylaws, in consultation with legal
counsel, is requested to prepare amendments to the
ASA Bylaws to add noncompliance with the “Guidelines
for Expert Witness Qualifications and Testimony”
as a ground for censure, suspension or expulsion
of an ASA member and to provide that the ASA Board
of Directors may refuse to accept the resignation
of a member who is subject to a pending complaint
that could result in censure, suspension or expulsion.
The Committee on Professional Liability, in consultation
with legal counsel, is requested to prepare amendments
to the existing ASA “Guidelines for Expert
Witness Qualifications and Testimony” to accomplish
the following:
| 1. To add to the preamble the concept that
the integrity of civil litigation depends on
“responsible” expert witness testimony; |
| 2. To impose on an expert witness the qualification
that the witness review and be familiar with
the relevant medical and scientific literature;
and |
| 3. To add objectively verifiable standards
for expert testimony, such as the witness testifying
for the truth and not the interest of one party
or the other, that the physician’s opinions
be documentable and that the witness note when
the views vary from common practice. |
In addition, the ASA Section on Fiscal Affairs
has been asked to prepare a report on the estimated
fiscal impact of implementing the above procedure.
The reports of the Committee on Bylaws, the Committee
on Professional Liability and the Section on Fiscal
Affairs will be considered by the ASA Board of Directors
at its annual meeting in August of this year. The
Board of Directors’ recommendations, as well
as the original reports, will be considered by the
ASA House of Delegates at the ASA Annual Meeting
in October 2003 in San Francisco, California. It
should be remembered that the ultimate decision-making
body of the ASA is the House of Delegates, and its
decision on this matter will be binding on ASA members.
If this initiative is approved by the House of Delegates,
an Administrative Procedure will be drafted to deal
with complaints involving allegedly irresponsible
expert witness testimony.
In conclusion, it must be noted that the house of
medicine must hold its members accountable for all
their actions, both in patient care and courtroom
behavior. Failure to do so would contribute to the
ongoing escalating medical liability crisis.
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Roger W. Litwiller, M.D., is Staff Anesthesiologist,
Carilion Roanoke Memorial Hospital, Roanoke,
Virginia. |
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