and

“quit OB after he got named twice, while he was still an intern!”

…and now, I’m in another field precisely because of this. I only got named once, two years after the fact on the day the SOL ran, and the plaintiff has yet to find an expert witness but the judge gave an additional year to find one….Think I’ll have my babies delivered in Canada…ain’t gonna be no OBs left in the states

Such scrutiny is only mandated in federal courts and in courts in those states which have adopted the Daubert standard.

This is not a blow to one “side” of the bar or the other. It is a testament to the fact that the courts CAN work as neutral factfinders and not as lotteries. All witnesses should be so scrutinized, by judges who have the courage and the knowledge as well as the determination to try to make an imperfect system to work fairly for all.

All experts should be held to a code of ethics which requires that they have basic qualifications and experience, and render opinions honestly and with full knowledge of all available evidence as well as the current standard applicable in the field in which they are testifying. All qualified physicians who can tolerate the process should be willing to serve in the capacity of medical expert, serving the courts, not the lawyers. And they should be compensated reasonably for this service, not “what the market will bear”, not on contingency, but in such a way as to reflect and reimburse them for the time this takes from their regular practice.

Anyone who is truly interested in this issue and in the cause of better medical expertise should visit http://www.ccemt.org, a nonprofit membership organization which I cofounded and which WILL help to report dishonest testimony by any witness identified by a member to the appropriate bodies, REGARDLESS of which side that witness “represents” ( in itself a mischaracterization of the appropriate role of a medical expert witness). Instead of complaining endlessly about this flawed system, why don’t we do something to change it?

You have nothing to worry about. Probably neither do the Gyn’s.

What’s happening is a stall payment tactic by the insurance company.

A number of years ago I was sent as a local IPA representative to be part of development of a new medical insurance plan with a local insurance company. It was stated in one meeting that if expected payout exceeded receipts in a given month, then “reasons” would be given for no payment. i.e., deliberate delay. I never returned.

I guesst that’s the right attitude to have. I know about 10 OB-GYNs, all early in their career (either directly or through their husbands, OB’s seem to marry ER DOcs alot) and every one wants to quit due to the malpractice crisis, especially those enjoying their first lawsuit. One of my best friends quit OB after he got named twice, while he was still an intern!

since time immemorial, all abscesses need to be drained, i.e., surgery is the treatment of choice. True tubo-ovarian abscesses are treated with surgery, with few exceptions, many times with laparoscopy, with removal of the adnexa influenced by the patient’s need for future fertility in the context of the severity of the damage.

I’m sure you meant to say that you admitted a patient with salpingoophoritis or an infection of her tube(s) and possibly ovary, placed her on antibiotics, and when she didn’t improve after 48 to 72 hours, you consulted a gynecologist who took the patient to the OR and found a tubo-ovarian abscess at that time, and found it appropriate, in the patient’s best interest, to remove her adnexa. If so, you and the hospital should bill both the patient and her insurance and have no fear of any malpractice action.

I was aware of the failure rate. My point was simply that some people left to deal with an unwanted pregnancy would (one would assume that if you’ve had a tubal you don’t want to be pregnant anymore)decide that a law suit was a good way to handle the “less than perfect outcome.” I was using that particular experience as an example of a bad outcome without violation of standard of care.

JH

“One element of a cause of action for medical malpractice is proof of the standard of care by which the defendant physician’s conduct is to be measured…. (T)he appellate decisions in this State (Illinois) have held that the plaintiff in a medical malpractice action generally must establish the standard of care through expert testimony.” (Walski v. Tiesenga 381 N.E.2d 279.)

That said, it goes without saying that expert witnesses must be competent. I wonder if the plaintiff in this Vioxx trial might have, if the case is not successful, a cause of action against the attorney involved. There is such a thing as attorney malpractice. For such a high profile case, you’d think that detail would be covered.

I actually like the idea of an independent panel of physician expert witnesses. They could be vetted for competency.

By the way, I’m not a lawyer. I’m an OB/Gyn and I have had malpractice actions against me. I figure its just part of the territory.

To Anon 1:09 PM;
All tubal ligations have a risk of failure, approx. 3/1000 or 1/300. If you were not informed of that risk, that’s poor pre-op management by your surgeon.