Letters to the Editor - Feb. 6, 2006

Medical community holds answer to problem of rogue expert witnesses - Health care facing similar economic breaking point as is predicted for oil

Medical community holds answer to problem of rogue expert witnesses

Regarding "Expert witnesses need scrutiny: The Tennessee approach" (Editorial, Dec. 19, 2005): I applaud the underlying message that there needs to be some oversight of the expert witness mechanism There is no shortage of even the most prominent chairmen who will sign on to impugn another based on dubious science, conjecture or opinion.

The Tennessee program has merit. However, it relies on a cooperative legislature and legal community to redress these issues. I applaud those in Tennessee that have worked together for this cause. Sadly, in many communities (Florida of personal interest) I have doubts about that possibility.

During Miami's daytime television, personal injury attorneys commercials run back-to-back. Hefty contributions from the personal injury legal community to state campaigns swing legislators.

These observations may lead one to target the legal profession for the morass of soaring medical legal expenses. That would be misguided; a lawyer is of no threat without the client and a willing expert to back him up. I therefore say, we, the medical profession, are the enemy. Hired guns are willing to say anything for the right price.

So how do we curtail these renegades? Can we fix the problem? The answer is yes.

I suggest that fixing the problem of the rogue expert witness rests with us, the medical community. What I propose is that each medical board devises a rotating expert witness pool. Any malpractice claim should be sent to three qualified practitioners from the same specialty (both academic and private practice) for review, evaluation and opinion. An independent report complete with exoneration or culpability would then be presented as expert opinion representing the specialty board of the accused, whether certified or not.

But would this plan silence the expert for hire? No. In fact, I would not suggest that we should or could.

I would point out that the weight of independent opinion without financial gain contingent on said opinion would render outlying testimony suspect. I concede that there will be some experts who will see a downturn in those lucrative legal fees. But with a more equitable tort process, that is a price we should all be willing to pay.

--Richard B. Silverman, MD, Miami Beach, Fla.

Health care facing similar economic breaking point as is predicted for oil

Regarding "Financial trouble predicted for Medicare" (Article, Jan. 2/9): Federal Reserve Board Chair Alan Greenspan's comments on commitment of Medicare resources versus the economy's capacity to pay for them is ominous. Like "peak oil," our double-digit increases in health care costs are outstripping our ability and resources to pay for them.

When is "peak health care"? Will it be 2008 or when? Like oil, it will be sometime sooner rather than later if we don't practice in a cost-efficient manner.

I suggest that we admit we can't pay for everything, prioritize research on cost-effective care and stop rewarding inefficient care.

--Michael J. Kitchell, MD, Ames, Iowa