Monday, December 4, 2023
Physicians - maximum of 0.25 AMA PRA Category 1 Credit(s)™
This article is intended for physicians considering testifying as expert witnesses.
The goal of this activity is to describe the ethical considerations regarding expert witness testimony by physicians, based on an ACP Case History and Commentary.
Upon completion of this activity, participants will:
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The cases and commentary were developed by the American College of Physicians.
Medscape, LLC designates this enduring material for a maximum of 0.25 AMA PRA Category 1 Credit(s)™ . Physicians should claim only the credit commensurate with the extent of their participation in the activity.
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This activity is designed to be completed within the time designated on the title page; physicians should claim only those
credits that reflect the time actually spent in the activity. To successfully earn credit, participants must complete the
activity online during the valid credit period that is noted on the title page. To receive AMA PRA Category 1 Credit™, you must receive a minimum score of 70% on the post-test.
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CME Released: 6/4/2019; Reviewed and Renewed: 7/14/2023
Valid for credit through: 7/14/2024, 11:59 PM EST
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Dr Whitman is a well-known and well-respected gastroenterologist. He is 60 years old and has been thinking of devoting some of his time to being an expert witness as he begins to contemplate a very gradual transition from an extremely busy clinical practice to retirement. Recently, he was contacted by a defense attorney who asked him to serve as an expert witness. The case involved a 52-year-old woman who had been in generally good health when she presented to the emergency department of the local hospital with a 1-day history of abdominal pain. Her condition had worsened rapidly. She was admitted to the hospital, having vomited numerous times. Her initial workup revealed probable high-grade small bowel obstruction, which was attributed to adhesions from prior abdominal surgery.
The patient's medical condition rapidly declined after she was hospitalized. By the following morning, she was in severe respiratory distress, acute respiratory distress syndrome had developed, and she was subsequently intubated. Hypotension and sepsis also developed. Because of the hypotension, she received about 15 L intravenous fluids in another unsuccessful attempt to bring her blood pressure to normal. However, acute renal failure developed and she died at 6:20 AM.
The final autopsy diagnosis was bilateral pneumonia. The diagnosis was made by histologic sections with acute pneumonia, including aspirated material; tissue Gram stain positive for multiple organisms; and respiratory culture positive for Klebsiella pneumoniae. A lawsuit was filed based on the failure of the gastroenterologist to treat or request a consultation on the pulmonary condition.
Dr Whitman has not served as an expert for a number of years because of clinical and teaching demands on his time, and he is wondering whether to proceed. He discusses his tentative idea to start to shift gears with a colleague who is a friend. But the colleague, Dr Stover, is very opposed to Dr Whitman serving as an expert. Dr Stover explains that he does not trust the legal system, and he recently learned of the experience of a friend and medical school roommate who served as an expert for a plaintiff in a medical malpractice case in which the verdict was in favor of the defendant. The defendant subsequently brought complaints for disciplinary action for unprofessional conduct to the state medical board and the expert's professional societies, alleging that the expert had testified outside of his area of expertise and was not knowledgeable about standards of care at the time of the adverse event, thereby breaching guidelines for experts. Dr Stover also vaguely remembers that there have been some court cases involving professional society review of expert witnesses. "Why would you want to take this on?" Dr Stover asks Dr Whitman.
Although Dr Whitman thinks he and other physicians should do their fair share to participate in the process, he is worried about the potential consequences of testifying. Dr Stover and other colleagues have declared they will never serve as expert witnesses. On the other end of the spectrum, another colleague of Dr Whitman's tells him she now spends the majority of her professional time testifying.
What should Dr Whitman do?
