Archives for December 2, 2005

AAEM Reviews Cases, and Names Names

I’ve written before that one of the things we, as a Profession need to do to decrease meritless malpractice cases is to put our own house in order as regards expert witness testimony. I do not advocate a wall of silence or a parroting of the ‘party-line’, but I’m all for exposing our erstwhile ‘colleagues’ who will give expert testimony that’s at odds with provable standards and actual practices.

AAEM has decided to join the party, explaining it thusly:

In order to file a malpractice claim, many states require plaintiffs to have an opinion from an expert that malpractice has occurred. A number of these so-called experts are physicians who seem willing to make any statement, no matter how outrageous, in support of a malpractice claim. These physicians can profit handsomely from their willingness give such testimony.

Alarmingly, a number of leaders in our specialty have chosen to supplement their income by giving “expert” testimony that is unfounded in current medical standards and practice.

AAEM has responded to suggestions by several members by creating this web site. It is designed to bring to light testimony by expert witnesses that is remarkable either because of its spurious nature or because it is particularly helpful to the emergency physician defendant. It is hoped that by publicizing such testimony, and the individuals who offer it, emergency physicians may find some measure of relief from the ongoing crisis.

Unlike the ACEP review, AAEM is naming names. AAEM has helpfully included the name of the plaintiff’s expert witness (which I’m going to leave out of this post, for now).

A look at the testimony in the case does make me, as a practicing EM physician, say “huh?” Here’s some of it:

Page 33 – line 11:

Question: “And have you treated patients like Mrs. Walker who have come here with these kind of symptoms with tPA?”
Answer: “All the time. I mean, unfortunately, it’s all the time. Not daily, but probably three or four times a week.”
Comment: The reviewers were surprised that a physician would claim to give tPA so frequently. Giving it at such a rate would probably exceed the usage at the busiest centers in the world. This seems like a wild exaggeration.

My ED sees about 75,000 a year and we don’t give tPA for stroke 4 times a month, let alone any one physician giving tPA for stroke 4 times a week.

Want to keep the roaches down? Turn on the lights. They don’t like the exposure, and for that reason ACEP and AAEM are to be commended for their efforts.

RSNA: Coffee Boosts Short Term Memory

Another reason to have a cup:

CHICAGO, Nov. 30 – A cup of coffee is good for the memory, at least the short term memory, according to research reported today.

In a study of 15 healthy men ages 26 to 47, functional magnetic resonance imaging (fMRI) detected significant activity in the brain’s memory centers 20 minutes after the men consumed 100 mg of caffeine, according an Austrian study reported at the Radiological Society of North America meeting here.

The activity was significantly greater than men who were imaged after consuming a matched placebo (P<0.05), said Florian Koppelstatter, M.D., of the University Hospital Innsbruck. He said the fMRI scan detected activity in the anterior cingulate cortex of the brain, which is responsible for some short-term memory functions.

This was by the Radiological Society of North America, and not Folgers, so you know it’s good.