DO Outlines Steps to Malpractice Reform

To the Editor:

Recently, I contributed toward the cause of the Osteopathic Political Action Committee (OPAC) in Washington, DC, with the following reservations:

• The message put forth by OPAC must reach a wider audience than just DOs. Osteopathic physicians understand many of the issues, yet the American Osteopathic Association still hesitates to challenge a segment of trial lawyers and their physicians who testify for plaintiff's counsel without accountability. Where is the American Medical Association in all this? Does that organization approve their physicians generating income this way? Before trial, these attorneys move the judge to limit information from the medical records that can be presented to the jury. The collaborating physician then bases his testimony and opinion to the jury solely on this limited information.

• The Osteopathic Political Action Committee must support intellectually honest and thoughtful candidates on both the state and national levels. Most Democrat and Republican candidates depend heavily on their political action committees' ability for rhetoric and for raising money. Do money or action speak louder than words? Look outside the usual two-party system of candidates.

• The media slant on malpractice reform must be put in check. Insist on live, one-on-one interviews—whether for minute-long or half-hour segments. This will promote clarity and an emphasis on the issues.

There is much to do. These ideas give some idea of the magnitude.

Response

John B. Crosby

American Osteopathic Association Chicago, Illinois

I read with great interest the letter submitted by Roger G. Michaud, DO. Dr Michaud makes some notably pointed and valuable remarks regarding how accountability standards should be raised for political candidates who receive funding through the osteopathic medical profession's political action committee. Osteopathic physician leaders may want to factor in the general line of reasoning outlined by Dr Michaud, as well as some of his more specific points in their future strategic deliberations.

I would like to specifically respond to Dr Michaud's comments regarding the American Osteopathic Association's (AOA) position on physician expert witnesses in medical malpractice cases. Without question, a physician who acts as an expert witness is often one of the most important figures in malpractice litigation. Despite the general distrust that exists between physicians and attorneys, physicians have an obligation to testify in court as expert witnesses on behalf of the plaintiff or defendant as appropriate. Ethical concerns arise, however, when physicians act in a partisan manner during the legal proceedings or accept compensation dependent on the outcome of those proceedings.

I cannot speak to the views of other medical organizations; however, the AOA is closely studying and monitoring this issue. For instance, the AOA's Bureau of State Government Affairs is currently compiling information on varying state laws regarding expertise and credentialing requirements for physician expert witnesses. The AOA's Committee on Ethics is further reviewing the possible establishment of AOA-endorsed qualifications and guidelines for DOs who serve in this capacity.

To help address physicians' increasingly complex litigation matters such as the role of expert witnesses, the AOA Litigation Fund was recently established. Historically, the AOA has limited its participation in lawsuits to amicus curiae briefs at the appellate level, which allowed the AOA to advise the court on a matter of law without directly being involved in litigation. The new litigation fund provides a mechanism by which the AOA may consider and provide financial support for members' legal cases at the trial or appellate levels. The fund will apply only to legal matters of national significance to the osteopathic medical profession and those supportive of the programs, policies, and mission of the AOA. I encourage DOs who need assistance in a case such as this type to contact the AOA's Division of Socioeconomic Affairs for more information.