Hitting a Nerve

Testifying about the standard of care outside of your specialty


I have no idea what the standard of care in cardiology is. Or nephrology, endocrinology, or pulmonary medicine.

the scales of justice in a courtroom are shown tomloel/ThinkStock

Nor do I think anyone in those fields tries to keep up to date on the latest in epilepsy, migraines, or Parkinson’s disease. They have their fields, I have mine. That’s the whole point of being a specialist: Medicine is too vast a subject for one person to know everything about it. Even my own field is further divided into subspecialties like vascular disease, neuromuscular disorders, and dementia, so I imagine other fields are, too.

Yet, there are still states where a physician of a different specialty can testify as to the standard of care in others for malpractice cases.

Think about that. An orthopedist testifying as to the competence of an ob.gyn. An adult neurologist claiming to be up to date on pediatric allergies. A family practice doctor stating what a neurosurgeon should be doing. All in a court of law, the most dreaded scenario for most of us.

Fortunately, there are several states that require an expert witness to be an actively-practicing, board-certified, specialist in the same field as the person they’re testifying against.

However, some states have little to no regulation of this, so an “expert witness” can be anyone with an MD/DO degree and a pulse. While a good defense attorney can hopefully pick this apart, the average jury is not composed of people with medical training. To many lay people, “a doctor is a doctor,” and it’s very hard to emphasize the degree of specialty differences to them.

Dr. Allan M. Block, a neurologist is Scottsdale, Ariz.

Dr. Allan M. Block

This difference is one (but certainly not the only) factor that drives the different malpractice costs between states. You’d think requiring own-field standard of care would be one of the least contentious malpractice reforms to make, but these days people fight tooth and nail about everything. The result of these battles is that states with the lowest malpractice rates tend to attract more physicians, and states with the highest can have trouble finding qualified people. In the long run, that only hurts those who need medical care.

Dr. Block has a solo neurology practice in Scottsdale, Ariz.

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