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Why is it so hard to find experts in medical malpractice cases?

I had an opportunity recently to talk to a retired anesthesiologist.  He was a medic in the army, later became a registered nurse, then a nurse anesthetist and then returned to medical school to become a full-fledged anesthesiologist.  Incidentally he was also a rancher.  Some perspective don’t you think?

So I asked him – why is it so hard to find an expert witness, especially locally.  I suspected that I knew the answer but I wanted his perspective. 

I do not recall the source but we discussed the fact that about 5% of the physicians out there practicing are responsible for about 80% of the medical malpractice.  If this is true why is the medical profession so unwilling to turn in their own? 

The answer of course is complicated and yet simple.  In my last post I emphasized the fact that we all make mistakes and no person is error-free.  The fear of one physician opining that another physician made a mistake raises the possibility that the physician opining will suffer retribution.  But professions are supposedly, at least somewhat, self-regulating.  If 5% of the physicians cause 80% of the medical malpractice a self-regulating profession should weed out the offenders.  Perhaps the offenders could become administrators or research physicians but not be allowed to continue hurting patients.  Simple but complicated.

Physicians sometimes are exposed to the criticism of their peers in what is called M&M meetings.  M&M is an acronym for mortality and morbidity.  Essentially this is a closed meeting where usually junior physicians present a recent case where they made a mistake and cost the patient their life or seriously harmed the patient.  M&M proceedings are strictly prohibited from publication because the system allows for this procedure as a means to improve the delivery of health care.  It is meant to be a forum where misdeeds are rehashed and all concerned profit from the learning (except the patient of course).  M&M are usually available and practiced in teaching institutions or large hospitals.  I am at a loss of how a solitary physician, after having made a mistake, learns from it or how the system might profit from his mistake.

Being an attorney is also a profession.  We self-regulate to a degree but we do it in the open.  The office of professional responsibility publishes monthly a list of those attorneys who are derelict in their responsibilities to their clients.  Sometimes an attorney will be simply admonished or sometimes the attorney will lose the right to practice law.  Perhaps the medical profession should consider full public disclosure when they make a mistake and harm their patients.  I will not hold my breath.

You can always reach me at george@utahmedlaw.com