The Expert Witness in Emergency Medicine

Conflicts of Interest in Emergency Medicine

“…The adjudication of malpractice claims is an essential mechanism for the recognition of substandard care and compensation of patients who suffer as a result . EPs have an important interest in maintaining practice standards and ensuring that the judgment of such standards remain within the medical community as opposed to others without medical expertise .…”

“…Consciously or subconsciously there may be a temptation to provide testimony in a manner such that the party who is paying the EP receives a favorable opinion . As a counterbalance, attorneys recognize how payment can skew testimony and often use that compensation to impeach the testimony of physician experts, especially if it is excessive …”

Who should provide expert opinion in emergency medicine‐related medical litigation?

“…This is not to imply criticism of the experts who were not emergency physicians, who were no doubt providing their opinions in good faith and may have been addressing causation or damages issues rather than standard of care issues. However, in the context of evidence of the standard of care in the ED, a lack of direct and recent experience of the ED context and its challenges could, at least theoretically, result in the identification of a standard that is not consistent with contemporaneous ED practice in Australia 10,11 . In this context, particular issues identified have been the challenge posed by rare conditions presenting with atypical clinical features, the constraints of ED practice, the balancing of clinical risk, the management of uncertainty, and that it is not feasible in ED to always make a firm diagnosis.…”

“…Given this, relevant literature highlights the importance of 'true' peers and like circumstances being used to establish the standard of care, and the negative impacts on justice for all parties if inappropriate standards are applied. 6,10,11…”