Upholding professionalism

Abstract

Objective: To review the disciplinary process by which the American Academy of Neurology (AAN) enforces its formalized standards of professional conduct. Methods:We reviewed the AANЈs Disciplinary Action Policy. We tracked the elapsed time from receipt to final decision of all allegations ("complaints") of improper conduct by AAN members submitted from 2004 to 2009. We placed each complaint into 1 of 4 categories: allegations of 1) improper expert witness testimony; 2) substandard care; 3) unprofessional conduct; 4) or both 2 and 3. We noted the type of complainant (AAN member or nonmember) and the final outcome for each complaint. Results:The AANЈs disciplinary process is a 5-step procedure with multiple reviewing bodies.

The Expert Witness in Medical Malpractice Litigation

“…126 Between 2004 and 2009, there were 58 complaints: 22 alleged improper expert witness testimony; 4 members were disciplined, 2 of whom resigned in lieu of discipline. 127 …”

Closed Medical Negligence Claims Can Drive Patient Safety and Reduce Litigation

“…Some see a governmentmandated reform that restricts this system as a desirable solution to this problem [28]. Specifically, alternative forms of compensation [23], damage caps limiting the right of recovery [7], and various means of making it onerous for a plaintiff to obtain and use a medical expert [18] have all been suggested as legislatively imposed strategies to reduce the burden of medical malpractice litigation.…”

The AAN disciplinary process

“…Neurosurgery is a notable exception. 6 A review of their experience with complaints from 1996 to 2006 noted a much higher percent of sanctions (68%) of neurosurgeons found to have offered improper expert witness testimony than was the case for neurologists as reported by Hutchins et al 5 One could conclude from the Hutchins et al 5 report that one should not practice neurology today without having access to the disciplinary process they describe. Being sued for malpractice is an unpleasant experience at best, even though the majority of claims are dismissed (65%) or settled (26%) (and in the 5% proceeding to trial, the defendant prevailed in 90%).…”

“…4 In this issue of Neurology ® , 2 attorneys who serve as counsel for the AAN join with the Chair of the Ethics, Law and Humanity Committee-a joint committee of the American Neurological Association, the Child Neurology Society, and the AAN-to present the current system that the AAN developed and employs to respond to the complaints of patients about their neurologist and to the concerns of the neurologists who believe themselves victims of inaccurate or otherwise inappropriate testimony or have witnessed unprofessional behavior by other neurologists: a complaint. 5 The article highlights that the majority of complaints reaching the higher levels of review are complaints by neurologists concerning improper expert witness testimony of neurologists, since patient complaints are generally either unsubstantiated, or more appropriately dealt with by others (for example, hospitals or states). The authors present the data on the substance and number of complaints, the length of time taken to reach a decision regarding action on the complaints, and the process used to reach a decision.…”