Breast society's expert witness guidelines address controversy
The question of qualifications for radiologists who testify as expert witnesses in malpractice cases has fueled an ongoing debate. The Society of Breast Imaging has entered the fray by publishing a set of guidelines it suggests are minimal qualifications for an expert testifying in court.
Though full of teeth, the guidelines may have little bite, according to a prominent radiologist with a background in malpractice issues.
"The SBI's object and purpose to stem, curb, if not eliminate inappropriate expert witness testimony, is honorable and admirable," said Dr. Leonard Berlin, radiology chair at Rush North Shore Medical Center and a legal columnist for the American Journal of Roentgenology. "But they are going about it the wrong way."
Berlin suggests the right way is through guidelines already established by the American College of Radiology. The SBI's recommendations for experts to read 2000 mammograms a year are totally unrealistic, he said. The FDA requires only 480 mammograms a year for its approval.
"The college criteria are far more logical and far less restrictive. You have to be honest and fair, know what you are doing, and know the subject very well. That's basically the standard," Berlin said.
The SBI?s recommendations are: · Experts meet FDA certification and criteria for interpreting mammograms for at least five years. · Experts have read at least 2000 mammograms a year during two years previous to their appearance in court. · If technically specific testimony is needed -- for example, stereotactic breast biopsy -- experts should have adequate training and experience that meets ACR requirements for accreditation in these areas. · Experts were involved in breast imaging at the time of the alleged malpractice. · If no longer in practice, experts meet requirements mentioned within two years of their participation in a case.
"We had multiple comments from society members concerned about the quality and experience of people who were testifying as experts in mammography malpractice trials," said SBI president Dr. D. David Dershaw, director of breast imaging at the Memorial Sloan-Kettering Cancer Center.
The SBI has neither the ability nor the intention to police expert witnesses' compliance with these criteria, he said. But the society hopes defendants, plaintiffs, and their attorneys become aware of the minimal qualifications its officials recommend before experts take the stand.
Plaintiffs or defendants should be able to cry foul whenever they get confronted with people who don't meet these criteria. They should call for the established guidelines to be met by the so-called expert, Dershaw said.
By law, physicians testifying as experts in virtually every U.S. court need not be either a specialist or related to the specialty being questioned in trial. All they have to demonstrate to most judges is that they are practicing physicians, have a license in good standing, and have a thorough familiarity with the subject at hand. Courts, therefore, may not accept these recommendations, Berlin said.
"It's up to the judge to decide whether you are qualified to testify as an expert," he said.
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