Professional oversight of physician expert witnesses: an analysis of complaints to the Professional Conduct Committee of the American Association of Neurological Surgeons, 1992-2006.
OBJECTIVE
To investigate the role of the professional conduct review program that is operated by the American Association of Neurological Surgeons (AANS). The program adjudicates complaints against AANS members for their work as expert witnesses in medical malpractice litigation.


BACKGROUND
Policymakers worry that physician expert witnesses who espouse unfounded views in malpractice cases may fuel inappropriate litigation. A growing number of professional societies have sought to oversee their members' work as expert witnesses by instituting standards to regulate this conduct and enforcing those standards through formal disciplinary procedures. The AANS runs the longest-established and busiest program of this kind in the country. Plaintiffs' lawyers and consumer advocates have questioned the even-handedness of this form of self-regulation.


METHODS
We reviewed the confidential case summaries of all 59 complaints involving charges of inappropriate expert witness testimony adjudicated by the AANS Professional Conduct Committee from 1992 to 2006. We developed descriptive categories for the characteristics of the complainant and respondent, the types of misconduct alleged, and the outcomes of the review, including penalties imposed.


RESULTS
The most common type of allegation was presentation of testimony that misrepresented the standard of care. Nineteen complaints (32%) were dismissed, but 40 (68%) resulted in sanctions ranging from censure to expulsion from membership. Both the frequency of complaints and length of sanctions have increased in the last 4 years. Although the AANS is highly attentive to procedural fairness, the overwhelming majority (57/59, 97%) of complaints related to testimony from witnesses acting for plaintiffs.


CONCLUSIONS
Professional organizations may play a useful role in oversight of expert witness conduct, provided they maintain procedural fairness and strive for impartiality, as the AANS program seems to have done. However, from a policy perspective, this form of oversight is incomplete and should be complemented by other mechanisms aimed at ensuring the quality of physician testimony.
Kesselheim
Aaron S
AS
Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02120, USA. akesselheim@partners.org
Studdert
David M
DM
D008318:Malpractice / Q000706:statistics & numerical data*; D009493:Neurosurgery; D012955:Societies, Medical; D014481:United States