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Peer review of testimony is vital.

I am troubled, but not surprised, by trial lawyer Miles J. Zaremski's attempt to mischaracterize peer review of expert witness testimony as an effort to silence those who would give such testimony ("Expert Witnesses Under Fire," Guest Editorial, Aug. 1.p. 8).

Peer review is, always has been, and always will be a time-honored mechanism to assure the public that physicians adhere to the highest standards. It is largely because of peer review that our profession enjoys the public confidence it so rightly deserves. As the provision of medical expert testimony requires not only a medical degree, but advanced levels of knowledge and skill, it is logical that it should be considered and integral part of the practice of medicine.

I was coauthor of the 1997 American Medical Association resolution that defined expert witness testimony as the practice of medicine. Prior to that time, physicians could go into court and state whatever they wished with absolute assurance that they would never be held accountable. As an obstetrician, I was appalled to see the marvelously effective pregnancy antiemetic Bendectin removed from the marketplace in the 1970s after its parent company, Merrill-Dow, felt it could no longer endure the time and expense of defending it against entirely invalid legal claims that it was causing birth defects. These claims were bolstered by expert testimony that was utterly dishonest and false according to every study of the matter. Similarly, the 3M Company was driven nearly to bankruptcy by physician testimony supporting claims that unruptured silicone breast implants were causing all manner of autoimmune diseases. Again, such testimony was completely untrue. It became patently obvious that there was a dramatic need for a system that would enforce honesty and accountability among expert witnesses.

As an expert witness who frequently provides consultative and testimony services for plaintiff's attorneys, I am not one bit frightened by the fact the testimony I give might be peer reviewed. There has never been an opinion I have rendered that has been based on anything other than clearly acknowledged and widely accepted tenets of professional standards. I welcome peer review of the opinion I have provided. My sense is that those who object to being peer reviewed are fearful that their medicolegal opinions might fail to live up to professional scrutiny.

Mr. Zaremski also fails to take into account that experts for defendants might just as well misbehave in their rendering of opinions as might those testifying for plaintiffs. Those of us who support a rigorous peer review system are just as alarmed when a plaintiff with a meritorious case loses because an expert for the defense gave dishonest testimony. Any system which makes itself available to review testimony must be as accessible to plaintiffs as it is to defendants.

We who believe that offering expert testimony in the legal environment is a noble and high-minded undertaking want our standards to be maintained at the highest level. For this to occur, there must be oversight of the process just as there is in the clinical arena.

What we are calling for is nothing more radical than accountability. If the medical profession is to maintain its reputation for credibility, we must ensure that what we do and say in the courtroom is reviewed by our peers with as much vigor as is our performance at the bedside.

David M. Priver, M.D., FACOG

San Diego, Calif.
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Title Annotation:LETTERS
Author:Priver, David M.
Publication:OB GYN News
Article Type:Letter to the editor
Date:Sep 1, 2008
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