In Reply: Dr Migden expresses common, and understandable,
frustration with the medical malpractice system in the United States. However,
his implied solution, that physicians should not provide expert testimony
in negligence cases, is not reasonable. In making his arguments, Migden compares
expert testimony with peer review. While I certainly understand the analogy,
it is not sound.
These 2 systems—medical malpractice in the courts and peer review
in hospitals—are intended for different, but related, purposes. The
peer review system is not designed to absolve physicians from responsibility
for their negligence, although that is sometimes the result. Rather, peer
review (and the associated legal privileges given to it) is intended to encourage
honest and full reporting of adverse events by physicians and careful evaluation
of quality by hospitals. Peer review provides an opportunity for health care
organizations and physicians to learn from their mistakes and put in place
systems to reduce future risks to patients.