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Dr. David Merenstein’s Journal of the American Medical Association article (“Winners and Losers”, JAMA. 2004;291:15-16, reprinted here), first noted here Jan. 14, continues to be the source of discussion in the medical community.

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Doctors on trial

by Walter Olson on January 14, 2004

In last week’s issue of the Journal of the American Medical Association ($ access), Baltimore physician David Merenstein writes about a malpractice case which resulted in a $1 million verdict against the residency program in which he was working (though he himself was let off the hook for liability) over his failure to insist on a PSA test in a middle-aged male later diagnosed with advanced prostate cancer. Central to the plaintiff’s attorney’s strategy was to put on trial the mode of medical practice known as “evidence-based medicine”. Medical blogger Ross Silverman at “The Bloviator” (Jan. 8), who is often critical of attempts to limit malpractice litigation, nonetheless finds the result in this case “horrible” and “ridiculous”. MedRants (Jan. 8 and Jan. 9) comments, as does Medpundit Sydney Smith (Jan. 9). More: The LitiGator, from Michigan, also comments (Jan. 18)

In the same Jan. 9 post, Medpundit links to an illuminating Cleveland Plain Dealer piece (Harlan Spector, “Fleeing the malpractice crisis”, Jan. 4) about a neurologist who lost his malpractice insurance and moved out of Ohio after he was hit with six claims. Six claims sounds like a lot, and we keep hearing that “problem doctors” account for a large share of the malpractice problem; but how weak were the six claims? Well, four of the six were dismissed before he had to meet with a lawyer; in a fifth, which is pending, the plaintiff has no lawyer of record. And the sixth? That resulted in a defense verdict, and was called “frivolous” by the presiding judge, who however also said: “They paid these experts who sign affidavits, and I can’t throw the case out.” “I feel like I’m being shot at all the time,” said the defendant, Dr. Bruce Morgenstern, who moved to less litigious Colorado.