State Issues

PaACEP participates in Expert Witness Amicus Brief

The MCARE (Medical Care Availability and Reduction of Error) Act 13 of 2002, states that, in a medical liability action, if a defendant physician is board-certified, then any plaintiff's expert must be board-certified "by the same or a similar approved board."  It also states (40 P.S. §512(c)(3)) that this requirement may be waived if "the court determines that the expert witness possesses sufficient training, experience and knowledge to provide the testimony as a result of active involvement in or full-time teaching of medicine in the applicable subspecialty or a related field of medicine within the previous five-year time period." 

PaACEP was recently asked by the Pennsylvania Medical Society (PAMED) to provide assistance in filing an amicus brief to support an emergency physician whose plaintiff's only expert was a physician who was board-certified and practicing as an obstetrician-gynecologist. 

PAMED agreed with our position that OB-GYN is not a closely-related field with respect to patients who present to the ED with abdominal pain.  The case is pending.  

Meeting with the New Secretary of Health

Chapter leadership, including President Henry Unger, MD, FACEP, President-elect, Ralph Riviello, MD, FACEP, Vice-President Noelle Rotondo, DO, FACEP, and Secretary Michael Bohrn, MD, FACEP, recently met with the new Secretary of Health, Dr. Eli Avila.  He is a practicing physician, attorney and public health executive. Before joining the commonwealth, he worked as Chief Deputy Commissioner of Health Services for Suffolk County, NY.  Dr. Avila has trained in internal medicine, ophthalmology, and occupational and environmental medicine.  

The meeting provided the chance to discuss our number one Department of Health (DOH) issue of boarding/crowding, but also sedation/analgesia, national healthcare reform, tort reform and public health and safety including helmet laws.  The chapter will continue to keep the dialogue going on these important matters.
 

Clear and Convincing Standard

The malpractice crisis has continued to plague physicians and influence the way they practice, in direct opposition of claims that the crisis is over. As tort reform is not a popular topic in legislature, the chapter has recently decided to pursue a different tactic. In Pennsylvania, verdicts in medical liability cases are based on the burden of proof standard of “preponderance of the evidence.” This means, that in order for the jury to render a plaintiff’s verdict, they need to agree that it was more likely than not that malpractice occurred. This is distinctly different than the “beyond a reasonable doubt” standard, which is typical in criminal cases. However, another standard exists. “Clear and convincing evidence” is a higher level of burden of proof and requires a plaintiff to demonstrate that their allegations are substantially more likely than not. This standard could encourage attorneys not to pursue marginal cases, resulting in decreased liability premiums and increased availability of liability insurance, which in turn could enhance patient access to care. The Pennsylvania Medical Society Board of Trustees is in support of this stricter standard of clear and convincing evidence as the basic standard of proof required to prevail in medical liability cases against physicians. Although this project will be very time-intensive and complete with challenges, it is an initiative which PaACEP is committed to fighting with the help and support of members.

Loan Forgiveness

The Governor introduced a plan to expand health care coverage to most uninsured in Pennsylvania. Rep. Josh Shapiro (D-Montgomery) then added an amendment to create a Physician Retention Loan Forgiveness Program for family practice, internists, and pediatricians. In an effort to have emergency medicine included, Henry Unger, MD, FACEP, PaACEP President-Elect, met with Representative Shapiro and provided PaACEP workforce survey results drawn from clinical departments and residency programs throughout the state. The chapter will continue in their attempts since emergency medicine physicians are sorely needed in many parts of the state.