The Board of Directors of ACEP issued on June 22, 2016 a public censure of Peter Rosen, MD, FACEP, for violation of ACEP’s Expert Witness Guidelines for the Specialty of Emergency Medicine and the Code of Ethics for Emergency Physicians.
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ACEP Now: Vol 35 – No 09 – September 2016Procedures for Addressing Charges of Ethical Violations and Other Misconduct
ACEP has a process for reviewing complaints of ethical violations or other misconduct. The complete process can be found online at www.acep.org/ethicalcomplaints. The following is a summary of procedures:
- A complaint of ethical violations or other misconduct may be initiated by an ACEP member, chapter, committee, or section.
- The ACEP Executive Director reviews the complaint and determines whether it is frivolous or refers it for review by the Bylaws and/or Ethics Committees or subcommittees, or refers it to be more appropriately addressed through judicial or administrative avenues.
- The respondent is provided with a copy of the complaint, along with any attachments, and given 30 days to respond along with evidence in his or her defense.
- The Committees, or their subcommittees, will consider whether the alleged action violates ACEP Bylaws or the Code of Ethics, which includes ACEP’s Expert Witness Guidelines. If they determine that a violation has occurred, they will then consider whether the alleged conduct warrants private censure, public censure, suspension, or expulsion from ACEP.
- The Board of Directors then receives the recommendation of the appropriate committee, the complaint and response, and at a meeting of the Board, votes to determine whether disciplinary action is warranted. The respondent is notified of the decision and may either request a hearing or accept the Board’s decision.
- At the hearing, the complainant and respondent each may be represented by counsel or any other person of their choice. The Board will then render a decision based on the hearing and provide written notice of its decision, along with its basis, to the respondent.
Possible Disciplinary Actions
- Censure
- Private Censure: A private letter of censure informs a member that his or her conduct does not conform with the College’s ethical standards; the contents are not disclosed, but the fact that such a letter has been issued will be disclosed.
- Public Censure: A public letter of censure shall detail the manner in which the censured member has been found to violate the College’s ethical standards.
- Suspension from ACEP membership shall be for a period of 12 months, after which the suspended member can be reinstated.
- Expulsion from ACEP membership shall be for a period of 5 years, after which the expelled member may petition for readmission to membership.
10 Responses to “ACEP Issues Public Censure Against Dr. Peter Rosen for Violating Ethics Code, Expert Witness Guidelines”
September 15, 2016
David ClineIf ACEP has issued a “Public” censure, and by definition, “A public letter of censure shall detail the manner in which the censured member has been found to violate the College’s ethical standards,” why doesn’t ACEP detail the violation in print. I believe this is a very serious issue for all ACEP members. Please release the details so ACEP members can avoid similar censure.
October 25, 2016
ACEP NowThe details of the case itself are not available for disclosure, but ACEP members can request to see the copy of the censure letter through our legal department. What we can say, based on the college manual/bylaws regarding these kinds of complaints, is that a complaint was filed in May 2015 about a member who violated ACEP’s Expert Witness Guidelines. As per the process, a subcommittee of the Ethics Committee was convened to review the complaint. Six people on the subcommittee represented a diverse group of members and included seasoned physicians, academicians, and one of the members who drafted the original ACEP Code of Ethics. Anyone who had a conflict of interest was recused. The subcommittee made its decision without consideration of the member’s past contributions to ACEP or emergency medicine. The decision was made based solely on the testimony presented to the subcommittee. The Board received the subcommittee’s recommendation, and voted to issue disciplinary action. There was a hearing with the member in question, and the Board rendered its decision in June 2016.
-ACEP Staff
October 19, 2016
Juan NietoI totally agree with Dr. Cline. ACEP appears to be
Ignoring it’s own policy on public censures.
This is truly an injustice to Dr Rosen , those who know him and the democratic process which ACEP stands on .
If it is public make it public! Stop the rumors.
The strain between DR Rosen and ACEP is well known
And this may have been an effort to discredit one of the founders of our specialty .
October 22, 2016
Louise B AndrewHere’s what the linked policy states:
Public Disclosure: The Board of Directors will publicize in an appropriate ACEP publication the names of members receiving public censure, suspension, or expulsion. This published announcement shall also state which ACEP bylaw or policy was violated by the member and shall inform ACEP members that they may request further information about the disciplinary action. If any person makes a request for information about disciplinary actions against a member who has received public censure, suspension, or expulsion, the Executive Director shall refer that person to the published announcement of that disciplinary action in an ACEP publication.
This policy is a bit circular. Although the article stated that this member was disciplined for violating the EW Guidelines and Code of Ethics, the policy says that a request for information may be made by any person, but that they will simply be referred back to the published article that presumably is already known to the person requesting information or they would not know to ask for information. Hmmmm. Unless this was intentional, the policy may need work.
October 22, 2016
Louise B AndrewMORE EDUCATION ON ETHICAL OBLIGATIONS OF EXPERTS NEEDED
David,
I recalled another article relating to this member that may help to answer your question. It can be found at
https://www.acepnow.com/article/need-new-standard-proof-medical-malpractice-cases/#comments
Even if this WAS the basis for the censure you inquired about, it still seems to me that more specifics should have been revealed in the public censure announcement if, as you pointed out, the policy is intended to have any teaching benefit to members.
I was one of the original authors of the expert witness guidelines. I can assure you that education of members as to what is and is not ethical in the expert witness arena was certainly the intent of the policy.
Sometimes, experts don’t really understand the concept of standard of care, and sometimes a potential expert’s vision is clouded by the persuasion and selective education about the case by an attorney who wants an advocate. Sometimes, experts are simply dishonest.
Some members also don’t realize that membership carries ethical obligations because it has not been brought home to them in recent years with renewal applications. (see, e.g., https://www.acepnow.com/article/aceps-expert-witness-ethical-policies-enforced/ )
I published a monograph in EMCNA 2005 on the Ethics of Being an Expert Witness in EM. You can find it here: http://www.emed.theclinics.com/article/S0733-8627(06)00029-0
October 23, 2016
Greg PalmerDr. Rosen is one of the founding fathers of Emergency Medicine and one of the most ethical physicians I know. I agree that for ACEP to release a public censure of Dr. Rosen without also publishing the particulars, tarnishes his name and reputation unjustly.
Shame on ACEP. There’s something rotten in Denmark.
October 24, 2016
Gerald (Wook) BeltranDr. Peter Rosen censured by ACEP
The American College of Emergency Physicians on June 22, 2016, issued a public letter of censure to Dr. Peter Rosen, a well-known emergency physician, textbook editor and medical leader, for providing testimony that was “false, misleading or without medical foundation” and was biased by hindsight.
[Further detail was provided by this commentor, but cannot be published by ACEP in a public forum, pursuant to ACEP’s pubic disclosure policies. ACEP members can request to see the copy of the censure letter through our legal department.–ACEP Staff]
October 28, 2016
Louise B. Andrew MD JDGreg, It could be argued that not disclosing the details actually protects the party who has received the censure from reputational harm. And such details may well be being concealed to protect the College from liability, for example, from libel charges.
Both the article, and the plain wording of the policy however state that the details should be disclosed publicly. But as the GC explains in the staff comment above, a later clause limits such “public” disclosure to ACEP members who specifically request to see the original letter. So as interpreted, it really is a form of “private” disclosure.
Nothing that I can think of prevents a member who receives such a letter about self or about another disciplined member from publicizing it, even here.
There is some deterrent value even to private censure, since an expert may be asked whether they have received any form of discipline from a professional association, and having to admit to this would put a dent in the income stream from expert witness work.
The problem with such “private” “public” censure is, as originally noted by Cline, that members may learn from the notice that there is some danger associated with providing expert witness testimony, but they may not understand what is, and is not, considered ethical expert witness behavior in an individual case.
All members should of course read the expert witness policy and be willing to sign the expert witness affirmation statement. Ideally, such information and agreement to abide by all ethics policies should once again be made a condition of continuing membership, as was intended when the policies were written.
Since there is definite value in members’ participation in the justice system as qualified expert witnesses who actually ARE emergency physicians (as opposed to other specialists who claim to know our standard of care), ACEP should definitely consider regularly educating members on how to provide expert testimony in an ethical manner.
November 7, 2016
Nick PapacostasThis is an interesting article about expert witnesses, as well as how ethical expert testimony is especially important in the era of some states passing laws requiring “gross negligence” to be the standard in winning a malpractice case against EMTALA providers.
http://epmonthly.com/article/gross-negligence-a-slippery-slope-for-dubious-expert-testimony/
November 3, 2017
Alex BromfieldWe do not know the entire details of the case so it is hard. From what I can tell it was testified that Dr. Rosen said the physician was “grossly negligent”, a much higher bar than simple negligence in other malpractice suits. A 15yo child ending up having a PE with only arthroscopic knee surgery is odd. Especially with no other supporting findings such as VS abn or swelling.
Missing this is not “grossly negligent”. I would think 50/50 on checking for PE. Weighing risk vs. benifit of contrast and radiation. Cannot use d-dimer, which leads to the other point:
He stated D-dimer is not elevated in post op patients, which is crazy.
I overall agree. Testimony was entirely biased by hindsight