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Lars Aanning has a warning: When it comes to medical malpractice claims, don't expect doctors to testify honestly against each other. "In essence, no supporting testimony from a defendant physician's colleagues can ever be deemed trustworthy, truthful or true -- because those colleagues have essentially sworn an oath of loyalty to each other," he writes.
Aanning should know, as he's done it himself. A surgeon in South Dakota, he says that he lied on the stand in a medical malpractice trial almost two decades ago and that doctors feel intense pressure to protect their colleagues from lawsuits, even if it means breaking their professional oaths.
Aanning wrote his "belated confession" for the Yankton County Observer at the end of August and cross posted it to the Pro Publica Patient Safety Community Facebook page shortly after. In it, he recounts the time, about 15 years ago, when he was called to testify in a colleague's malpractice trial:
I had never been on the stand before as a defendant's witness. But I had no problem with joining in, and accepting the defense mantra that no negligence or breach of "standard of care" had occurred, and that the surgeon had "done everything right." I wasn't going to be a squealer-- fat chance!
"But from that very moment I knew I had lied -- lied under oath," he writes, "and violated all my pledges of professionalism that came with the Doctor of Medicine degree and membership in the AMA." The "loyalty demanded of me" by his clinic and his colleagues overcame those concerns, he says.
For a doctor to do anything but defend a fellow physician would "brand that colleague a whistleblower, a virtual has-been, and permanently mark him as a betrayer -- with retirement or relocation the only viable outcomes."
Aanning lied "as a matter of course," he told Pro Publica in a Q&A, as a result of the "cultural attitude I was immersed in," one that "viewed all attorneys as a threat" and justified anything that would thwart them.
Aanning concludes that doctors' employment contracts "hold physicians loyal to the organization" and should be considered "barriers to honest testimony by a physician's colleagues."
Aanning has since retired from medicine and now works with medical malpractice lawyers on the plaintiff's side, he told Pro Publica. He says he hasn't thought about whether it was his personal fault the patient in his case lied, though he has considered meeting that man's widow. "But cumulatively between what I said and the other testimony -- it was never a level playing field for the plaintiff."
"People don't recognize it. How the judges don't recognize it and the system doesn't recognize it is beyond me," he says.
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