From the blog of medical expert witness Dr. Barry E. Gustin, MD, MPH, FAAEP:

Locality Rules and Qualifying Medical Experts

As medicine evolved, however, standards of practice slowly became homogenized across all communities, rural and urban. This happened because medical specialty and subspecialty organizations developed, and physicians were held to the same practice standards. Training became uniform, with all programs employing the same curriculum, using similar textbooks, and subjecting all doctors-in-training to the same qualifying exams, initially, and for recertification. Since the locality rule existed to essentially protect the country doc, the general practitioners who were not as well trained and did not have easy access to the latest medical knowledge and training, it did not apply to those medical specialists and subspecialists who claimed to have advanced training and unique skills. Thus, by the mid-1960’s, in most jurisdictions, these physicians were no longer able to invoke the locality rule when they were sued for malpractice. Instead, they were now required to meet a national standard of practice in their particular specialty. This marked the beginning of the end of the locality rule.

Insurance expert witness Jim Leatzow has been educating and insuring professionals about the risks to their businesses for twenty years. At Leatzow.com, he offers a glossary of jargon associated with risk management. Two of the terms he defines are:

Run-Off Period Time following the expiration of an E&O policy which is then covered by a tail policy or endorsement.

Tail Coverage/Policy Tail coverage/Tail policy covers a firm for their risks that were created while a traditional E&O policy were in force, but where the firm is no longer practicing for whatever reason. This is typically called the “Run-Off Period”. It is different because no new work is being undertaken by the firm and any prior risk is “running off” or decreasing as time goes by. A tail policy may be purchased (subject to underwriting) for a period of years and is paid for at issuance. Tail policies generally are “fully earned” upon issuance, which means that there will be no return premium, even if the Tail Policy is cancelled early before its expiration date.

From the blog of medical expert witness Dr. Barry E. Gustin, MD, MPH, FAAEP:

Locality Rules and Qualifying Medical Experts

Where do these rules come from and why are they important? Many years ago, there truly was a disparity between the levels of medical care rendered in rural areas versus urban areas. Full-service hospitals were always located in large cities. Physicians and clinics in rural areas had limited facilities, and house calls were common. Standards of medical practice were different for each circumstance. The basic idea was that it would not be proper to hold a rural physician to the same standard as an urban physician. Medical organizations were concerned that if a rural practitioner were held to a higher standard in an environment that could not support those higher standards, physicians would avoid practicing medicine in rural areas. Also, in those days, there was no uniformity in training and there were no standardized board exams. For certain, urban physicians had better training and support than rural physicians.

Insurance expert witness Jim Leatzow has been educating and insuring professionals about the risks to their businesses for twenty years. At his website he offers “Common Questions and Their Answers” to professionals in the green design industry, e.g. landscape architects, arborists, and irrigation designers:

Here’s answers to a few of the most common questions people have regarding risk management for landscape architecture professionals in our FAQ section.

Why do I even need professional liability (E&O) insurance?

In Truck/Tractor-trailer brakes and accident reconstruction,
equipment and machinery expert witness Robert R. Reed writes on ABS anti-lock brakes:

Large trucks and tractor-trailers with ABS anti-lock brakes involved in crashes and accidents have complex systems that must be identified and accounted for in reconstruction and causation issues. Misconception as to skid marks at scenes of crashes can be attributed to the truck/tractor-trailer involved by the police or the investigating agency. Upon investigation and inspection of truck/tractor-trailer it should be noted if the unit has ABS anti-lock brakes and if the system is working. This could change the investigation and reconstruction dramatically as to stopping distance and actions of trucks. ABS systems can apply and release the brakes 5 times a second to keep wheels from locking up and skidding. Numerous times skid marks are attributed to units that did not lock the brakes or skid the tires.

In Barry Zalma on Bad Faith: Time to Put A Stake Through the Heart of the Tort of Bad Faith, insurance expert witness Zalma writes:

After the creation of the tort of bad faith, if an insurer and insured disagreed on the application of the policy to the factual situation, damages were no longer limited to contract damages as in other commercial relationships. If the court found that the insurer was wrong it could be required to pay the contract amount AND damages for emotional distress, pain, suffering, punishment damages, attorney’s fees and any other damages the insured and the court could conceive. It was hoped that the tort of bad faith would have a salutary effect on the insurance industry and force insurers to treat their insureds fairly. However, claims for $40.00 wrongfully denied resulted in $5 million verdicts. Juries, unaware of the reason for and operation of insurance decided that insurers that did not pay claims were evil and that they wrote contracts so they never had to pay. They punished insurers severely even when the insurer’s conduct was correct and proper under the terms of its contract. The massive judgments were publicized and many insurers decided fighting its insureds in court was too expensive regardless of how correct its position was on the contract.

In Preventable Medical Errors, medical expert witness Perry Hookman, M.D., writes that cancer outpatient medication errors may be more common than previously thought.

The increasing number of medications — prescription and nonprescription — used by older people has raised the potential for harm from serious drug interactions, doctors warn in a report published 12/24/08 in the Journal of the American Medical Association. In a survey of more than 3,000 adults 57 to 85 years old, more than half of respondents reported using 5 or more prescription medications, over-the-counter medications, or dietary supplements. Nearly 30 percent used at least 5 prescription medications. Four percent of respondents were using 1 of 11 drug combinations that put them at risk for a major adverse drug reaction because of an interaction between medications. Five of these combinations included nonprescription medications, including aspirin, niacin, garlic, and Ginkgo. Nearly half of these hazardous combinations involved the use of anticoagulants (warfarin) or antiplatelet agents (aspirin), raising the risk of bleeding.

In Obama and Russia, international law expert witness David Satter writes that finding a way to keep an aggressive Russia under control is “one of the most serious challenges facing President Obama.” Satter, an expert witness on Russian politics, society and the Russian legal system, offers basic principles for dealing with Russia that can help cut the learning period short for an American president:

2. Don’t Assume Sincerity.

The Russian leaders defended the right of the Abkhaz and South Ossetians to secede from Georgia but leveled Grozny when it was a question of Chechnya trying to secede from Russia. They denounce the U.S. anti-ballistic missile system in Eastern Europe while facilitating the threat from Iran against which the systems are intended to defend. As for the passionate denunciations of Western encirclement, Russians understand that NATO membership for Georgia and Ukraine poses no military threat but they are loath to give their real reason for opposition which is that the example of democracy in former Soviet republics could inspire demands for democracy in Russia itself. For seven decades, the need to feign belief in Soviet ideology turned Russia into a nation of actors. President Obama should keep this in mind when confronted with Russian “outrage” over some aspect of Western behavior.

Barry Zalma, insurance expert witness and Principal of Zalma Insurance Consultants, writes on insurance risk:

It is dangerous in most legal analyses to limit the conclusion to one factual issue. Underwriting insurance requires the analysis of multiple factual issues that can increase or decrease the potential for loss. The underwriter and the actuary want to cover those risks where the insurer can collect sufficient premiums to pay all losses that can be anticipated and to still have enough to make a profit for its stockholders. Insurers cannot allow hysteria over global warming to effect their decisions with regard to a particular risk. They must review all of the potential factors that can effect the risk so that a well run, well built structure, on land above sea level in New Orleans becomes a risk an insurer is willing to take for a reasonable premium while a home in Beverly Hills, well built on stable ground owned by a person who has suffered five fire losses in the last ten years and three theft losses in the last five years, becomes an unacceptable to a prudent underwriter.

In Obama and Russia, international law expert witness David Satter writes that finding a way to keep an aggressive Russia under control is “one of the most serious challenges facing President Obama.” Satter reports that the Russian economy is unraveling and changes to the Russian Constitution are planned that will probably return Putin to office and make him president for life. Not only is Russia threatening to target American anti-missile installations in Eastern Europe but also to interfere with them electronically which Satter describes as “unquestionably the action of a hostile power.”

Satter, an expert on Russian politics, society and the Russian legal system, offers basic principles for dealing with Russia that can help cut the learning period short for an American president:

1. Don’t Treat the Russian leader As a “Friend.”