Home Letters Flu vaccine, expert witnesses

Flu vaccine, expert witnesses

January 2011

Published in the January 2011 issue of Today’s Hospitalist

Flu vaccine: Should it be mandatory?
Mandatory influenza vaccination, as a condition of employment, is a patient and workforce safety issue whose time has come. ("Coming soon: Mandatory flu vaccination?")

Knowingly exposing co-workers and patients to the risk of influenza is as unacceptable as exposing them to rubella, hepatitis B or tuberculosis “three infectious diseases where compliance with hospital regulations is strictly enforced.

Just as hand-washing campaigns have empowered patients to ask if their health care providers have washed their hands, we should be initiating similar campaigns to motivate patients to inquire about their providers’ influenza vaccination.

Amesh A. Adalja, MD
Pittsburgh, Pa.

More on expert witnesses
Having testified several times as an expert witness, I’ve been struck by the fact that the issues that often appear crucial in court are situations not covered by "evidence-based medicine." (Letters, "Serving as expert witness,")

Usually, a bad outcome has been preceded by a series of actions that are unique in their complexity. Those actions may never have presented themselves with enough frequency to allow any rational examination or establishment of "correct" practice.

Lawyers search for witnesses who agree to argue for or against the physician’s behavior, based on the evidence available for "somewhat similar" situations or for "common sense" approaches. Those in turn are based on a crude understanding of human physiology. Because it’s empirically non-existent, the standard of care is something that has no objective, undisputed reality. Therefore, it is a creation of trial lawyers and their hired minions.

William Reichert, MD
Spartanburg, S.C.