What It's Like to Be an Expert Witness; Docs Fight Contracts; Syphilis Drug Shortage

— This past week in healthcare investigations

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INVESTIGATIVE ROUNDUP over an image of two people looking at computer screens.

Welcome to the latest edition of Investigative Roundup, highlighting some of the best investigative reporting on healthcare each week.

What It's Like to Be an Expert Witness

Being an expert witness in a courtroom can be a taxing experience for academics, who are increasingly being called to the witness stand, according to .

Science took a deep dive into how academics are recruited to becoming expert witnesses, and what it's like to actually serve as one -- whether for the plaintiffs or for Monsanto in ongoing glyphosate trials, or for parties on either side of the recent trial looking into whether acetaminophen can cause autism or attention deficit hyperactivity disorder (ADHD).

While the work can be lucrative, it can also take up significant amounts of time and cause stress. Being involved in court cases can also shade perceptions of one's professional commitment. Others feel an obligation to share their expertise with the justice system, Science reported.

Lawyers often recruit academics to serve as expert witnesses, but they are frequently turned down, succeeding in about half of their pitches, one lawyer told Science.

Those who do get involved may find themselves feeling obligated to the lawyers who hired them. David Sedlak, PhD, an environmental engineer at the University of California Berkeley, said, "You hang out with the lawyers for many hours. You're having meals and socializing with them. You're part of that team. Your human nature is, you're going to want to please them, by telling them what they want to hear."

Docs Fight Back Against Noncompetes

Doctors have been fighting back in court against restrictive noncompete agreements, according to .

Noncompete clauses prevent doctors from taking a job with competitors within certain geographic regions for a year or longer. Doctors argue that this has prevented patients from receiving critical care as it further limits the number of specialists in a community.

David Lankford, MD, an Indiana pediatrician, told NBC News that he believes "many critically ill children and their families would have to travel significant distances at significant hardship to get access to care."

Lankford left his position at Lutheran Hospital in Fort Wayne after a round of layoffs increased his workload, but when he accepted a position at nearby Parkview Health, his former employer sued. Since then, Lankford has been in a months-long legal battle over his ability to continue to care for patients.

Employers claim the noncompete agreements are necessary to protect their investments in recruiting and supporting their doctors. Doctors said the restrictions only lead to patient harm and silencing of providers unhappy with working conditions at their hospitals.

"We have seen these noncompetes increase exponentially over the last several years, and it really goes against the very ethos of medicine," Omar Atiq, MD, president of the American College of Physicians, told NBC News.

While doctors are starting to win some of these cases, Atiq said, it is still rare for them to challenge their noncompete agreements in court due to the financial and professional consequences.

Critical Drug Shortage as Syphilis Cases Rise

As cases of congenital syphilis rise in the U.S., there's a critical shortage of the only medication for treating pregnant patients, .

The shortage of penicillin G benzathine (Bicillin L-A) -- which is only made by Pfizer in the U.S. -- is expected to exacerbate the growing crisis, the news outlet stated.

In 2022, more than 3,700 babies were born with syphilis, including almost 300 who were stillborn or died as infants, ProPublica reported. More than 50% of these cases occurred because the pregnant parent was never properly treated, despite being diagnosed in time. The 200,000 syphilis cases in 2022 represented a 79% increase over 5 years, and infections among pregnant people and their babies jumped 250% during that time period, the news outlet stated.

The increase in cases paired with the ongoing shortage has left many doctors scrambling to find doses of the treatment -- 3 are required -- for their pregnant patients.

ProPublica reported that the government isn't doing much to slow the spread of the disease, though it could pressure Pfizer to be more transparent. Pfizer blames the shortage on increased demand for both the adult and pediatric versions of the drug.

In July, the CDC asked healthcare professionals to preserve any remaining doses for pregnant people, according to the investigation.

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    Michael DePeau-Wilson is a reporter on ’s enterprise & investigative team. He covers psychiatry, long covid, and infectious diseases, among other relevant U.S. clinical news.