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Paul Kenneth Bronston, MD
One Jib Street, Suite 202
Marina del Rey, California 90292-5982
310-301-9426 FAX: 310-823-2433
Email:
drprotec@comcast.net
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Emergency Medicine, Quality Assurance & HMO's
Areas of Expertise
- Emergency Medicine
- Emergency Medicine & Active Labor Act (EMTALA).
- Hospital Liability
- Utilization Review
- Risk Management
- Pre-Hospital Care
- Medical Insurance
- Reimbursement/Bad Faith
- Quality Assurance
- HMO/Managed Care Liability
- Elder Abuse
- Ethics
- Hospital Liability
- Credentialing
Board Certification
Professional Membership
- Chairperson, National Ethics & Professional Policy Committee
American College of Medical Quality
- Fellow, American College of Emergency Physicians
- Distinguished Fellow, American College of Medical Quality
- Diplomat, American Board of Quality Assurance & Utilization Review Physicians
- Member, Board of Trustees, American College of Medical Quality
Expert/Consulting
- Medical Insurance Companies
- Utilization Review Organizations
- Paramedic & Nurse Liability
- State's Managed Care
- Workers Compensation & PRO Organizations
- Hospital Quality Management Consultant
- Reimbursements Issues
- Merit Evaluations
- Depositions & Trial Testimony
BIO
Dr. Bronston is the National Chairman of the Ethics &
Professional Policy Committee of the American College of Medical Quality, a
member of their board of trustees & has been instrumental in the drafting &
adoption of national standards in medical quality management.
He has extensive defense & plaintiff medical-legal experience regarding
medical bad-faith & provider fraud issues. He has consulted & lectured for
medical malpractice insurance companies regarding managed care systems &
their impact on physicians performances & the liability issues involved.
Dr. Bronston was the plaintiff expert witness in the landmark Wilson vs. Blue
Cross of California case, which involved medical insurance & utilization
review responsibility & liability in a patient's bad outcome.
Dr. Bronston has consulted with the State of California regarding workers
compensation reform & the State's medical quality & utilization management
regulations covering this area. He was instrumental in advising &
formulating the Certification Standards for the new Health Care Organizations
(HCOs) for the Division of Workers Compensation. He continues to advise the
State regarding the enforcement, management & oversight of these new
oversight review systems & has been a special consultant for the Department of
Managed Health Care which regulates Health Maintenance Organizations (HMOs).
Dr. Bronston is a medical consultant/reviewer for the California Medical Board
and a physician expert reviewer for the State Peer Review Organization (PRO).
Dr. Bronston has more than eleven years of experience consulting for both
private utilization review organizations & the providers of medical care
regarding justifiable, accountable, defensible & documented medical decision
making.
He lectures nationally to The Association of Trial Lawyers of America (ATLA),
The Defense Research Institute (DRI) & The National Judicial College among
others on various issues such as appropriate development & implementation of
practice parameters/guidelines, physician credentialing/profiling
issues/report carding, medical necessity & benefit determinations, &
standards of care. He brings ethics, clarity & practicality to medical
decision-making & the interacting oversight review systems which ultimately
produce quality medical care delivered in an efficient & cost-effective
manner.
Dr. Bronston is a board certified physician in emergency medicine &
continues to practice in Los Angeles, California. He was national sub-
committee chair on economic credentialing for the American College of
Emergency Physicians (ACEP) & was a contributing author on managed care in
ACEP's book "Emergency Medicine Risk Management". He has sat on his
hospitals' quality assurance & utilization review committees & brings a balanced,
common sense & practical approach to problem solving & system development.
CURRICULUM VITAE
MEDICAL BOARDS
- Emergency Medicine
November 1987 - Re-Cert December 2005
- Qualitv Assurance & Utilization Review
October 1989
- California FLEX Exam
June 1983
- ECFMG # 33 5-532-8
July 22, 1981
EMERGENCY DEPARTMENT EXPERIENCE
- Co-Director Emergency Department
GREATER EL MONTE COMMUNITY HOSPTIAL
May 1987 - November 1987
- Emergency Medical Staff
- Kaiser Permanente Hospital
- Century City Doctors Hospital
QUALITY ASSURANCE UTILIZATION REVIEW EXPERIENCE
- Chairperson, National Ethics & Professional
AMERICAN COLLEGE OF MEDICAL QUALITY
Policy Committee
September 1991 - Present
- Assistant Chairperson, National Ethics Committee
AMERICAN COLLEGE OF LEGAL MEDICINE
July 1996 - December 1998
- Member, Ethics Committee
AMERICAN BOARD QUALITY ASSURANCE & UTILIZATION REVIEW PHYSICIANS
November 1990- May 1992
- Consultant. Qualitv Assurance Standards
DIVISION OF WORKERS COMPENSATION STATE OF CALIFORNIA
September 1993 - February 2001
- Special Consultant on HMOs
DEPARTMENT OF MANAGED HEALTH CARE STATE OF CALIFORNIA
April 1997- 2002
- Medical Expert/Consultant
MEDICAL BOARD OF CALIFORNIA
July 1996 - May 2001
February 2006 - present - # 602879
- Physician Expert Reviewer
CALIFORNIA MEDICAL REVEIW, INC.
SAN DIEGO, CA
State Peer Review Medicare Organization
1994 - Present - # PE5972
- Sub-Committee Chair
AMERICAN COLLEGE OF EMERGENCY PHYSICIANS
Economic Credentialing
January 1995 - September 1996
- Member, Qualitv Assurance Committee
BROTMAN MEDICAL CENTER
August 1992 - December 1995
- Member, Utilization Review Committee
BROTMAN MEDICAL CENTER
February 1992 - December 1995
- Physician Advisor
PRIVATE UTILIZATION REVIEW ORGANIZATIONS
February 1987- Present
POST GRADUATE TRAINING
- Residency / Emergency Medicine Program
KERN MEDICAL CENTER, Bakersfield, California
July 1984 - June 1986
- Internship / Internal Medicine Program
WAYNE STATE UNIVERSITY MEDICAL CENTER, Detroit, Michigan
July 1983 - June 1984
EDUCATION
- Doctor of Medicine & Surgery
UNIVERSITY OF BOLOGNA, Bologna, Italy
November 1976- February 1983
- Italian Language & Cultural Diploma
UNIVERSITY OF FOREIGNERS, Perugia, Italy
October 1975 - November 1976
- Bachelor of Arts in Psychology
UNIVERSITY OF CALIFORNIA, Berkeley, California
June 1971 - June 1973
- Psychology
ARIZONA STATE UNIVERSITY, Tempe, Arizona
June 1969- June 1971
HONORS
- Dean's Honor List
UNIVERSITY OF CALIFORNIA, Berkeley, California
RESEARCH EXPERIENCE
- Clinical Research on Arterial Hypertension
UNIVERSITY HOSPITAL, Perugia, Italy
September 1975 - August 1976
- Member, Expert Panel
MEDIC ALERT FOUNDATION, INC.
Professional Liability Cost Savings Research Study
February 1992 - April 1995
PUBLICATIONS
- Review on Carbon Monoxide Poisoning
TOPICS OF EMERGENCY MEDICINE - January 1987
- Professional Policies
ETHICS & PROFESSIONAL COMMITTEE, AMERICAN COLLEGE OF MEDICAL QUALITY
1991 - Present
- Hidden Dangers Lurk Behind Practice Parameters
HEALTH MANAGEMENT NEWS, MIAMI FLORIDA - December 1994
- Financial Inducements & Practice Guidelines in Medical Decision-Making
SOUTHERN CALIFORNIA MEDICINE, OAKLAND, CALIFORNIA - March 1995
- Contributing Author on Managed Care in Emergency Medicine
EMERGENCY MEDICINE RISK MANAGEMENT- Second Edition - Published by ACEP, October 1997
CERTIFICATIONS/LICENSES
- Certified, Fellow American Academy of Emergency Medicine, 1999
- Certified, Fellow American College of Emergency Physicians, 1989
- Certified, Diplomat American Board of Emergency Medicine, 1987
- Certified, Fellow American College of Medical Quality, 1990
- Certified, Diplomat American Board of Quality Assurance &
- Utilization Review Physicians, 1989
- California Medical License Number A41 120, 1984
- California DEA Number AB 2858085
- UPIN # D76043
PROFESSIONAL SOCIETY MEMBERSHIP
- Member, Board of Trustees
American College of Medical Quality, 1991 - Present
- Treasurer & Member of Executive Committee
American College of Medical Quality, 1996 - Present
- Fellow
American College of Emergency Physicians, 1989 - Present
American College of Emergency Physicians, 1984 - Present
- Member
National Council Against Health Fraud, 1993 - Present
- Member
American Health Lawyers Association, 1993 - 1998
- Member
American College of Legal Medicine, 1994 - 1998
- Member, Executive Board
American College of Forensic Examiners, 1995 - 1997
- Member, Executive Board, Scientific & Technical Advisors
American Board of Forensic Examiners, 1995 - 1997
- Member, Position Statement Committee
American Board Forensic Examiners, 1995 - 1997
- Member
Trial Lawyers for Public Justice, 1996 - 2002
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TRAVEL
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- Europe
- North Africa
- Asia
- Indonesia
- Bahamas
- Tahiti
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Australia
Russia
India
Central America
Caribbean
Israel
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FORMER EMERGENCY DEPARTMENT EXPERIENCE
Emergency Medical Staff
- HUNTINGTON BEACH HOSPITAL
October, 1995 - April, 1999
- VALLEY PRESBYTERIAN HOSPITAL
1985 - June 1993
- DOMINGUEZ MEDICAL CENTER
September 1988 - April 1991
- MEDICUS MEDICAL GROUP
December1986 - 1991
- VALLEY HOSPITAL MEDICAL CENTER
January 1986 - February 1987
- CENTINELLA MEDICAL CENTER
November 1994 - April 1996
- BROTMAN MEDICAL CENTER
April 1989 - August 1997
LECTURES
- BASICS OF UR/QA
NATIONAL CONFERENCE, AMERICAN COLLEGE OF MEDICAL QUALITY
June, 1992
- ETHICS COMMITTEE POLICIES
NATIONAL CONFERENCE, AMERICAN COLLEGE OF MEDICAL QUALITY
June, 1993
- MEDICAL QUALITY MANAGEMENT
MEDICAL MANAGEMENT DEVELOPMENT ASSOCIATES
August, 1993 - Present
- ETHICS
MANAGED CARE CONGRESS
January, 1994
- LIABILITY ISSUES IN A MANAGED CARE ENVIRONMENT
NORCAL MUTUAL INSURANCE COMPANY
1994
- ETHICS IN MEDICAL DECISION MAKING
WOMEN IN HEALTH CARE ADMINISTRATION
June, 1994
- PRACTICE PARAMETERS, "THE GOOD BAD & THE UGLY"
CORONA REGIONAL MEDICAL CENTER
November, 1994
- PRACTICE PARAMETERS, "THE GOOD BAD & THE UGLY"
HOLY CROSS HOSPITAL, Chicago, Illinois
Novemher, 1994
- OVERSIGHT REVIEW SYSTEMS IN THE EMERGENCY MEDICAL SYSTEM
QUALITY ASSURANCE SECTION, LOS ANGELES FIRE DEPARTMENT
January, 1995
- PRACTICE PARAMETERS, "THE GOOD, BAD & THE UGLY"
PETALUMA VALLEY HOSPITAL, Petaluma, California
February 1995
- MANAGING MEDICAL QUALITY FOR WORKER'S COMPENSATION IN CALIFORNIA
NATIONAL CONFERENCE, AMERICAN COLLEGE OF MEDCIAL QUALITY
April, 1995
- QA/UR, THE BASICS, "THE GOOD, BAD & THE UGLY"
IBC, USA CONFERENCES, INC., Philadelphia, Pennsylvania.
June 1995
- "THE GOOD. BAD & THE UGLY," PHYSICIAN SURVIVABILITY IN THE '90s"
COOK COUNTY HOSPITAL, Chicago, Illinois
November 1995
- QUALITY MEDICAL CARE: A PHYSICIAN'S PERSPECTIVE"
NATIONAL COLLEGE OF ADVOCACY, ATLA, Atlanta, Georgia
September, 1997
- "SURVIVING THE MANAGED CARE CRISIS"
RANCHO LOS AMIGOS MEDICAL CENTER, Downey, California
June, 1998
- "WHAT LAWYERS CAN DO TO IMPROVE HEALTH CARE BY HMOs"
ATLA ANNUAL CONVENTION, Washington, DC
July, 1998
- "MANAGED CARE IN EMERGENCY MEDICINE"
DEFENSE RESEARCH INSTITUTE, ANNUAL CONVENTION, Chicago, Illinois
September 24, 1998
- "HMO ISSUES"
NATIONAL JUDICIAL COLLEGE, Reno, Nevada
May 20,1999
- "FAILURE TO DIAGNOSE & TREAT IN THE EMERGENCY DEPARTMENT"
AMERICAN TRIAL LAWYERS ASSOCIATON, Las Vegas, Nevada
November, 2002
- "MARKETING THE LABORATORY A KEY PARTNER IN PATIENT SAFETY"
CENTER FOR DISEASE CONTROL & PREVENTION (CDC)
April 13-15, 2003
CONSULTING ACTIVITIES
- Member, Medical Advisory Board
AVIVA FOUNDATION
August 1993 - October 1997
- Consultant, Medicaid Reimbursement Issues
H. F. SYSTEMS
February 1994- 1995
- Consultant, Emergency Department
LODI MEMORIAL HOSPITAL, Lodi, California
November 1996
FORMER MEDICAL LICENSE
- State of Michigan
DEPARTMENT OF LICENSING & REGULATION
Permit ID # 003984, Expiration 6/30/84
UTILIZATION REVIEW ORGANIZATIONS
- HealthMarc
Minneapolis, MN
September 1988 - Fehruary 1995
- Health Cost Consultants. Inc.
1850 Centennial Park Drive, Suite 200
Reston, VA 20191
1990 - 2004
- Med Trac
P0 Box 290429
Nashville, Tennessee 37229-0429
March 1990 - January 2001
- Care Review/National Health Services. Inc.
9200 Shelbyville Road, Suite 700
Louisville, KY 40222-8504
1994 - 2004
- Focus Healthcare
7101 Executive Center Drive, Suite 160
Brentwood, TN 37027
1990 - 1994
- Valuetrac
Portland, OR
1991 - 1994
- Associate Medical Review
Metairie, LA
1988 - 1992
- Spectrum Review Services
3845 FM 1960 West, Suite 110
Houston, TX 77068
1992 - 2004
- Value Health Sciences. Inc.
2400 Broadway, Suite 100
Santa Monica, CA 90404
1989 - 1990
- Baxter/Health Data Institute
Santa Monica, CA
1989 - 1991
- Maximus-Center for Health
1 Fishers Road, 2nd Floor
Pittsford, NY 14534
September 2003 - 2004
ARBITRATION EXPERIENCE
- Certificate of Training - Arbitrator I Workshop
November 12 - 13, 2001
American Arbitration Association
Los Angeles, California
- Certificate of Training - Arbitrator II Workshop
November 6 - 7, 2002
American Arbitration Association
Los Angeles, California
- Listed on Roster of Neutrals
November, 2001 - Present
American Arbitration Association
Los Angeles, California
- Listed on the Roster of Neutrals
2001 - Present
American Health Lawyers Association
Washington, D.C.
PERSONAL & PROFESSIONAL REFERENCES
Furnished upon request
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