Medical Logo 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


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
  • Emergency Medicine
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
TRAVEL
  • Europe
  • North Africa
  • Asia
  • Indonesia
  • Bahamas
  • Tahiti
  • Australia
  • Russia
  • India
  • Central America
  • Caribbean
  • Israel
  • 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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