Michigan: The Consequences of Legislative Change and Competition for Death Investigation Turf in Michigan

Abstract

Michigan has experienced a surge in the appointment of board-certified forensic pathologists as the County Medical Examiner, seeing an increase from eight counties with slightly less than 50% of the state's population in 1999 to 20 counties with 75% of the state's population in 2013. This article examines this positive change in Michigan, provides information that may explain this trend, and describes the competitive process that many counties are using to identify and appoint their County Medical Examiners. There is competition among forensic pathologists not only for County Medical Examiner positions, but for fee-for-service forensic pathology services as well. Virtually all counties in Lower Michigan and some counties in the Upper Peninsula have autopsy services provided by the 17 board-certified forensic pathologists who live and work in Michigan, and five additional forensic pathologists who live and work in nearby states. Statutory changes have created the opportunity for competition (turf battles) among individual forensic pathologists or practice groups of forensic pathologists. Such competition can have positive effects, but can also have negative impacts such as reduced stability in a county's death investigation system or even job security for forensic pathologists. The emerging trend in Michigan is one of forensic pathology operations of board-certified forensic pathologists (BCFP) serving regions of counties within the state.