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- What are the fields of Orthopedics and Orthopedic Surgery?
- Who needs an expert consultant/witness?
- Who hires an expert consultant/witness?
- Who pays for the expert?
- Who can testify as an expert?
- Will an expert say what I want?
- Who makes the best expert?
- Do experts work on a contingency basis?
- Why not use
the physician who treated me as an expert?
- Should I have an orthopedic or
neurosurgical expert if I have a spine or back problem?
- How much time does it take an expert to prepare an opinion?
- Will Dr. Fox be my doctor?
- Has Dr. Fox always been accepted as an expert?
- Does Dr. Fox take all cases?
- Does Dr. Fox work for insurance companies or plaintiffs?
- Does Dr. Fox guarantee results?
- Do I have to use Dr. Fox's opinion in my case if I don't like
his opinion?
- If I do not use or agree with the opinion, do I still have to
pay the fees?
- What records are needed for Dr. Fox to generate
a good expert opinion?
- How do I get Dr. Fox to render an opinion on a
case?
Orthopedics and orthopedic surgery are the medical and surgical fields of
treatment of the musculoskeletal system, including bone, joint, tendon, nerve,
muscle, pelvis and spine. Orthopedic surgeons take care of a large number
of conditions from factures (broken bones), to nerve and tendon injuries, spine
injuries (disc injuries, soft tissue injuries, fractures, pinched nerves), and
conditions involving arthritis, degenerative conditions, congenital conditions, and medical conditions
involving the muscles, bones, joints, tendons, ligaments, nerves and spine.
Many parties involved in litigation will need an expert consultant/witness.
In personal injury cases, an expert may be needed to relate the injuries to the
event or accident. Additionally, the client may ask the expert to
calculate future costs or loss of use. In malpractice cases many states require
almost all cases to be certified by an expert in the field (with the unusual
exception of cases where malpractice is obvious to a non-medical individual).
The expert will need to certify that the standard of care was breached.
Furthermore, the expert may testify as to damages. In
malpractice cases the plaintiff will hire an expert as will the defendant.
An expert witness may be hired by an attorney (plaintiff or defendant) or
insurance company. Occasionally a court will appoint an expert to advise
the court. Most cases involving allegations of malpractice will have more
than one expert (generally an expert hired by the plaintiff and another hired by
the defense). Many states require that an expert in the field
certify the plaintiff's malpractice case.
An individual
or patient
will sometimes hire an expert. Some attorneys will bear the costs of
the case (which may include the costs of expert) while others will not.
The attorney or insurance company who hires the expert witness pays the expert fees. These
fees or a portion of these fees may be recoverable as a cost of the litigation.
Additional retainer for services may be required and separate financial policies apply to individuals hiring an expert.
Dr. Fox does not provide services on a contingency basis.
The court or judge decides whether an individual is qualified as an expert.
Currently in most states any physician can testify in any field of medicine
although expert witness testimony generally is much more powerful if given by an
expert trained in the specialty. These rules are changing at the current
time to try to prevent a physician from testifying outside of the field of his
training. Chiropractors generally are not be accepted as experts in a
court of law--and in some states are
specifically barred--(although treatment may be paid
for depending on whether a physician states it was medically necessary).
The American Academy of Orthopaedic Surgeons has recommendations of what
attributes qualify a physician as an expert in orthopedics (Dr. Fox meets all
requirements).
Often treating physicians are called as witnesses in a case. Some
treating physicians have been qualified as experts, others have not (but may be
at the time of deposition or trial), while others are not experts and will not
be qualified. Many physicians are interested only in providing medical
care and do not want to be involved in legal cases. In many cases, the
time involved in litigation is much more than was originally involved in the
medical care. The physicians who provided the treatment have a job which
is providing medical care and are not necessarily interested in becoming
involved in the outcome of a lawsuit. Many physicians see no duty to become involved in
litigation and may view a request to testify or be deposed as a nuisance that
interferes with medical care of other patients. Additionally a treating physician if used as an expert may spend little or no time in
preparation or analyzing the records. Sometimes treating
physicians work out well as
experts, sometimes not.
In other cases, such as those involving physical therapy, the treating
physician may be closely associated or may even own the therapy practice. In
such a case the treating physician might have a financial interest in the
outcome of the case. In these cases, it may be wise to have an outside
expert to provide an independent point of view.
Often the best expert is the physician who gives the most logical, well thought-out and cogent explanation of the facts in
language that the judge and jury can understand. Many experts try to
testify outside of their field of training--this is not appropriate and
generally the opinions are discounted by the courts. Therefore, the expert
should be a physician trained in the specialty in question. A good expert can
logically defend his opinion and is not biased in his conclusion (i.e. he
accepts and incorporates the valid points made in an opposing view) . Experts who have testified for plaintiffs as well as defendants are generally
held in higher regard by the court (since they do not appear to have a bias toward the plaintiff or defendant). Dr. Fox has testified for
insurers as well as plaintiffs and is well regarded in local courts.
Finally, a local physician is generally best, as the client will not appear to
have needed to search far to locate an expert to testify on his
behalf.
Expert opinion is just that, expert opinion--not bought and paid for
testimony. Some "experts" give paid opinion (i.e. an opinion that is not based
on medical knowledge and practice, but is an opinion specifically
formulated to support the client's case). Paid opinion may not
be well supported and often can be disproved or be shown to be not well
thought-out. The client is best served by correct
medical opinion that consistent with generally accepted medical opinion.
Often the expert with the most logical, well thought-out, prepared, and
factually based opinion will prevail if there is more than one expert in a case. If an expert appears to have been paid to have a certain opinion (i.e. it is not
well justified and logically thought out) then the court and jury are
likely to discount the opinion.
A first-rate expert gives a reasonable, justified opinion that takes into account all
of the facts with which he has been presented.
Experts generally do not work on a contingency basis. Dr. Fox does not
work on a contingency basis. An expert who chooses to work on a
contingency basis may have the validity of his opinion questioned when it
becomes apparent that he will only be paid if the client prevails in the legal
case. Some states specifically prohibit experts from working on a contingency basis.
Orthopedic Surgeons and Neurosurgeons both treat a variety of conditions of
the spinal column. Most spine conditions fall within an area of overlap between
these specialties. Experts in each specialty may be able to testify equally well in this
area based upon the each individual's training and experience. Some areas
such as spinal cord injuries with paralysis and tumors of the spinal cord
itself, are usually treated by neurosurgeons, while others, such as fracture
treatment and instrumentation of the spine, are often covered by orthopedic
surgeons. In some cases both specialties will work together. These
boundaries between specialties are not uniform throughout medicine and vary by surgeon, his training and expertise, and sometimes even by the region of the country. Disc problems, pinched nerves,
soft tissue injuries, and arthritis of the spinal column are treated by both specialties. Dr.
Fox has personal experience as a physician and surgeon with non-operative treatments
and operative treatments, including micro-surgical treatment, decompression,
fracture treatment and instrumentation (including plate fixation, pedicle screw
fixation and surgical cage implantation).
An expert opinion does take time to formulate. A high-quality expert renders
his opinion after a comprehensive review of the records and speaking with the client (attorney)
involved. An interview with the injured individual may also be helpful (if the expert
is hired by the plaintiff). Dr. Fox can prepare an expert opinion on an expedited basis, but additional costs and fees
may be
involved--an expert opinion prepared without adequate time may be worse than
no expert opinion at all (i.e. an expert should not be asked to formulate an opinion that should require hours or even
days of review, reading and preparation
in the time just prior to trial). Dr. Fox does not take all cases offered and if
there is insufficient time to prepare, may refuse to participate.
Some cases may require relatively few hours to prepare, others are more
complex and require more time. The preparation of the opinion is
often closely related to the volume of medical records (i.e. it is impossible to
give a reliable opinion without actually reading the records). Some
records are thorough and easily legible, others are handwritten and cryptic.
The clarity of the records may play a significant factor in the time needed to
interpret the records.
Dr. Fox does not treat the patients or give medical advice to the patients
for whom he serves as an expert consultant. Dr. Fox is licensed to practice and
maintains an active federal DEA number, however Dr. Fox does not treat the
patients for whom he gives expert opinions. There have never been any
malpractice judgments or settlements made on Dr. Fox's behalf.
Dr. Fox has testified by deposition and at trial for Louisiana courts, Mississippi
courts and Federal courts. Although Dr. Fox has never been refused qualification
as an expert, Dr. Fox cannot guarantee that he will always be accepted as an
expert in the future. Dr. Fox limits his case analysis and
testimony to areas of medicine that he has specific experience and training
(e.g. Dr. Fox would not testify in a heart surgery cases unless there were an orthopedic aspect of the case).
Back to Top
Both. Experts who have testified for plaintiffs as well as defendants
are generally held in higher regard by the court (since they do not appear to
have a bias toward the plaintiff or defendant). Dr. Fox has testified for insurers as well as plaintiffs and is well regarded in local courts.
Many cases will have experts on both sides Back to Top
No. No expert or attorney can guarantee results. Dr. Fox gives his honest opinion to the best of his medical
knowledge. Medical care is the subject of varied opinion and different experts
may give different opinions about the same care. No expert can guarantee a
result or that a review of a chart will result in a favorable opinion to the
client.
This is a legal opinion and the client or his attorney can best answer this
question. Dr. Fox is not an attorney. In general, in Dr. Fox's
experience, an adverse opinion is not discoverable if the party requesting it
does not utilize or list the consultant as an expert. On the other
hand, generally Dr. Fox will not accept a case for review that he does not feel
has some merit. Dr. Fox does not agree to provide any specific finding in
his opinions.
Yes. Dr. Fox does not work on a contingency basis (in some states it is
illegal). Dr. Fox's time is valuable and he provides his service under
contract. A retainer and engagement contract is required prior to
commencement of services.
Dr. Fox has expertise to offer in many cases. He does not, however, take all
cases. Some cases are not within his area of expertise. In other cases, Dr. Fox
may not agree with the attorney's conclusions for the basis of the suit. Dr. Fox
offers his expert opinion but will not offer testimony which is not medically correct. At other times,
Dr. Fox may not be available for the time requested or the opinion can not be formed in the timeframe
needed. Dr. Fox reserves the right to participate
as he deems appropriate and ethical.
Dr. Fox needs to be provided with a complete set of records (medical records,
pleadings, physician and insurance company correspondence, and other expert
opinions) as possible. A thorough understanding of the case is best
to avoid incorrect conclusions or inaccurate opinions. Dr. Fox likes to review the actual tests (the X-rays
films, Myelogram films, MRI
scans etc.), as the films contain much more information than the description of
these films from the radiologist or treating physician. Sometimes an
examination of the client (if Dr. Fox is retained by the plaintiff) is warranted Occasionally a visit to a facility is required to
examine equipment or understand how an injury occurred.
The more information provided, the more accurate, complete, and justifiable
the opinion will be.
Contact Dr. Fox to set up a free
initial phone review.
Christopher D. Fox, MD.
Copyright © 2005. All rights reserved.
Revised: 07/01/05.
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