My Story: 30 Years as an Orthopedic Surgeon/Medical Expert Witness Part 3

This week, Bruce Raymond Wright, respected inventor, author and personal motivator continues his interview with Dr. John L. Chase. Part 3 of several parts in which Dr. Chase tells his story 30 Years as An Orthopedic Surgeon and Medical Expert Evaluator & Witness.

Bruce Wright: There are many misconceptions about medical legal work.  Which of them are the most erroneous, and why?

Dr. John Chase: Whenever doctors hear a lawyer, they think malpractice.  And so they think of somebody attacking their credentials, and their skill, and their capability.  And they’re just very negative towards attorneys and the law in general.  But, malpractice is simply whether you meet the standard of care or not.  So that shouldn’t be so threatening to physicians.  If they’re doing a good job, then there’s not really a worry, because they are meeting the standard of care.

Personal injury, Workers’ Compensation, retirement disability and all that which does involve attorneys and some involve courts, is not necessarily medical malpractice.  So doctors don’t have to feel threatened that their own skills and education and competence and all is on trial.  They should feel gratified and recognize that their skill is needed in another way, which is very lucrative if you know how to do it well.  Also, it provides a community service because you help to fairly resolve all these problems that are being litigated.

So in personal injury, the attorney, instead of becoming an adversary becomes your colleague.  They are very engaging and intelligent.  They usually have a liberal arts education as opposed to our very scientifically oriented education.  They are fascinating people.  They’re a pleasure to work with.  And some of the funniest people I’ve ever run into.  On the other hand, like with many professionals in any occupation, they can be hard to work with as well. Knowing how to do an excellent job mitigates those problems.

The attorney on plaintiff or other side, you know, can be adversarial, because he or she is trying to win a case.  But you just need to know where it’s coming from.  It’s not you they’re after.  They are trying to win their case and either minimize or maximize the award.  You’re being used to help mitigate that and explain that so they attempt to diminish your effect, and they’re doing the best they can.  So it’s all a process.  And it doesn’t have to be personal.

So you need to remember that.  If you get into it you realize it’s very intellectually stimulating. It’s different than what you normally do, so it really adds a lot of value to your life and your practice.

Bruce Wright:  What does it take to be an excellent medical evaluator and expert?

Dr. John Chase: I would say that first is to find out what your role is and how you can do it skillfully.  Then take that into how to do a historical interview of an adversarial person, how do to an examination of someone who might accuse you of hurting them during the examination, how to function in an environment where an opposing attorney limits your ability to do things the way you’re used to doing them so you have to learn a new way.  After that I think learning how to interpret diagnostic information consistent with a causation argument as to what caused this abnormality.  All that leads to the biggest part of the whole process, that is, writing a useful and skillful report.

To be successful in this business you need to learn how to write skillfully, and communicate well both verbally and in writing.  After the report is done, then you have to testify in a certain percentage of cases.  It’s a whole gamut of education, communication, and teaching skills that you learn all along the way.

Bruce Wright: Does being able to do all of these other multidimensional complex aspects of medical work strengthen your capability as a medical provider?

Dr. John Chase: Absolutely. Learning all the other things that go on in the world that involve your patients is incredibly educational.  Also, you realize that people have secondary agendas to why they tell you things that they tell you.  In a treatment setting, primarily doctors are interested in what’s wrong and what to do about it.  They’re not used to considering what caused it.

You start to be a little skeptical about what your patients tell you, and don’t take everything at face value.  You start looking at a bigger picture and change the way you reach diagnostic impressions, make treatment recommendations and carry out treatment plans.

During the first couple of years after we started our group,  orthopedic surgeons involved came to me and said they hadn’t wanted to do this work at the beginning, but once they got started they realized it was making them better doctors. I never forgot that.  It does improve your ability to be a better clinician, a better surgeon, and a better physician.

Next Week: What the Future Will Bring