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Medicolegal Reporting

We have had several enquiries from members interested in involvement with medicolegal reporting and wondering how one gets started. Richard Warren has long experience in this field and writes:

 “How can the specialist expertise of musculoskeletal physicians be made better available in presenting the medical evidence used in personal injury (PI) claims? Most medical reports in claims for back and neck injuries sustained at work or in car accidents, or whatever, are written by orthopaedic surgeons. The situation is unlikely to change spontaneously. Those arranging the medical report would need to be persuaded that they would be well served in instructing a musculoskeletal physician to examine the patient, review the medical records, and provide a written opinion.

So who arranges the medical report? Usually this is the solicitor advising the claimant. Solicitors who do a lot of PI work have their own favoured medical experts whose work they are familiar with. Medical reporting agencies have flourished over the past decade. These agencies have various doctors from different specialties on their books and many solicitors find it convenient to use these agencies to provide the medical report. Insurance companies involved in defending a claim may instruct a medical expert also as a “second opinion”. Often however (especially in the low value claims) the insurance company accepts the medical report submitted by the claimant. It is therefore the solicitors regularly undertaking PI work on behalf of the claimant, and the medical reporting agencies, which need to be persuaded that they can obtain a comprehensive, authoritative medical report from a musculoskeletal specialist. How can this be done? Essentially it is a matter of raising the profile of musculoskeletal physicians, something, which is difficult to do given their relative scarcity. A direct approach from BIMM to each individual medical reporting agency would undoubtedly carry authority. An official approach by BIMM to solicitors who are members of APIL (the Association of Personal Injury Lawyers) would also be a good idea.

    There are various organisations, often commercial undertakings, which offer to train and even “accredit” medical expert witnesses. Training in writing medical reports may be beneficial. Completing one of these courses does not however guarantee that the number of requests for medical reports is going to increase. Any organisation which offers some form of so-called accreditation as a medical expert witness, having paid to attend one of the organisation’s training programmes, should be treated with caution. Quite simply there is no such thing as an officially accredited medical expert witness as far as a court of law is concerned. The situation is under discussion between various government departments but any official accreditation procedure for medical experts is unlikely to be introduced in the short to medium term. A certificate of so-called “accreditation” is unlikely therefore to be the key to a lucrative career in medicolegal practice.”

Certainly the legal reports that are obtained concerning one's own patients often seem remarkably ignorant and inept as they give opinions about the likely cause of pain, the extent of disability the patient should have and the prognosis. There is surely a need for musculoskeletal physicians to get involved. If you would like BIMM to look into training for this role or to get involved in PR to solicitors then let us know."
British Institute of Musculoskeletal Medicine
BIMM