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Selecting a medical expert is the single most important decision an attorney makes when preparing a case. The impact that a physician who is knowledgeable, prepared, experienced and personable can make on a case cannot be over-estimated. However, many of these intangible qualities are simply not apparent from a CV, nor can they be deduced from the typical, hurried phone conversation that many medical experts grudgingly provide inquiring attorneys. Ideally, an attorney would obtain a referral to a medical expert from a trusted colleague, one who had experience with the recommended expert. However, this is not always possible given the multitude of specialties and the scheduling issues inherent in the medical profession. When a referral cannot be obtained, an attorney must then either cold-call potential experts or contact a company specializing in providing medical experts. The pitfalls of cold-calling medical experts are well known to every attorney. Most doctors simply will not accept calls from attorneys no matter how many calls are made or the nature of the messages. These doctors are simply too busy, dislike attorneys or are uninterested in legal work. Hours of valuable time are wasted attempting to merely get a doctor on the phone. Once a doctor is contacted, it is virtually impossible to make an intelligent decision as to the doctor’s suitability over the phone, simply because very little can be ascertained during this brief encounter. While the CV is useful for disqualifying clearly inappropriate specialties, the CV does not provide the attorney with information concerning the doctor’s experience in regard to the case’s medical issues; the ease with which the doctor works with others, including the retaining attorney; his ability to communicate clearly to a jury; his ability to handle a withering cross-examination; his commitment to seeing the case through to completion; and his level of preparation or his integrity when it comes to billing. War stories concerning the failings and billings of medical experts are legion. Of course, there are pitfalls associated with companies specializing in providing experts, medical or otherwise. Many of these companies are simply r�sum� clearinghouses that charge a fee for indiscriminately providing attorneys with stacks of resumes. These firms do not have staff physicians who can authoritatively evaluate the medical issues in a case or an expert’s suitability. These companies do not screen the credentials, personality, litigation history, availability or billing practices of the experts referred. Obtaining CVs in this fashion is actually worse than cold-calling experts because the attorney has now paid for the privilege of cold-calling experts who may or may not be suitable. Fortunately, not all medical-legal consulting groups are clearinghouses for r�sum�s. In the absence of a referral from a trusted attorney or physician, these companies can be extremely valuable resources for quality experts. What follows is a list of criteria that an attorney should look for when considering a medical-legal consulting group. � In-house medical staff. The company contacted should possess an in-house staff of physicians capable of discussing the medical issues and the appropriate medical specialties. This initial contact with a physician is crucial to obtaining a clear picture of the medical issues and selecting the appropriate specialties. Often, multiple medical specialties have been involved in a patient’s care, creating problems in determining who was responsible for any deviations from the standard of care. The in-house, staff physicians should be capable of analyzing the care provided and identifying those specialties associated with the key problem areas. In many cases, these specialties are not obvious to the layman. The same can be said regarding causation experts. � Familiarity with the suggested experts. Once the appropriate specialties have been determined, the staff physicians should be able to provide CVs from doctors who have been carefully pre-screened and credentialed and with whom they have discussed your case. Ideally, a physician, familiar with the facts of your case and experienced in medical-legal work, will make a blind presentation of the pertinent medical issues to potential experts, not revealing whether the case is for the plaintiff or defendant, and evaluate their suitability to act as an expert in the case. This “suitability” evaluation should include the doctor’s education, training and experience (medical and legal); their communication skills; their willingness to work with counsel and their commitment to see the case through to conclusion. Only after this procedure has been completed should a CV be provided to the attorney. � Expert services contracts. The “disappearing expert” problem is one that most attorneys have encountered. Working with a company that has contracts with its physicians makes the attorney the third-party beneficiary of a contract that obligates the expert to complete the case. While not an absolute guarantee, a contract either with the expert or the consulting group is a powerful tool for compelling compliance, as well as providing recourse to the attorney injured by non-compliance. � Cost-containment protocols. Expert fees in medical negligence cases can run into the tens of thousands of dollars, and yet an attorney has little recourse but to pay all expert bills once the expert has been designated. Arguing about fees will only alienate the expert and jeopardize the attorney’s case. A good medical-legal consulting group will review an expert’s fees and, if they are excessive, handle the delicate task of asking the expert to justify them. Because the expert knows his fees are subject to review by another medical professional, he is far less likely to inflate his hours at the attorney’s expense. This simple protocol can result in thousands of dollars of savings over the course of a case. Another essential cost-containment protocol requires the expert to provide time estimates for each task requested by the attorney before performing it. These estimates should be subject to attorney approval. This procedure prevents the attorney from being surprised by an unexpectedly expensive billing for the expert’s time. � Quality experts. Finally, the medical-legal consulting group should consist of a large network of available doctors, in all specialties and regions of the country, who are board-certified, actively practicing and not performing substantial amounts of medical expert work. Nothing affects credibility more than a history of testifying for only plaintiffs or only defendants, or a doctor who no longer practices medicine but makes his living by providing trial testimony. Most importantly, these medical experts should have been screened and credentialed by other physicians who are capable of judging the relative merits of their CVs, assessing their communication skills, following up on medical and legal references and determining each expert’s particular strengths. Ideally, a working relationship with a medical-legal consulting group provides the attorney with access to a medical staff capable of clarifying medical issues, selecting appropriate medical specialties, and, when required, providing the attorney with capable, qualified physicians who will testify on behalf of their honest, unbiased opinions. Garth Sullivan Esq. and Barry Gustin, M.D., M.P.H., are with Berkeley, Calif.-based American Medical Forensic Specialists, which provides attorneys medical-legal consulting services and medical experts. If you are interested in submitting an article to law.com, please click here for our submission guidelines.

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