The debate about who is the best person to do a medical report in personal injury or medico-legal matters is one that seems to run and run. Obviously as a Consultant Orthopaedic Surgeon who treats general orthopaedic trauma but also has a sub-specialist interest in shoulder and elbow problems I am likely to be somewhat biased in my opinion. I believe that a Consultant Orthopaedic Surgeon is best placed to act as an expert in medico-legal matters relating to the musculoskeletal system. In my clinical practice (as the Associate Clinical Director for Trauma and Orthopaedics at The Royal Liverpool Hospital, The Major Trauma Centre for Liverpool and Subspecialist Shoulder and Elbow Surgeon) I only deal with orthopaedic problems and as such have an in depth knowledge of them. For me the key is in the name. An expert witness should indeed be an expert in the matter they are dealing with and indeed the court will expect them to be so if they have given an opinion.
As a group of doctors I have massive respect and admiration for General Practitioners. They deal with everything from pre-conception to post-death from the head to the toe. Although a significant proportion of general practice and Primary Care medicine is dealing with musculoskeletal problems the depth in which they deal with them is fairly superficial and when conditions get even remotely complicated they are referred in to the local hospital for further management. It is exactly the thing that I admire so much about General Practitioners that to my mind makes them a poor choice for dealing with medico-legal matters. When a report is provided to the Court, the Court will, quite rightly, assume that the expert providing the report has a full and detailed understanding of the problems being discussed. In reality only a Consultant Orthopaedic Surgeon is likely to have a full in depth understanding of musculoskeletal injuries and thus are likely to be the only people that can give an expert opinion.
I am sure there is appeal for the legal team in obtaining reports from General Practitioners who generally will charge less than a Consultant Orthopaedic Surgeon, however the age old adage of ‘you only get what you pay for’ is probably likely to apply in this setting.
So, when asked about the pros and cons of obtaining reports from Consultants or General Practitioners the key for me is in the role of an Expert Witness, in that the Court will expect the witness to indeed be an expert, and in the title of a General Practitioner who by definition is a generalist. Consultant Orthopaedic Surgeons on the other hand are increasingly sub-specialist dealing with areas of special interest in which they are truly experts and thus better placed to fulfil the role of an Expert Witness to the Court.