Courting Justice: ENT Surgeons in the Witness Box

The legal sphere may not be a physician’s natural habitat, but it is an area in which a medical professional’s knowledge and experience can be instrumental. According to a recent report, the call for evidence-based and experience-based medical opinions in legal cases has been on the rise (StatPearls [Internet]. https://tinyurl.com/2ndm5j99). Understanding this, many professional medical societies, including the American Academy of Otolaryngology–Head and Neck Surgery (AAO-HNS), provide their members with specific recommendations or guidelines for serving as expert witnesses (AAO-HNS. https://tinyurl.com/mszk2t23).

For physicians who embrace the call, providing expert medical testimony is both enriching and enlightening. For many others, however, it is a foreign territory. “The medical–legal world is a big black box for most physicians. We get no training in it and don’t know much about it,” said David Terris, MD, regents professor of otolaryngology– head and neck surgery and surgical director of the Augusta University Thyroid and Parathyroid Center in Georgia. Dr. Terris has been doing expert witness work since 1994, with a focus on the thyroid and parathyroid specialties. “For me, [this work] has offered two great opportunities: one, to help some of my colleagues in need of good expert witness testimony, and two, to exercise a different part of my brain.”

Requirements and Expectations

Providing medical expert testimony involves several phases: engaging in thorough preparation to form an opinion, participating in an interrogatory (written discovery), sitting for a deposition (oral discovery), and, in some cases, testifying before a trial jury. The preparation period involves reviewing all the materials and records relevant to the case, including others’ depositions. Through this process, the physician forms their opinion. “It’s like cramming for a final exam,” Dr. Terris said. “You want to be totally prepared for the questions that you’re going to get in your deposition, to have the important facts of the case at your fingertips. That’s a commitment that one needs to make at the outset.”

“In general, your opinion is going to be based on your fund of knowledge, and not on outside references,” said M. Boyd Gillespie, MD, MSc, professor and chair of the department of otolaryngology–head and neck surgery at the University of Tennessee Health Science Center in Memphis. “However, occasionally there is a situation in which one side is making the case seem less complex than it is, and you may need to pull some literature that would be helpful and offer it to the side that you’re working with as potential evidence for the case.”