Medical Expert Services

Medical Expert consultations by medical consultants which provides medical review, opinion and legal testimony conducted by well-credentialed, well-qualified physicians in active medical practice and who are not predominately professional witnesses who do nothing else in medicine but testify.

Medical Experts competently selected as a public service for  plaintiffs &/or defendants to render honest, unbiased  medical expert opinions.

1. Pre-Suit Consulting

Often, the specific type of specialist(s) needed is at first not clear. But during the “pre-suit” period at no cost over and above the initial retainer we can convene a Medical Roundtable of experts from the same and different specialties to review the medical records and provide advice regarding potential issues, strengths, weaknesses and exposure to damages ... and a supportive affidavit when appropriate from the most qualified specialist. From most expert witness services’ agencies or bureaus, success or failure depends on the luck of the draw of a particular medical expert chosen by a non-physician or layperson. No one here, who is not a physician ever makes any decision or handles any aspect of your case.

2. Expert Testimony

In the event our opinion is favorable to your case that goes to litigation or arbitration, the certified medical specialist will provide credible testimony in litigation as well as negotiation, arbitration, or mediation. You have complete free choice to accept or reject any recommendations.

3. Mediation and Arbitration

Many of our certified specialists are highly trained in the techniques of ADR, or alternate dispute resolution- especially those conflicts that arise between HMOs, Hospital and Medical Staffs as well as individual members of the Medical Staff.

WHY CHOOSE PERRY HOOKMAN MD PROFESSIONAL ASSOCIATES INSTEAD OF A  COMMERCIAL EXPERT WITNESS REFERRAL BUREAU?

1.No extra charges

There are never any extra charges. As a public service we never bill for intermediary’s fees, broker’s fees, or finders’ fees in providing you with a medical expert.  No extra fees are ever added to your bill either in the initial retainer or covertly added to the hourly charge of the expert, as usually happens with other referral agencies and expert bureaus. There are no verbal or written contracts between Perry Hookman MD and any other physician or expert. There are no commissions, fees or payments, made either to or from Perry Hookman MD PA to any other expert or physician. And even after you have chosen a medical expert no money ever changes hands between Perry Hookman MD and any other expert or corporation, agency, bureau or any other intermediary-in fact you nor the expert has no further relationship to Perry Hookman MD,PA. Why? Because we deem a good match between a competent independent medical expert with a plaintiff or defendant rather than an agency contracted “professional expert”, as a valuable public service which will ultimately  improve the U.S. health care system.

2. We Exclusively Communicate Only With Medical Experts and NO other Professions, Trades or Occupations

We communicate with a competent array of teaching hospital physicians, in private practice and/or university medical schools who have our assurance that they will independently perform their expert roles without any pressures arising from the usual contracts between bureaus or agencies and their physician experts. We promise all medical experts that they will be called upon to provide only honest, independent, and unbiased opinions. We are thus able to involve a forthcoming network of highly qualified physicians and health care experts from private practice and academia who would not otherwise offer to assist in Pre-suit and Litigation processes. These specialists do not have to share their hourly billings with anyone else. They are able to provide expert advice on clinical guidelines and the applicable standard of care since they live it every day in their office, hospitals and medical schools. They can help expose any medical errors in the testimony of other medical experts, and may provide assistance during the discovery process. They may also help on request, to coordinate the testimony of all the Attorney’s medical experts.

3. We can select the most appropriate medical expert by roundtable discussion of each case

Our specialists may engage in a confidential, scholarly, and collegial roundtable discussion of the case at no extra charge. This is done on a case-by-case basis to more thoroughly analyze the problem(s), and to identify the overlapping medical and surgical interspecialty and other issues.  In this way, from the very beginning we select - even in the most complex cases- the most appropriate expert(s) for Case Review &/or Testimony with a more complete understanding of the healthcare strengths and weakness of the case. The knowledge that a single expert can gain through this roundtable conferencing selection process comes from other specialists in the same or different medical and surgical fields thus saving much research time and hourly billing by only one specialist.

Experts chosen in complex cases without the benefits of our roundtable discussion process will not know all the potential medical and other healthcare issues which may arise. This also usually applies to the attorney who is requesting the services of a specialist expert witness either from a list, an advertisement, or an expert witness agency. For that reason our superior method of expert selection, which differs from the others adds increased value and credibility at no extra charge. Wherever possible the Daubert criteria (see 6.Daubert-below) that apply to all experts are kept in mind. We believe this is associated with the greatest degree of success in Malpractice Case Review, and Litigation for Medical Malpractice. We also offer support for Utilization Review, Arbitration, Mediation, Negotiation, Quality Assurance, Medical Case Review, Managed Care/HMO Issues, and Alleged Healthcare Fraud and Abuse.

4. Knowledge of the Standard of Care

We believe that an expert, who may be called upon to testify, should from the very first stage of the process know all the potential strengths and weaknesses of a case. S/he should know this from the point of view of his and other overlapping specialists.  That’s why an expert should not be selected by the usual random luck of the draw by a non-healthcare layperson. Usually an agency or bureau picks from stable of contracted professional witnesses in the mistaken assumption that all a case needs is just any physician in the same specialty to testify as to THE “standard of care.” It’s usually not that simple. Because with the advent of a new generation of managed care medical insurance carriers, not to mention standards set by multiple different specialty organizations, there are now varied standards of care - some published - some not.

5. Timely Telephone Report

Turn-around medical record review time can be less than a week upon request. Upon completion of review the expert will contact the attorney by telephone and discuss the findings. Our experts will not recommend pursuing a Malpractice case unless a finding is made that the case is meritorious. If a case is not deemed appropriate for litigation you will be so informed by telephone -and not in writing -unless requested. We believe it is of utmost importance that you receive a timely, honest and objective evaluation of your case.

6. HOW THE DAUBERT-KUMHO RULINGS AFFECT MEDICAL EXPERT WITNESSES (from an article in preparation for publication by Perry Hookman MD)

The 1993 Supreme Court Daubert ruling followed by the 1999 Kumho decision now imposes significant incentives to both plaintiff and defendant in Medical malpractice cases to bar unreliable expert testimony. The Daubert – Kumho rulings now make the proper selection of an appropriate medical expert crucial. Because now the Daubert’s “gate keeping” role for trial judges may exclude even a Board Certified medical expert in the same specialty. 

Daubert teaches that one should not just rely on the credentials of the medical expert. The medical expert in Federal court, and increasingly in the State courts, must be more than credible, as evidenced by Board Certification. Testimony must continue to be based on medical knowledge within the physician’s expertise. But whenever possible, the medical expert must currently also support all methodology and opinions with objective documentation and “reliable methodology”. The important questions now are: Has the expert’s theory or technique in question been tested? Has it been subjected to peer review and publication? What is its error rate? Do standards exist? Is there widespread acceptance in the medical community? In summary with what learned treatises from peer reviewed medical publications can the medical expert document and thus support his opinions or theories?

Thus now the medical expert must increasingly make a great effort to document all his stated opinions from peer reviewed medical literature. This requires thorough research of published clinical guidelines (used in this context -if accepted by the court under Federal Rules of Evidence 803(18)- as learned treatises), &/or Specialty Position Statements. The medical expert must also research medical articles from evidence based medical literature, &/or current peer reviewed published articles on the medical standard of care, -dealing with the litigated issue(s) during the contested period.

Objective information has always been important, especially when other medical experts as is usually the case have opposite medical opinions based on anecdotal “experience”. But objective and documented medical information is now crucial. In some instances the medical expert’s opinion on the standard of care when supported by peer reviewed medical literature was admissible even though his professional background did not perfectly match that of the defendants.

The competent medical expert in the new millennium realizes that the real world documentation of the medical standard of care is usually not found in classic medical textbooks whose out of date medical information is already about 5-10 years old -even on the day of publication. Instead, every tenet of the expert’s theory, opinion, and reasoning must now be supported by adequate documentation from peer-reviewed medical literature whenever appropriate. Thus support of the expert’s medical opinions now demands a thorough familiarity with peer reviewed current medical journals, and good computer dexterity with the medical research engines of Medical School Hospitals, Medline, and the National Library of Medicine.

References:

Daubert v. Merrell Dow Pharmaceuticals Inc., 509 U.S. 579 (1993)

Kumho Tire Co. Ltd. V. Carmichael, 526 U.S. 137 (1999)

States that have adopted the Daubert rules as of 1999: (from Alston and Bird LLP):

Idaho, Kentucky, New Mexico and Vermont, Arkansas, Delaware, Iowa, Louisiana, Massachusetts, Montana*, North Carolina, Ohio, Oklahoma, Oregon, South Carolina, South Dakota, Texas, West Virginia and Wyoming have adopted Daubert.

See, e.g., Jones v. State, 862 S.W.2d 242, 244 (Ark.1993); Nelson v. State, 628 A.2d 69, 73-74 (Del. 1993); Carolan v. Hill, 553 N.W.2d 882, 888 (Iowa 1996); State v. Foret, 628 So.2d 1116, 1123 (La.1993); Commonwealth v. Lanigan, 641 N.E.2d 1342, 1349 (Mass. 1994); Statev. Blain Southern, 980 P.2d 3 (Mont. 1999); State v. Goode, 461 S.E.2d 631,639 (N.C. 1995); State v. Clark, 655 N.E.2d 795, 811 (Ohio Ct. App. 1995);Taylor v. State, 889 P.2d 319, 328(Okla. 1995); State v. Futch, 860 P.2d 264, 270-71 n.7 (Ore. Ct. App.1993); State v. Dinkins, 462 S.E.2d 59, 60 (S.C. 1993); E.I. duPont deNemours and Co. v. Robinson, 923 S.W.2d 549, 556 (Texas 1995); State v.Derr, 451 S.E.2d 731, 743 (W. Va. 1994); Springfield v. State, 860 P.2d435, 443 (Wyo. 1993

*See Medical Malpractice Case of the Month, October,2000 0n this web site - www.hookman.com

States that have not yet adopted the Daubert rules: (from Alston and Bird LLP):

California, Georgia, Illinois, New York, and several other states have not yet adopted the Daubert standard.

See, e.g., Mattox v. State, 875 P.2d 763 (Alaska 1994); State v. Johnson, 922 P.2d294, 296 (Ariz. 1996); People v. Leahy, 882 P.2d 321, 324 (Cal. 1994); People v. Lyons, 907 P.2d 708, 712 (Colo. Ct. App. 1995); Flanagan v. State, 625 So. 2d 827 (Fla. 1993); Orkin Exterminating Co. v. McIntosh, 452S.E.2d 159, 165 (Ga. Ct. App. 1994); People v. Lowitski, 674 N.E.2d 859(Ill. App. Ct. 1996); Armstrong v. City of Wichita, 907 P.2d 923 (Kan. Ct.App. 1995); State v. Harvey, 1997 WL 422956 (N.J. July 30, 1997); People v. Victory, 631 N.Y.S.2d 805, 811 n.12 (1995); State v. Jones, 922 P.2d 806,808 (Wash. 1996).

In states declining to follow Daubert, these jurisdictions typically continue to follow the “general acceptance” test articulated in Frye v. United States, 293 F. 1013 (D.C. Cir. 1923). Although the Frye test predated the Federal Rules of Evidence by half a century, it continued to serve as an aid to their application until Daubert held it inapplicable to cases arising under Rule 702.As a consequence, several states adopting Daubert have relied on the similarity between  their evidence codes and the Federal Rules of Evidence.

See, e.g., State v. Parkinson, 909 P.2d 647, 654 (Idaho Ct. App. 1996)(noting Idaho’s rule is identical to the federal rule); Mitchell v. Commonwealth, 908 S.W.2d 100, 101 (Ky. 1995) (same); State v. Alberico, 861P.2d 192 (N.M. 1993) (same); State v. Brooks, 643 A.2d 226, 229 (Vt. 1993)(applying Daubert because Vermont’s rules are “essentially identical” to the federal rules).

(From Alston and Bird LLP):

7. Is There An Alternative To Bitter and Expensive Litigation?
(from a 9/26/97 Seminar by Perry Hookman MD, Chairman, Medical Malpractice Mediation Panel,  The Society of Professionals in Dispute Resolution- 25^th International Conference, Orlando Florida)

Alternative Dispute Resolution (ADR) includes arbitration as well as mediation. It is an absolute imperative to today’s litigious environment with increasing claims not only against Healthcare Providers but also Attorneys. ADR in lieu of litigation can often achieve more favorable results. It works best in those cases where the HMO or Hospital and Medical Staff Member(s) do not want to publicize their disputes. And contrary to misconceptions surrounding the National Physicians Data Bank, it can also play at least a limited but effective role during the earliest phase of a pending medical malpractice suit to prevent it from escalating into expensive and bitter litigation.

In contrast to risky litigation with an uncertain resolution, and which may result in at least one disgruntled party, mediation diffuses hostility. It avoids embarrassing public disclosure and creates a better relationship for those who may have to work and meet again. It keeps supervision of the settlement with the parties themselves, while protecting their vital interests.

What can you lose? Mediation can be terminated at any time by either  party. So litigation may go on as planned if mediation fails, with an added appreciation by both parties of all the pertinent issues. Both parties remain protected. The mediator will not give testimony. All statements, admissions, or proposals, and any records, documents, or information disclosed to the mediator, are strictly confidential. Because of this, out of court Healthcare Dispute Resolution is often more desirable.

All Physicians should become proficient in the techniques of ADR and Mediation and use these techniques at work as well as home. More Physicians should become certified in Mediation( through the American Medical Association, or the American Association of HealthCare Lawyers) and become a Mediation expert. We see an expanding role of the trained physician in heath care disputes wherever possible. We try to match appropriately trained Physician Mediators in various cases as a public service.  We bill no intermediaries’ charges or commission fees when asked to match a mediator with a case. We make available to Physicians, Healthcare and Liability Insurance Carriers plus also Defense and Plaintiffs’ Attorneys a free choice of objective and impartial Healthcare mediators, or co-mediators.

These Healthcare experts can help you, at lower costs, gain added value to your efforts at every stage of an active or impending Healthcare dispute. They will work with you to resolve problems, using negotiation, litigation, mediation, or arbitration. They understand the complexities of the healthcare industry and the conflicts faced by healthcare executives, lawyers, physicians, and nurses. They can be helpful in disputes involving medical staff board problems, physician credentialing, physician contracts, HMO / hospital / patient / insurance carrier liability problems, medical malpractice and a variety of other healthcare issues.

These health-care experts have earned the compulsory credibility so necessary for frank and honest communication with Healthcare Professionals. They can provide continuing reality checks and impel genuine discussion for a speedier, more creative, and comprehensive resolution. They have the expertise to better understand not just the stated position of both parties, but more importantly to distinguish their actual from their perceived interests. Experience teaches us that in certain matters we cannot rely only on the jury system to always recognize all the applicable healthcare issues and also take into consideration the future interests of both parties. But Heath Care Mediation experts can do this; and thus can help   formulate win - win resolutions.   ADR - with a trained and experienced Physician Healthcare Professional - is not just a cost containment measure. It is faster. It is fairer. It is confidential. It works!

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