Let's Help Each Other

Physical therapy is changing rapidly. As a PT with more than thirty years of experience, the changes observed in the last ten years triple those of the first twenty years. The pace of change is not slowing down. The Medigraph Blog will serve as a forum that will enable us to exchange ideas and assist each other. This blog will be used to share billing, documentation, and any other ideas to improve any aspects of our profession. If we share what we have learned, we can develop a resource that enables our collective understanding to advance our careers.

As profit margins grow smaller and expenses grow larger, we need to assist each other to survive and prosper. If we share our experiences we can help each other to grow professionally, administratively, and financially. Our professional lives, our livelihood, and our personal lives are intertwined. Our resources individually are limited. Together we can accomplish more than we can individually. Let's help each other


Tom Kane, PT
MediGraph Software

Physical Therapists as Expert Witness. Perspective, Fees, and Fears
10/6/2011 1:59:00 PM
I often have receive calls from MediGraph Subscribers wanting to discuss the subject of expert witness testimony.  Callers want to learn of my experience in this area to help prepare for this task and address the uncertainty surrounding this responsibility.  Because this area of PT often goes un-addressed I will present some thoughts from my experience with appearing as an expert witness, including the appropriate fees. 
As physical therapists it is reasonable to assume that we may have to testify in a proceeding involving a patient.  This statement is especially true when treating work related injuries, personal injury patients (motor vehicle accidents, slip and falls, etc.), or other injured patients where liability is an issue.  Having appeared as an expert witness and having coached others that have appeared, testifying under oath can be intimidating on the first encounter.  The uncertainty of not knowing what to expect is the most disturbing aspect of this task for those that will appear for the first time.
For clarity, the party that is suing (usually the patient) is the plaintiff.  The party being sued (usually the insurance company) is the defendant.   When appearing as an expert, one side  is your ally and the other is your adversary.  Usually, but not always, the party that pays for your appearance is your ally, as they believe your testimony will support their position.  The goal of the attorney that is your ally is to establish your credibility.   The goal of the attorney that is your adversary is to destroy your credibility.  Sadly, the authenticity or factual nature of the case is often not as important as counsels'' ability to make you appear  believable or unbelievable.  For example, in one of my first appearances as an expert witness I was testifying on behalf of a patient that I treated (the plaintiff) three years prior to my testimony (it took three years for the case to be heard in court).  The patient was asked in a prior deposition, "Mr. X, how many times did you receive traction or exercise for your condition?"    This patient replied, "I don't remember exercising or traction."   As stated previously, the patient, a laborer, was treated three years prior to his deposition.  He could not recall receiving therapeutic exercise or traction.   When my testimony was rendered, counsel asked me:
Counsel:  "Are these your records?" 
TKane:     "Yes."
Counsel:  "Is this your bill?" 
TKane:     "Yes"
Counsel:   "You claim that you provided traction and therapeutic exercise to Mr X on 12 occasions." 
TKane:     "Yes."
Counsel:  "But under deposition Mr. X denied ever receiving those treatments.  Are you certain that you provided these treatments?"  
TKane:    "Yes."
Consel:  "How can you be sure when the patient has no recollection what so ever?"
TKane:   "Because my documentation reflects those treatments." 
Counsel:  "So, because these treatments appear in your notes, we are supposed to believe that you gave these treatments even though Mr. X states he cannot remember what traction or therapeutic exercise is?" 
TKane:   "Yes."
At this point, plaintiff's attorney (the patient's counsel) objects, stating that Mr. X is not an educated man, he is not a physical therapist, this treatment was rendered three years ago, to ask Mr. Kane to asses Mr. X's ability to recall, blah, blah, blah.  The point here is to illustrate that opposing counsel will attempt to discredit your testimony and destroy your credibility no matter how truthful your statements or intentions.  This kind of tactic is especially true in a jury trial where  the members of the jury are far more impressionable than an arbitration hearing before a judge or panel, where the audience is not so easily swayed by such tactics.  After gaining experience, my answers to this type of question changed.  I would respond truthfully but with greater understanding of how this portion of expert witness testimony works, preventing myself from falling into that well placed trap.  This is just one example of what expert witness testimony experience.  There are many others, including those surrounding FCE testimony.
Regarding fees for expert witness appearances, my fees varied depending on the situation.  There are a few variables to consider, including:
  1. How complicated is the case?  Testimony in a straight forward history (fracture, post surgical rehab, etc.) will require less preparation time than a more complicated course of treatment.  Your prep time should be reflected into your cost.
  2. Where will this testimony occur?  Fees vary based upon such variables as a video deposition in my office, in the attorney's office, before an arbitration panel, or before a jury?
  3. How much will it cost to pay someone to handle my patient load when I am absent?
Generally, the minimum fee that I charged for my testimony was $750.  For a Deposition in my office I charged $750-$1000.  For a deposition in an attorney's office I would charge $1000-$1250.  For a jury trial appearance I will charge $1500-$1750.  Jury trials usually involve more delays and waiting.  This degree of uncertainty from a time perspective when compared to the other areas presented above should be considered.
I hope this brief overview proves helpful.  As with other issues from MediGraph Subscribers, my consultation in this area as well as any other areas is free of charge.  Feel free to call.
Tom Kane, PT