The medico-legal expertise: Solid medicine, sufficient legal and a measure of common sense

All through medical school, aspiring medical practitioners spend most of their time learning about the inner workings of the human body and study to pass their exams so that one day they may be in the position to accomplish that ever-daunting task, already pursued by their predecessors , to serve mankind, to restore normal health, to stamp out disease, to prevent its occurrence, explain sicknesses to patients and stay out of jail. Once in practice however, the physician may be called upon one day to assess medico-legal aspects of a case in his practice or that of a colleague, something he may never have been shown how to do while in medical school. Has the point of Maximal Medical Improvement been reached, is there an impairment? A functional limitation? A temporary or permanent disability? A handicap? Did the incident cause the injury and the sequelae? Is there an apportionment? An aggravation of a pre-existing condition? Is there evidence of malpractice? Is the individual employable? Part-time or full-time? Are there other investigations or treatments to come? Would you be willing to testify in court? Answers to these questions are equally important in the overall helping of mankind, particularly for the great multitude toiling in the manual working class who are most often subjects involved in the medico-legal process. Because such people seldom have the capabilities of changing careers in mid-stream, they require some form of support should they become unable through misadventure to continue in their chosen pre-injury line of work. THE EXPERT The physician who feels drawn to get involved in medico-legal matters is usually a specialist in practice for at least 10 years (orthopaedics and psychiatry are the most common) and begins to take on cases (expertises) from publicly-funded agencies such as the Workmen's Compensation Board, Provincial Automobile Insurance, Pensions Board, the Military. In time, depending on his performance and reputation, other agencies may come calling: Insurance Companies, individual legal firms, medical protective agencies, unions. Although the various mandators want the same answers, each one words their questions differently to suit their ends and each produces different guides for the evaluation of permanent disability. The old adage of "caveat emptor" for the employee, perhaps thinly veiled, can still be seen to be present. The physician who does "expertises" becomes known as an "expert" not so much because he holds every discernable award or has performed brilliantly on the medical …