Emergency medicine used to be called A&E—some say that this stood for anything and everything. Due to the breadth of ailments and injuries encountered by emergency services, it would seem that as an emergency medicine expert, I could undertake writing reports on many areas of practice. However, it is becoming increasingly clear, with many court cases that serve as cautionary examples, that judges are not impressed when experts give opinions incongruent with their expertise. It is therefore paramount to accurately determine which expert witness would be a correct fit for any given case.
The emergency department is most often the entry point to the hospital for urgent patients. However, some of these may have been referred by their general practitioner to a specialist team and are subsequently seen by specialists in the pertinent department, not by emergency medicine doctors. It would therefore be appropriate for the care provided to such a patient to be opined on not by an emergency physician but by an appropriate specialist.
Moreover, it is important to consider the decision-making process. While a patient may have been initially seen by the emergency department team, if they have been referred to a specialist for admission but the specialist team has made the decision to discharge the patient and that latter course of action is alleged to be have been negligent, then it is up to another specialist to evaluate that decision, as the final say did not lie with the emergency team.
In those circumstances, while I would be able to justify giving a report on the care provided by the emergency department by using the proportionality guidelines outlined in the Civil Procedure Rules as a reference, the key evidence may actually require a different specialist. One should not simply write a report stating that there needs to be another report, particularly if this simply adds to the costs of the proceedings. Agreeing to produce such a report, while cognizant of the fact that the opinion of a different expert is required, would only show a disregard for the time and resources of all parties involved.
In a similar scenario, with the increased pressures faced by emergency departments, a patient may be directed to a co-located primary care service. While the streaming decision may be one that I would be able to opine on as an emergency physician, the care provided in the primary care service may or may not be appropriate for me to report on, depending on my level of expertise in that area.
In my previous writing, I have always made it a point to emphasize the need to be confident in your area of expertise before taking on a case. As I have elaborated on that in this article, I do not believe this can be emphasized enough. Whether you are an expert considering taking on a case, or a solicitor looking to engage an expert’s services, be certain to have a good grasp on what type of expertise is required for the case at hand.