Below, Tracy shares details of her work in the legal sector and the niche the firm was established to fill. We also hear from Michael Jonathan Clark, an ENT expert with Med Legal Pro, who gives us some insight into what his work entails.
Tracy Liberatore
Please tell us about the work you do as head of Med Legal Pro (MLP).
A large part of what I do is help attorneys figure out which expert it is they need. For example, sometimes they call with case facts and don't know what sort of expert they need. More often than not, they call thinking they need one type of expert when they really need another. The most common area where this comes up is in deciding between a medical examiner and a medical toxicologist. It is very fact-specific details that cause it to be one rather than the other.
My unique combination of medical and legal degrees enables me to move in both circles. I can speak about medicine to the doctors and other medical providers to help them understand the cases and screen them to see if they are the right expert for the case. I can also help them understand the legal aspects of the case so they can better understand what it is they are supposed to be doing. This is most helpful with new experts who are not familiar with the law.
What led you to found MLP?
I started MLP from the ground up while I was attending law school. I started locally with one attorney who gave me a chance to work in his office and attend depositions. From there I did my internship with his office and the federal public defenders', as well as another criminal defence office, to give myself a more well-rounded exposure to the legal world.
I started with nursing home cases and a single expert, which quickly turned into a niche based on requests for other experts for the same cases he was already working on. He got so busy I had to find other nursing home experts to pick up some of the case overflow. The most frequent request I would get was for a conscious pain and suffering/cause of death expert, which is where Dr Diaz came in. We had also been working together for years but as of April, I took him on as a more full-time expert, handling his marketing and business so he could work solely on cases. Seeing how this business model worked for everyone involved, I decided again to replicate it as appropriate experts would arise.
My expert practice is quite different from other expert firms out there. I did not really market MLP directly; I replicated what worked with a single expert – that was marketing the expert directly and running the business side of things so the expert could work on the cases solely and not worry about trying to run a business. I handle all their marketing, contracts, retainers, record gathering and other aspects involved in taking on a case. As an attorney, the retainers go into a trust account, so if there is a refund due our clients never have to worry about the funds not being available to be returned, as I adhere strictly to the rules required as an attorney for retainers.
A large part of what I do is help attorneys figure out which expert it is they need.
Since 2020 I have expanded my experts beyond nursing homes to include a few others who I feel are at the top of their profession. I would not feel comfortable marketing them otherwise.
How else has MLP developed its services since its inception?
The other thing we offer is a 30-day turnaround on case reviews, unless otherwise specified. From time to time we do have a case where an expert gets so busy we have to find another to take on the overflow or extend review times, but this will be known up front on the initial intake call.
We also handle case screens by nurses for merit review if there is a question of whether or not there is a case to pursue. This is good if there is any question about the validity of a case and best to learn up front before investing thousands of dollars on experts, depositions and years of work in a case.
By far the biggest part of what we do is help manage experts from both sides. For the expert we manage their business; for the attorneys we help them find the right expert and make sure things are done on time and deadlines are met. This is how the business has evolved over the years and how it continues to grow now going forward.
Matthew Jonathan Clark
Can you tell us about the types of cases that you provide assistance on in your capacity as an expert witness?
To date I have aided in a variety of cases as an expert witness. My first venture in including being an expert witness as a part of my career focused on medical billing and coding. I had a unique expertise as a physician who has lectured on medical coding from a surgeon’s perspective, and this insight allowed me to have the particular skills to evaluate records and determine if the documents supported the diagnostic codes and procedures billed and if they should be paid services.
Recently, I have branched out to review cases involving determining the most likely cause of injury or death of clients, both in regard to a traumatic event that necessitated medical care and to medical errors that resulted in unexpected and avoidable complications. These cases have involved different aspects of my speciality from hearing loss all the way to severe airway compromise.
How can an ENT expert support clients in their cases?
As an otolaryngologist, I have expertise in a narrow focus of medical and surgical issues involving the head and neck region. Many clients have developed hearing loss from occupational noise exposure or traumatic events involving firearms or explosives, and benefit from my expertise in evaluating the type and severity of hearing loss and ruling out other potential causes. My speciality also involves diagnosis and treatment of cancers of the head and neck, and I have provided expert opinion regarding possible relationship to environmental or occupational chemical exposure and the onset of their malignancy. I am also frequently contacted to evaluate complications of surgical procedures in the head and neck region to determine if the complication resulted in management that was outside the standard of care.
What is the typical process involved in this?
When I am contacted to provide an opinion in a case, I am generally provided the appropriate medical records to review and often will set up a time to take a detailed history and, if possible, perform my own examination of the client. If needed, I will then discuss with the client’s attorney regarding arranging additional testing. If there are any specific questions regarding a differential diagnosis, variation in management of the situation, I will then research current published literature in formulating my opinion. As additional expert opinions become available, I will review and consider if a rebuttal report is necessary.
By far the biggest part of what we do is help manage experts from both sides.
As the case progresses, I typically will work with the client’s attorney to prepare for deposition and/or live testimony. In the area of billing and coding, I will review the specific CMS guidelines as well as any other insurance contracts and regulations to determine my opinion on whether the billed procedures were determined to be medically necessary and covered procedures.
How has your practice as a medical and a legal professional developed during your time in the field?
I started working as an expert in billing and coding. After reviewing several sets of records and becoming more comfortable in writing expert reports, I agreed to entertain other types of cases. As I am approached by a client, I try to obtain as much information as I can up front on the specifics of the case to determine if I can provide an opinion that would be beneficial and, if not, try to make it clear early on to avoid wasting time and effort and determine that I cannot support the needs of the client. I find that my approach to a client differs considerably to how I routinely approach my patients in my medical practice.
As I have taken on a wider range of cases and tried to consider both cases for the plaintiff as well as the defendant, I have found that around 20% of my practice involves working as an expert. Although I still enjoy evaluation patients in my office as well as performing surgeries and procedures, I find it refreshing to have a portion of my work that involves some solitude and has flexibility so I can attend to it at my convenience and from any location.
Are there any trends in the sector more widely that you can share with us?
Personally, the most interesting trend I have noticed is the transition after COVID to utilising teleconferencing technology such as Zoom. I find it convenient to be able to participate in meetings with both the clients and their attorneys over Zoom instead of travelling, but more importantly, the requirement of participating in depositions has become much less time-consuming and costly for all involved. I believe these changes may encourage my colleagues in otolaryngology who avoided work as an expert to reconsider, as they can incorporate it into their work with less disruption to their clinical practice as well as their personal lives.
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What sets Med Legal Pro apart as a network for connecting clients and medical professionals?
I personally do not believe that I would have considered taking on more than the occasional case as an expert without Med Legal Pro. Tracy and her team not only connect me with law firms looking for my specific area of expertise, but they provide a central secure access for the clients to upload records, keep me apprised on due dates for reports, provide support for writing a more clear and concise opinion and keep my schedule for upcoming depositions and court dates as needed. They also keep an updated CV, list of prior work and depositions and live testimonies so that it can be provided in a timely manner.
Tracy Liberatore, Founder
Michael Jonathan Clark, ENT Physician
350 Aston Mountain Road, Spring Brook Twp, PA 18444, United States
Tel: +1 844-633-5345
Tracy Liberatore is the founder of Med Legal Pro LLC and has worked as a physician assistant in North East Pennsylvania since 2003. She has worked in various specialties, including ENT, head and neck surgery, psychiatry, physiatry, urgent care and hematology-oncology, and is proficient with electronic medical records. She graduated from law school with high honours and as valedictorian of her class in 2016, earning the Jack R Goetz award, and currently works for many renowned law firms as a medical-legal consultant.
Michael Jonathan Clark is a board-certified ENT physician and published author with an active clinical practice and 12 years’ worth of experience. His areas of speciality include otolaryngology, audiology, hearing loss, chronic ear disease, facial pain and numbness, chronic rhinitis, vestibular testing and many others.
Med Legal Pro LLC provides medical-legal consulting services on a broad range of healthcare law issues, including medical malpractice, personal injury and nursing home negligence. The firm’s network of healthcare professionals can also assist with medical records chronology, medical case summary preparation and the location of suitable expert witnesses.
