safety. All members of the surgical team including doctors, nurses and technicians are encouraged to speak out about any safety concerns. Roughly speaking, what proportion of your career has consisted of your expert witness practice? Expert witnessing has been a small but enjoyable part of my career—I find it challenging and intellectually stimulating. I practiced anesthesia for nearly 20 years before taking any cases as an expert witness. I accepted my first case as an expert witness in 2018, so I have been an expert witness for about 15% of my anesthesia career. I still practice anesthesia full-time, so my expert witness activities are limited, occupying about 5-10 % of my time. Even this relatively small involvement has provided me with valuable experience. I believe I ama better, more careful anesthesiologist because of my efforts as an expert witness. What qualitieswould you attribute to an effective expert witness? Effective expert witnesses need to pay attention to details and be organised. Experts who are confident in the face of criticism, can think on their feet, and know how to teach are invaluable. The ability to explain difficult concepts clearly is also key. An effective expert witness can make complex issues understandable both verbally and in writing. Sometimes, experts must think up their own analogies to get the point across. I once explained competitive inhibition by likening it to team musical chairs where two different teams of chemicals (e.g. Fentanyl and Narcan) compete for opioid receptor binding sites (chairs). If one team vastly outnumbers the other, it will get almost all the chairs, displacing the other team and negating its chemical effect. One of the things that helped me to be a more effective expert witness is related to my teaching experience. Although I no longer have the kind of daily personal interaction with anesthesia residents as I did while at UCSD or during my military service, I still have opportunities to teach students the basics of anesthesia. Because even the basic anesthesia textbooks are too long and detailed for students and residents on a 2- to 4-week anesthesia rotation, I wrote a short handbook for the rotators while I was in the US Air Force. Over the years I have revised it several times and offered it to help teach students at Baylor University Medical Center. Recently, I decided to formally publish Anesthesia Basics for Medical Student and Resident Rotators. Although these rotators have medical training, most of them have little background in anesthesia. Consequently, while writing and revising this textbook I had to keep in mind who my audience was and what kind of explanation would best convey the concepts I was trying to teach. I chose my words carefully and added analogies, graphs, charts and illustrations to clarify my meaning. This kind of writing is great practice for explaining concepts as an expert witness. 73 MAR 2022 | WWW.LAWYER-MONTHLY.COM EXPERT WITNESS What advicewould you give to another MD looking to train as an expert witness? The law can seem very intimidating at first, but serving as an expert witness, like all endeavours, gets easier with practice. You are already an expert — years of schooling, training and experience have made you an expert in your field. To be an expert witness you just need help with the witness part. There are several organisations that train medical expert witnesses and various social media websites with willing mentors. Invest some time and effort into getting yourself trained. Get feedback on your work from mentors as you are learning. Get listed in a directory. Answer inquiries promptly. Work hard and give good value to your clientsbutdonotundervalueyour services — especially as you gain experience. Do not be afraid of depositions. Remember you are the expert. Do not get rattled by aggressive questions. Take a deep breath and answer the question honestly. Stick to your guns, but graciously admit when you have made a mistake and move on. Tell the truth; your integrity is priceless. You will probably get more inquiries from plaintiffs than defence counsel at first. Take both kinds of cases — it will make you a better expert. If you fear taking plaintiff cases, start by taking cases that make you say, “Oh my gosh, they did what?!” Maintain your objectivity and do not be swayed by retaining counsel who may try to push you into opinions that are not truly your own. Your opinion of the standard of care and causation should be the same regardless of who retains you. When you sign your name to an affidavit or a report, make sure you understand what it says and that it reflects your opinion accurately. Medical expert witness work can be rewarding and exciting. It can make you a better doctor and a more careful documentarian. It is not for everyone, but if you have an interest in it, I encourage you to explore being an expert witness. Juries and even judges and lawyers do not know enough about the medical considerations to be able to decide the case.
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