Benefits of working with a medical reporting organisation

In our latest bite-sized CPD article, MAPS Trustee and Expert Witness Institute Governor, Peter Mulhern explains why working with the right MRO is beneficial to expert witnesses.

In his excellent article Once Upon a Time There Was A Consultant Ophthalmologist, Professor Charles Claoué makes some very interesting points about how to manage an expert witness practice. He talks about establishing his company, Eye-Law Chambers, a collective of ophthalmology medico-legal expert witnesses.

Traditionally, most expert witnesses have operated as self-employed or employed practitioners and contracted directly with the instructing solicitor or insurer for whom they are producing reports. Many experts still follow this model, but over time different structures have evolved, including various types of medico-legal agencies and medical reporting organisations.

Self-declaration being the best kind of declaration, I am a retired solicitor and now a trustee-owner of one such reporting company, MAPS Medical, which has facilitated the production of more than 300,000 expert reports and currently operates a panel of around 4,500 experts. Of course, working with an MRO may not be for every expert, but for many, it provides a beneficial structure in which to produce reports.

In a recent report (IRN Research, UK Medico-Legal and Insurance Services Market 2021: Market Trends Report July 2021), it was noted that in 2020, there were in excess of 100 medico-legal service organisations providing expert medical reports to law firm, insurance, employer and in-person customers and also facilitating rehabilitation and allied therapy services. These organisations range from small to large and cater to different parts of the medico-legal market.

For an expert considering working with an MRO, a good place to start may be to consider what they want out of the relationship. As Professor Claoué says, the intellectual challenge and rigour involved in writing reports brings great job satisfaction, but in reality, the reports aren’t produced in an intellectual vacuum. As an example, in 2020, Bond Solon reported serious issues for experts in getting paid for the work that they do, with 96% of responding experts having experienced some degree of late payment by instructing parties and 53% reporting regular late payment. Some solicitors can be unreliable payers, particularly during unpredictable financial times.

Working with the right MRO may be a good way to avoid payment and other problems, although there are a number of issues for experts to consider:

What type of cases does the expert want to report in?

The medico-legal world has a spectrum of work from low value road traffic accident soft tissue injury cases through to cases involving injuries of the utmost severity and/or the most complex clinical liability circumstances. There would be little point signing terms with an agency that specialises in low-value soft tissue injury cases using the MedCo format, if the expert’s interest is in cases at the other end of the spectrum (or vice-versa).

How much work is the expert looking for?

It is important for the expert to consider whether they are looking to engage with one or a small number of MROs that can supply as much work as the expert wants. The size and customer-source profile of the MRO may be important factors for the expert to consider.

How much time does the expert want to devote to their medico-legal practice and how much flexibility do they wish to retain?

Acting as an expert witness is often combined with the expert’s clinical work. Apart from in cases of historical liability circumstances, the courts increasingly expect expert witnesses to be in or only recently retired from relevant clinical work. Some MROs expect their experts to agree to strict service level agreements, such as committing to a minimum number of appointments/reports per month, or to giving the company control over their appointment diary. Some experts may feel completely comfortable with this approach, but others may be looking for a different balance in their work.

Does the expert want to be responsible for marketing and growing their own medico-legal practice?

Some experts may of course be fortunate enough to grow their practice on the back of personal or professional recommendations, but that is not possible for all. Alternatively, an expert might pay for professional marketing or build their own website, but neither route brings any guarantee as to the regularity or quality of the work. Working with the right MRO should see the expert receiving regular, good-quality work from reputable sources who have clients with genuine injuries.

Does the MRO provide material to help the expert with their CPD requirements and annual appraisals?

Both are essential to the maintenance of a successful medico-legal practice.

Expert witnesses shouldn’t have to waste time on chasing payment, arguing about the quality of delivered reports, or engaging in legal enforcement proceedings in the near certainty that the end result will be that they never receive another instruction from the law firm in question.

Working with the right MRO allows the expert to agree payment terms that are clear and reliable. Experts should be paid the due amount on time so that there should be no need for credit control or enforcement. The expert should feel confident that the right MRO will be a good source of quality work with repeat instructions, long-term business relationships and standardised instructions.

If, at the end of this consideration an expert feels that working with an MRO might be right for them, then in these unpredictable times it would always be wise for the expert to carry out some due diligence to identify that the organisation has a good track record of payment and is ‘good for the money’.

For some top tips on financial due diligence for expert witnesses, please see Costs and Getting Paid from the EWI online conference 2021.

This article first appeared in the EWI publication Expert Matters, Spring 2022 edition, and is reproduced with their kind permission.