Putting a bad pun in the title is always a great start to a blog post, right? Try the veal, I’m here all week. But seriously, proving medical causation of an injury in a personal injury case nearly always requires expert medical testimony. There a few exceptions for objective injuries that would be obvious to a layperson (like cuts and bruises), but generally proving medical causation requires a physician to testify that within a reasonable degree of medical probability, the injury or medical condition was causally related to the accident.
The most obvious source of this testimony is the plaintiff’s treating physician. There are strengths and weaknesses in using a treating physician as an expert witness. One of these can be that since you generally do not choose the treating physician, you are stuck with their qualifications, however good or bad they may be.
This issue can arise when the treating physician turns out to hold the degree of Doctor of Osteopathy rather than Medical Doctor. When this happens, it is a natural area of cross-examination. Juries expect physicians and expert medical witnesses to be M.D.s, and tend to be skeptical when they are not.
One way to try to remedy this is to point out that in practice, this is a distinction without a difference. On direct (and perhaps in cross-examination of the defense expert) illustrate the commonalities between the holders of the two degrees.
A few days ago, I came across Declaratory Ruling 97-1 of the Maryland Board of Physician Quality Assurance. It contains a paragraph that neatly explains the many similarities and the singular difference between the two degrees:
“According to Education of the Osteopathic Physician, a publication of the
American Association of Colleges of Osteopathic Medicine, both doctors of medicine
and doctors of osteopathy are physicians who have taken a prescribed amount of
premedical training, graduated from an undergraduate college and received four years
of training in a medical school. They both use scientifically accepted methods of
diagnosis and treatment, and are often licensed by the same state medical board. The
philosophical difference is the osteopathic profession’s emphasis on the importance of
the musculoskeletal system in health and disease and the development and uses of
manipulative diagnosis and treatment.”
It is easy to see how this kind of information can be useful in putting together a list of questions that may help in ameliorating any credibility issues that may arise with a witness who holds a D.O. degree. These are all things that would be very difficult for a defense expert to deny on cross.
I will save a .pdf copy of this ruling to use in the next case where my treating physician expert is a D.O. I will have to remember to let you know how it turns out. Does anyone else out there have experience with this issue? How did you handle it?