When reviewing panel qualified medical evaluator reports, it’s common for practitioners to gloss over the “research” section despite the fact that the respective doctor is relying on said research to come to the conclusion with the respect to causation, nature, extent and apportionment.
If a PQME/agreed medical evaluator does rely on research in order to assess the applicant, it is important to review and determine if there are any red flags.
The most common red flag in PQME reports is the doctor will list the research with only the “abstract” section attached to the report. In all likelihood, the PQME used a search engine, such as PubMed, to essentially perform a Google search of scientific research that fits the doctor’s diagnoses.
If the doctor lists only the abstract portion, it is certainly worth reviewing the article to make sure the study is valid for the particular applicant and whether the abstract reflects the findings as supported by evidence in the scientific paper.
Arguably, the most important section in a scientific paper is the “methods and materials” portion. In the methods and materials, the scientists will inform of the test subject’s information (ethnicity, age, preexisting conditions, whether the study was performed blind or double blind, sample size, etc.). As a rule, the larger the sample size, the more trustworthy the study. However, be aware that these scientific papers are theories, not laws. As such, most often the authors will make a conclusion based on the data in the scientific article and note that further research is required.
In using scientific studies cited by a PQME, the easiest way to attack the validity of a doctor’s report is:
In practice, the majority of scientific studies with which we can attack PQMEs are limited to a condition related to internal medicine. In order for that to be an effective strategy, it is best to depose the doctor rather than request a supplemental report.
Should the attorney request only a supplemental report, it will allow the doctor to actually perform research and/or change his opinion with respect to causation. Here are two examples where the PQME changed his mind based on the studies the doctor cited, which incorrectly led to the diagnoses:
In summary, it is easy to skim through a PQME report to determine if the applicant has reached permanent and stationary/maximum medical improvement in order to try to settle the case. However, in cases that are not run-of-the-mill slip-and-fall orthopedic claims, it is worth spending the extra time to determine if the doctor relied on any scientific studies in coming to a conclusion with respect to causation. While these cases are few and far between, attorneys are capable of saving clients money by using the doctor’s hand-picked studies against the doctor in deposition.
David M. Bishop is an associate attorney at Bradford & Barthel’s Fresno office. This entry from Bradford & Barthel's blog appears with permission.
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