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Advantages and Disadvantages of a Moderate Volume, High Location PI Medical Practice - Dr Mark Burgin

03/06/19. Dr. Mark Burgin BM BCh (oxon) MRCGP discusses how of diversity in approach is central to agencies ability to deliver a high quality service that is inclusive.

Personal injury is an issue for all ages and abilities so that a ‘one size fits all’ service will lead to less favourable treatment of those with protected characteristics. (1)

Many experts offer high-volume clinics from the major urban centres and provide an essential service to the great majority of the claimants.

Other experts provide a more individualised service focusing on those who are not well served by the high volume experts by having a number of clinics in underserved areas.

These experts offer a flexible service responding to the needs of the claimants and develop special skills to manage the more challenging cases.

Individualised care

A clinic that is running 6 patients to the hour simply cannot offer a forty-minute appointment to a distressed claimant with complex injuries.

The answer is not to force high volume experts to slow down, in case there is a complex case, but to instruct an expert whose system is already prepared for the individual’s needs.

Mental health problems commonly present with behaviour issues in the waiting room and the consultation which take time to manage in a sensitive way.

For an agency knowing that a clinic offers 15 or even 20 minute appointments as standard can mean that they can choose an appropriate service for their clients.

Flexible services

High volume experts are usually running to capacity and are reluctant to take on additional duties that are less well remunerated or will cause increased overheads.

Their business model is to offer low cost reports to maintain demand and keep the costs associated as low as possible so they are the workhorses of PI medical reporting.

Moderate volume experts cannot compete on price as their cost per case can exceed the fee they would receive and instead offer flexibility to the agencies and solicitors who instruct them.

Flexibility can be home visits in remote locations, dealing with the red tape for prison visits, offering one off clinics filling gaps in coverage and taking on the more difficult cases.

Specialist services

Moderate volume experts develop skills in part because they are work in more clinics and have greater contact with physios, chiropractors and osteopaths.

Many clinics will be only partly filled giving them time to meet with colleagues and practice techniques they have learned in areas such as psychosocial and child examination.

Having longer to make a complete assessment and associated disability is important where the claimant has suffered complex injuries such as scaring and balance issues.

Developing an understanding of injuries in LVI low velocity impacts requires experience and an understanding of susceptibility to injury from pre-existing conditions.


The diversity of individual needs in low value personal injury has led to similar diversity in the experts who serve them as illustrated by examination of two basic models.

The high volume – low venue expert is able to offer the cheapest prices and the quickest appointments but does not cover smaller towns.

The moderate volume – high venue expert is able to offer appointments close to the claimant’s address and offer more flexible and individualised care.

Moderate volume experts prefer a flexible model of working perhaps for the same reasons they became a doctor, the enjoy providing a service to those in need.

Doctor Mark Burgin, BM BCh (oxon) MRCGP is on the General Practitioner Specialist Register.

Dr. Burgin can be contacted on This email address is being protected from spambots. You need JavaScript enabled to view it. and 0845 331 3304 website

  1. The Equality Act 2010.

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