PI Brief Update

Finding Solutions to the Shortage of Family Medical Experts - Dr Mark Burgin

02/10/23. Dr. Mark Burgin BM BCh (oxon) MRCGP uses systems analysis techniques to identify the key reasons that influence medical experts choice to work in the family courts.

I have previously identified that medical experts lack the breadth of expertise, those who hold controversial views are punished and kept in the dark about key aspects in the case. (1)

Even in a simple case a paediatrician may be asked about emotional aspects of the child’s health which is outside of their expertise.

Both medical experts and the courts complain about the amount of money that is available for medical reports but increases in fees may not resolve the problem.

There is unlikely to be any great increases in the fees provided to medical experts and more money would not make medical experts any happier about the situation.

Guidance for Medical Experts

Comprehensive guidance for medical experts identifying those aspects that should and should not be covered by a report would keep experts in their areas of expertise.

Courts will not react well to being told that areas of emotional health, learning difficulties, behaviour problems are not within the expertise of the doctor.

Justice may grind to a halt whilst courts are forced by a ‘work to rule’ to obtain additional reports from specialists who each in turn provide limited evidence.

There may be a call for child protection specialists who can provide expensive and bespoke reports on all areas that the court requires but this is likely to increase costs.

Disability analysis

There is a conflict between the questions that courts ask in family law and the types of evidence that doctors are able to provide from their expertise.

Few medical experts receive training in disability analysis which looks at functional restrictions from illness (whether diagnosed or not) and explains how this will affect a child’s needs.

This technique can provide simple explanations to the questions raised by the court so that it would be rare that a doctor would have to give evidence.

These time and cost savings plus the flexibility of a disability analysis report may make this the preferred solution for both experts and courts.

General Practitioners as Experts

General practitioners use the biopsychosocial model to assess a child holistically and I have written about how these techniques can be used to provide evidence for the courts.

Where a child has special needs they will already be under the care of specialists and GPs are experts at interpreting the complex information provided in the medical records.

Where there is an issue that is material for the court and no evidence from a specialist is available in the records the GP can explain to the court why an opinion on this point is required.

GPs are very much cheaper than specialists and have a broad psychological and physical expertise making them the ideal first line expert issues except the child-parent relationship.

Conclusions

The shortage of family medical expert witnesses may feel like a threat to justice but it represents an opportunity for generalist experts to provide disability analysis reports.

Paediatric experts once freed from having to provide answers to questions that are outside of expertise will be able to concentrate on high value reports.

These changes will be pushing on an open door as there are few parties who are happy with the status quo and they represent a win-win solution.

The guidance should not written by a single speciality but involve all disciplines from social workers, health visitors, school nurses in additions to doctors.

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

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

1. Burgin 2018 How Will the New Advice for Paediatric Experts Affect the Availability of Experts for Defence Work in Family Courts? pibriefupdate.com
2. Burgin 2019 Families: Educating Children (awaiting publication) lawbriefupdate.com
3. Burgin 2019 Play as a Method of Assessing Creativity 2019 (awaiting publication) lawbriefupdate.com

Image ©iStockphoto.com/Tippapatt

This is part of a series of articles by Dr. Mark Burgin. The opinions expressed in this article are the author's own, not those of Law Brief Publishing Ltd, and are not necessarily commensurate with general legal or medico-legal expert consensus of opinion and/or literature. Any medical content is not exhaustive but at a level for the non-medical reader to understand.