How to choose a Forensic Psychiatrist Expert? - Part 2.

Choose an expert who speaks clearly and simply. Experts, who are dominated by a theoretical orientation, tend to talk in jargon that you may find difficult to understand and which, in turn, the jury will not understand (and may even find irritating or condescending). Experts should speak clearly, simply and, as much as possible, without jargon. They should demonstrate the kind of "common sense" thinking that makes them approachable. When I testify in court, I know that I have done a good job when the jurors feel comfortable enough to ask me questions before I step down from the witness stand.

Here is an example of psychoanalytic jargon in the opinion section of a report that could have been deadly if it had gone unchanged. "In my opinion, Mr. Smith regressed to a pregenital level after he was mugged. He displaced his anger unto his wife and his internal objects." Believe it or not, this is a direct quote from a report I reviewed for a colleague. I sarcastically told him that a jury might think that Mr. Smith was not only mugged but also castrated! The psychiatrist was actually trying to say that "Mr. Smith began to have a change in his personality after he was mugged. He was angry and depressed because he thought that he should have tried to fight off the attackers and he took his anger out on his wife."

In order to give equal time, a psychopharmacologist said that Dr. X. was guilty of malpractice in his treatment of a man from China because the "removal of a methyl group from citalopram is principally dependent on CYP 2C19 AND 3A3/4 since 20% of Asians are deficient in the former." I think that you get the point here and I will not translate it into English!

Request the expert's most recent Curriculum Vitae. Study it carefully. Is he a graduate of an American medical school? If he attended an offshore medical school, the adversary attorney may use this against you. The opposing attorney may try the same strategy if your expert is a D.O. rather than an M.D.

Get the expert's fee schedule. Don't look for a bargain and don’t assume that the most expensive expert is the best. Quality psychiatric expert work is labor intensive. I have found that an Independent Psychiatric Examination is usually more costly than reports by other specialists. I actually do read all of the records sent to me and spend at least 4 hours evaluating a litigant. I am often surprised by other experts who feel that a 2-hour evaluation is adequate to get the job done. Although I do not tape interviews, I do make an effort to get direct quotes from the interviewee. A longer evaluation is usually more helpful in detecting malingering, as well as defensiveness and symptom magnification by the interviewee.

Check to see if the expert's hourly fee is consistent with his training and experience. I have been contacted by attorneys who were in a rage when they got bills from novice experts whose fees were higher than the most respected forensic psychiatrists in the area. Although the attorney should have checked the fee schedule in advance, the overcharging was often predictable and part of a pattern of unethical behavior. I am irritated by the expert who charges for the most miniscule piece of work such as a brief phone call.

Everything else being equal, I would expect a psychiatrist's hourly fee to be higher than that of a psychologist, psychiatric social worker or psychiatric nurse. I discuss this issue in other parts of this web site.

Pay special attention to the expert’s fee schedule if she has associates working for her. This could be a red flag regarding not only the final bill but, but more importantly, the quality of the report. I have seen invoices in which the senior expert and an employee bill for the same work.

Ask about his "no show" and/or late cancellation policy. Where does he prefer to do his evaluations? Will he travel, if needed?

Keep in mind that the final bill is not always the crucial issue. It is possible that the expert is simply working harder on your case. Take a look at her report and see how it compares with the work of other experts that you have retained in the past. I have had senior attorneys say that my final bill is higher, but insignificant because of the favorable settlement that they have been able to negotiate. In a few cases, the insurance company has saved as much as $200,000.

source - http://www.rsostowskimd.com

How to choose a Forensic Psychiatrist Expert? - Part 1.

One of the most daunting and frustrating tasks for an attorney is trying to find the best possible psychiatric expert and then deciding if this doctor is the right choice for the case at hand. Historically psychiatry has been the least understood of the medical specialties. Many attorneys do not even know the difference between a psychiatrist and psychologist, let alone what constitutes a "top notch" forensic psychiatrist! Although one may be a superb clinician or researcher, this is no guarantee of even passable skills in forensic psychiatry. In fact, many renowned psychiatrists confess to intense anxiety at the mere "thought" of being deposed or undergoing cross-examination in court.

To add to this confusion, forensic psychiatrists often have radically different opinions about the same case. Are they "hired guns or quacks?" Rarely. Over the last 30 years, I have reviewed hundreds of reports by forensic psychiatrists, most of whom aspire to be as honest and thoughtful as possible in formulating their opinions. I believe that these seemingly “polar opposite” opinions usually reflect different theoretical orientations and variable clinical skills rather than unethical behavior.

Notwithstanding this confusing state of affairs, the task of finding a psychiatric expert is often delegated to an associate or a paralegal who does an internet search, makes a few phone calls and goes back to the partner with a curriculum vitae, a fee schedule and not much else. However, by asking a few key questions, it is possible for a junior staff member to shine and have a significant impact on the outcome of the case.

Always listen to your "gut reaction" to the prospective expert. Try to determine the basis for your emotional response if it is intense. When we meet someone for the first time, we are picking up a multitude of clues about who this person really is. Some of these clues come from the way the person looks, walks and talks. However, we also pick up information based on our unconscious reactions. Good psychiatrists use this tool all the time. Do not forget that a powerful positive response to a person is just as important as an intense negative response.

As an aside, research has shown that we are more effective in determining if someone is lying to us by listening to them on the phone rather than listening to them in person! It seems as though body language and facial expression is a way of distracting the receiver.

Don’t be afraid to ask a "stupid question." In fact, there is no such thing. For example, I have found that medical students ask better questions than psychiatric residents or even full-fledged psychiatrists. They tend to ask questions that get to the core of a subject, often picking up inconsistencies. Often, the less that you know, the less likely it is that your thinking is contaminated by preconceived ideas or prejudices.

Remember that when you speak to the expert, you are the one who is doing the hiring. If s/he is rude to you now, imagine how s/he will treat you after you retain her! Do not hire this person unless you are a "masochist!"

Although we prefer to avoid the topic, some physicians and attorneys have psychiatric dysfunctions. It comes with the territory. The work is demanding and patients and clients are not always appreciative.

source - http://www.rsostowskimd.com