Lecture by John Jurica – Episode 452
In today's presentation, we conclude John's guide to expert witness consulting Part 2.
Part 1 of this presentation was posted last week and can be found at The Complete Guide to Expert Witness Consulting for Physicians Part 1.
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Challenges and Prerequisites
Despite the rewards of this part-time consulting business, challenges exist. Record reviews can be lengthy and tedious, while depositions and trials involve potential confrontation, cross-examination stress, and scheduling challenges. Long case timelines (often 2–3 years or more) require sustained commitment, and over-reliance on expert work risks being labeled a “professional witness,” undermining credibility.
Prerequisites are straightforward: board certification and active clinical practice in the relevant specialty, with recent and relevant experience. Strong communication skills, calmness under pressure, coachability, and an ethical, objective mindset are essential. Experts emphasize that one need not be the nation’s top specialist; credibility and ongoing practice suffice. It is advisable to work both the plaintiff and defense sides when possible for balance.
Getting Started and Growing the Business
Physicians typically begin through personal referrals, such as from their own malpractice defense attorneys or colleagues. Networking at specialty meetings, with malpractice insurers, or via LinkedIn helps. Formal training (CME-eligible courses), books, and directories accelerate entry (see links below).
To grow, treat the work as a professional micro-business: set up an LLC and proper accounting. Market ethically through directories and attorney networks. Most work (80–90%) remains flexible record review; depositions comprise 10–20%, and trials are rare. Directories found at Medical Advisors, SEAK, and others can provide leads, though most charge fees. Training costs are quickly recouped with the first or second case.
Summary
Expert witness consulting represents one of the smartest side gigs for actively practicing physicians. It combines high compensation, flexibility, intellectual engagement, and meaningful impact while allowing continued clinical practice and income diversification. For the objective, credible, and communicative physician this work offers an excellent way to leverage medical expertise.
NOTE: Look below for a transcript of today's episode.
Links for Today's Episode:
- The Complete Guide to Expert Witness Consulting for Physicians Part 1.
- Expert Witness Startup School by Dr. Gretchen Green
- Dr. J. Jordan Romano Expert Witness Coaching
- SEAK Resources
- Physician Side Gigs Resources
- Medical Advisors
- MDStaffers
- JurisPro
- Nonclinical Career Academy
- 19 Presentations from the 2023 and 2024 Nonclinical Summits
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The Complete Guide to Expert Witness Consulting for Physicians Part 2
Now what are some of the challenges? Well, I think probably what comes to our minds, and it certainly did to me when considering doing something like this is that it's okay doing chart reviews.
I mean, it can be boring and it can be tedious at times, but it can also be interesting. but what about when you actually have to. testify against one of your colleagues, or, or you just need to testify on behalf of one of your colleagues. And you have to sit there and you have to feel like you're, what you're saying is being questioned.
And you might even feel as though you're being attacked if you're, going through a deposition, the way that the questions are asked and the implications are that are made by the other, counsel, the other attorney. and if you don't enjoy confrontation or at least, a good debate, then it could be very stressful.
So I think that's the thing that stops most of us from doing this. Just the thought of being on the hot seat, so to speak. now my advice to you on, as you think about it, things that way is to really reconsider that because. It's just like you're going to try to talk to your patients, you're going to take the information and you're going to try to explain it, whether it's good news or bad news.
And we're trained to do that. And, this is actually a reason why some people get sued is because they don't have patience. They don't take the time to explain to their patients what's really happening and dumbing it down in a way. I mean, you, you can talk with a colleague and use all the vernacular, but you, you're stupid to do that.
If you do that with patients. You don't talk in medicalese in, in day-to-day practice trying to explain to patients and their families. And, sometimes you must break it down to a high school level, to a grammar school level. Sometimes there's language barriers, but ideally your patient and your understanding and you have good communication skills so that you can.
Use terminology that gets the same message across as it would to one of your medical colleagues, or even a nurse or someone else in healthcare, as well as with someone who has no medical background. And that's really what we should do anyway as physicians, because 90% of our patients don't have any medical or nursing background.
The record reviews can be lengthy. when they say, I've got a case for you, and here's the situation, chances are you're not going to be able to review that case in 90 minutes and call it good. you're gonna have. The, whatever it was, whether it was, outpatient treatment, whether it was inpatient, could be multiple, admissions and what medical records are like.
And, there's probably some new ways to thin that out in terms of if you're looking at a stack of a thousand pages from a hospitalization and more, even longer if it's been a major hospitalization. But if that you find too tedious, then you won't like this because that's the majority of the work, at least going into it.
If you look at it more like, wow, this is an interesting case and I'm really getting into it. I'm looking for things that stand out that don't seem right, or mistakes that might have been made or accusations of mistakes. And in your opinion, none of, no, none of those were made. So again, that's what some people dread and that's why some people won't go into this.
Doing depositions and
going to trial, that can be not only a challenge, emotionally or intellectually, but it can be. That's where the scheduling issues can be difficult. you know, I, as I said, was involved in several depositions for different reasons. Most of the time they're flexible, because there is no set court date that's pushing that.
Normally you're working through the process. Everybody knows that depositions have to be done, and there's usually multiple depositions of different, different experts or just different witnesses. But when you get to that point of depositions and then going to trial, then you need to have a little bit of flexibility because the legal system isn't always that flexible.
They're really good at postponing things. but in terms of finding, a time that's convenient for you might take a little juggling. So that's one of the challenges. you can be labeled as basically a professional, witness or that your opinions are biased or, some that usually occurs because you are, doing too much.
you're doing too much. Expert witness work and not enough practice. So if you're down to one day of practice a week, or maybe you've taken two or three months off, you're not sure if you're gonna go back into practice or something. Once you get to the point where you're spending most of your time doing the expert witness work as opposed to clinical, then your opponents may, label you as a professional witness, a paid, paid witness, so to speak.
Who's got, Ulterior motives. Even your colleagues might point at you and say, Hey, you're not really practicing much. You're doing a lot of, expert witness, and I know you're making a lot of money, but I don't know if I really trust you, in terms of being an excellent physician still.
So that's what's gonna happen. And some states require you to do so much, practice, you have to be in practice and has to be so much, and most of the expert witnesses that I know are doing this less than halftime for sure. So you gotta be careful about that. But as long as you're doing that, you're, this should not be a big deal.
But you definitely need to maintain an active clinical practice and need to be, very aware of what the usual, standard of care is in, in your geography.
And experts agree that this work is not for everyone. So cross examinations and the long case timeline can be the biggest hurdles. yeah, I mean these cases go on for years. My experience cases I've been involved with, whether they're medical legal from a, a liability standpoint or some other reason, some family issue, get pulled into disability cases, whatever it might be.
Those things go for years and. I would say in my malpractice accusations, even if I was just, a side, physician or somehow got pulled in for no reason, that can still take anywhere from three to five years to end. So if you're an expert witness, you might not get involved in that case until it's already been on the books for a year.
But you can expect to go two or three years in most cases before that thing is wrapped up completely and you're kind of on the hook, to finish that up. Even if you were to retire and you've done a deposition or two, you'll, you really should follow through and, be involved with, testifying if it does not get settled in the meantime.
So. What are the prerequisites? Well, you gotta be board certified, actively practicing in your specialty. That's basically it. Having a lot of extra degrees doesn't really make any difference in this situation unless you're kind of doing some more forensic type of testifying, like a pathologist or something like that.
you do have to have recent and relevant clinical experience to even do this job. In some states, it's a requirement. if even if it's not a requirement that you're in active practice to a certain degree in a particular state, the, the opposing counsel is going to, make it. Pretty obvious that, your opinions might be suspect.
So you need to have ongoing clinical experience. it's best if you're working on both sides. Now usually you're going to end up working on one more than the other. Part of it's just chance. Part of it is what I mentioned earlier, that if your first case or two, or from a previous experience working with a defense attorney on your behalf, well then the only cases they're gonna pull you in on are being, working for the defense because that's what they'll need you for.
And they'll get that word out to their colleagues and you can actively help them get that word out. And, So you're going to naturally, probably start by doing more of those. But obviously the plaintiff side needs just as much help as the defense side does. And you can, you can do the other side because you'll, you can look at a case and say, Hey, I don't, I think you need to settle on this based on what I see.
Or I, I can't take this on because I really don't agree that there was malpractice. So, I mean, you can turn those down, but not all the cases, as much as we as physicians hate to see malpractice cases, proceed. not all of them are, without merit. I remember I was shown an EKG once by one of my colleagues.
Well, it wasn't by my colleague, it was about my colleague. It was, it was an EKG. And I somehow came out to find out who it was later, but I, I was told it was in the city where I was working, which is really more of a small town. And I looked at the EKG and they said, you're a family physician, right?
Yeah. I've got a case, or someone's asking me to represent them and I just want you to tell me what you think about this EKG. So I got paid for that. It's like a, like an hour's worth of pay just to look and tell me. And it was pretty clear that this is a person that was having an acute MI on an EKG.
And, I'm not a cardiologist, but there are certain things that we all know that if we see that some of those acute changes on an EKG, that, if they have any symptoms at all, or maybe with no symptoms, depending on, what's going on, they should be sent to the emergency room or. At least get an EKG or call a cardiologist to look at them, whatever your act, your action would be.
And I looked at it, I said, yeah, that person's having a heart attack. Okay, well this person was seen by, my client was sent home. So again, I didn't have all the details in the case, but basically what they wanted to know just in that instance was, should a physician, a failing physician be able to recognize that.
And so, this, this case probably was just settled, from the beginning. And it was probably most of the, work done on it was what the level of the settlement should be and was probably based on to what extent the patient was damaged or injured. I mean, if it, they did go home with a heart attack, but.
Had some upset stomach and came back 30 minutes later, went to the ER and was treated and nothing bad happened. That's one thing, obviously what's more likely is the patient went home and had a serious complication if this wasn't recognized. So that particular physician, I mean that particular physician, needed to be not reading EKGs at that point, but the main thing was if the patient was injured, they're entitled to some kind of compensation for that, at least their medical bills and pain and suffering and so forth.
So, anyway, that's just me trying to say why. That's another reason to do both plaintiff and defense cases. And the other thing is obviously if you're doing plaintiff cases, then you'll know what the plaintiff's perspective is when you're on the defense side as well. So it just balances things out for you.
You gotta have strong communication skills. You need to have calmness under pressure. I would call that being unflappable. So even though the attorney who's interviewing you or deposing you or questioning you in trial might come across as accusatory or aggressive, it really doesn't matter. You need to be very calm, very unflappable.
You need to listen. You need to respond in as short way as possible. Yes, no short answers. Have good communication skills. Be patient because not everyone's going to understand right away what you're trying to explain. And then have the coachability, and I mentioned this too, because you're going to get a lot of coaching on this from the.
Attorney that you're working with, whichever side you're on. And so that's gonna be great. That's where you can learn a lot of skills as you go. And your attorney is going to tell you what to expect, what to expect by a jury, what to expect by a judge, what to expect from, um, the attorney on the other side, whichever side it is.
And they're going to admonish you to remain calm. Take your time and, don't go off on tangents and just answer the question with the reasoning behind the question from your medical expert level of, training and experience as a physician and to have an ethical and objective mindset. And, it can be a very interesting process.
And experts agree that you do not need to be the top expert in the country. You simply need to be credible and actively practicing. Okay? So, if you're caring for these kinds of patients that you're, that the case involves, and if you've got your license and you're hopefully at least residency trained, fellowship trained and board certified, that's basically all you need.
and the rest of it is about commitment and taking the time and being efficient and being effective, and being thorough and communicating well. So that's the crux of it, and all those things that you learn will help you in other parts of your life and your career. Now, how do you get started? Well, you can network discreetly with colleagues.
Ask them, are they doing any expert witness work? They know people that are that, that are doing that. When you go to your specialty societies meetings, can you run into your colleagues, can you reach out to your, co medical school grads, your residency, partners, your fellowship, partners, and are they doing some defense or, or the vice versa type of activity?
As a, an expert witness, you can ask your malpractice insurer. I happen to be with the State Medical Society sponsored insurer, so they were pretty friendly with physicians and their attorneys would definitely answer questions and give us advice about things including whether to go into this field.
There are formal things. Of course there are, there are structured training, there are courses that are even CME eligible and tax deductible. All this stuff is tax deductible if it's going towards your side hustle, your side gig. let's see, and I'm going to give you some specifics in a minute. when there are directories too, to point you to find work.
So we're, I'm looking at this, this terms of getting started from two standpoints. one is from how to learn about this career, this side gig, this consulting career. And the other is in how to find, referrals, how to find work. So some of these do both, so that's why I bring it up now. but if you can talk to.
Your friends, colleagues and so forth. if you don't know anyone that's doing this, you can start looking around LinkedIn, for example. and. you can respond when someone from your own insurer just asks you to serve as maybe doing chart reviews, and then the de depositions and trials will come later.
yeah, so what else I wanna say about getting started? yeah, there's also some books that you can use, that you can access. I think it might be coming on an upcoming slide, but for right now, let me just say that most first cases come through personal referrals. So that's how I was exposed to it initially.
Training and visibility accelerate the process dramatically though. So this is the summary of what this section is about. So in terms of getting started, be open to it. Try and do some networking. even in your local town, you probably have an attorney and, for, business aspects, for contracts for purchasing a home, selling a home, things like that.
Well, you can ask that attorney, who are the, attorneys in town here that do malpractice? And can you link me up with them and I can talk to them and learn more about this whole field? So now what about growing the business? Once you say, okay, I've, I've done my first, I had that one come to me through a personal contact and now I thinking I might wanna do more of these and actually look for this kind of work.
how do I do that? Ultimately, you're going to wanna get quality leads that come in over time. You're going to want to be on someone's. Electronic Rolodex saying, okay, I have a new case. It's this specialty and it has this special need. And 'cause every case is different. And for you to be on their, Rolodex and, and they will call you, text you leave, you, send you an email, whatever.
You should try to build that network across plaintiff and defense bars. try and get to know, you might wanna focus on one more than the other, but you wanna get a list of those local, attorneys and see if you can become part of their, universe. we don't, pay people for referrals of course.
So that's why this slide says market ethically. But you can use LinkedIn, you can, to identify people in your county. Or in your state, you might wanna reach out to you. There are directories that I'm gonna talk about in a minute. There are agencies that hire you, to be on their panel where they, they may take a little bit of cut just for the, the, the benefit of being on their listing.
but the other thing is it has to be treated as a real business. So what does that mean? That means you get an accountant to set up your books. You get an attorney to set up your LLC, you do some research, find out what the rates are in your locale and maybe even get some mentoring if you haven't, gone into some formal training.
And you can get started that way and just grow it and learn as you go. Now here's what the experts agree on. Physicians who approach this as a professional micro business scale faster and enjoy it more than those who treat it as an occasional hobby. Okay? So if you're just doing the occasional case here and there, 'cause someone tracks you down, okay, that's fine.
But that's not really a side hustle per se, just like, some extra money on the side. But if you wanna make it to where you can really cut some of your hours back on the clinical side and do this, then you need a little more attention and to do everything properly from the get go. which is why I mentioned the accounting and the, attorneys being involved with setting this up.
Alright. How do you set your fees? Well, just from my experience and talk, people I've spoken with and research I've done, if, if you, I'm saying the typical range is 500 to $900 per hour, it's a little bit skewed because there are more lawsuits involving, I think. Obstetricians, orthopedic surgeons, neurosurgeons, et cetera, et cetera.
so their hourly rate for their clinical side is fairly high. So the typical range for their, expert witness consulting is gonna be higher Primary care, as I've noted on this slide, it's probably gonna be between three and 600, more or less. But like I said, the procedural list are usually much higher, but all time is billable.
You the first thing, you, the first papers you review, the prep, the talking to the attorney, the deposition, if it goes to trial, anything you do, including just getting on the phone and talking with the attorney, you should keep track of. Charge whatever it is that you are charging per hour. Sometimes they'll do a deposition, which the prep and the deposition, they'll all be included in a single sum, and you can off often get that paid ahead of time.
And you might even have a little contract that your attorney can put together for you that says, okay, you're going to give me before the, deposition, I need $1,500. which includes the hourly rate, estimated at, whatever, $500 an hour for three hours. With the proviso though, that if it takes more prep or it has to be redone or whatever, you'll get paid later on top of that.
But sometimes you can bill those ahead of time from what I've, learned from my colleagues. so the fees are market driven. Charging too low can signal inexperience, so you don't try to undercut by charging $200 an hour. They'll look at you like, eh, what's wrong? But charging too high can just invite a hired gun attack on cross examination.
And it also can mean you might not get the case. it, it is kind of a bottomless pit in a way, but if attorneys are used to paying six, seven, $800 an hour, then they're not gonna pay you $1,500 an hour unless there's just something really, really special about the skills and experience that you have for their case.
All right. What about costs involved in setting this thing up? It's not really that expensive really, to get started. you could take some training courses and even the coaching and the best training courses that I'm aware of are, they're no more than five to $8,000 at the most. Some are less than that for sure.
you might wanna put yourself in a directory. You might wanna join an agency that'll get you cases, you like. In terms of the training courses, generally one case will. Pay for any course you might have taken to get you set up. you have some costs to set up your LLC and to set up your accounting and your chart of accounts.
when you have that kind of a business, it's not integrated with your practice usually and if you have other businesses, but if you are practicing, it should be separate and it should be treated as such. And you gotta be ready for tax preparation. If it's an LLC, which it probably will be, then you have to do its taxes separate from yours and then put 'em all together at the end of the tax year.
and my wife and I have had, I think between us six or eight LLCs over the years, and each one needs its own accounting and, we've pretty much gone to, using, QuickBooks online, and it has great access by our accountants. And we had our help, had help from our accountants for most of those to get things set up properly so that you, when bills come in and you pay the bills, you can track it and it integrates with your bank accountants so forth.
And you have an LLC that protects you from liability for some kind of business error. And, let's see, the other cost is just the time investment. it takes you a little longer than, if you're taking a real long time to go through the records because of a procedural issue or not knowing how to connect or something like that, then you, you need to discount those fees a little bit.
So you, that could be an unexpected cost. But basically the costs are pretty low to start this kind of a consulting business. Oh, here's where I got the books listed. there are books, and you can imagine now these, oddly enough, they're expensive books. Some of these are a hundred, 120, $130, but it's less than one hour of coaching.
So, I'm just going to rattle these off really quickly for those that maybe don't, aren't looking directly at the slides, but look up inside the expert witness world. That's the newest one on this list from 2025 by Michael CVaR. You've got testifying in Court Guidelines and for the expert witness.
It's from 2022 by Stanley l Brodsky, Stanley l Brodsky's, also on a book called The Expert Witness, more Maxims and Guidelines for Testifying in Court. That one's from 2015 and how to Become a Dangerous Expert. Witness is written by Steven Baki and James Mandi, who are the two people that, basically that run Seek, that's SEAK, and I'll be talking about Seek in a minute.
So there's four books, there's other books available. But going through something like that just quickly would give you a good headstart on this process. Most physicians recoup training costs with their first or second case. The biggest cost is the learning curve, not the dollars. So this is not like opening a new practice in buying an office, building in all kinds of things like that, that the, the investment at the beginning is pretty low.
just some time and effort and networking and so forth. what do you expect in terms of the actual. Work that you're doing. Everyone asks this question, they, they think the chart reviews are cool. You get paid 3, 4, 500, $800 an hour to review charts. Okay, that's awesome. But then the depositions, the trial testimony, how much is gonna happen?
how much am I gonna be bogged down doing that? Unless you're really looking forward to that. But here's a, here are the numbers. 80 to 90% of the work is gonna be record review. you might get pulled into cases that will be dropped before it even goes anywhere. You might get pulled into a case and have a consultation with the attorney and say,
I would stay away from this case. Or, this doesn't look like it's something that's going to, be a valid, malpractice, situation. Or also, this is, this is something we should proceed with. Or, so sometimes you don't even, you just have to do like a written review or something like that.
And just say, I would skip this one if I were you, but eventually you're gonna need to go through and do some full, case reviews and a lot of reading and summarizing and so forth. That's 80 to 90% of the work. It's got the flexible evenings, weekends, and whatever hours you assign to, assigned to that.
It can go as low as one hour to 2, 3, 4, 10, 20, 40. depending on how comprehensive and how extensive this case is, now they say depositions are basically 10 to 20%, one in five to one in 10, something like that. Usually those are two to four hours of actual time with prep, and then they're schedule in advance and they're mostly virtual now.
They used to be face-to-face. Those mine were all face-to-face and now. Most of them are virtual and there's all kinds of things they have to be set up to make those things work. But it's definitely more convenient. Now, the downside on that in a way is then you're gonna have to find a place where you can be secluded and quiet and, be on that call for an hour or two, whatever it is.
So you need to have a good place to do that, whether it's at home or placed in your current office or elsewhere. And then, as I mentioned earlier, rarely the trial testimony, that one, because everyone's trying to juggle the schedules, you gotta be able to say, okay, three weeks from now, yeah, this time works.
And although I'm normally in the office, seeing patients, I can move those patients, move those surgeries and what have you. So a little bit of flexibility there. And travel possibly, if you're not doing it virtual, it is becoming more common to have it done virtual. But, there's still live, trials, obviously where they want you to be in court.
And I would say still the virtual are not the majority for sure. So what's our quote on this one? The vast majority of your work stays in the flexible review phase. Trials are uncommon, but require planning. Yeah. Makes sense. That's not too crazy. Okay. Some key observations here, we're kind of coming to the end.
I'm gonna wrap this up. So this is a side gig, consulting type business. It's accessible to any actively practicing board certified physician. There's ongoing demand and, this is not going away in the near future. there's some virtual tools that have dramatically improved the flexibility. So you've got, remote access, that's one.
And AI is, is starting to, you can. Summarize things with AI tools now quite easily. And I recently spoke to someone who was pro promoting a software program that would go through medical records and summarize them for you. Now, I don't think they would a hundred percent eliminate the need to, to read through those, but when you get a summary like that, you can be more focused to start out with.
And the secret to success is being credible to communicating very well and having some patience in the process, mainly of building the business, but also, in working with other people, as a, expert witness. And, if you can have that teaching mindset and have a business approach to this, it will be a very positive thing for you to, to do, in addition to your clinical work as the experts agree that this is a high reward side gig for the right physician, flexible, lucrative.
Intellectually engaging and also is a, not only is it lucrative, but it's a way to diversify your income so you can do more surgeries and make more money, but then if you lose your job, you don't have any diversification. So it's, it's both lucrative and, has the ability to diversify your income quite readily.
All right. The bottom line is, is this is one of the smartest side gigs for practicing physicians. It offers a highly diversified income, flexible hours, continued clinical relevance and meaningful impact, and you can start small, stay objective, build your reputation, and the rest will follow for the right physician.
This work lets you leverage your expertise, reduce clinical grind if desired, and regain control of your time and income. That's what they all agreed on. Okay, I wanted to focus on the educational, sources, resources here for you. the first is the Expert Witness Startup School by Gretchen Green, md.
You can find that and you can, if, if you're seeing the video, obviously you can take a, a snapshot of this, but I'll walk through them very quickly for those that are just listening here only. So Gretchen Green School is called theexpertresource.com, so it's all one word, and you'll find her program.
Then you can see a medicalexpertwitness.com. That's where you'll find Jay Jordan Romano, also a physician, medical expert. witness.com. That's all one word. Then seek. SEEK is known for having an annual conference on nonclinical careers. I've heard that that annual conference, which went on for about 18 or 20 years, has been terminated, or they're not doing the live in-person version of it.
So they may have done a virtual version of it last year, and they might do it in the future, but they have all kinds of support for educating you about becoming an A, an expert witness, and you can search for that on seek.com. Seek is spelled SEAK seek.com. Now to get you started. There are many directories that you can become part of or access, and they sometimes require a fee.
I think most of them do, but maybe not all of them, but Seek has one. So look for their, their directory that you can sign up for. They definitely charge you SEA k.com. seek.com. Then there's a physician side gigs that's the same as a Facebook group, physician side gigs.com/side-gigs, and I think they have a place where you can register there.
They might charge you as well. There's Medical Advisors Inc. At tech Med experts.com. Then you've got MD Staffers. It's all one word, MD, S-T-A-F-F-E-R-S, md, staffers@mdstaffers.com. Medical doctor, expert witness, those are hyphenated. And then Juris Pro, J-U-R-I-S, capital PRO. You can find that@jurispro.com as well.
So those are all directories. There was five direct directories that you can use to get your, consulting business going. Alright, well I thank you for your attention today. We covered a lot of material and as I thought it went very long. So you're going to, if you're listening to the podcast, you'll be hearing, this will be, you'll part one and then you'll go back into the following week and hear part two.
So I appreciate you for being here. You can reach me by text or email@john.ika.md at gmail.com. And with that I'm going to close this presentation down and come on back, live on the video for those that are watching and say that,
Say that. That's it for today's presentation. You can find related links in the transcript of today's lecture in the show notes@nonclinicalphysicians.com slash guide two expert witness consulting part one. That's all hyphenated. Again, nonclinical physicians.com/guide to expert Witness Consulting part one.
That's the number one, and those are hyphenated. And then join me next week for part two of this presentation on Expert Witness Consulting on the Physician Nonclinical Careers podcast. Also, you can learn about being a sponsor of the podcast and share your message with thousands of physicians online@nonclinicalphysicians.com slash sponsorships, or set up a short zoom call.
That's probably the better way to do it@nonclinicalphysicians.com slash zoom. Call. And don't forget that the opinions expressed here are mine. And while the information provided in the podcast is true and accurate, to the best of my knowledge, there's no guarantee that using the methods discussed will lead to success in your career, life, or business.
So always consult an attorney, accountant, or career strategist before making any major decision about your career. All right, bye for now. Hope to see you next week.
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The Complete Guide to Expert Witness Consulting for Physicians Part 2
Now what are some of the challenges? Well, I think probably what comes to our minds, and it certainly did to me when considering doing something like this is that it's okay doing chart reviews.
I mean, it can be boring and it can be tedious at times, but it can also be interesting. but what about when you actually have to. testify against one of your colleagues, or, or you just need to testify on behalf of one of your colleagues. And you have to sit there and you have to feel like you're, what you're saying is being questioned.
And you might even feel as though you're being attacked if you're, going through a deposition, the way that the questions are asked and the implications are that are made by the other, counsel, the other attorney. and if you don't enjoy confrontation or at least, a good debate, then it could be very stressful.
So I think that's the thing that stops most of us from doing this. Just the thought of being on the hot seat, so to speak. now my advice to you on, as you think about it, things that way is to really reconsider that because. It's just like you're going to try to talk to your patients, you're going to take the information and you're going to try to explain it, whether it's good news or bad news.
And we're trained to do that. And, this is actually a reason why some people get sued is because they don't have patience. They don't take the time to explain to their patients what's really happening and dumbing it down in a way. I mean, you, you can talk with a colleague and use all the vernacular, but you, you're stupid to do that.
If you do that with patients. You don't talk in medicalese in, in day-to-day practice trying to explain to patients and their families. And, sometimes you must break it down to a high school level, to a grammar school level. Sometimes there's language barriers, but ideally your patient and your understanding and you have good communication skills so that you can.
Use terminology that gets the same message across as it would to one of your medical colleagues, or even a nurse or someone else in healthcare, as well as with someone who has no medical background. And that's really what we should do anyway as physicians, because 90% of our patients don't have any medical or nursing background.
The record reviews can be lengthy. when they say, I've got a case for you, and here's the situation, chances are you're not going to be able to review that case in 90 minutes and call it good. you're gonna have. The, whatever it was, whether it was, outpatient treatment, whether it was inpatient, could be multiple, admissions and what medical records are like.
And, there's probably some new ways to thin that out in terms of if you're looking at a stack of a thousand pages from a hospitalization and more, even longer if it's been a major hospitalization. But if that you find too tedious, then you won't like this because that's the majority of the work, at least going into it.
If you look at it more like, wow, this is an interesting case and I'm really getting into it. I'm looking for things that stand out that don't seem right, or mistakes that might have been made or accusations of mistakes. And in your opinion, none of, no, none of those were made. So again, that's what some people dread and that's why some people won't go into this.
Doing depositions and
going to trial, that can be not only a challenge, emotionally or intellectually, but it can be. That's where the scheduling issues can be difficult. you know, I, as I said, was involved in several depositions for different reasons. Most of the time they're flexible, because there is no set court date that's pushing that.
Normally you're working through the process. Everybody knows that depositions have to be done, and there's usually multiple depositions of different, different experts or just different witnesses. But when you get to that point of depositions and then going to trial, then you need to have a little bit of flexibility because the legal system isn't always that flexible.
They're really good at postponing things. but in terms of finding, a time that's convenient for you might take a little juggling. So that's one of the challenges. you can be labeled as basically a professional, witness or that your opinions are biased or, some that usually occurs because you are, doing too much.
you're doing too much. Expert witness work and not enough practice. So if you're down to one day of practice a week, or maybe you've taken two or three months off, you're not sure if you're gonna go back into practice or something. Once you get to the point where you're spending most of your time doing the expert witness work as opposed to clinical, then your opponents may, label you as a professional witness, a paid, paid witness, so to speak.
Who's got, Ulterior motives. Even your colleagues might point at you and say, Hey, you're not really practicing much. You're doing a lot of, expert witness, and I know you're making a lot of money, but I don't know if I really trust you, in terms of being an excellent physician still.
So that's what's gonna happen. And some states require you to do so much, practice, you have to be in practice and has to be so much, and most of the expert witnesses that I know are doing this less than halftime for sure. So you gotta be careful about that. But as long as you're doing that, you're, this should not be a big deal.
But you definitely need to maintain an active clinical practice and need to be, very aware of what the usual, standard of care is in, in your geography.
And experts agree that this work is not for everyone. So cross examinations and the long case timeline can be the biggest hurdles. yeah, I mean these cases go on for years. My experience cases I've been involved with, whether they're medical legal from a, a liability standpoint or some other reason, some family issue, get pulled into disability cases, whatever it might be.
Those things go for years and. I would say in my malpractice accusations, even if I was just, a side, physician or somehow got pulled in for no reason, that can still take anywhere from three to five years to end. So if you're an expert witness, you might not get involved in that case until it's already been on the books for a year.
But you can expect to go two or three years in most cases before that thing is wrapped up completely and you're kind of on the hook, to finish that up. Even if you were to retire and you've done a deposition or two, you'll, you really should follow through and, be involved with, testifying if it does not get settled in the meantime.
So. What are the prerequisites? Well, you gotta be board certified, actively practicing in your specialty. That's basically it. Having a lot of extra degrees doesn't really make any difference in this situation unless you're kind of doing some more forensic type of testifying, like a pathologist or something like that.
you do have to have recent and relevant clinical experience to even do this job. In some states, it's a requirement. if even if it's not a requirement that you're in active practice to a certain degree in a particular state, the, the opposing counsel is going to, make it. Pretty obvious that, your opinions might be suspect.
So you need to have ongoing clinical experience. it's best if you're working on both sides. Now usually you're going to end up working on one more than the other. Part of it's just chance. Part of it is what I mentioned earlier, that if your first case or two, or from a previous experience working with a defense attorney on your behalf, well then the only cases they're gonna pull you in on are being, working for the defense because that's what they'll need you for.
And they'll get that word out to their colleagues and you can actively help them get that word out. And, So you're going to naturally, probably start by doing more of those. But obviously the plaintiff side needs just as much help as the defense side does. And you can, you can do the other side because you'll, you can look at a case and say, Hey, I don't, I think you need to settle on this based on what I see.
Or I, I can't take this on because I really don't agree that there was malpractice. So, I mean, you can turn those down, but not all the cases, as much as we as physicians hate to see malpractice cases, proceed. not all of them are, without merit. I remember I was shown an EKG once by one of my colleagues.
Well, it wasn't by my colleague, it was about my colleague. It was, it was an EKG. And I somehow came out to find out who it was later, but I, I was told it was in the city where I was working, which is really more of a small town. And I looked at the EKG and they said, you're a family physician, right?
Yeah. I've got a case, or someone's asking me to represent them and I just want you to tell me what you think about this EKG. So I got paid for that. It's like a, like an hour's worth of pay just to look and tell me. And it was pretty clear that this is a person that was having an acute MI on an EKG.
And, I'm not a cardiologist, but there are certain things that we all know that if we see that some of those acute changes on an EKG, that, if they have any symptoms at all, or maybe with no symptoms, depending on, what's going on, they should be sent to the emergency room or. At least get an EKG or call a cardiologist to look at them, whatever your act, your action would be.
And I looked at it, I said, yeah, that person's having a heart attack. Okay, well this person was seen by, my client was sent home. So again, I didn't have all the details in the case, but basically what they wanted to know just in that instance was, should a physician, a failing physician be able to recognize that.
And so, this, this case probably was just settled, from the beginning. And it was probably most of the, work done on it was what the level of the settlement should be and was probably based on to what extent the patient was damaged or injured. I mean, if it, they did go home with a heart attack, but.
Had some upset stomach and came back 30 minutes later, went to the ER and was treated and nothing bad happened. That's one thing, obviously what's more likely is the patient went home and had a serious complication if this wasn't recognized. So that particular physician, I mean that particular physician, needed to be not reading EKGs at that point, but the main thing was if the patient was injured, they're entitled to some kind of compensation for that, at least their medical bills and pain and suffering and so forth.
So, anyway, that's just me trying to say why. That's another reason to do both plaintiff and defense cases. And the other thing is obviously if you're doing plaintiff cases, then you'll know what the plaintiff's perspective is when you're on the defense side as well. So it just balances things out for you.
You gotta have strong communication skills. You need to have calmness under pressure. I would call that being unflappable. So even though the attorney who's interviewing you or deposing you or questioning you in trial might come across as accusatory or aggressive, it really doesn't matter. You need to be very calm, very unflappable.
You need to listen. You need to respond in as short way as possible. Yes, no short answers. Have good communication skills. Be patient because not everyone's going to understand right away what you're trying to explain. And then have the coachability, and I mentioned this too, because you're going to get a lot of coaching on this from the.
Attorney that you're working with, whichever side you're on. And so that's gonna be great. That's where you can learn a lot of skills as you go. And your attorney is going to tell you what to expect, what to expect by a jury, what to expect by a judge, what to expect from, um, the attorney on the other side, whichever side it is.
And they're going to admonish you to remain calm. Take your time and, don't go off on tangents and just answer the question with the reasoning behind the question from your medical expert level of, training and experience as a physician and to have an ethical and objective mindset. And, it can be a very interesting process.
And experts agree that you do not need to be the top expert in the country. You simply need to be credible and actively practicing. Okay? So, if you're caring for these kinds of patients that you're, that the case involves, and if you've got your license and you're hopefully at least residency trained, fellowship trained and board certified, that's basically all you need.
and the rest of it is about commitment and taking the time and being efficient and being effective, and being thorough and communicating well. So that's the crux of it, and all those things that you learn will help you in other parts of your life and your career. Now, how do you get started? Well, you can network discreetly with colleagues.
Ask them, are they doing any expert witness work? They know people that are that, that are doing that. When you go to your specialty societies meetings, can you run into your colleagues, can you reach out to your, co medical school grads, your residency, partners, your fellowship, partners, and are they doing some defense or, or the vice versa type of activity?
As a, an expert witness, you can ask your malpractice insurer. I happen to be with the State Medical Society sponsored insurer, so they were pretty friendly with physicians and their attorneys would definitely answer questions and give us advice about things including whether to go into this field.
There are formal things. Of course there are, there are structured training, there are courses that are even CME eligible and tax deductible. All this stuff is tax deductible if it's going towards your side hustle, your side gig. let's see, and I'm going to give you some specifics in a minute. when there are directories too, to point you to find work.
So we're, I'm looking at this, this terms of getting started from two standpoints. one is from how to learn about this career, this side gig, this consulting career. And the other is in how to find, referrals, how to find work. So some of these do both, so that's why I bring it up now. but if you can talk to.
Your friends, colleagues and so forth. if you don't know anyone that's doing this, you can start looking around LinkedIn, for example. and. you can respond when someone from your own insurer just asks you to serve as maybe doing chart reviews, and then the de depositions and trials will come later.
yeah, so what else I wanna say about getting started? yeah, there's also some books that you can use, that you can access. I think it might be coming on an upcoming slide, but for right now, let me just say that most first cases come through personal referrals. So that's how I was exposed to it initially.
Training and visibility accelerate the process dramatically though. So this is the summary of what this section is about. So in terms of getting started, be open to it. Try and do some networking. even in your local town, you probably have an attorney and, for, business aspects, for contracts for purchasing a home, selling a home, things like that.
Well, you can ask that attorney, who are the, attorneys in town here that do malpractice? And can you link me up with them and I can talk to them and learn more about this whole field? So now what about growing the business? Once you say, okay, I've, I've done my first, I had that one come to me through a personal contact and now I thinking I might wanna do more of these and actually look for this kind of work.
how do I do that? Ultimately, you're going to wanna get quality leads that come in over time. You're going to want to be on someone's. Electronic Rolodex saying, okay, I have a new case. It's this specialty and it has this special need. And 'cause every case is different. And for you to be on their, Rolodex and, and they will call you, text you leave, you, send you an email, whatever.
You should try to build that network across plaintiff and defense bars. try and get to know, you might wanna focus on one more than the other, but you wanna get a list of those local, attorneys and see if you can become part of their, universe. we don't, pay people for referrals of course.
So that's why this slide says market ethically. But you can use LinkedIn, you can, to identify people in your county. Or in your state, you might wanna reach out to you. There are directories that I'm gonna talk about in a minute. There are agencies that hire you, to be on their panel where they, they may take a little bit of cut just for the, the, the benefit of being on their listing.
but the other thing is it has to be treated as a real business. So what does that mean? That means you get an accountant to set up your books. You get an attorney to set up your LLC, you do some research, find out what the rates are in your locale and maybe even get some mentoring if you haven't, gone into some formal training.
And you can get started that way and just grow it and learn as you go. Now here's what the experts agree on. Physicians who approach this as a professional micro business scale faster and enjoy it more than those who treat it as an occasional hobby. Okay? So if you're just doing the occasional case here and there, 'cause someone tracks you down, okay, that's fine.
But that's not really a side hustle per se, just like, some extra money on the side. But if you wanna make it to where you can really cut some of your hours back on the clinical side and do this, then you need a little more attention and to do everything properly from the get go. which is why I mentioned the accounting and the, attorneys being involved with setting this up.
Alright. How do you set your fees? Well, just from my experience and talk, people I've spoken with and research I've done, if, if you, I'm saying the typical range is 500 to $900 per hour, it's a little bit skewed because there are more lawsuits involving, I think. Obstetricians, orthopedic surgeons, neurosurgeons, et cetera, et cetera.
so their hourly rate for their clinical side is fairly high. So the typical range for their, expert witness consulting is gonna be higher Primary care, as I've noted on this slide, it's probably gonna be between three and 600, more or less. But like I said, the procedural list are usually much higher, but all time is billable.
You the first thing, you, the first papers you review, the prep, the talking to the attorney, the deposition, if it goes to trial, anything you do, including just getting on the phone and talking with the attorney, you should keep track of. Charge whatever it is that you are charging per hour. Sometimes they'll do a deposition, which the prep and the deposition, they'll all be included in a single sum, and you can off often get that paid ahead of time.
And you might even have a little contract that your attorney can put together for you that says, okay, you're going to give me before the, deposition, I need $1,500. which includes the hourly rate, estimated at, whatever, $500 an hour for three hours. With the proviso though, that if it takes more prep or it has to be redone or whatever, you'll get paid later on top of that.
But sometimes you can bill those ahead of time from what I've, learned from my colleagues. so the fees are market driven. Charging too low can signal inexperience, so you don't try to undercut by charging $200 an hour. They'll look at you like, eh, what's wrong? But charging too high can just invite a hired gun attack on cross examination.
And it also can mean you might not get the case. it, it is kind of a bottomless pit in a way, but if attorneys are used to paying six, seven, $800 an hour, then they're not gonna pay you $1,500 an hour unless there's just something really, really special about the skills and experience that you have for their case.
All right. What about costs involved in setting this thing up? It's not really that expensive really, to get started. you could take some training courses and even the coaching and the best training courses that I'm aware of are, they're no more than five to $8,000 at the most. Some are less than that for sure.
you might wanna put yourself in a directory. You might wanna join an agency that'll get you cases, you like. In terms of the training courses, generally one case will. Pay for any course you might have taken to get you set up. you have some costs to set up your LLC and to set up your accounting and your chart of accounts.
when you have that kind of a business, it's not integrated with your practice usually and if you have other businesses, but if you are practicing, it should be separate and it should be treated as such. And you gotta be ready for tax preparation. If it's an LLC, which it probably will be, then you have to do its taxes separate from yours and then put 'em all together at the end of the tax year.
and my wife and I have had, I think between us six or eight LLCs over the years, and each one needs its own accounting and, we've pretty much gone to, using, QuickBooks online, and it has great access by our accountants. And we had our help, had help from our accountants for most of those to get things set up properly so that you, when bills come in and you pay the bills, you can track it and it integrates with your bank accountants so forth.
And you have an LLC that protects you from liability for some kind of business error. And, let's see, the other cost is just the time investment. it takes you a little longer than, if you're taking a real long time to go through the records because of a procedural issue or not knowing how to connect or something like that, then you, you need to discount those fees a little bit.
So you, that could be an unexpected cost. But basically the costs are pretty low to start this kind of a consulting business. Oh, here's where I got the books listed. there are books, and you can imagine now these, oddly enough, they're expensive books. Some of these are a hundred, 120, $130, but it's less than one hour of coaching.
So, I'm just going to rattle these off really quickly for those that maybe don't, aren't looking directly at the slides, but look up inside the expert witness world. That's the newest one on this list from 2025 by Michael CVaR. You've got testifying in Court Guidelines and for the expert witness.
It's from 2022 by Stanley l Brodsky, Stanley l Brodsky's, also on a book called The Expert Witness, more Maxims and Guidelines for Testifying in Court. That one's from 2015 and how to Become a Dangerous Expert. Witness is written by Steven Baki and James Mandi, who are the two people that, basically that run Seek, that's SEAK, and I'll be talking about Seek in a minute.
So there's four books, there's other books available. But going through something like that just quickly would give you a good headstart on this process. Most physicians recoup training costs with their first or second case. The biggest cost is the learning curve, not the dollars. So this is not like opening a new practice in buying an office, building in all kinds of things like that, that the, the investment at the beginning is pretty low.
just some time and effort and networking and so forth. what do you expect in terms of the actual. Work that you're doing. Everyone asks this question, they, they think the chart reviews are cool. You get paid 3, 4, 500, $800 an hour to review charts. Okay, that's awesome. But then the depositions, the trial testimony, how much is gonna happen?
how much am I gonna be bogged down doing that? Unless you're really looking forward to that. But here's a, here are the numbers. 80 to 90% of the work is gonna be record review. you might get pulled into cases that will be dropped before it even goes anywhere. You might get pulled into a case and have a consultation with the attorney and say,
I would stay away from this case. Or, this doesn't look like it's something that's going to, be a valid, malpractice, situation. Or also, this is, this is something we should proceed with. Or, so sometimes you don't even, you just have to do like a written review or something like that.
And just say, I would skip this one if I were you, but eventually you're gonna need to go through and do some full, case reviews and a lot of reading and summarizing and so forth. That's 80 to 90% of the work. It's got the flexible evenings, weekends, and whatever hours you assign to, assigned to that.
It can go as low as one hour to 2, 3, 4, 10, 20, 40. depending on how comprehensive and how extensive this case is, now they say depositions are basically 10 to 20%, one in five to one in 10, something like that. Usually those are two to four hours of actual time with prep, and then they're schedule in advance and they're mostly virtual now.
They used to be face-to-face. Those mine were all face-to-face and now. Most of them are virtual and there's all kinds of things they have to be set up to make those things work. But it's definitely more convenient. Now, the downside on that in a way is then you're gonna have to find a place where you can be secluded and quiet and, be on that call for an hour or two, whatever it is.
So you need to have a good place to do that, whether it's at home or placed in your current office or elsewhere. And then, as I mentioned earlier, rarely the trial testimony, that one, because everyone's trying to juggle the schedules, you gotta be able to say, okay, three weeks from now, yeah, this time works.
And although I'm normally in the office, seeing patients, I can move those patients, move those surgeries and what have you. So a little bit of flexibility there. And travel possibly, if you're not doing it virtual, it is becoming more common to have it done virtual. But, there's still live, trials, obviously where they want you to be in court.
And I would say still the virtual are not the majority for sure. So what's our quote on this one? The vast majority of your work stays in the flexible review phase. Trials are uncommon, but require planning. Yeah. Makes sense. That's not too crazy. Okay. Some key observations here, we're kind of coming to the end.
I'm gonna wrap this up. So this is a side gig, consulting type business. It's accessible to any actively practicing board certified physician. There's ongoing demand and, this is not going away in the near future. there's some virtual tools that have dramatically improved the flexibility. So you've got, remote access, that's one.
And AI is, is starting to, you can. Summarize things with AI tools now quite easily. And I recently spoke to someone who was pro promoting a software program that would go through medical records and summarize them for you. Now, I don't think they would a hundred percent eliminate the need to, to read through those, but when you get a summary like that, you can be more focused to start out with.
And the secret to success is being credible to communicating very well and having some patience in the process, mainly of building the business, but also, in working with other people, as a, expert witness. And, if you can have that teaching mindset and have a business approach to this, it will be a very positive thing for you to, to do, in addition to your clinical work as the experts agree that this is a high reward side gig for the right physician, flexible, lucrative.
Intellectually engaging and also is a, not only is it lucrative, but it's a way to diversify your income so you can do more surgeries and make more money, but then if you lose your job, you don't have any diversification. So it's, it's both lucrative and, has the ability to diversify your income quite readily.
All right. The bottom line is, is this is one of the smartest side gigs for practicing physicians. It offers a highly diversified income, flexible hours, continued clinical relevance and meaningful impact, and you can start small, stay objective, build your reputation, and the rest will follow for the right physician.
This work lets you leverage your expertise, reduce clinical grind if desired, and regain control of your time and income. That's what they all agreed on. Okay, I wanted to focus on the educational, sources, resources here for you. the first is the Expert Witness Startup School by Gretchen Green, md.
You can find that and you can, if, if you're seeing the video, obviously you can take a, a snapshot of this, but I'll walk through them very quickly for those that are just listening here only. So Gretchen Green School is called theexpertresource.com, so it's all one word, and you'll find her program.
Then you can see a medicalexpertwitness.com. That's where you'll find Jay Jordan Romano, also a physician, medical expert. witness.com. That's all one word. Then seek. SEEK is known for having an annual conference on nonclinical careers. I've heard that that annual conference, which went on for about 18 or 20 years, has been terminated, or they're not doing the live in-person version of it.
So they may have done a virtual version of it last year, and they might do it in the future, but they have all kinds of support for educating you about becoming an A, an expert witness, and you can search for that on seek.com. Seek is spelled SEAK seek.com. Now to get you started. There are many directories that you can become part of or access, and they sometimes require a fee.
I think most of them do, but maybe not all of them, but Seek has one. So look for their, their directory that you can sign up for. They definitely charge you SEA k.com. seek.com. Then there's a physician side gigs that's the same as a Facebook group, physician side gigs.com/side-gigs, and I think they have a place where you can register there.
They might charge you as well. There's Medical Advisors Inc. At tech Med experts.com. Then you've got MD Staffers. It's all one word, MD, S-T-A-F-F-E-R-S, md, staffers@mdstaffers.com. Medical doctor, expert witness, those are hyphenated. And then Juris Pro, J-U-R-I-S, capital PRO. You can find that@jurispro.com as well.
So those are all directories. There was five direct directories that you can use to get your, consulting business going. Alright, well I thank you for your attention today. We covered a lot of material and as I thought it went very long. So you're going to, if you're listening to the podcast, you'll be hearing, this will be, you'll part one and then you'll go back into the following week and hear part two.
So I appreciate you for being here. You can reach me by text or email@john.ika.md at gmail.com. And with that I'm going to close this presentation down and come on back, live on the video for those that are watching and say that,
Say that. That's it for today's presentation. You can find related links in the transcript of today's lecture in the show notes@nonclinicalphysicians.com slash guide two expert witness consulting part one. That's all hyphenated. Again, nonclinical physicians.com/guide to expert Witness Consulting part one.
That's the number one, and those are hyphenated. And then join me next week for part two of this presentation on Expert Witness Consulting on the Physician Nonclinical Careers podcast. Also, you can learn about being a sponsor of the podcast and share your message with thousands of physicians online@nonclinicalphysicians.com slash sponsorships, or set up a short zoom call.
That's probably the better way to do it@nonclinicalphysicians.com slash zoom. Call. And don't forget that the opinions expressed here are mine. And while the information provided in the podcast is true and accurate, to the best of my knowledge, there's no guarantee that using the methods discussed will lead to success in your career, life, or business.
So always consult an attorney, accountant, or career strategist before making any major decision about your career. All right, bye for now. Hope to see you next week.
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