I’m “just a GDP” – can I still be an expert witness?

Firstly, “just a GDP” is a very poor choice of phrase – apologies to all the hard-working GDPs out there! As we’ve written in other blogs, being an expert witness absolutely does not mean that you have to be a Consultant or a Professor or a dentist with many years of experience – the word expert simply refers to the fact that as far as the court is concerned you are qualified to provide an opinion on your area of expertise which happens to be relevant to that case (and that the court will doubtless know very little about).

The legal system wants dentists who are closely aligned (professionally) with the dentist against whom the allegations have been raised to assist them with a claim. In this way the court will be as reliably informed as possible as to what a reasonable expectation is regarding the relevant standard of care.

So if you are a general dental practitioner then you are absolutely appropriate for cases involving general dental practitioners (and there are plenty of such cases). If you are an orthodontist then you are appropriate for cases involving orthodontics. And so on!

Since a lot of cases arise from general dentistry, in such matters an experienced GDP is ideally qualified to provide the court with an answer to the question – “Did the Defendant provide care to the Claimant in accordance with a practice accepted as proper by a responsible body of GDPs?” Or “Were the actions of the Defendant reasonable and consistent with the accepted standards of care at the time of the incident?”

It would not be appropriate for a Professor of Orthodontics to comment on the case involving the quality of a root canal treatment provided in general dental practice.In the same way, it would not really be ideal for a Professor of Restorative Dentistry to comment on the same case – the disparity in training and experience between the average GDP and a Professor is significant enough that a Professor might not be suitably placed to describe to the court what is a “reasonable” outcome for a GDP.

You will have the opportunity with every case to “take it or leave it” before committing to being involved, so don’t worry about potentially finding yourself involved with a case that you are not comfortable with against your will. Typically, a solicitor or representative from an indemnity organisation will contact you via email with a brief outline of the case and the identities of the Defendant and Claimant (a “conflict of interest” check). If the treatment in question does not fall within your area of expertise then you must obviously decline the approach – you will not be popular if you write a report regarding something you have little experience of only to have to admit this many months or years later once the case has progressed.

Occasionally you may accept instructions on a case, only for there to be an unexpected allegation that you are asked to respond to that is not within your area of expertise (this might be dental or non-dental, such as psychological injury arising from the dental treatment). If this was not detailed in the original approach then it is reasonable to simply say that – you should never feel coerced into giving an opinion on a matter that you are not qualified to. (In our three-day course we will specifically cover how to manage such difficult conversations with solicitors if/when you are put into this type of situation).

Similarly, if you have any personal or professional relationship with either the Defendant or Claimant then you will most likely be ineligible to be involved – discuss this with the instructing party if you are not sure. (It’s a small world in dentistry!)

So if you are worried that you don’t have enough qualifications to do expert witness work, this is unlikely to be the case. As long as you restrict your involvement to cases that are within your own field of expertise – and are appropriately equipped with the relevant training – then you are sufficiently qualified.

In terms of how experienced you need to be, this is unfortunately quite difficult to provide a definitive answer to. The Academy of Royal Medical Colleges (AMRC) state “The healthcare professional should have the necessary clinical knowledge, training and experience to act as an expert witness. What this means in terms of role, qualification or length of experienced will vary between professions. Individual professional bodies may choose to provide further guidance in respect of their profession. However, the court will need to be satisfied that the professional has the level of expertise for their evidence to be accepted”.

Essentially, if you are newly qualified then it is highly unlikely that a solicitor would consider you to be sufficiently experienced to be able to provide a well-balanced and reasoned opinion. The same would also apply to any specialty within dentistry – for example if you started placing implants a year ago and have completed only a handful of cases then solicitors are not likely to send you cases regarding implant dentistry, even if you have been a GDP for many years. The Royal College of Surgeons of England (RCS-expert-witness-good-practice-guide-2019.pdf) state that “it is unlikely that surgeons can claim ‘expert’ status in the first five years of consultant life”. For dentists, there is certainly a range of opinion on how long is long enough, but for a clinician to have sufficient experience to provide not only their own opinion on a matter – but crucially, what other reasonable opinions the profession might have – would take 5-10 years of practicing the type of dentistry in question.

In terms of whether you require further training in law or medical ethics, I will again defer to the Royal College of Surgeons and their document “The Surgeon as an Expert Witness – A Guide to Good Practice” who write:

“Some surgeons undertake a master’s course in medical ethics, sometimes touching on medical law. On occasion, they do so in the belief that it will enhance their practice as an expert witness. Doubtless academic ethic and law is a rewarding subject that will enhance the candidate’s clinical practice, since it improves knowledge of consent, confidentiality and tissue ‘ownership’, among other things. It is nevertheless important to realise that surgical expert witnesses are valued for their knowledge in surgery, a filed where lawyers are very unlikely to have personal experience. Experts are not valued for their knowledge of the law outside the exceedingly narrow sphere of the provision of expert evidence. For this reason, while any surgeon is encouraged to pursue legal studies as a matter of general education, it would be a mistake to believe that a law degree will make them more attractive as an expert”.

In summary, don’t be put off if you feel that you are under-qualified -it might even be fair to say that there is more risk attached to being over-qualified as one might no longer be representative of most dentists working in practice. Experience is key though.