Opinions and testimony of expert witnesses and independent medical evaluators.

Objective: To clarify the guidelines and responsibilities of expert witnesses and independent medical evaluators (IMEs).

Design: Literature review and personal opinion.

Setting: There have been concerns about the objectivity of expert witnesses and IMEs due to potential financial conflicts of interest.

Results: Medical-legal work such as expert witness testimony and independent medical evaluations are a recognized part of the practice of medicine. As such, the opinions and testimony of expert witnesses and IMEs should be held to the same scientific and ethical standards as clinical practice. The concept of "expert" differs when used by the legal system vs when used by physicians. Expert testimony should be based on the best available evidence and standards of care, which requires that experts stay current in their field of expertise, and revise old opinions as new information is published. Personal experience alone is rarely sufficient. A medical expert should be in active practice caring for the type of patient involved in the legal action or, alternatively, be able to demonstrate competence to provide an opinion in the specific area of interest.

Conclusions: Testimony should be honest and evidence-based. Testimony and reports should be accurate, impartial, and relevant. Both should be based on current scientific evidence, and avoid the role of advocate for the party. The physician should testify as if the opinions and their bases are subject to peer review.