From a healthcare standpoint, personal injury cases can involve a wide array of professional disciplines ranging from medical, chiropractic, physical therapy, speech therapy, and psychology to name a few.
The Role of the Rehabilitation Doctor in a Personal Injury Case
These different healthcare specialties not only treat the patient to help them return to their prior level of function, but each discipline can offer specific insight into the patient’s progress and future prognosis.
Many times, however, an expectation is put upon the treating medical doctor to give an opinion about the overall prognosis of a patient. While medical doctors can say whether they think a person has achieved “Maximum Medical Improvement”, they typically have to consult with the patient’s rehabilitation doctors to determine the patient’s actual rehabilitative potential. The difference here is that medical doctors diagnose and treat pathology and rehabilitation doctors such as physical therapists, evaluate and treat dysfunction.
The reason why this collaborative opinion with the rehabilitation doctor is so important is because of their unique training. For example, if you ask a physical therapist to prescribe certain medications or read an MRI report, they are not able to do this because it is out of the scope of their practice and they are not trained to do so; not to mention they are not licensed in this field. On the other hand, if you asked a medical doctor to perform a physical therapy rehabilitative treatment regimen they would not be able to successfully treat this patient because they simply aren’t trained in doing so. Each respective discipline, both medical and rehabilitative, have their own unique set of skills and training which gives them credibility to opine on different aspects of the patients’ overall prognosis.
Oftentimes in trial, the question “what is the patients’ rehabilitative potential” comes up and whether or not they have reached their “Maximum Rehabilitative Potential” and/or achieved “Maximum Medical Improvement”. If the appropriate experts are not in line to give an expert opinion on this topic, it will be difficult to prove to a jury if “Maximum Medical Improvement” or “Maximal Rehabilitative Potential” have been achieved.
As a Doctor of Physical Therapy, I have testified in trial numerous times against medical doctors ranging from orthopedic surgeons, physiatrists, and interventional pain physicians. Quite often the opposing experts have differing opinions than mine regarding the improvement of the patient. It’s not necessarily that their opinion is wrong, but more often that it comes down to their opinion being based off of the patient’s pathological condition and whether or not that diagnosable condition has been cured or if there is an impairment that still exists. From the rehabilitation doctor’s perspective, we are looking at the overall rehabilitation potential of the patient and whether their function will improve or regress over time; thus providing a rehabilitative prognosis.
Medically, the patient may have reached “Maximum Medical Improvement” from a disease or pathology standpoint, but the doctor of physical therapies’ standpoint considers whether the patient has reached “Maximum Rehabilitative Potential”. The physical therapist has the education, experience, and expertise to opine on this question with certainty and should be integrated into determining the overall prognosis of the patient.
Make sure you provide the insurance company and/or jury members both the medical doctors’ AND rehabilitative doctors’ opinions in order for an accurate and well-rounded prognosis to be made.
Dr. Brad Poppie has over 20 years of personal injury experience providing care as a treating doctor, coordinating rehabilitative case management, and expert trial testimony services. If you have a client that you would like to discuss their need for an expert report, please contact me directly at 720-982-2000 or email me at: brad@injuryreportingconsultants.com