From a healthcare standpoint, personal injury cases can involve a wide array of professional disciplines including medical, chiropractic, physical therapy, speech therapy, and psychology to name just a few.
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.
To further break this down consider this: If you asked a physical therapist to prescribe certain medications or read an MRI report, they wouldn’t be able to do so because it’s out of the scope of their practice and 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 training and skill sets that give them credibility to opine on specific aspects of the patients’ overall prognosis.
Now knowing that your patient’s medical doctor can only opine on a portion of your client’s injury and recovery, you can see why a collaborative approach with various healthcare professionals is critical when determining a patient’s overall prognosis. When the question “what is the patients’ rehabilitative potential” or “has the patient achieved maximum medical improvement” is inevitably asked in trial, 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 has 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. Most often, the opposing opinion of these experts is different from mine in regards to the improvement of the patient.
It’s not necessarily that their opinion is wrong, it typically comes down to their opinion being based off of the client’s pathological condition and if 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.
From a medical standpoint, the person may have reached maximum medical improvement from a disease or pathology standpoint, but the doctor of physical therapies’ view is if the person 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.