Games Experts Play

Examples:

1. Claiming all cranial nerves normal.
(99% never test the first cranial nerve, i.e. smell or taste)
2. Giving the plaintiff the answers.
(Can you smell this chocolate?)
3. Helping them with the test.
(Can you read this word FROG?)
4. Ignoring the bloody obvious.
(Claimant has weakness on side opposite of brain injury.
Solution: don’t test that side)
5. Playing stupid.
(Ignoring records clearly identifying brain damage)
6. Claiming all results normal then not being able to define it.
(Doctor, you claim the grip strength is normal. What IS the expected normal grip strength for someone this age, gender and body habitus?)
7. Not testing visual fields adequately.
(Holding fingers in front of face instead of to the side)
8. Not measuring for range of motion or atrophy.
(Bring a tape measure out. Ask the doctor if he had bothered to take the time and actually measure for atrophy. What would results be? Measure your own client if you have to)
9. Underlining only those parts of the records helpful to the opposing side.
10. Claiming the neuropsychological testing in favor of TBI is irrelevant. However, on cross examination admitting:
They do not understand how to give or interpret the tests.
And
They do not know what the test tests for and don’t understand the results. However, the results they do not understand are irrelevant. (Translation: I receive the radiologist’s report on my wife’s mammogram. It is positive for cancer. I don’t understand mammograms so I throw it in the trash)
11. Doing a decent exam reflecting positive signs of TBI then claiming
TBI is not the cause.
Laws of parsimony demand simplest
explanation first. However, doctor claims the symptoms
(all of which can be explained by TBI) are really caused by l3
different conditions, all of which just happened to manifest
themselves after an accident that can cause TBI.
12. Claiming studies show…..
(Demand the name of the study. Bring your laptop with air card to deposition and offer to pull it off National Institute of Health Data Base)
13. Deferring ONLY to opposing doctors who have spent the least time with the patient and have a dog in the fight
14. Palpating spine OVER clothing.
(There is no way a spasm is going to be as detectable over several layers of clothing vs. over actual skin. Don’t they usually take the time to gown their own patients? Why didn’t this patient rate such consideration?)
15. Altering results by manner with which test is given.
(Example: doctor may take a paperclip and barely place any pressure at all on the left side where one would expect symptoms to be then ask the patient if he or she feels the pressure. Then on the alternating side where no pain would be expected he may push the pin so hard into the skin that it hurts and then claim malingering)
16. Claiming the condition was idiopathic.
(Really? What are the statistics wherein individuals spontaneously develop HNPs verses those in a high speed crash? The opposing side never produces articles showing probability. SO the client is 55 years old. She’s been alive for over 20,000 days. There is a one in 20,000 chance she develops a herniated disc and it just so happens it occurs spontaneously after a crash which can cause such herniation but didn’t)
17. Most people develop this condition anyway.
(Really? Where are the articles showing that most people in their 20’s have herniated dics? Many doctors claim research shows most people with herniated discs are asymptomatic. They are referring to an article in the New England Journal of Medicine wherein asymptomatic individuals were given lumbar MRI’s and some were found to be abnormal. In all cases (yes, every one) the doctor had not actually read the article. In reality, it indicated a majority of people who had lumbar MRI’s and were asymptomatic did NOT have herniated discs)
18. Ask the doctor to tell you what did cause it.
(Often they have no answer but must admit a crash can cause the condition)
19. Ask them to agree nothing occurred prior in time that caused the symptoms until the crash.
(The crash can cause the condition. However, in this case it did not but you, doctor, don’t know what did? Sounds very stupid, this argument)
20. The doctor takes a “just take my word for it” and “It’s based on 30 years experience” tactic.
(Point out that medicine changed significantly since the doctor went to medical school. In fact, many new tests were developed and much research has been conducted on various diagnosis, right? Then point out his file had no articles and he’s done no internet research on this at all. Point out that he can say anything he wants, claiming it’s backed up by 30 years experience but if we wanted to know where the science was to support his conclusions, we’d have to conclude there is none)