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Hiring a Forensic Physician, What Will it Cost?


Expert Witness: ForensicExpertPro
What you can expect to pay an Expert Witness in Medicine

How much is an Expert Witness going to cost?

“Find an Expert Witness” is the task given you, as an attorney or paralegal.

You make a few calls and ask for a Fee Schedule. You think, logically, that the hourly rate will help you decide, but the real question is:

“How much will it cost in total, if the Expert is retained?”

The Expert’s hourly rate is less relevant to both of you than understanding the scope of the work, and what it might cost overall to take the Expert to testimony or generation of a report.

Experts are differently efficient, experienced, able to focus on what’s important. Those skills drive costs. Fees per hour do not. A $400/hour expert may take 30 hours ($12,000) to accomplish what the $600/hour expert does in 10 hours ($6,000.).

Skill, experience and efficiency, not an hourly rate, drive time and
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thus cost.

The $600/hour expert might make a powerful impression on the jury. The less expensive expert’s rate may reflect very little testimony experience. This means you are a guinea pig.

In Court, do you want the lowest bidder?

Specific Fees and Data are discussed below but bear in mind, if you want to know how much the Expert Witness will cost:

• Communicate about the case effectively and early.

• Discuss the details of the Expert’s work.

• Clarify how you will handle the cost of changes in scope, expectations and the Expert’s role.

• Stay in touch to avoid unhappy surprises.

• A Forensic Psychiatrist or Psychologist may charge more than the attorney (or not). A surgeon, still more.

Either way, fees reflect expertise that no one else has. That is the nature of an Expert Witness.

Contingency, Flat Fee and Liens

Let’s get the question of contingency and flat fees (and liens) out of the way.

PI attorneys are especially likely to want to “spread the liability” by retaining Expert Witnesses on a contingency or lien basis.

An expert witness can never work under any fee restriction that implies the Expert’s fees rely on the successful outcome of the case.

Imagine that information coming out on the stand. It’ll be a bloodbath.

Some doctors accept liens—a variation of fees dependent on outcome. Lien physicians are almost always treaters—the injured party is a patient. There is a conflict of interest when you retain this doctor as an Expert Witness. Medical information obtained during treatment is protected by HIPPA. It cannot be considered in a med-legal report unless the “patient/examinee” signs a release with full understanding their private medical information will be available to more than one attorney and perhaps the Court.

Never ask an expert witness to accept payment by lien or contingency. It weakens your case. It is unethical for the expert.

Objectivity of an expert relies 100% on pay-as-you-go.

Their services are billed by the hour, due as fees. This protects your client’s client case during testimony. And strengths and weaknesses of an expert will become relevant in settlement negotiation.

Fees by the Hour

So, what is the right amount to pay an Expert?

I dig deep into the data in my article What Experts Should Charge: A Case Study in Forensic Psychiatry and Psychology. I find fee ranges for Forensic Psychiatrists and Psychologists to be nearly the same in most medical specialties. Exceptions include Surgeons, Neurologists and Orthopedists who charge more and have a larger mark-up for testimony, in my limited experience.

In the case of orthopedists, higher than usual fees are a direct reflection of the large volume of PI cases.

Surgeons and neurologists reflect the highest dollar medical malpractice and standard of care cases, where wrongful death, again, reflects big ticket damages.

Fees in the Expert Witness Marketplace

The usual suspects in answering this question:

• Word of mouth from other attorneys, or inferences from anecdotes
• Discovery: what are other experts charging? How about o/c’s experts? Experts you’ve used in the past? Fee Schedules that have come across your desk.

*Psychologists are not physicians but I include information here because attorneys do not always understand the difference.

Independent Data
I discuss data below and in greater detail on my website. Here's the short and sweet: Data is:

• Inadequate, but not dismissible research.
Expert Witness referral companies have surveyed those experts who list with them. The samples are tiny, the bias great, the data interesting, but not reliable.
• Dismissible research. Articles on the subject overwhelmingly refer to Bureau of
Labor Statistics data. It is completely unreliable because the BLS documents income reported by workers. It doesn’t distinguish between clinical practitioners and forensic or expert witness income. BLS Stats Unfolded.

Breaking it down Based on Anecdotal Experience and Observation in the Real World

In 15 years of reviewing expert fees, here are rules of thumb. Remember, supply and demand are the heart of capitalism. Forensic work is no different: if there are no experts in the relevant field in your area, expect to pay more than those where experts are clustered. Usually those are medical school college towns where residents and Fellows are building a private practice.

The Numbers


Early Career in Medicolegal Work 5 years or Less

5 years’ or less of experience in forensic/expert witness work. Board-Certified in Forensic Psychiatry: charge $400-475/hour (all things being equal, may be lower end of the scale in rural areas and higher in metro areas.)

Remote IMEs may keep costs down, as travel time can be a pricey proposition.

Mid-Career in Medicolegal Work, 6-10 years

6-10 years of experience. A mid-career level medicolegally qualified doctor charges $550-800 depending on (1) skill eliciting valuable information from an Independent Medical Examination and Records, (2) a well-written report, (3) testimony experience and the ability to hold their own in trial and deposition. A doctor who meets all 3 standards may charge $800+ per hour. Vet doctors for these qualities. Ask for references, talk to other attorneys.

10 Years or More

10 years or more of medicolegal experience with testimony experience and a strong reputation: $800-$1200/hour.

This category includes doctors at the top of their field, who are respected for their forensic opinions. They may be a specialist in a single feature, like PTSD. Such a person can charge $1,000 or more/hour.

Testimony Rates: Expert Witnesses charge more for testimony, usually $200 above their base fee. A daily minimum is sometimes required which can mean a day of testimony is $4,000-10,000/day-even if testimony is scheduled in the afternoon and the expert is pushed to the next day. If the expert has issued a good report and held their own in deposition, they are a contributing factor in settlement negotiations, as is the anticipated cost of testimony.

Rush Fees: If you ask an Expert Witness to jump in on short notice, perhaps requesting a report within a week or two (and the IME and records review that precedes it), you may be charged a rush fee—which increases the base rate.

Other Expenses: No Show and Cancellation Fees are a considerable problem for physician expert witnesses as they must clear their schedule of patients and other work. Expect such fees and factor it into the big picture question “what will this cost?”

Outliers

Doctor doesn’t know the value of their time.

Doctors sometimes charge less than their counterparts, simply because they do not know that information, or don’t care. An expert with a great deal of experience and reputation may charge the same as someone early in their career.

Doctor is in high demand—many cases but few experts in their field in a given geographic area.

Some states do not have many experts in a given field with medicolegal experience. Specialists may be even harder to find. If geography is relevant, such experts may charge more than the numbers mentioned above.

For example, California has a lot of medical schools or schools with a strong Psychology department, as well as schools with Forensic Psychiatry Fellowships. There are many Forensic Experts. On the other hand, cost of living is high. Attorneys have a lot of choice among qualified medical experts.

Texas, on the other hand, includes a number of major metropolitan areas. Oil and other industries are based there, as are in-house counsel departments. The vastness of such an industry means more lawsuits.

There are only a few Fellowships in Forensic Psychiatry in Texas and considerably fewer Board-Certified doctors with medical-legal experience.

The East Coast is littered with excellent medical schools and Fellowships, as well as people and lawsuits. Academia in Fellowship schools like Yale and Harvard ensure the geography reflects those who have published widely and may be at the top of their field. This skews all numbers. They are outliers and there is no rule.

The charges likely cross a wider range at the top and bottom end of fees described in this article.

I base my impressions on reviewing expert disclosures, depositions, conversations with attorneys about their experience and rates disclosed to me first-hand by experts. Altogether, the sample is tiny. But consistent. Not outliers yet.

Monkey Wrench

Unique Expertise. If the case calls for expertise in an area not well-understood, like sex addiction, severe psychotic disorders, psychopaths, capital cases, Defense Base Act, Maritime or Military jurisdictions (to name a few), fees will be higher.

Forensic Psychologists Charge 20-50% less than Psychiatrists on average with two exceptions.

Forensic psychologists are paid less than forensic psychiatrists in the forensic expert marketplace, as a rule.

Exception #1. Unique Expertise. The exception is specific unique expertise (see above) that outweighs a psychiatrist for the case. A Board-Certified Neuropsychologist or trained in the treatment of children and adolescents can usually charge more than their counterpart without such training.

Exception #2. High value Credentials like Board-Certification. At last count there were fewer than 300 Board Certified Forensic Psychologists (ABPP) in the country. This additional training is very different than the clinical or research Psychologist. Board-Certification in Forensic Psychology adds value to the Expert and increases the fee—for good reason.

Outside the Box: The Expert You Didn’t Expect

An expert witness who is neither a licensed psychologist nor Board-Certified Forensic Psychiatrist may be the right fit with the facts of a case, when unique expertise trumps credentials.

I work with a Licensed Marriage and Family Therapist. He holds a PhD in Marriage and Family Counseling, not Psychology. He is a Certified Sex Therapist, with additional Certification in Transgender Health. He holds elected positions to State and National specialty accreditation programs and is an Associate Professor at Drexel University. He can consult about issues that many Forensic Psychiatrists or Psychologists may not: Sexual addictions or atypical sexuality considerations in civil, criminal and family court cases including sexual dysfunction, loss of consortium, LGBQT factors, discrimination tied to gender, gender diversity and transgender, military discrimination of transgendered people, emotional distress associated with changes in sexuality post injury, impact on a family.

My point isn’t that an LMFT is a logical choice for an Expert Witness. My point is knowledge and relevant credentials should not be overlooked.

What is the “True” Scope of Work Behind the Cost?

Records

Is the Expert asked to review and comment on records? If this number changes over time (very common), it becomes important to adjust cost expectations. When 2 boxes of records become 12, the bill will jump dramatically. How long does it take you to read 6,000 pages?

Time in an Independent Medical Examination (IME)

• One examinee has a lot to say and has personality traits or mental disorder causing them to take extra time to say it. Another is malingering and keeps things short, sweet and uncooperative. The difference can be 2 hours or 5.

• An IME is compelled by the Court and involves travel and commitment to full days (usually 8 hours) in fees

New Information from Other Experts or Revealed in Discovery

• Another expert has a report and testing results the opposing side’s Expert wants to review before rendering an opinion.

• Unfolding deposition testimony conflicts with the information considered by the Expert.

• The records produced in discovery tell a new or different story. E.g., hospital notes, personnel records, any records that tell a new story.

The Data—a Sidenote

The article on my website takes apart the “Research.” Here’s a summary:

US Bureau of Labor Statistics. What the research says about Forensic Psychiatrists:

2017 BLS Forensic Psychiatrists?

• Forensic psychiatry is not a category researched by the BLS.

• For general Psychiatry they report an hourly wage of $103.89. It may be in the context of a salary which has added value in the form of benefits or risk factors (prison). Location is a factor: rural clinic? Insurance rate? Medicare provider? Private psychotherapist? The number has no context.

2016 BLS, for Forensic Psychiatry. Same as 2017, but less money.

2016 BLS Forensic Psychologists:

• Forensic Psychology is not a category researched by the BLS.

• Bizarre Median pay for clinical psychologists: $36.17 per hour which is reported further as $75,230 per year. This figure doesn’t even meet the threshold of insurance-set fees or Medicare. We do not know if these numbers reflect a full-time practice or part-time practice. The numbers are useless.

2008: The most oft-used quote “The U.S. Bureau of Labor Statistics reports that the average salary of a Forensic Psychologist was $64,140 as of May 2008.” I found no such confirmation.

2009: American Psychological Association. “Report of the APA Salary Survey.” Forensic psychologists are addressed only once, under a subcategory “Direct Human Services – Other Psychological Subfields (Licensed only).” There were 711 psychologist respondents of which 5% were forensic psychologists.

Various Years; 2000-2017: Discussion of hourly rates appear in blogs, blogs, blogs. No supporting data provided. Many quote the same US Bureau of Labor Statistics numbers above, with the same flaws.

Private Surveys

Experts pay to be listed in two Expert Directories. These directories conduct annual fee surveys:

A survey is sent to membership. In one survey, of 1030 respondents in all fields of endeavor, 32 psychiatrists and 29 psychologists responded. I learned a doctor could choose more than one specialty. In other words, 32 psychiatrists might also be 32 PTSD experts or 32 Depression Experts. Statistically unreliable.

The second directory outlines its exceptional methodology then fails to specialties. Information about a Psychiatrist cannot be distinguished from a surgeon. It is not a useful source of information.



ABOUT THE AUTHOR: Beryl Vaughan aka ForensicExpertPro
Ms. Vaughan has been a legal case manager for 20 years and for the past 15 years consults to Physicians who serve as Expert Witnesses including Psychiatrists, Psychologists and other Mental Health Professionals. She consults to Attorneys. She works with attorneys and doctors as a liaison between (a) the nature of a case and (b) the expert best qualified to opine and educate triers of fact and attorneys.

Copyright ForensicExpertPro

Disclaimer: While every effort has been made to ensure the accuracy of this publication, it is not intended to provide legal advice as individual situations will differ and should be discussed with an expert and/or lawyer.For specific technical or legal advice on the information provided and related topics, please contact the author.

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