Standard of Care Engagement Process
A standard of care review proceeds in five steps, from engagement and conflict check to testimony. Counsel opens it by stating the clinical questions and the specialty of the care under review, so the fit with the reviewing physician is confirmed at intake together with conflicts, before scope and retainer are set in writing. The physician's record review follows, and every opinion in the report is tied to the applicable standard and the literature behind it.
Engagement process
- Engagement and conflict check: We confirm the clinical questions, check for conflicts, and establish the retainer and scope.
- Medical records review: A board-certified physician reviews the medical record, imaging, and relevant clinical documentation.
- Standard of care analysis: We evaluate whether the care provided met accepted clinical standards, supported by the medical literature.
- Opinion and report: We document the findings, the applicable standard, and the basis for each opinion in a written report prepared to the admissibility and disclosure standards that govern expert evidence.
- Testimony: We provide deposition and trial testimony and prepare rebuttal opinions as opposing reports are produced.
Questions about standard of care engagement process
What happens first in a standard of care review?
Intake: the clinical questions, the specialty of the care under review and any conflicts are confirmed before scope and retainer are set, so a matter outside the reviewing physician's specialty is identified then rather than after retention. The engagement agreement then fixes scope, standard of care alone or with causation, the retainer and the deadline the report must meet.
What records does KWVRS need to begin a standard of care review?
The complete medical record for the episode of care, the imaging and the relevant clinical documentation, since the opinion rests on what the record shows was done and when. The clinical questions the review must answer, and which providers' care is at issue. Any medical opinion the other side has already served, with the deadline the report must meet, so the review is scoped against it.
Is a physician's record review always part of a standard of care review?
Yes; it is the review. The reviewing physician reads the record, the imaging and the documentation and evaluates the care against what a reasonable practitioner in the same specialty would have done at the time and place of treatment. There is no interview of the patient; the opinion is a medical reading of the record, supported by the literature where needed.
What does KWVRS deliver at the end of a standard of care review?
A written report that states each finding, names the standard it was measured against and gives the basis for every opinion, in the form the forum's admissibility and disclosure rules require, with a literature review where the questions call for documented clinical standards. It addresses clinical standards and, when retained for it, medical causation; negligence, liability and damages are for counsel and the court.
Can a standard of care review be limited to a rebuttal of the other side's expert?
Yes. Rebuttal opinions are prepared as opposing reports are produced and can be the whole engagement: the physician reads the served opinion against the record, the standard it applied and the literature it relied on, and reports where the two diverge. Causation can be added when the assignment calls for it, and independent medical evaluations remain a separate service, offered for New York and New Jersey matters only.
Who conducts a standard of care review at KWVRS?
A licensed physician, identified to counsel when the engagement is confirmed. Because the standard is what a reasonable practitioner in the same specialty would do, the specialty of the care under review is confirmed against the reviewing physician's at intake, and some states specify expert qualifications by statute, which counsel confirms for the forum.
Related reading
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