Obtaining expert testimony has always been the most difficult part of medical
malpractice litigation. Historically, there have been two competing interests:
members of a professional group did not want to testify against their
colleagues, but they did want to run their competitors out of business.
Allopathic physicians were happy to label homeopathic physicians as
incompetent, and any physician would dispute the competence of a
chiropractor. These rivalries led the courts to use the legal doctrines of the
school of practice and the locality rule as the basis for qualifying a person as
an expert witness.
The school of practice distinctions also predated modern medical training and
certification. At one time medical practitioners were divided into chiropractors,
homeopaths, allopaths, osteopaths, and several other schools based on
different philosophical and psychological beliefs. Since state legislatures did
not discriminate among these different schools of healing, judges were
reluctant to allow litigation to be used to attack an approved school. Except for
chiropractors, allopathic practices (and osteopaths using primarily allopathic
methods) have driven out the other schools of medical practice. The courts
retain the traditional school of practice rule when they refuse to allow
physician experts to question chiropractic care or chiropractors to testify in
cases with physician defendants.
While not as rigidly enforced as the school of practice rule, differentiation of
physicians into self-designated specialties is also taken into account. (Self-
designated because few state licensing boards recognize specialties or limit
physicians’ right to practice the specialties in which they have been trained.)
The relevance of the specialty qualifications of an expert witness depend on
whether the case concerns procedures and expertise that are intrinsic to the
specialty or general medical knowledge and techniques that are common to all
physicians. This dichotomy is reflected in strategies for expert testimony.
Whether the parties to the lawsuit will stress the specialty or general
knowledge depends on the qualifications of the expert that each has retained.