#129 - When your Clinical Documentation Ends up In Court: What Healthcare Providers Need to Know with Dr. Pankti Fadia, Part 2

Performance. Tech is everywhere, but here's the uncomfortable truth. Most clinics don't have a tech problem. They have a decision making problem. Welcome to the Factor podcast, where we talk about the stuff they didn't teach you in school, how to grow your practice, refine your clinical skills, and get better results for your patients. We're here to help you navigate the real world challenges of being a healthcare provider, from delivering top notch patient care to running a business that doesn't run you into the ground. Whether you're fresh out of school or scaling your practice, we're diving into effective, cutting edge treatments to get patients better, faster. We'll also talk about business strategies and tactics to help you work smarter and not harder, and the mindset shifts required to thrive as a top performer in your field so you can build a career you love without burning out. If you're ready to learn what works and what doesn't from leading experts in industry, innovators, and respected clinicians across a wide range of specialties, you're in the right place, my friend. Let's dive in. Welcome back to the Factor podcast, where we bridge the gap between rehabilitation performance and real world clinical practice. I'm your host, Jessica Riddle, and today we're continuing our two part conversation with doctor pank Te Fidia, dc MBA on what chiropractors need to know when clinical care intersects with the legal system. In part one, doctor Fidia helped us understand the personal injury case timeline, the importance of documentation, the difference between clinical and legal causation, and why your notes may eventually become much more than clinical records. In Part two will move deeper into what happens when those records are requested, questioned, or used in legal proceedings. Doctor Fidilla will walk us through subpoenas, affidavits, depositions, trial testimony, and the ethical issues chiropractors need to be aware of when working in the personal injury space. She'll also share practical advice for providers who may one day be asked to defend their documentation, explain their treatment decisions, or provide testimony regarding a patient's care. And one of the biggest themes in this episode is confidence, not arrogance, not overstepping your scope, and definitely not trying to play attorney. But the kind of professional confidence that comes from knowing your notes, understanding your role, and standing behind the care you provided. Whether you regularly treat personal injury patients or only occasionally encounter these cases in practice, this conversation is a valuable reminder that preparation matters because when your documentation enters the legal arena, clarity, credibility, and professionalism can make all the difference. Now, let's get into part two of Clinics to Courtrooms with doctor Pankt Fidia. So let's talk about the PI case timeline. Most of the time, somebody will get into an accident, will hire an attorney, and if you work with them, that lawyer will send you an LOP and you're asked to schedule a patient. A patient will start treatment. This is pre litigation phase, meaning there's no ongoing case against any insurance company. This is where a lot of evidence is being gathered. That's where you come in. So all the patients that you're seeing while they're live with you, the case is going to get into litigation. That's why your notes matter. But right now there's no pending case and that's all pre litigation. You'll hear that word a lot in practice. Pre lit pre litigation litigation meaning once you file paperwork in the court. At this point, the case is being litigated, meaning that it's actively being worked out in the court proceedings. So the treatment happens at your office. You may refer them out to other providers. They will go do whatever they need to do, and at some point the treatment will be done. This is when attorneys will often ask you to send bills and records, and so you do that. At that point, the lawyers, the plane of attorneys will make a demand letter. It's like a packet, and they will send that to the insurance company. So you'll often hear that from the attorneys when you're in practice, that, oh, we are sending a demand letter soon. We need everything right away. And these are the words that you'll hear a lot most cases. About ninety five percent of the cases that you will see will settle at this stage, maybe more than ninety five, let's just say ninety five. Approximately ninety five percent of the cases will be done. They'll settle. It's good. You will never have to worry about your documentation. Hopefully you get paid, but it's done. If not. The next stage is mediation and arbitration. This is again not litigation, but can get complicated depending on the jurisdiction that you're working under. But long story short, again, it's not full blown. Let's litigate this case in court. They're both arguing plain if attorneys trying to talk to the insurance adjusted at this point and trying to negotiate. So it's still mediation arbitration, this process where sometimes they the other side, meaning that there may be a defense attorney at this point. Both sides are meeting and trying to reach a resolution. Nobody wants to take cases to the core or even attorneys because it's expensive, so people try to settle again, very likely at this stage, but sometimes negotiations fail. So now let's talk about litigation. You will know that a case is in litigation when you will start getting and I want to use this word harassment from a lot of third party records retrival companies. If you practice personal injury, you know what I'm talking about. For those who don't, you will start getting third party companies asking you for bills and records. And this is not from the patient's attorney side, This is just random. There's companies for that. So basically your defense side is hiring this third party records retribal companies, and they'll start sending you subpoenas for documents and things like that, so you know, okay, this is your first time knowing that this particular case is in litigation. Besides that, there's no way for you to know that because you're so busy in your practice. You're not going to call the law firm and say, hey, what's going on with this? But once you start seeing that, you know that, Okay, maybe right now they're just asking for documentation, but if they don't settle, there may be a point in the future that I may have to go and testify, either through deposition or in trial. Then comes the deposition segment. Again. Most of the cases do settle, even in the early phases of litigation, but there is a process called discovery, meaning at this stage, both parties are now exchanging evidence that they have and this is the time in a case where depositions are being taken. So there's two types of deposition. There's written deposition questions that you will receive, which is DWQ and it's mostly yes and no answers, or they may be asking you to produce records again, there's no live testimony here and catropractice are not afraid of this. It's normal business. Your staff can do all of that. They can answer the dwqs, they can do affidavits. Make sure you verify information. We want to know what information is being sent out by your staff. But it's not generally stressful. And then comes the time when you have to be the post. Now, if the pliniff attorney meaning your patient's lawyer, wants you to give an expert testimony, they'll reach out to you, generally via email. They'll ask you for an invoice, make sure you build them for your time. And this is separate from whether or not the lawyer receives a settlement and then you get paid on the lop. This is separate. This is for your time to give a testimony. So that's plaintiff attorney usually asking you an email, and you can negotiate your price per hour with them. All of that separately. They'll set it down side for you to present your deposition and we'll talk about depositions later. But sometimes you can get subpoena meaning the other side will issue you a subpoena to compel you to testify. When that happens. It's not coming from your patient's attorney. It's coming from the other side, and they are not going to pay you for that practice tip that has happened to me and I Whenever you get the subpoena, they somebody will come in deliver it to you and it will have on that subpoena. If you read it, it'll know who's doing who and you know that you're not party to the case because you're not being served, you're being subpoena. You're coming in as a witness, so your name's nowhere on the document. I mean, as far as parties are concerned. And then you'll see what they're asking in the subpoena. They're asking you to give an oral testimony and they may also ask you to bring documents. It'll have the lawyer's name on it, both for the plaintiff and the defense, so you know that this is coming from the other side and not from the patient's attorney. You can always email them and ask them to compensate you for your time. Again, it's hard because they are not legally required to pay you the defense side, but a lot of the times they'll say, sure, doctor, how much do you charge and they'll negotiate with you and then you can reach an agreement. But you have to do a little bit of persistence confidence and tell them you're busy, because we are busy. Again, settlement can reach at any stage. So they may set a date for you to do your deposition, but they can settle before that. They can settle right after your deposition. You never know when the case is going to get settled. Sometimes even before the jury, right after closing arguments, a case can settle. So settlements can happen at any state, So just be mindful of that, just because you have a trial date and you take time off of work and all of that, and you may even show up to the court and they settle that morning. So I always tell my chiropractor buddies, like, if you're going to go to court and you're taking time off, you have to ask for your money for your time, even if they settle. So that's something that you have to negotiate with the plaintiff side. Of course, the defense is not going to negotiate with you. They don't legally have to. But most of the time your plane if attorneys will say sure, we understand, things happen so communicate with them in writing and make sure that you're compensated because this is not part of your lob this is extra and know your worth. All right, let's move on to tort law basics negligence. You will not hear these terms in practice, but it's good to understand what's going on. So when a driver messes up and causes an accident, you can bring a lawsuit against that driver and bring that insurance company into that case with the vehicle of negligence. That is the legal cause of action. And in order to prove negligence, a plantiff attorney has to prove four things. Duty, breach, causation, and damages. Duty and breach is something that the lawyers have to worry about. So I'm not going to get into that, but just to explain you, duty would be it's my duty to be careful when I'm driving, and I breach that duty if I don't follow the rules, the traffic rules. So that's how they bring those elements, and evidence for those elements in courtrooms where you and I are going to get challenged as chiropractors is causation and damages. So the other two buckets causation and damages. That's where majority of our testimony will come into play. Causation is the number one battleground. Every defense attorney will target you and your notes when it comes to causation. They want to make it sound like the accident did not cause this injury. Every case they'll say it's pre existing, it didn't happen from the accident, that were exaggerating, or the client or the patient is exaggerating. That's what the defense will say every single time. It's a given. So causation is a battleground. You will use your notes to link causation. They will use your notes to make it sound like causation is poor or there's no documentation for causation. So remember causation very important. A lot of the chiropractors don't document causation at all, and we'll get into that later. Damages again, not battleground for sure, but not that difficult to prove. This is where your bills come into place. When they say bills and records, the records goes towards causation. The bills are now used to prove damages, and not only just your bills, but the entire whatever the patient did, whether the any er record, any medical doctor, any anybody that they've seen. All that becomes past medical damages. Then there are other types of damages that the plaintiff can bring future. There's past medical and there's future medical. This is when somebody is severely injured that they're going to need maybe twenty four to seven nursing facility, things like that. I'm just giving you examples. But there's also what's going to happen in the future. So past medical are your bills. Future medical is speculative in so many ways, but a clever attorney will try to make that evidence come in and get compensation for what will happen in the future. There's other types of non economic economic damages, which again you don't need to know from your perspective, but it's always good to know overall what happens in a negligence case. So let's talk about causation. Clinical causation is very different from legal causation. So when what we study in school about causation, if somebody has ridiculopathy, then you're thinking okay, and maybe a disk injury there, so that is your clinical causation. Legal causation is proving that whatever injury or symptoms this patient is presenting with is directly link to this particular accident. And it's easier said than done because clever defense attorney is well. Like I said, they have AMMO, they will use everything in your notes, any kind of past medical history to say this is pre existing, all sorts of stuff. So what can we do to make our documentation better? You have to link the injuries to the accident. So if somebody got into an accident yesterday and they presented with neck pain, don't just say they got into an accident, they came with neck pain today, because you see there is this missing piece of evidence there. You have to say they got into an accident on this particular date and because of that accident they are presenting with pain today. So just simple word connecting those two sentences now helps your notes look better. As far as causation is concerned, that is because of this accident, the patient is presenting with this symptoms. So causing, like the causation aspect, very very important. Document Make sure you document mechanism of injury. A lot of us don't do that. We just say patient presents with pain back mechanism of injury because of car accident also if there's any extremities involved for a regular spine injury neck and back. It's sort of implied at this point that if somebody has a car accident injury, whiplash injury, that it's neck and back. So we don't have to worry too much about explaining neck and back pain. But if they have knee pain, shoulder pain, ankle pain, you have to go a step forward and document that why. So always good practice to ask your patients did you hit your knee to the dashboard or if they present with wrist pain, explain where was your arm or your hand was it on the steering wheel? What happened? Get that information from the patient and document it. If they give you that information, do it. If they say, oh, I don't remember, but it hurts, then you can always document that don't remember exactly what happened, accident happened too fast, but did not have any pain before the accident, but now after the accident they said that their risk is hurting, And so that helps. Be truthful, but be persuasive when you're writing now timing of symptom manifestation again link directly towards causation. It's important that most of the time. It depends on the case. If you have a case that the accident happened recently and you saw them two or three weeks within that timeframe, it's implied the timing is easy. That's a good, good story. But you will get cases in practice that accident happened six months ago and they're having pain right now. There's not much you can do about that as far as documenting causation. But you can say, ask the patient, what did you do for this gap that six months? Did you treat at home? What happened? Why were you not able to get treatment sooner? And they'll tell you, oh, I didn't have transportation, I didn't have that. It's okay to document that. Like I said, be truthful. But these are the questions that you can ask your patient, and it'll make you not a regular chiropractor, but a well informed chiropractor who understands how to alleviate or increase the value of their notes. And so what you ask in your history matters. It's not a cookie cutter. Let me just ask all this accident questionnaire. No, no, no, think look at the date of the accident, see if there is gaps, Try and see if you get information out of them to kind of connect causation there. It'll make your notes more valuable. Acute versus chronic symptoms. This is so common every defense attorney will say, this is not a cute, this is chronic. That's where you're orthopedic testing your palpatient skills. Everything will come into play here. Your doctors, you know how to document acute versus chronic, but also know that in real life, we get our plaintiffs the way we get them, meaning every patient will have pre existing conditions and it's okay, it's fine if they have car accidents in the past, it's okay to document that. But then you can also document sure they had accident previously, that there is a history of car accident, but they didn't have much pain before this accident, and this accident exacerbated their symptoms. So one sentence can now say, sure, my patient is sixty five years old and had some arthritic changes in the spine, but it's doing fine, and now after this wreck, and if they are feeling exacerbation of symptoms, and then say that document that. So connecting again to causation will help you make your notes stronger, and that testimony is now backed up by your notes. History of past pain prior collisions, very very important. There's no such thing is hiding a bad fact. Like I said, a lot of our patients will have multiple car wrecks, or they're older, they've got other comorbidities and other issues going on. Defense will point at that, and it's fine let them. You can always say they had those issues, but this accident exacerbated their symptoms, which they did. And the next in line is that this particular phrase, reasonable medical probability, very very important phrase every time a defense attorney asks you in person or in trial or off the record, So, doctor, are you sure? Are you sure that this injury is caused by this car wreck? Are you one hundred percent sure? Well, let me tell you, doctors, you don't have to be one hundred percent sure. The legal standard is reasonable medical probability meaning more likely than not, meaning if you are about seventy percent sure that this type of symptoms will manifest after a car accident, you have everything that you need to give that statement. You don't have to be one hundred percent sure that all these injuries are because of this accident. You just have to be more likely than not sure. So The standard is reasonable medical probability and that you can say that with confidence. No one can be one hundred percent sure. Can you be sure enough? Yeah, I have reasonable medical probability that my patient symptoms stem from this particular injury. Let's continue with strong documentation. Mechanism of injury very important. Police document that, definitely document that. For extremities, do your regular range of motion testing, orthopedic testing. You can use outcome measures also vestry, and there are so many out there. INDI it's good to use those because you can use that as objective data, not just what patient is saying. But hey, look I did all this testing and proof. I have evidence to show that they were hurting and now after treatment they've gotten better progression. Things like that, you can use them. Functional limitations very very important. Don't just document pain, also document things that they are not able to do. From practice perspective, a lot of the times my patients are saying, oh the pain is same or they're not giving you much. But if you ask them or are you able to do your ADLs? Can you handle cooking, cleaning house stores? Are you able to drive like before? Can you go to the gym? Depending on patient's age and their functional activity status before the accident. Good questions to ask, and these are the things that you can ask every time they come in and document it on your soap notes to saying functional limitations, things that are not able to do like they used to before the accident. Good good documentation. Progression of care. This is something that will help you when defense will try to make it sound like your care is redundant or not medically necessary or excessive when they say, well, doctor, did you really need to see this patient twenty something times? Yes? And why? Progression of care so you don't just say pain levels went down. Also say functional limitations that you documented early are now getting better. If they're getting better, Also use your outcome measures do it again, re examine things like that to show medical necessity. This is how you build strong documentation to kind of justify the number of treatments that you're giving this particular patient. Updated diagnosis. I have seen so many chiropractors. I don't know if this is lazy conduct or I don't know why, but a lot of chiropractors stop doing re examination and they're not updating diagnosis once they get the imaging results back. So we send out for let's say MRI, you're suspecting that there is a bulging disc her needed disc. Now you have confirmation on the MRI that they do, go back and change your diagnosis. Added, it's important to update diagnosis that shows that this is not just a regular cookie cutter case that everybody has the same DIO. No, I am changing my treatment plan based off of whatever imaging I'm getting, and I'm also updating diagnosis, and so your initial diagnosis is there, but then you kind of refine it depending on what happens next, depending on the imaging finding. So if somebody may have a specific right now, maybe you just documented sprain strain at the shoulder, but now you know exactly which muscle, then be more specific. It's hard to do in practice. Trust me, I've been doing this for eight years. I see a lot and patients a month and it's just, oh, I have to do this again. But you have to because it's good and it also gives you strong notes to defend, and then you can alter your treatment plan based off of what's going on. You can document that Okay, I suspected that there was sprain strain on the shoulder, but now I know that there is I don't know, super spinnatus tair. So we've added this kind of exercises to rehab that and so that adds value to your notes and consistency. Again, because of the EHRs WUS Cairo touch or there's so many out there, there can be inconsistency, so be mindful of that. Like let's say you forgot to add the soap and you went back and you added it, and everything from the first two visits kind of rolled back into this one, so your visit fifteen has the same level of pains as visit second, and on the sixteenth again it dropped down to like nothing. So be careful. You're very busy and there may be sometimes your staff is doing the soaps for you. So you as the doctor, you're the one who's responsible for your notes. You're the one who's signing it, so it has to sound consistent. Make sure if there are gaps and treatment that you document that in things like that. Common documentation mistakes, copy paste notes. This happens a lot in practice. And when you'll find people that are in the same crash, like four people in the same car crash, right, and all four of them have the same identical diagnosis list. They have same muscular skeletal findings, and some things are going to be the same. If you treat athletes and you're treating concussion, a lot of the documentation is going to be the same. So that's my argument always like, hey, I'm a chiropractor, I see muscular skeletal injuries, I treat car accident patients. A lot of these things are going to be the same. My choice of orthopedic testing are going to be the same. But there has to be some things that are different, right, because every human being is different. So that is your job to be the best doctor that you are. Use all the training that your chiropractic school taught you, and in document things that are different. Don't be copy pasting notes. Try to find individualistic finding. It can be very simple like peal patient finding, so something that is unique to that particular patient. That's one way to negate the allegation of copy pasted notes. Gaps in care very very important. This is where defense will come in and say your patient is not hurting, Your client is not hurting, they are not coming in or you have not seen them in three months. You never did it re exam so gaps in care is always a problem. We can't control this. You can't force your patient to come in. You can recommend them. That's the best you can do. So do your best to document gap here, Ask them what happened, didn't have transportation, rated, was traveling? Was sick? This? That the other. If they give you answers, document and do your best. If they don't give you answers, there's nothing you can do. It's not much you can control in this area. But educating your patient is important. Definitely communicate with them, have your staff communicate with them. Let them know gaps is bad, bad, bad. And if there's a really humongous gap, like re exam, please please do a re exam. Inconsistency we talked about that already. Over and under treatment another way. Defense will like to target our notes. They'll always say they'll always say you treat them way too many times, and lately they're saying under treatment, which is a new one that I'm seeing. So yeah, they will always attack you on that. Be confident in responding to these answers. If you documented that many visits, you documented that many wizards, it's industry standard, and stick with it. Be confident when you answer these questions, if you yourself seem defeated when answering those questions and you feel like if you're not confident in your own notes, like how are you going to convince a jury, let alone a defense attorney. So make sure that if you set a treatment plan that you're one hundred percent by it. I don't want to say what number is, Okay, one number is not. It really depends on the patient. We are. We're very patient centric, and we make the decision based on the client, on the patient, not like this scale of this number of sessions for every patient. Now it's just patient dependent and it depends on many, many, many, many factors, comorbidities and age of the patient, how active they are, the severity of their injuries, things like that. Okay, last, but not the least. Please please cairopractors, if you take one thing, one thing from this webinar, do not do not document attorney driven care. What do I mean by that? I have seen notes where chiropractice are written attorney denied, MRI attorney approved, MRI attorney did not approve additional treatments. Please don't document that. It's common sense, but people do it. All the time. I understand what you're trying to communicate there. Maybe there is some way you're trying to document that I did my due diligence. I think the patient needs MRI, but the attorney denied it. When you document things like that, you're saying that it's attorney driven medical care, and that's going to be a big no no. It's a major red flag, not only for that case that you're asked to give a deposition for, but overall for overall ethics. We can't have attorneys practice medicine. We can't have attorney's practice chiropractic care. It's your call, So please refrain from documenting that. Even internally a lot of these internal notes are now being discoverable. So be very careful if imagine that these documents are being read in court and you not want to write something that you can get in trouble with. Let's talk about affidavits and subpoenas. So subpoenas, like we already discuss, you can get subpoena by the defense attorney to come and give a deposition. Besides that, you can also have subpoenas for documents records with trival companies. Third party companies will give you those subpoenas, and they can be really broad. If they are asking for information such as your internal notes or your communication with the plainiff attorneys. That's too broad of a skull and they should not be asking, but they will, so I recommend that if you feel like they're fishing for information, reach out to the PLANEFF attorneys. Sometimes you may have to get your own lawyer to quash those because that's not right. But they'll try their best, and it's annoying, but we all have to deal with that. You can charge them for providing them with records reasonable fee, and they're not your friends, so it's okay to buy time and make it difficult for them. Sometimes I ask them I will release it once your check is cleared, to make sure I'm getting paid for it. But yep, you will see that a lot in practice, so be careful. You don't have to worry about doing them yourselves, especially the written questions that yes and no the dwqs. Your staff can do them. Your staff can sign them, but at the end of the day, your license on the line, so I always review it. If it's standard, they'll know what to do. But if they're asking for very detailed, complicated language. Look it up, hire a lawyer. If you need to depositions, we have to do another seminar. But yeah, depositions basically plain. If attorney or defense attorney asking you questions, it's testimony under oath. It can be online or in person. Back in those days they used to come into your office and do it. Now most of these are done on zoom, but they can still come in office and do it. It's not done in the court. It's testimony outside the court. But because it's basically testimony that can be used in court. So if you're not going to be available to give your life testimony in court, a lot of the times it's recorded in a deposition setting, and that way they can use that instead of you going to court the court reporder's presence, so everything that you say is going to be transcribed and every time you say and and all of that also gets documented. So sometimes when you read it, like ah, it sounds cringe, but it's the nature of the game, and so it's important that you prepare for deposition. It can be really long, anywhere between two to six hours depending on the case, and it can be used for more than one case. Doctors don't really pay attention to that, but true, a deposition that you may have given two years ago for this particular attorney can be used for a case that's coming up three years from now, or if they're trying to find or come after you, they can use that. So that's deposition. We have to do another webinar for that. But you can always use your own lawyer if you're really intimidated or you feel like they're trying for you to give statements that has nothing to do with the case that you're being called to do a deposition for. So it's this person suing this person. You are a fact witness, but they're asking you all the questions pertaining to where you're working and other stuff has nothing to do with that, and you're suspecting some kind of weird things happening. Yeah, just call an attorney, have them come in. There's so much more that lawyers can do to protect you in a deposition settings, but majority of the times is related to the case. You can charge them a reasonable fee and you can give you a testimony, and we can't. In giving the testimony, defense will try to attack your credibility and deposition. Main thing they'll try to say, you don't know what you're talking about, that it's all attorney driven treatment. Everything is over treatment for them. They'll say the treatments are not medically necessary. They'll say or MRIs if we're not necessary, that you have a financial gain or incentive for sending them out for imaging testing. They'll attack you in a scope of practice. For these are for dcs that have a DC and P setting that they are doing not only chiropractic care but also a little bit of medical in there, so they'll try to attack you on those. They'll find documentation gaps and then long story short, the goal for deposition is to make you look like you're not smart enough or you're lying in front of the jury and our jury, depending on the jurisdiction that you're from, sometimes there's a jury bias. Still people think that chiropractic take care is not as credible as medical care. That they think that we're not perfect doctors or good doctors or real doctors, and so they will try to attack you on the jeury bias. So what do you do? You talk about your amazing education that your school gave you, all the science classes, that you've taken and that you've been doing this for this many years. And when you start talking and you're using just the right amount of medical knowledge with plain language that somebody else will understand, then this goes away so very quickly, the jeury bias goes away as they start listening to you. You have to sound smart and confident, because guys, understand this. You're not giving a testimony to your professors. You're giving a testimony to a juror that whose education level is probably no more than ninth grade education, and that's what they teach us in law school. So you have to use simple language and not sound arrogant, but also at the same time confident and explain them what chiropractors do and how we help this patient and be confident. E whether that's deposition or life testimony, it's important that you believe in your treatment and you believe that you're in a profession to help people. And it radiates in the way you communicate, how to have a handled a position. Answer only what is asked. Please remember, defends counsel not your friend. Plaintiff counsel also not your friend. You are not here to build a case for them. You're just defending your notes. You're not really defending the client. That's the lawyer's job. Let the lawyer defend the patient. Let the lawyer make or break the case for the patient. Your job is to stay focused on your notes, So answer only what is asked, stay within your skulle. Plaintiff attorneys are notorious for asking you a questions that are outside your scope. Your patience attorney will ask you, so, doctor, do you think the surgery was necessary? Or do you think the surgical bills are industry standard? Or they'll ask you about accident reconstruction, and it can get murky. Sometimes you have credentials to talk about it, depending on the person who's doing the depending on the doctor. Some doctors don't. And so it's okay to say that's not within my scope. It's fine even if that upsets them, that's okay. But stay within your scope. That will protect your license and your credibility. It's okay to say I don't know, please do not guess. That again, goes down to credibility. If you're honest, people can see that. Defend your notes, not the patient, very very important. Don't go out of your way in making a case. For the patient. That is not your job. Let the lawyers do that. If they're a good lawyer, they can handle it. If there's a bad fact, it's okay. Let the lawyer be the lawyer. You're not the lawyer, you are the doctor. You are defending your notes. Please do not lie, because that's perjury. You can use a license for that, So no lying. If you don't know, you can always say I don't know. It's based off of your personal knowledge. If you don't have the personal knowledge, don't answer it. Just say I don't know. It's okay to say that. Trial testimony looks very similar to deposition testimony, but it's high stakes. Why because it's live. In trial, there is a judge there. In depositions, you don't have a judge, so even if the other side objects, there is no life ruling on the objection, But in trial testimony there is, which makes it easy for us as experts to give our testimony because it's short. They're not going to hold you in court for four or five hours. You may be waiting for your turn, but you're not giving a testimony for that long. It's pretty quick. It's fast, it's very jury focused, so simple language is the key. You have to sound confident but not arrogant. You have to you don't have to be necessarily charming, but you don't also have to sound or somebody who's industry expert like. You're not giving a testimony to your professors of your catapractic school. You're talking to somebody that will believe everything that you're saying if you're saying it right. So make sure that you understand who your audience is. That adds value to your testimony. If I'm giving a testimony to my professor, I'm going to be scared because i have to justify everything. But when I'm answering it to my mom or I'm explaining why I'm to my patient, for example, why I'm explaining to my patient why you need to come in for this many number of visits, I'm able to do it more confidently. So always remember that your audience last, but not the least. That wraps up Part two of our conversation with doctor Panktifidia. In this episode, we move beyond documentation and into the realities of subpoenasard's requests, depositions, trial testimony. We talked about expert witness credibility and the ethical considerations that come with working in the PI or personal injury space. One of the biggest takeaways from this conversation is that chiropractors don't need to be afraid of the legal process, but they do need to be prepared. That means knowing your documentation, staying within your scope, answering only what is asked, avoiding speculation, and understanding that your job is not to defend the patient's entire case your job, your most important role, is to explain and support the care that you provided. Doctor Fidia also gave an important reminder that professional credibility starts long before a deposition or courtroom testimony. It starts in the exam room, in your clinical reasoning, in your documentation habits, and in the way you communicate your role as a healthcare provider. And perhaps most importantly, this episode is a reminder for healthcare providers to take pride in the value of conservative care when documented clearly and delivered ethically. The work that you do matters not only for the patient's recovery, but also for how that care is understood and represented when it becomes part of a larger legal process. A huge thank you to doctor Panktifidia for sharing her unique perspective as both a practicing chiropractor and a soon to be attorney, and for helping providers better understand how to navigate this complex intersection of healthcare and law. As always, thanks for listening to the Factor podcast. Be sure to subscribe, follow, or share this episode with a colleague or friend, and we will look forward to seeing you next time. Hey guys, if you like what you heard today, I encourage you to visit our website at Factor hyphenstore dot com that's spelled fak tr hyphenstore dot com to find out more information about all that we have to offer. We have a variety of online offerings as well as our hands on Factor Rehab System course scheduled in cities around the globe. Be sure to also check out our event calendar and bookmark any of these upcoming live webinar dates coming up in the near. Future so you can join us live. 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