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

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, 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 2-part conversation with Dr. Pengti Fadieh, DC, MBA, on what chiropractors need to know when clinical care intersects with the legal system. In Part 1, Dr. Fadieh 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 2, we'll move deeper into what happens when those records are requested, questioned, or used in legal proceedings. Dr. Fadia 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 2 of Clinics to Courtrooms with Dr. Pengti Fadieh.

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. The 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 alive 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-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 at 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 plaintiff 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. So most cases, about 95% of the cases that will— that you'll see will settle at this stage, maybe more than 95. Let's just say 95, approximately 95% of the cases will We'll be done. They'll settle. It's good. You will never have to worry about your documentation. Hopefully you get paid, but yeah, 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. Plaintiff attorney is trying to talk to the insurance adjuster at this point and trying to negotiate. So it's still mediation, arbitration, this process where sometimes 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 court, 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 retrieval 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 the defense side is hiring this third-party records retrieval 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 2 types of deposition. There's written deposition questions that you will receive, which, 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 chiropractors 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 deposed. Now, if the plaintiff attorney, meaning your patient's lawyer, wants you to give an expert testimony, they'll reach out to you generally by email. They'll ask you for an invoice. Make sure you bill 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 via email, and you can negotiate your, your price per hour with them, all of that separately. They'll set a date aside for you to present your deposition, and we'll talk about depositions later. But sometimes you can get subpoenaed, meaning the other side will issue 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 and deliver it to you, and it will have on that subpoena if you read it, it'll know who's suing who, and you know that you're not party to the case because you're not being served. You're being subpoenaed. 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, and 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, 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, like right after closing arguments, a case can settle. So settlements can happen at any stage. 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 plaintiff attorneys will say, sure, we understand things happen. So communicate with them in writing and make sure that you are compensated, cuz this is not part of your LOP. 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, 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 their insurance company into that case with the vehicle of negligence. That is the legal cause of action. And in order to prove negligence, a plaintiff attorney has to prove 4 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, your 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 2 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 preexisting, it didn't happen from the accident, that we're 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, don't document causation at all. And we'll get into that later. Damages, again, not a 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 entire whatever the patient did, whether they 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 24/7 nursing facility, things like that. I'm just giving you examples, but there is 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 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 radiculopathy, then you're thinking, okay, it may be a disc injury there. So that is your clinical causation. Legal causation is proving that whatever injury or symptoms this patient is presenting with is directly linked to this particular accident. And it's easier said than done because clever defense attorneys will, like I said, they, they have ammo. They'll use everything in your notes, any kind of past medical history to say this is preexisting, all sorts of stuff. So what can we do to make our, 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 2 sentences now helps your notes look better as far as causation is concerned. That is because of this accident, the patient is presenting with these 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 neck pain, back pain. 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, well, where was your arm or your hand? Was it on the steering wheel? What happened? Get that information from, from the patient and document it. If they give you that information, do it. If they say, Oh, I, I don't remember, but it hurts. Then you can always document that. Don't remember exactly what happened. The accident happened too fast, but did not have any pain before the accident. But now, after the accident, they said that their wrist is hurting. And so that helps. Be truthful, but be persuasive when you're writing. Now. Timing of symptom manifestation, again, linked 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 2 or 3 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 6 months ago and they're, 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 6 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, this is so common. Every defense attorney will say this is not acute, this is chronic. That's where your orthopedic testing, your palpation skills, everything will come into play here. You, you're 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 preexisting 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 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 65 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, 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 as 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 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 100% sure? Well, let me tell you, doctors, you don't have to be 100% sure. The legal standard is reasonable medical probability, meaning more likely than not, meaning if you are about 70% sure that this type of symptoms will manifest after a car accident, you have everything that you need to, to give that statement. You don't have to be 100% 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 100% sure. Can you be sure enough? Yeah, I have reasonable medical probability that my patient's symptoms stem from this particular injury. Let's continue with strong documentation. Mechanism of injury, very important. Please document that. Definitely document that for extremities. Do your regular range of motion testing, orthopedic testing. You can use outcome measures, Oswestry, and there are so many out there, NDI. It's good to use those 'cause you can use that as objective data Not just what patient is saying, but, hey, look, I did all this testing and I have 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, are you able to do your ADLs? Can you handle cooking, cleaning, house chores? 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 they're 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 20-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, reexams, 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 reexamination 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, herniated disc. Now you have confirmation on the MRI that they do. Go back and change your diagnosis. Add it. It's important to update diagnosis. That shows that this is not just a regular cookie-cutter case that everybody has the same diagnosis. No, 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 findings. So 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 8 years. I see a lot of new 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 of the shoulder, but now I know that there is, I don't know, supraspinatus tear. 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 that we use, ChiroTouch, or there's so many out there, 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 2 visits kind of rolled back into this one. So your visit 15 has the same level of pains as visit 2. And on the 16th, again, it dropped down to like nothing. So be careful. We'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 in treatment that you document that and 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 4 people in, in the same car crash, right? And all 4 of them have the same identical diagnosis list. They have same musculoskeletal findings. And some things are gonna be the same. If you treat athletes and you're treating concussion, a lot of the documentation's gonna be the same. So I, that's my argument always like, hey, I'm a chiropractor. I see musculoskeletal 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 document things that are different. Don't be copy pasting notes. Try to find. individualistic finding. It can, can be very simple, like palpation findings, something that is unique to that particular patient. That's one way to negate the allegation of copy-paste 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 3 months. You never did a reexam. 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, but that's the best you can do. So do your best to document gaps in care. Ask them what happened. Didn't have transportation, right? Was traveling, was sick, this, that, the other. If they give you answers, document it. 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, they'll always say, they'll always say. You treat them way too many times. And lately they're saying undertreatment, which is a new one that I'm seeing. So yeah, they'll always attack you on that. Be confident in responding to these answers. If you documented that many visits, you documented that many visits. It's industry standard. Stick with it. Be confident when you answer these questions. If you yourself seem defeated when answering those questions and you feel like, I think I— if you're not confident in your own notes, like, how are you going to convince a jury Let alone a defense attorney. So, so make sure that if you set a treatment plan that you are 100% by it. I don't, I don't want to say what number is okay, what 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, chiropractors, 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 chiropractors have 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 somewhere you're trying to document that I, 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 are asked to give a deposition for, but overall for overall ethics. We can't have attorneys practice medicine. We can't have attorneys 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 would not want to write something that you can get in trouble with. Let's talk about affidavits and subpoenas. So subpoenas, like we already discussed, you can get subpoenaed by the defense attorney to come and give a deposition. Besides that, you can also have subpoenas for documents. Records retrieval 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 plaintiff attorneys, that's too broad of a scope 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 plaintiff attorney. 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 like make it difficult for them. Sometimes I ask them, I'm— I will release it once your check is cleared to make sure I'm getting paid for it. But yep, you'll see that a lot in practice. So be careful. You don't have to worry about doing them yourselves, especially the written questions, the 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 plaintiff 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 the 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 live 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 reporter is present, so everything that you say is going to be transcribed. And every time you say and, and, uh, all of that also gets documented. So sometimes when you read it, like, oh, 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 2 to 6 hours depending on the case, and it can be used for more than one case. Doctors don't really pay attention to that, but it is true. A deposition that you may have given 2 years ago for this particular attorney can be used for a case that's coming up 3 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 are working and other stuff has nothing to do with that. And you are 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 it's related to the case. You can charge them a reasonable fee, and you can give your testimony and be confident in giving the testimony. Defense will try to attack your credibility in 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. Overtreatment for them. They'll, they'll say the treatments are not medically necessary. They'll say your MRIs were not necessary, that you have a financial gain or incentive for sending them out for imaging testing. They'll attack you on a scope of practice for— these are for DCs that have a DCNP 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 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 jury bias. So 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, 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 jury bias goes away as they start listening to you. You have to sound smart and confident because, guys, understand this, you are not giving a testimony to your professors. You're giving a testimony to a juror whose education level is probably no more than 9th 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, whether that's deposition or live testimony. It's important that you believe in your treatment and, and you believe that you're in a profession to help people, and it, it radiates in the way you communicate. How to handle deposition? Answer only what is asked. Please remember, defense 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 scope. Plaintiff attorneys are notorious for asking you questions that are outside your scope. Your patient's 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 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. Stay within your scope. That'll protect your license and your credibility. It's okay to say, I don't know. Please do not guess. That's, 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 lose 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 live 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 4 or 5 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—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 chiropractic 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 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 2 of our conversation with Dr. Pengti Faddea. In this episode, we move beyond documentation and into the realities of subpoenas, records 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. Dr. Fadilla 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 Dr. Pankti Faddea 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-store.com. That's spelled F-A-K-T-R-store.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. And of course, the biggest compliment we can receive is for you to help us spread the word to your friends, colleagues, and classmates. You'll find all the important links as well as info about our sponsors in the show notes, so be sure to check those out.