Over the past several months, as I’ve taken on more medical-legal work, one of the most valuable lessons I’ve learned came during preparation for a high-profile civil case in which I was retained as a rebuttal and impeachment expert for the defense.

Although I ultimately was not called to testify, the preparation process itself was eye-opening. The attorneys emphasized something that runs counter to a surgeon’s instincts:

In expert witness work, you must stay strictly within the scope of what you were retained to address.

It sounds straightforward, but for physicians—and particularly for surgeons—this discipline requires conscious effort. In clinical practice, we are trained to think broadly, anticipate unexpected findings, adjust our plan during surgery, and solve problems in real time. No two patients are exactly alike, and our specialty values adaptability.

Plastic surgeons, in particular, may have both an advantage and a challenge in this regard.
We tend to be strong listeners and careful observers, comfortable with nuance and problem-solving—qualities that help maintain focus on the specific question at hand. At the same time, our clinical mindset is built around improvisation and changing course when needed. In the operating room, expanding your thinking is often essential; in the legal arena, expanding your opinion can be a liability.

The message I received from counsel was clear:

• Don’t broaden your opinion.

• Don’t answer questions you weren’t asked.

• Don’t drift into issues outside your assignment.

• Deliver a focused, narrow, objective expert opinion—and nothing more.

This became especially apparent when compared with some of the plaintiff’s expert opinions in the case, which wandered far beyond the actual issues in dispute. That contrast reinforced the importance of providing opinions that are precise, grounded, and directly tied to the medical questions relevant to the case.

Even though I wasn’t called to the stand, the preparation itself was invaluable. It shaped how I now approach expert witness work—with clarity, restraint, and an understanding that sometimes the strongest, most defensible position is the narrowest one.

I look forward to sharing more reflections as I continue to grow in this field.

— Donald I. Altman, M.D., M.B.A., M.L.S.
Plastic Surgery Expert Witness & Independent Medical Examiner
Email: donaldaltmanmd@gmail.com