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At the heart of general practice since 1960

Practice is a walking centre

From Dr Vaughan Smith

Taunton, Somerset

I was interested to see your article on GP traffic injury reports (News, 19 November). Until last year I did a great deal of such medicolegal work myself, both for agencies, and directly for solicitors.

I gave it up last year because I was tired of seeing patients who didn't want to get better, and felt I was fuelling the compensation culture.

I agree that the agencies generally have a poor track record. I found several that were entirely unprofessional, treated their GP 'experts' with contempt, clearly got pretty rich themselves, and passed on only a small proportion of the proceeds to the GP.

Many of them were slow to pay, and I had to use the Small Claims Court on two occasions over the years.

My advice to anybody going into this field would be:

· Have an obsessively clear written contract with the solicitor or agency in advance of each case, stating precisely what will be paid and when.

· Try to work directly with solicitors whenever possible.

· Try to have a very efficient secretarial and IT system.

· Plan for appointment lengths of at least an hour.

· Set aside a half-day for doing the work.

·Negotiate a fee in advance, and refuse to see the client in future until this has been paid as DNAs are not infrequent.

· Maintain your professional integrity. Give a good-quality report promptly, but make sure you're impartial ­ remember you're working for the court rather than the claimant.

· In particular, when (as is so often the case) the claimant alleges severe continuing symptoms but has not sought any treatment for them, highlight this in your report so that the court can draw the obvious conclusions.

· Remember, a small number of claims are fraudulent, relating to accidents that either never happened, or were self-induced. If the accident wasn't witnessed, and the injuries weren't objectively corroborated, highlight this in your report.

· Keep an open mind. Many claimants have suffered a genuine injustice and deserve some compensation.

· Don't be too anxious about having to defend your opinion in court. I did well over 1,000 reports over a 10-year period and never had to go to court. But do bear in mind that it is a small possibility, and be prepared to defend your opinions with objective evidence in the form of your clinical findings, medical experience, and papers from the literature.

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