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Dr Asef Zafar - A GP Medico-legal Profile and Opinions on the MedCo Changes

Medico Legal

Dr Asef Zafar is a GP medico-legal expert currently working across the accident medical and clinical malpractice industry.

General Practice (GP) Expert Witnesses are tasked with writing reports for court cases and pre-court discussions. As a GP expert witness Dr Zafar is flexible in his skillset and abilities, being able to write detailed reports on soft tissue injuries, recovery times and the related psychological impacts. He performs examinations in his many local venues and normally turns around the report the same day.

He regularly holds each of his venues across the South-East of England and sees several thousand clients a year in his different clinics. This large inflow of clients and a background of 20 years as a general practitioner allows Dr Zafar to hold experience in many different types of injuries and the different mechanisms at their causes. Dr Zafar regularly sees clients with a wide mix of varied symptoms, from complex whiplash injuries to simple lacerations, salon-negligent burns to needle-stick injuries and much more. This ensures that Dr Zafar stays on top of the regular changes that happen throughout the industry and that he holds the latest knowledge on how long each injury is likely to last.

Dr Zafar works with both solicitors and medical bookings agencies and has a vast experience in report writing. This experience in report writing is complemented by intensive industry-specific training courses with Bond Solon and CertMR to ensure that all his reports are produced to an extremely high standard. This training also focusses on the necessary skillset to provide confident and precise facts and opinions when called to give evidence in court. He holds a team of dedicated secretaries to maintain his diaries and to book in clients. This team of secretaries is also responsible for making Dr Zafar’s clinics run smoothly by ensuring that all the client’s details are received and entered into the system, phoning all of the clients before a clinic and making sure that they know when and where the appointment will be held (in addition to the appointment letter that each client is sent) and giving directions to ensure that all clients attend on time. The team of secretaries is always ready to help clients with any queries that they may have, starting at 8am on a clinic day to ensure that anyone lost before the clinic can receive directions and finishing at 7pm most days to ensure that directions can be given to people who work in the day. Dr Zafar has noticed a significant positive impact in attendance since the secretarial team has started to telephone clients. The clients that do not answer their telephones to confirm their attendance are also noted to be the least likely to attend. Patients arrive at the venue to be greeted by the doctor’s full time clinic co-ordinator, who takes the clients through to the waiting room and shows them to the doctor at their appointment time.

Dr Zafar’s venues are all based in and around the South-East of England. This gives clients a wide choice of locally available venues and ensures that most patients are happy and able to attend. He currently holds venues in the following areas: East Ham (London), Watford, High Wycombe, Crawley, Tunbridge Wells, Southampton, Chelmsford, Southend, Colchester, Ipswich, Norwich, Cambridge, Brighton and Barking (London). These venues are all held at least once a month and are carefully selected, with dedicated waiting rooms and private but comfortable examination rooms. Where possible Dr Zafar chooses venues with on-site parking, but obviously in some of the town-centre venues this is sometimes unobtainable. Dr Zafar always makes sure that at the one or two venues where parking is not available, there is public parking available nearby. Dr Zafar employs a team of secretaries to help clients find the venues and they will often try to make contact with the client beforehand to advise them of the nearest car park. Where a patient cannot attend an appointment, the doctor can give quotes for a
home/prison visit.

Home visits rely on one of Dr Zafar’s main skillsets, his impeccable bedside manner and consistent ability to provide a sense of comfort and ease amongst
patients. He is able to examine the client in the comfort of their own home and instil a sense of calm amongst his patients; this calming influence can often be seen through the reports as a calmer patient often tends to remember key details that are often lost in stressful moments.

Prison Accidents occur more often than some may think and Dr Zafar rarely goes a month without seeing one or two of these clients. This can cause quite an impact to his day, as often he will wait in the prison reception for a few hours just to see the client for just under an hour. These visits regularly produce some of Dr Zafar’s most difficult cases, with symptoms that could be permanent and prisoners with an already low mood being subjected to further anxieties and
stresses. Dr Zafar has spent some time as a Locum General Practitioner working in Prisons, allowing him a great deal of insight into how the health care system works inside prisons, where the possibility for an oversight can occur and how best to treat a patient with the sometimes limited resources available. This has also allowed him to comment upon and write several medical negligence reports set in the prison setting.

Alongside prisons, Dr Zafar has also spent time working in Hospitals, GP Practices and on Army bases. This has allowed him a detailed view of the National Health System, including the places where resources and abilities may be stressed. This in-depth view of the different aspects of the Medical industry as a whole has given Dr Zafar a great deal of understanding of the areas in which a patient may have been given under-satisfactory care. This experience is the background that he draws from when producing reports for his Medical Negligence cases.

Medical malpractice is a busy area of the medico-legal field; supplying the doctor with interesting cases which often contain more than meets the eye. These cases are often won or lost on the quality of the doctor-in-question’s notes, with this being a large factor in the review of the case. Dr Zafar’s reports on Medical malpractice take the standpoint of an ‘ordinary GP’, looking at what should and would have been done by another doctor had they been faced with the same decisions. This type of report often focusses heavily on the patient’s psychological state of mind and how the accident has affected them through its long term impacts.

As a GP Expert witness, Dr Zafar has been working through the recent MedCo changes to the industry. This wide sweeping series of changes was kick-started in April this year with an aim to improve medical reporting and tackle fraud throughout the medicolegal industry. These changes started with a rush for many medical experts and reporting agencies to sign up and register. The MedCo system has been met with some dismayed complaints, following delays and a lack of explanation of many of the features. Through the MedCo system, client cases are allocated to a list of randomly selected experts and agencies, for the instructing party to make the final choice. This in practice has seen a shake-up of the current system, with larger agencies immediately noting a drop in instructions that took several weeks to start to even out. Smaller agencies however seemed to take a boost in instructions during this time, with many bursting forth with instructions and requests for terms of contracts. This sudden instability across the positions of the medical agencies was initially a little shocking for Dr Zafar and his company, but his mix of venues and consistent reputation for quality has helped him to maintain a comfortable level of instructions as the market continues to re-settle into its new position. One noticeable feature of the new MedCo system is the influx in Direct Expert instructions. These instructions -which are notable for the solicitor instructing MedCo registered experts directly- seem to be consistently on the rise.

From the initial requests from some solicitors wanting to test the waters, Dr Zafar has seen a surge in confidence and satisfaction amongst Direct Instructed cases, with many solicitors coming back to instruct him with several other cases. Writing reports directly for solicitors is nothing new for Dr Zafar, who has been requested several times in the past to write these. What is quite new however, is the large names in the industry that are now coming through with requests for direct instructions; A sure sign that the industry and its changes have not yet stopped transforming into the new set roles that will ultimately come of them. This does however seem to suggest that now is the time of the Direct Instruction, with solicitors and law firms large and small seeking to do away with much of the indirect communication that seems to delay and confuse difficult cases. Dr Zafar returns most reports the same day as the medical, examination avoiding needless delays and waiting on case handlers to send on the same. This seems to be one of the more sought after features of Direct Instructions, as solicitors race to get their cases completed sooner and take on the next from the ever growing piles of instructions.

MedCo definitely brings its own spectrum of advantages and disadvantages to the several different types of users in the medico-legal market. For the law firms and solicitors it pushes a divider between them and their regular agencies. This obviously will ruffle a few feathers in the market, but pushes a distinct advantage to the smaller (2nd Tier) agencies who are now being considered for cases that would have otherwise been given to someone else. From the patient’s perspective however, this allows for a lot more risk as they are now being examined by a doctor who the solicitors have not previously vetted. This twist of changes has obviously affected some parties more favourably than others. This has the potential to improve somewhat however as MedCo has previously expressed a desire to internally vet each expert to assure their consistent quality.

So as large agencies are shrinking and small agencies are on the up, direct experts are being given their fair time to shine. As a choice in a completely fair market they seem to be growing in consumer confidence, a decision helped no doubt by the fact that many experts’ names will be recognised as being on several of their past reports. This shake up was made with the intent of leaving fraudulent claims very little room to hide; Whether this has proved effective will need to be seen over the next few months and years, but for the time being it appears clear that now they have sailed over the majority of the early turbulence,
MedCo is here to stay.

With regards to future MedCo decisions however, it is unclear when they will come and in what order. There has been talk of instituting a vetting system for all experts, deciding a stance of action on the multiple MedCo agencies and streamlining the current instruction system, but without much more information released on these as yet. Small changes seem to be made to MedCo as and when they are deemed necessary; including the recent changes to allow solicitors to add multiple clients to a case so that linked cases can be seen together. This was becoming a readily apparent issue as patients were somewhat understandably refusing to be booked when their relatives were being booked elsewhere with another expert. Another recent change for the better is
allowing solicitors to see direct experts full consulting addresses, targeting recent complaints about the systems confusing layout.

Dr Zafar is looking forward to what the future of the industry may hold. The MedCo shake up is an exciting prospect that could potentially lead to beneficial changes across the wider industry. With a bit of work and a little clearing up he believes that the system could be made to work in the future. The larger agencies that are currently struggling seem to be facing an even further uphill battle, as the good reputations and relationships that they have built up over the last few years are put under more stress than ever from the new regulations and working practices. Smaller agencies and direct expert instructions seem to have more potential to ride out the storm, but seem to be lacking an independent assurance of quality. In conclusion, Dr Zafar feels that whilst MedCo is here
and now, the future regulations and reviews to come will be the true test of the industry’s future.

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