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Expertise is transient but renewable. It is insufficient to know, without the capacity to critically think about the information and apply it accurately.

Spine Med-Legal

Dr. Dillin has performed med-legal reviews since 2004. He keeps an active Rule 26. He has testified predominantly in California trial courts and federal court, but has also appeared in legal proceedings in multiple states.

  • Independent medical evaluations – Physical spine exam
  • Independent medical evaluations – Verbal summary
  • Independent medical evaluations – Written reports
  • Independent medical reviews – Verbal summary
  • Independent medical reviews – Written reports
  • Tele-Legal Video Conferences (Zoom)
  • Mediations & Depositions
  • Arbitrations & Exhibits
  • Trials & Exhibits


Teleconferencing has shortened the space between all of us. During the COVID era, we learned that depositions, arbitrations, and even trials could take place over Zoom.

Tele-legal services are offered to supplement traditional physical presence. Often visual explanation clarifies when words alone might not suffice.

Tele-legal defines a new, exciting, and innovative communication tool. Physical presence is preferred for the direct impact at arbitration and trial.

Tele-legal is an enhancement, not a substitute for traditional med-legal services.

What we know?

Richard Rothman, MD, PhD, developed the first algorithms used in spine surgery. The value of the organized evidence-based decision-making pathway allows the best clinical decisions in the context of the best available science.

It was an honor to spend one year with Dr. Rothman and Dr. Simeone during my spine surgery fellowship. They clearly shaped my subsequent clinical spine practice, and their influence continues to this day.

How do we use it?

Pat Croskerry, MD, PhD, is a pioneer in critical thinking in medicine, and the analysis of errors in diagnosis. As Director of the Teaching and Assessing Critical Thinking Program at Dalhousie University Medical School, Halifax, Nova Scotia, Canada, he provided his distilled knowledge in understandable and practical terms, so clinicians could incorporate “error reduction” into their individual clinical practices. Expertise is transient but renewable. It is insufficient to know, without the capacity to critically think about the information and apply it accurately.

Old Thoughts

In 1989, I wrote the following in an invited article titled, ‘A Fellow’s Education.

“My attention returned to the spine. I find myself immersed in its categories. I wonder if I have a philosophy. I resist its definitions. I tell myself it is unnecessary to verbalize it; it has simply been assimilated like oxygen. I have continued to study, directing my efforts towards biology and the mechanisms of its expression, accounting for the accuracy and scientific basis of the thought processes, facilitating the explanation of abstracted concepts, and above all, a willingness to challenge even my most cherished assumptions.

I read more articles about basic science and the natural history of disease. I rustle through the data on the accuracy of diagnostic tests, the correlations of historical facts, and physical exams with certain pathologies. I analyze the clinical trials and their conclusions with the objective measure of accepted scientific methodology before leaping toward answers. I’ve begun to form an idea of what I know about the spine and what I don’t know, and I have an idealized concept of what might be.”


It’s 2024, and as I re-read my 1989 article, nothing has really changed. I have given a lot of thought to this seismic undulation beneath the surface of what we do. I have concluded: process leads to product. You should be able to explain how you got there.

So, when it comes to expertise, a little humility is needed. “Everybody is ignorant, only on different subjects.1” Will Rogers cast the position perfectly.


1 . Will Rogers (Forman M (ed.): The World’s Greatest Quotations. New York: Exposition Press. 1970.