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—Plaintiffs whose attorneys retain Dr Coyle to review an alleged medical liability case are indeed fortunate, as Dr Coyle's approach takes into account the costs that must be borne by those plaintiffs to retain an expert witness to review a claim, even where it is determined that liability does not exist. However, Dr Coyle's letter raises an important problem inherent in the current civil justice system—that of access to the system and the attendant costs of access. Plaintiffs' attorneys must hire costly medical experts to review cases and to testify in court in support of the plaintiffs allegations. Those plaintiffs who have lesser amounts of damages often cannot find an attorney to represent them, because any anticipated payment, whether by way of settlement or verdict, will be insufficient to yield an adequate contingency fee for the plaintiffs attorney and to cover the high costs of expert witness(es).In
Johnson I. Reviewing Potential Malpractice Cases-Reply. JAMA. 1992;267(19):2604. doi:10.1001/jama.1992.03480190046022