The number one factor driving the costs in medical malpractice cases are medical expert witnesses. This is especially true when a nationally recognized expert is utilized to testify on behalf of the patient. Because of the reluctance of most local physicians to testify in their own state against local physicians, most medical expert witnesses must be obtained from out of state. This drives the cost of medical malpractice cases higher.

Most medical experts charge between $350.00-$500.00 per hour to assist with the case. If a medical expert is to be used at trial, the rates go even higher. Some experts charge $2,500-$4,000 per day for travel and testimony time.

Many medical malpractice cases require the use of several different expert witnesses. For instance, in a failure to diagnose cancer case an expert will be needed to testify that the initial physician erroneously missed the cancer and an oncologist or surgeon will be needed to testify about the consequences of the delay in making the diagnosis in terms of the patient's prognosis.

Qualified, top-notch medical experts are busy people. Most have ongoing medical practices. To set aside an entire day or week for testimony requires them to cancel or not schedule patient appointments thereby causing the loss of substantial income they would have otherwise received. Of course, the lawyer will want to make sure that those experts are intimately familiar will all aspects of the case which will require the expenditure of funds at the physician's hourly rate for preparation time for the deposition or trial.

Many expert witnesses require that a retainer of several thousand dollars be sent in advance of their review of the records which will be deducted for the time spent reviewing the case. Others have a set per diem charge they assess to travel out of state or for deposition testimony.

In a typical case, the same medical expert witness will review the records no less than three times. The first time he reviews them he does so to screen the case for merit. He reviews them again in preparation for his deposition, which is often taken 8-10 months after his initial review and he reviews them for a third time in preparation for the trial of the case. Since most cases involve volumes of records, the review process alone can be quite expensive.