Seventeen years in emergency departments and urgent care. Currently lead physician associate at a Connecticut community emergency department, and still working clinical shifts.
Most record review is done by people who have left the floor. That is not a small difference. A reviewer who last worked a shift a decade ago is reading a chart produced by documentation systems, staffing patterns, and time pressures they never experienced. They tend to find deviations that are not deviations, and to miss the ones that matter.
I am writing these notes myself, in the same system, under the same constraints, most weeks. When I say a reassessment should have been documented and was not, I am describing something I do and chart routinely, not a standard I read about.
The judgment a merit screen requires is the same judgment I exercise on hospital committees. I sit on the serious safety event classification committee, the mortality review committee, and the sepsis committee. That work is adverse-event analysis at a peer level: taking a bad outcome apart, separating the parts that were foreseeable from the parts that were not, and reaching a defensible position under scrutiny from colleagues.
That is functionally the same exercise as a merit screen, done weekly, and it is a more relevant qualification than courtroom hours for the question you are actually asking at intake.
I regularly precept physician associate students, which means explaining clinical reasoning to people who do not yet have it. That skill translates directly to writing for counsel, who are highly intelligent and have no reason to know what a lactate of 4.1 implies or why a documented reassessment matters so much.
Where the treating clinician was a physician associate or nurse practitioner, the questions are specific: what was within scope, what triggered a supervision or escalation requirement, what a reasonable PA in that setting would have done. In many jurisdictions the standard of care for a PA has to be established by someone familiar with PA practice. A physician expert can speak to the medicine, but scope and supervision questions do not map cleanly onto a physician's experience, and opposing counsel knows it.
Send the party names and the facility. I run the conflict check the same day at no charge, before any case facts change hands.