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September 23, 2025
Winning with Experts: Five Qualities Every Medical Malpractice Expert Should Have
By Jacob H. Pierce
In a Virginia medical malpractice case, your expert witnesses can make or break your client’s chances of success. Whether you are defending a surgeon or representing a patient who claims harm, your experts will likely shape the jury’s understanding of the medical issues more than any other witness at trial. In medical malpractice trials, which hinge on disputed issues of the standard of care and proximate causation, the jurors’ final decision usually rests not on what the parties say or the arguments made by the attorneys, but on which experts they believe.1
Unfortunately, not all expert witnesses are created equal. Some have strong credentials but lack presence on the stand. Others are affable and clear but lack strong academic or professional qualifications. Some experts crumble under pressure, while others excel in the courtroom or during their deposition. What separates a winning expert from a merely adequate one? In my experience trying and defending medical malpractice cases in Virginia, there are five qualities you want (and need) your expert witness to have: (1) expert knowledge and active clinical practice, (2) practices in Virginia, (3) prior expert experience, (4) credibility and likability, and (5) strong communication skills.
(1) Expert Knowledge and Active Clinical Practice
Under Virginia Code Section 8.01-581.20(A), an expert witness testifying on the applicable standard of care in a medical malpractice case must satisfy two mandatory requirements: (1) they must have expert knowledge of the standards of the defendant’s specialty and what conduct conforms or fails to conform to those standards, and (2) they must have actively practiced in the same or a related field of medicine within one year of the alleged act or omission at issue. These are commonly referred to as the “knowledge” requirement and the “active clinical practice” requirement. Failing to establish either prong can result in your expert being excluded and your case potentially faltering.
This means that when selecting an expert, you should look for someone whose medical education, training, and current clinical practice align closely with the defendant’s. Suppose your case involves an orthopedic surgeon who treated a pediatric patient’s wrist fracture. In that case, your expert should be a pediatric orthopedic surgeon or an orthopedic surgeon who routinely treats pediatric wrist fractures and actively performs the same procedure at issue, if a surgery is involved. Virginia courts require that an expert’s field of practice and clinical activities match the defendant’s specialty in a meaningful way to meet the statute’s requirements. This first point is not a recommendation but a legal requirement.
(2) Practices in Virginia
While an expert witness in a Virginia medical malpractice case does not need to practice within the Commonwealth, selecting a Virginia-based expert offers both legal and practical advantages that can meaningfully strengthen your case. Legally, Virginia is a unique jurisdiction with a statewide standard of care, requiring the expert to demonstrate familiarity with the standards applicable to a Virginia health care provider. Although the practical standard of care often aligns with national norms, Virginia law requires proof of this familiarity. Virginia Code Section 8.01-581.20(A) states that an expert licensed in Virginia is presumed to know the standard of care within their specialty. The same statute allows expert testimony from those familiar with the statewide standard of care, even if they do not practice in Virginia. Qualifying an out-of-state expert requires extra steps, like securing a letter from the Virginia Board of Medicine stating the expert meets Virginia’s educational and examination requirements for licensure in Virginia and asking the proper foundational questions during direct examination at trial. Although these are not difficult hurdles to clear, they introduce additional layers of procedural work that can be avoided entirely by retaining a Virginia-based expert, saving time and reducing points of challenge during motions in limine or voir dire.
Beyond legal considerations, a Virginia-based expert brings a level of practical credibility that is difficult to replicate with an out-of-state expert witness. Jurors may instinctively trust a physician who speaks with an accent and cadence familiar to the region, and who may reference hospital systems and medical groups by name during testimony. For instance, if your case is set in Richmond, an expert who is a professor of medicine at Virginia Commonwealth University will likely be immediately recognizable to the jury, many of whom may have personal ties to VCU. Similarly, an expert physician affiliated with the University of Virginia carries the weight of UVA’s strong statewide reputation, lending your case additional authority when the expert testifies.
Logistics can further favor using Virginia experts. They are usually more accessible for in-person witness preparation, local depositions, courtroom walk-throughs, and last-minute strategy sessions before trial without the unpredictability of cross-country travel or scheduling conflicts across time zones. While virtual platforms like Zoom and Microsoft Teams have improved flexibility in witness preparation, the immediacy of in-person strategy and on-site courtroom familiarization remains unmatched, particularly in high-stakes trials.
Finally, using Virginia experts allows you during the closing argument to emphasize to the jury that your experts are physicians who actively practice in the Commonwealth, understand local health care realities, and care for the same patient population as the defendant. In contrast, you can highlight that your opponent’s experts are from out of state and lack firsthand experience with the everyday challenges of practicing medicine in Virginia. This can be a subtle yet powerful point in persuading jurors that your case is grounded not just in medical theory but in the lived practice of medicine within their own communities.
(3) Prior Expert Experience
Expert testimony is about far more than medical knowledge; it is also about navigating the realities of litigation. A brilliant physician can quickly become a poor expert witness if they do not understand how trials and depositions work. Prior experience as an expert, even in just a few cases, can make a significant difference in deposition performance and courtroom testimony.
Experts who have previously testified understand the rhythm of direct and cross-examination at trial, how a deposition is conducted, the importance of answering only the question asked, and how to maintain professionalism under pressure. They are less likely to make mistakes such as volunteering unnecessary information, hedging when clarity is needed, or contradicting prior statements. Prior expert work also gives you, as the attorney, an opportunity to thoroughly evaluate the witness. You can speak with colleagues who have previously retained the expert, review past transcripts to gauge how their testimony withstands cross-examination, and confirm that none of their prior opinions could be used against them.
Ideally, your expert will have experience testifying for both plaintiffs and defendants, reinforcing the perception of neutrality and fairness. While you do not want a “professional testifier” who loses credibility with the jury and is seen as a “hired gun,” you also do not want a first-time expert witness who freezes when opposing counsel becomes aggressive. Aim for the expert who has a balanced level of experience: someone who is seasoned but not jaded, confident but not combative, and tested but not overexposed.
(4) Credibility and Likability
No matter how impressive your expert’s credentials may be, if the jury does not trust or like them, their testimony will lose impact. Credibility and likability are two of the most important qualities in trial advocacy, especially when your case hinges on a battle of the experts.
Credibility often depends on aspects of the expert’s education and professional background, such as the medical school they attended and where they completed their residency and fellowship. You should also consider where they currently work, their professional title, whether they have published relevant medical literature on the issues in your case, and whether they teach medical students or residents. These are just some of the key factors to keep in mind when assessing your expert’s background.
Likability in an expert witness goes far beyond a friendly smile or steady eye contact. It involves the expert’s appearance and demeanor, which should convey humility, clarity, patience, and an objective tone. A likable expert communicates with the jury as a teacher, not a hired gun—they are someone there to explain, not to argue. This means acknowledging reasonable points raised by the other side, avoiding overly technical jargon, and clearly articulating the sound reasoning behind their opinions. Jurors tend to reward experts who come across as sincere, thoughtful, and genuinely committed to helping them understand what happened and why it matters. When an expert appears fair, balanced, and focused on the truth rather than “winning,” they are far more likely to earn the jury’s trust.
During your initial encounter with an expert, watch closely for potential red flags: Does the expert interrupt or talk over you? Do they struggle with tough or probing questions? Do they become defensive, evasive, or visibly uncomfortable under pressure? Do they present as arrogant or impatient? These behaviors and qualities can undermine an expert’s credibility on the stand. The ideal expert remains calm, composed, and respectful, even when challenged, and maintains a steady, professional demeanor throughout. These traits convey credibility and are key ingredients for earning the jury’s trust and making a lasting, persuasive impact.
(5) Clear Communication
A medically accurate opinion is of little value if the jury cannot understand it. Medical malpractice cases often involve complex anatomy, surgical procedures, diagnostic criteria, and intricate decision-making processes. If your expert cannot explain these concepts in clear, engaging, and plain terms, the jury will tune them out, leaving the opposing expert’s testimony to potentially carry more weight.
The best expert witnesses are, at their core, excellent teachers. They use visual aids, analogies, and simple language to make complicated concepts accessible without oversimplifying them. They break down complex charts, imaging studies, or treatment plans in ways that leave jurors nodding in understanding rather than looking confused or intimidated.
Watch out for experts who give long-winded, rambling answers or slip into lecture mode on difficult-to-understand medical concepts. While lengthy answers may read well in a deposition transcript, they can lose jurors’ attention in the courtroom. Clarity, brevity, and effective pacing are essential. Ideally, your expert should be able to break down complex medical issues in plain terms that any ordinary person could grasp, no matter how complicated the topic may be.
It is also important to remember that jurors look to your experts for permission to find in your client’s favor. They do not just want to understand what happened; they want to know whether the physician’s decisions were reasonable or not under the circumstances at the time. A well-spoken expert who can clearly articulate why a doctor’s actions did or did not meet the standard of care can empower the jury to reach a fair verdict with confidence.
Final Thought: Your Experts Are Your Case
Medical malpractice trials are, at their core, stories told through experts. The plaintiff’s experts usually tell a story of preventable harm while the defendant’s experts typically convey a story of reasonable care under difficult circumstances. The jurors choose which story they believe, and that will often decide the verdict. That is why the experts you pick matter so much. When you find the ideal experts and prepare them properly, you gain advocates in the courtroom and on the witness stand who can carry your case all the way to a favorable verdict for your client.
Jacob H. Pierce is a trial attorney who uses his knowledge of the health care industry and his litigation experience to vigorously defend medical professionals from malpractice claims
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