Credibility, Observation, and the Examiner's Discipline: Insights from Dr. Daniel Robin

Dr. Daniel Robin is a Melbourne-based orthopaedic surgeon and sub-specialist in complex hip and knee surgery. On the third episode of Medico-Legal Mastery, Dr. Robin addresses the dimension of IME practice that separates competent examiners from truly defensible ones: the clinical discipline to observe without treating, document without judging, and report facts without crossing into opinion.

The mindset shift

A central challenge for surgeons entering the IME space is the fundamental reorientation required.

"You wear two different hats when you're an orthopaedic surgeon - a treater versus an independent medical examiner. You've got to be very cognizant of it."

To enforce that boundary from the outset, Dr. Robin addresses it explicitly with every claimant at the start of each examination.

"I am not in a position today to give you advice of any sort, whether you've had appropriate treatment or inappropriate treatment, what treatment you should be getting in the future. It takes out my ability to remain independent. Independent is the functional word."

This is not merely procedural. Dr. Robin notes that maintaining neutrality extends beyond spoken language to unspoken expression - a raised eyebrow, a reaction to a treatment decision, a casual comment about a prior surgeon's approach. All of it can compromise independence before the formal examination has even begun.

Observation as a clinical tool

Dr. Robin's approach to credibility assessment begins well before the formal physical examination.

"I examine them basically when they get up out of a chair, from the minute they get up out of the chair to the time they walk into the office. I'm watching their gait. Those are the things they don't even realise I'm doing."

In one recent case, a claimant describing severe, unremitting low back pain, rated eight out of ten in intensity and affecting all activities of daily living, was observed to rise from the examination couch with no visible difficulty at the conclusion of the appointment.

"She literally leapt up off the couch like nothing was wrong. It was like she was a teenager."

Dr. Robin is careful to note that his role is not to adjudicate on such observations, but to document them.

"My report will read: the client stated this. However, on examination, she was seen to have surprisingly good range of motion. I'll leave that for the judge to interpret as they see fit."

When objective findings don't tell the whole story

Credibility assessment is not simply a matter of identifying exaggeration. Dr. Robin is equally attentive to cases where limited objective pathology conceals significant functional impact.

He illustrates the point with two examples: a tradesperson missing just 10 to 15 degrees of shoulder elevation in an occupation requiring constant overhead work, and a professional cyclist

with a shoulder injury whose entire performance depends on upper limb shock absorption over three to five hours of competitive riding.

"The objective findings may not be profound, but the functional impact for that individual may be significant. And that needs to be considered when assessing someone and writing their report."

To fully understand functional impact, Dr. Robin asks claimants to walk him through their working day in granular detail — and when verbal description falls short, he asks them to show him photographs.

"I had a guy who had to load up a trailer that carried glass. He had photos on his phone of how they get the glass onto the trailer. Now I get it. Now I understand what's required of your job."

Conflicts of interest and the negligence brief

Dr. Robin addresses a scenario many surgeons encounter as their medico-legal practice grows: the request to opine on a colleague's alleged negligence. His position is unambiguous. On more than one occasion, he has declined such briefs when professional familiarity with the surgeon in question makes genuine impartiality impossible.

"If you see yourself having to render an opinion against someone's actions, where you know that individual, it's very hard to be impartial. And I think if you can recognise that, it's definitely to your advantage, and it's to the advantage of the client as well."

He frames early identification of conflict as a practical skill for surgeons new to the space. A one-page summary from the instructing solicitor is usually sufficient to establish whether a conflict exists before the brief is accepted.

Serving the court

Underpinning Dr. Robin's entire approach is a principle instilled through mentorship early in his medico-legal career: the IME examiner exists to serve the court, not the instructing party. "We are here to serve the court. Our primary role is to make the court's job easy. We don't need to tell the court what to do, but we do need to give them the information they need to formulate an opinion."

In practice, this means returning to the facts at every point of uncertainty.

"The client says this. The documentation says that. The examination looks like this. These are the facts. If I just keep going back to that, I figure the rest of it will play itself out."

Listen to the full interview with Dr. Daniel Robin here, or find Medico-Legal Mastery wherever you get your podcasts.