Kathryn Rowe is an Expert Witness and Physiotherapist with over 17 years of clinical experience in neurological, spinal and orthopaedic rehabilitation. She works with adults and young people following traumatic brain injury, spinal cord injury, amputation and complex multi-trauma. Here she tells us about her Expert Witness work, why she still practises as a physiotherapist in the community, and what she wishes she had known when she started out.

I never set out to become an Expert Witness.

A friend – an occupational therapist – recommended it. My first reaction was scepticism; I was proud of being a strong NHS clinician. But when I looked into it properly, I realised that Expert Witness work was still fundamentally about helping people. When someone has been seriously injured through no fault of their own, and the NHS doesn't have the resources for the intensive, long-term rehabilitation they need, being part of the process that secures that for them matters. That never loses its weight.

I work predominantly on personal injury cases.

I’m instructed on cases involving road traffic accidents, workplace injuries, and traumatic brain injuries. I also take on spinal cord injury, amputation, and complex multi-trauma cases – both quantum and liability.

On the defendant side, around 90% of my cases involve the NHS. The root cause is almost always the same thing: a breakdown in communication between clinical teams.

I keep a deliberate balance between claimant and defendant work.

This matters more than people might think. If you only ever work for one side, you risk losing your objectivity – even without realising it. I'm not there to win a case: I'm there to give my honest clinical opinion.

Physiotherapy lends itself to impartiality reasonably well. It's more black and white than other areas of expertise – either someone needs physiotherapy, or they don't. Neuro physios in particular tend to reach similar conclusions, because we've all trained through the same NHS pathway and follow the same evidence base. I can count on one hand the times I've outright disagreed with a fellow Expert.

As an Expert Witnesses, I have to be ready to say no.

I've been in situations where a solicitor has tried to steer me toward a particular conclusion. My response is always the same: “I know what you're asking me to say, but no.”

Home hydrotherapy pools and specialist equipment are always contentious because they add significant cost. That's where I feel I have to stand my ground – and I do.

Conference – where Experts meet with counsel and barristers to discuss the case – is partly a test of that. If you're going to court, you cannot crumble under questioning. Conference is where you find out whether you can hold your position.

I enjoy the conference process. Sitting with counsel, listening to the arguments, picking apart the logic — there's something genuinely interesting about it. I like the intellectual challenge of analysing everyone's position and piecing it together.

I haven't been to court yet, but I prepare as though I'm going.

Cases have always settled, or joint Expert meetings have produced an agreed statement before it gets that far. But I bring as much research evidence into my reports as I can because I want to be able to defend every line.

I still see patients. It's not optional – it keeps me credible.

Alongside Expert Witness work I continue to practise as a physiotherapist in the community, and I also work as a Case Manager. You cannot offer an expert opinion if your clinical practice is out of date. I need to know what current research looks like, what rehabilitation approaches are being used, what patients are actually experiencing.

My three roles – clinician, case manager, Expert Witness – feed into each other constantly. Being an Expert Witness has even changed how I document my clinical work. I’ve become more rigorous.

The longer you do this work, the better you get.

But only if you stay curious and stay humble. Reading other Experts' reports influences how you write your own. That's not a weakness. The danger is arrogance – thinking you've got nothing left to learn.

I'm now asked for by name by solicitors, which took a while to get used to. Calling myself an Expert still felt strange for longer than I'd like to admit!

The responsibility of being an Expert Witness caught me off guard when I first started.

There is a real person at the centre of every case. Someone who has been injured, whose life has changed, who is relying on every professional involved to do their job properly. Whether I'm instructed by the claimant or the defendant, my duty is to the court. I don't think I fully appreciated that when I began.

The practical demands are also significant. Court dates don't move. You're frequently asked for things urgently. The volume of material you have to read and digest – medical records, treatment histories, other Experts' reports – can be enormous.

I go and see the people at the centre of these claims, and they are always so nice.

I got into physiotherapy to help people. Even in the private medico-legal world, that's still what it's about – you just usually have more resources available to you.

When I hear that a case has settled – even though we rarely learn who it settled in favour of – it does feel worth it. That person is getting what they need. That still matters to me.

My advice to anyone starting out: don't do it without support behind you.

Having an agency behind me has been invaluable, particularly in the early years. When your first report comes back covered in tracked changes after a quality assurance review, it can feel daunting. But that process is how you learn.

Speak to other Expert Witnesses. Take every opportunity to observe court proceedings without actually being part of a case. Mock trial days are enormously useful, but ultimately nothing will prepare you until you're there.

It's a steep learning curve. I've been doing this six years and it's taken me that long to feel truly comfortable in the role. Cases still surprise me, but I really enjoy the process of it now.

On AI: I think it could catch you out if you become too reliant on it.

I would never put other people's confidential records or Expert Reports into an AI tool and have it generate a summary for me. This work involves real people and sensitive information. More than that – it requires a human brain. You have to analyse, weigh, interpret, and take responsibility for your opinion.

The clinical judgement, the independent reasoning, the willingness to defend your conclusions under scrutiny – that has to be yours.