From Trauma Surgeon to Medicolegal Expert: The Journey of TLA Director Stuart Matthews
TLA Director and Co-founder Stuart Matthews is a Consultant Trauma Surgeon whose broad medical experience ranges from initially practising as a GP in the British Army to Senior Specialist in General Surgery, to then training in Trauma and Orthopaedic Surgery as well as many years in personal injury and clinical negligence practice.
Stuart is vastly knowledgeable Medical Expert for both personal injury cases and clinical negligence cases. He has also been preparing Screening Reports for decades so has also overseen the expansion of the pro bono service given his in-depth broad medical knowledge and understanding of medicolegal.
What was your first job and what did your responsibilities include?
I started working at 16 as an accountant’s clerk working for the car firm Kennings where the majority of my time was spent filing invoices.
How much was in your first pay packet and what did you spend it on?
I earnt £20 a week and probably spent most it on golf balls. I was passionate about the game at the time, but I kept losing balls!
Describe how your career developed to the present day
I became a medical student. My father was in the Army and had a retired officer’s pension. We were means tested and my medical student grant was reduced to about £50 a term.
In those days, a medical textbook would cost up to £50, and my father couldn’t afford to give me much, so I worked part-time to make up the difference. I started as a barman but in my final year at medical school I joined the Army because they gave me a second lieutenant’s salary. This meant I was able to buy my first car.
I did a short service commission of five years, spending four as a GP/Regimental Medical Officer. I then managed to persuade the Army to let me start surgical training, I took on a regular commission and was promoted from Captain to Major with an increased salary and promise of higher professional training to become a specialist. I trained in General Surgery initially because the Army wanted me to fulfil my war role. I then persuaded both the Army and the Royal College of Surgeons to allow me to change to Trauma & Orthopaedics. I have military experience both in peacetime and wartime during conflicts across the world.
In the United Kingdom and within the NHS, surgeons were divided into specialities, but I still had a general interest in multi-trauma injury, working in units which allowed me to have a wider experience of looking after the entire range of injuries and not just broken bones. I became what the Army called a Senior Specialist in General Surgery which is the similar to a senior registrar in the NHS. I was appointed as a senior registrar at Oxford’s John Radcliffe (JR) hospital in 1989 where I was then specifically trained in trauma.
I eventually became a Military Consultant in Trauma & Orthopaedics in 1993 and was accelerated to the rank of Lt Colonel before my due time. I was posted to the Queen Elizabeth Military Hospital (QEMH) specialising in post-trauma reconstruction, which was in conjunction with a Plastic Surgeon, for the soft tissue aspect. I was also appointed as Senior Clinical Lecturer in Military Surgery to the Professor of Military Surgery at Millbank, and I was a contributor to the War Surgery Courses. During that time, I set up an Advanced Trauma Life Support (ATLS) Course at the QEMH and later at Frimley Park Hospital. I was elected as the Orthopaedic representative on the ATLS steering Group of the Royal College of Surgeons, a post I occupied on two occasions. Unfortunately, Defence Cost Study number 15 meant that plastic surgeons were no longer felt needed and so I found myself unable to do pursue my professional interests. It seemed that there was a failure to appreciate the distinction between post traumatic soft tissue reconstruction and cosmetic surgery.
Having taken retirement from the Army, I took up a consultant post as a civilian at St James’s University Hospital in Leeds (known as Jimmies) and I was also appointed Senior Lecturer where I developed my practice to pure trauma and post trauma reconstruction introducing the Ilizarov method to Leeds.
After seven years in Leeds, I then secured the post of Consultant Trauma Surgeon in 2003 at the flagship Oxford Trauma Unit. At the time the JR Trauma Unit was unique as being the first UK Trauma Unit to have 24-hour resident on-call consultants delivering trauma care, assisted by trainees. I became Clinical Director of Trauma at the JR in 2006 for 3 years & I worked there until 2015.
My wife, who was a GP and my four children were still based in North Yorkshire. This coupled with the stress of commuting regularly on my days off between Oxford and my main home in Yorkshire caused me to look for work nearer home. In 2015 I was appointed as Consultant Surgeon in Major Orthopaedic Trauma at the Leeds General Infirmary (LGI). This was a great role both personally and professionally, where I would also be working alongside an old Army colleague.
Five years later at the age of 64 I took premature retirement and decided to focus on my medicolegal work through TLA Medicolegal and my position within the British Trauma Society. I also continue to review academic papers in Trauma and Orthopaedics. I have been preparing medicolegal reports since 1989. Personal injury and clinical negligence reports are not only based on medical facts and evidence but are very academic in nature and therefore stimulating and challenging.
Describe a typical day
First thing, I let the dogs out, feed my tropical fish collection, have a nice Hot Lava Java coffee and open up my laptop to complete my medicolegal work. After lunch, and depending on the weather, I may do some gardening. I attend to my bees, which has been a lifelong hobby of mine. I am also a qualified beekeeper and microscopist member of The British and Devon Beekeepers Association. I have five hives and we produce our own honey. I also enjoy pottery and I have my own kiln and potter’s wheel.
Who / what have been the biggest influences on your career?
The first big influence on my career and my attitude was the late Colonel John Carter, a brilliant General Surgeon and an extremely irascible person who took me under his wing. We hit it off very well. He was as sharp as a tack, a very skilled technical surgeon and extraordinarily fast. When we met, I was just a Senior House Officer. There was a patient who had undergone previous ulcer surgery and was suffering from a recurrence of his ulcer. Following a thorough assessment of the patient, the Colonel said to me: “Right, what does he need?” and I said I thought he required a Polya-gastrectomy. He stated we would do the operation together but when it came to it, he asked if I had swatted up on the procedure, and he left me to do it by myself whilst he peered over my shoulder. The surgery was successful and that one experience early in my career transformed me from a lumps, bumps and hernia surgeon into a proper surgeon.
Then there was Peter Worlock when I was a senior registrar on the Oxford Trauma Unit and later Professor Keith Willett, who eventually became the Government’s National Clinical Director for Trauma Care to the Dept of Health. Keith Willett became a Consultant Trauma Surgeon six months before me but was hugely supportive of me and showed me new ideas and techniques. I learned from Peter and Keith an enormous amount, both medically and professionally. They had such inspiring attention to detail both in respect of the patient and the surgery did everything without deviation based on best principles. They were a force of nature and were dedicated to their work with huge motivation and a talent for educating the trainees. They always knew exactly what to do under pressure, and Peter was an inspiring leader, hence why he became a role model.
What has been your best decision?
To retire early from the NHS at the age of 64. I am twice past President of the British Trauma Society, and I was treasurer for some 25 years and a previous Trustee. I am still actively involved on the committee. I also Peer Review medical papers on a regular basis, on complex multisystem trauma. The British Trauma Society and my medicolegal work through TLA Medicolegal keep me very challenged. There is still so much to learn in the world of Trauma and Orthopaedics and I enjoy remaining within the surgical and academic network having published some 80 papers in peer reviewed journals.
Is there anything in your medicolegal work that really irritates you?
Dishonesty amongst some Medical Experts. The majority give excellent balanced opinions but there is a very small number who seem prepared to take a view that is biased towards the interests of the instructing party. I believe in telling it as it is, warts and all. That is surely the duty of an independent expert.
What has been your most satisfying medicolegal moment?
There was a case of a young professional lady who had a complex fracture of her leg, amongst other injuries and this injury had been repeatedly negligently treated. The expert on the Defending side opined that her treatment had been reasonable. This in my view was not the case and I backed up my opinion with the relevant literature on treatment of these complex fractures and took great pains to explain the principles in understandable language. The Defendants refused to budge from their Experts position and the case proceeded to Court. The Court relied upon my evidence and the Claimant was awarded around £1,500,000. That was in my view a very justified decision, and she deserved the compensation because this negligence will affect her and her mobility for the rest of her life, and I hope the doctors involved will learn from their mistakes.
How do you see TLA Medicolegal developing over the next five years?
I see TLA continuing to expand and develop organically. TLA medicolegal has achieved this through reputation, consistency and a highly experienced medicolegal knowledge.
TLA has always maintained its core values of supporting and looking after the Medical Expert and our lawyer clients equally. We have always been an advocate for our Medical Experts alongside always providing an outstanding service for instructing lawyers. It’s our teams level attention to detail, their medical and legal knowledge and the quality of our Medical Experts that set us apart.
TLA is uniquely exceptional at managing multiple Medical Experts on a single complex case, sometimes as many as eight. Training new Medicolegal Case Managers is a priority over the next few years within our expanding team, and training can take up to two years. TLA have invested in this training since our inception and with instructions substantially increased over the last 12 months, we are looking forward to the challenges of growth securely in the knowledge we have an outstanding office team along very content Clients and Experts.
We will stick to our core values and never compromise on Client and Expert service and support levels.