Opinion ID: 1890216
Heading Depth: 2
Heading Rank: 3

Heading: Substantially the Same Specialty

Text: The next issue in interpreting section 538.225.2 is determining the meaning of substantially the same specialty. The legislature did not provide statutory guidance, so this Court's task is to determine what the legislature intended from the plain meaning of the phrase. If the legislature does not expressly define statutory language, it is given its plain and ordinary meaning, as typically found in the dictionary. Derousse v. State Farm Mut. Auto. Ins. Co., 298 S.W.3d 891, 895 (Mo. banc 2009). Specialty is defined as an aptitude or special skill in a particular endeavor. WEBSTER'S THIRD NEW INTERNATIONAL DICTIONARY UNABRIDGED 2186 (1993). The legislature chose to modify specialty with the phrase substantially the same. `Substantially,' as the word is used in the statute, is synonymous with `practically', `nearly', `almost', `essentially' and `virtually.' Lane v. Lensmeyer, 158 S.W.3d 218, 227 (Mo. banc 2005). By using that phrase, the legislature recognized that there may be situations in which the health care provider who gives an opinion as to the standard of care may not have the exact board certification as the defendant. [6] Instead, the health care provider may have a different board certification but may practice substantially the same specialty because of an expertise in the medical procedure at issue. [7] Many medical procedures are not peculiar to one board certification. See, e.g., John I. Brewer, Good Fences Make Good Neighbors: The Scope of Medical Specialties, 16 OBSTETRICS & GYNECOLOGY 235 (1960) (explaining how other specialties overlap with obstetrics and gynecology). To rebut the Defendants' motion to dismiss, the Spradlings filed an affidavit by Dr. Mathis, which included his curriculum vitae. During the course of his career, Dr. Mathis has performed or assisted in more than 3,000 vertebroplasties and remains in the active practice of medicine, including performing vertebroplasties. [8] He also has served in several leadership roles for the American Society of Spine Radiology and the American Society of Neuroradiology. In the span of 15 years, he has given more than 50 lectures and 15 scientific presentations about vertebroplasty. Dr. Mathis has written at least 15 book chapters as well as at least 20 peer-reviewed scientific publications concerning vertebroplasty. He co-authored the first book about vertebroplasty, which first was printed in 2002. Additionally, from 2000 to 2007, he served as a medical consultant for education for a bone cement company. As a part of that position, Dr. Mathis taught physicians, including neurosurgeons, how to perform vertebroplasties. While Dr. Mathis is a radiologist rather than a neurosurgeon, his experience establishes that he was actively practicing substantially the same specialty as the defendant in that he has sufficient experience in performing vertebroplasties. Dr. Mathis is not board certified in the same field of medicine as Dr. Sprich. [9] But under Webster's dictionary definition of specialty, Dr. Mathis has an aptitude or special skill in performing vertebroplasties, as evidenced by his performance of or assistance in over 3,000 vertebroplasties. In addition, his publications, lectures, and seminars exhibit his academic interest and expertise in vertebroplasties. Dr. Mathis is the type of legally qualified health care provider as intended by the legislature when it used the phrase substantially the same specialty. By enacting section 538.225, the legislature sought to prevent plaintiffs from relying on opinions from health care providers with minimal to no experience in performing the procedure in question. The Spradlings' reliance on Dr. Mathis' opinion was the type of reliance the legislature sought to authorize. The trial court's dismissal of the action was error.