Perspectives of Medical Practitioners in India on Medicolegal Teleguidance by Forensic Medical Experts: A Mixed-Methods Approach

BackgroundMedicolegal cases (MLCs) sit at the interface of healthcare and the justice system, demanding accurate documentation and legal compliance, yet India's forensic medicine workforce is grossly outnumbered by its clinical workforce.This gap has widened further with the new criminal laws, the Bharatiya Nyaya Sanhita (BNS), Bharatiya Nagarik Suraksha Sanhita (BNSS), and Bharatiya Sakshya Adhiniyam (BSA), which heighten medicolegal risk for non-specialist practitioners, particularly in peripheral settings.Teleguidance from forensic medical experts has been proposed as one way to address this gap.This study explored the perspectives of registered medical practitioners in Tamil Nadu and Puducherry on the need, utility, and implementation of medicolegal teleguidance by forensic medical experts. MethodologyA convergent parallel mixed-methods design informed by Good Reporting of A Mixed Methods Study (GRAMMS) principles was used.Quantitative data were collected through a validated online questionnaire from practicing medical practitioners who handle MLCs, recruited by convenience and referral sampling (266 responses; 265 analyzed after one exclusion).Qualitative data were collected through semi-structured interviews with a purposive subsample of 25 survey respondents (9.4%).Descriptive statistics and Pearson's chi-square tests with Bonferroni correction were used for quantitative data.Interview transcripts were analyzed by inductive thematic analysis, and the two strands were integrated at the interpretation stage. ResultsOf 265 practitioners, 157 (59.2%) reported two years or less of MLC-handling experience, and 49 (18.5%) had postponed medicolegal documentation while awaiting guidance.Most agreed that teleguidance could help in handling MLCs (209, 78.9%) and improve the efficiency of report preparation (224, 84.5%), and 219 (82.6%) had a moderate-to-high composite need score.Overall, 246 (92.8%) were comfortable with teleconsultation technology, and 238 (89.8%) wanted structured training.Qualitative analysis identified six themes: challenges in documentation, credibility of forensic expertise, benefits and limits of real-time consultation, ethical and legal concerns, infrastructural barriers, and training and policy frameworks.Need showed a nominal association with current professional role (χ² = 15.33,df = 6, p = 0.018) that did not remain significant after Bonferroni correction.Teleguidance was perceived as most useful in clinico-forensic toxicology, traumatology, and medicolegal report writing. ConclusionPractitioners in this sample perceived a moderate-to-high need for medicolegal teleguidance by forensic experts and reported high readiness to adopt it, especially for report writing and for toxicology and trauma cases.Teleguidance should complement, not replace, direct examination and independent medicolegal assessment by the treating doctor.Its effects on documentation quality, efficiency, and medicolegal outcomes were not assessed in this study.These should be tested in prospective pilot studies within a clear legal framework aligned with BNS/BNSS/BSA, using secure digital infrastructure and, potentially, integration with existing platforms such as eSanjeevani and MedLEaPR.