Virtually every medical malpractice case presents issues as to the permissible extent of discovery of the plaintiff's medical records. CPLR §3101, requiring "full disclosure of all matter material and necessary in the prosecution or defense of an action," and CPLR §4504, codifying the physician-patient privilege, require reconciliation on specific facts. The oft cited decision of the Court of Appeals in Koump v. Smith, 25 N.Y.2d 287 (1969), established long ago that plaintiffs who affirmatively place their physical or mental condition in controversy waive the doctor-patient privilege. As amplified by the court in Dillenbeck v. Hess, 73 N.Y.2d 278 (1989), "[A] party should not be permitted to affirmatively assert a medical condition in seeking damages … while simultaneously relying on the confidential physician-patient relationship as a sword to thwart the opposition in its efforts to uncover facts critical to disputing the party's claim." Id. at 287. In the ever-increasing complexity of malpractice litigation, this reconciliation often requires more skill than is available to the task.