I read a little scenario typed by someone elsewhere on how effectively the prosecution could handle that doctors report - with the doctor on the stand on cross:
Q: In your report, you said that the defendant's nose was "likely broken". What led you to this conclusion?
A: Well when I examined it there was <medical jargon> and <more medical jargon> all of which pointed to the possibility of a closed fracture.
Q: Oh. The possibility. So it wasn't a confirmed diagnosis?
A: No it wasn't a confirmed diagnosis.
Q: What did you do from there?
A: <more medical jargon and explanation of medical procedure in situations like this> ... Since I had no way of being certain I referred him to a specialist for confirmation.
Q: Did he see the specialist for confirmation purposes?
A: No he declined my recommendation.
Q: Oh. So you're saying he refused to go?
O'Mara: Objection! Asked and answered!
Judge Lester: Overruled. Answer the question.
A: That's correct.
Q: And because of that he wasn't able to confirm the fracture?
A: That's also correct.
Q: From a medical standpoint, could you say for certain that the defendant's nose was broken?
A: No I could not. *glances at notes* As I said, there was a strong possibility of a closed fracture but without Dr. <specialist>'s diagnosis I can't confirm it one way or another.
Q: Thank you for your testimony.