Lawyers PI Program
 
“Building a PI Practice”

 #40

 From the Desk of:

 Mark Studin DC, FASBE (C), DAAPM, DAAMLP


“What to Say and Do When Meeting With Lawyers”

 

The Talking Points

 

The following are a list of issues that should be discussed when talking with lawyers. These points are the “hot issues” that lawyers have and are necessary to create that “all important” shift to get them to refer to you. The goal is not for them to like or respect you (although that is never bad), the goal is for them to refer to you because you can help both their clients and their cases.

1. Timely reports

One of the biggest problems is lawyers having to beg and plead for doctors to send them reports. You must emphasize that your office is very responsible in getting paperwork out timely. However…it is here that you need to explain the “Chronology of Symptomatology.” It will take a very concise explanation to let the lawyer know that they do not want the reports on their clients the second care has ended. I strongly suggest that you practice this explanation on a staff or family member prior to the meeting, as this issue can enhance or destroy a relationship.

2. Results Sent Automatically

As explained in a previous consultation, there needs to be a calendar system to send test results to the lawyers automatically. You will need on file an “Authorization to Release Records,” that you should get immediately from the lawyer upon starting the care of their client. At the 6-8 week period, you should have placed on a calendar, the patient and lawyers name, and package up all of the records and deliver them (or mail if you do not have the time, a poor alternative). This will allow the lawyer to make a decision on their client. Many times there are no findings and the lawyer will release the client. This is as important as the lawyer winning a case. Think of how much money the lawyer could spend working on a non-fruitful case. The lawyer will be very appreciative to know as early on in the case as possible, that there are no positive findings.

 

 3. Narrative

Your narrative should have been critiqued by me and certified that it is in an admissible format. It then is placed in a binder and laminated. This has been explained in detail in previous consultations. You tell the lawyer that you want to show them your final narrative, as you are very proud of the format. Inform them that the format was created by over 10,000 personal injury lawyers nationwide, and it clinically correlates “causality, bodily injury and functional loss” in the conclusion. Show them the laminated narrative and go over it page-by-page. DO NOT GIVE THEM A COPY! They will ask for one, as they want to share it with their other specialists. They can have a copy upon referring a patient and you can tell them that. It will get a laugh.


4. Persistent Functional Loss

This topic will get the lawyers attention in a very large way because…this is what adds value to their cases if present in an honest and ethical scenario. First and foremost, never exaggerate the facts. The facts are the facts. You have to go into great detail with the lawyer on how you query the patient and then ask the patient to create a document detailing every aspect of their persistent functional loss. Explain that you break it up into 3 parts; personal, family and work losses. Your goal is not to put it in medical terms, but to create a real life, “in a living color explanation” that will detail what their client can no longer do as a result of their injuries.

 

5. Testing

Make sure during your narrative explanation to the lawyer you detail your aggressiveness in ordering testing for your patients as clinically indicated. A very big issue for the legal community and patients alike are doctors that are wary of ordering tests. Can you imagine being a patient in pain, going to a doctor and the doctor says to you:

 

“I know that you are in a lot of pain and it could be coming from your spinal cord or spinal nerves. However, I want to wait a few weeks before ordering an MRI.”

 

What the doctor is really saying is that he wants to wait a few weeks to see if you have structural damage that can cause further neurological problems. If you didn’t run immediately from that doctor’s office, I would think something’s wrong with you. Think about your recommendations to your patients. Are you saying the same thing to them? If you are and you do convince the patients to wait, it’s the lawyers that are going to run from you. First, because most of them care about their clients' well-being, and second, they are seeking documentation for their cases. You as a doctor are not concerned about the documentation for the lawyer’s case. You are only concerned for the well-being of your patient.

 

 6. Educational Binders

This is the tool needed to create the paradigm shift to get the lawyer to want to meet with you. The above issues are all to gain the confidence of the lawyer to you as an expert. Now that you have established yourself through clinical excellence in both caring for your patient and documenting “causality, bodily injury and functional loss,” you can set the stage to get the referrals.

 

Make sure you have prepared in advance (as explained in consultations #30-32) the educational binders for the lawyer. Do not give it to them or show them the binder until after you have gone through the above talking points, as you do not want to distract them from those topics. Make sure your CV has been critiqued by me and that it is in the front cover of the binder. This is a critical point for reasons previously gone over.

 

Start by explaining a couple of the educational pieces and inform the lawyer that you are part of a research program that covers 2 new medical-legal educational topics, in a brief article format, on a monthly basis. It is here that you offer to meet with the lawyer monthly to give them a copy in color for their binder and explain the topics to both them and their staff. Let them know that it only takes about 5-10 minutes each month. Make sure that you also inform them there is no fee for this, as you “really enjoy the teaching part.”

 

Most lawyers will want you to meet with them and create the appointment on the spot. It is your goal to get them to commit to the same time each month, as there are new topics monthly.

 

 7. The P-IME or Second Opinion

Here is where you get the referral. Explain to the lawyer that while reviewing the medical-legal educational topics monthly, if they have any cases that they want you to review, it will be your pleasure to do so, and the fee is a cup of coffee (there must be a fee attached, no kidding). The conversation goes as follows:

 

“Over the last few years, it has been my experience that the legal community underutilizes its resources on cases. I am a resource. For many lawyers, I go into their offices and after teaching the medical-legal concepts, I review some of their cases. What most lawyers don’t understand is that 1 word in a medical report can add an extra 0 at the end of a settlement or verdict, and most, if not all lawyers, don’t speak our language.”

 

As a note, that word is myelopathy. This is where you will get their attention by letting them know you can add tremendous value by reviewing their cases.

 

“It takes me about 10 minutes to review a case for you, and I will give you a written page explaining what the client has wrong and what they need, if clinically indicated. Many cases simply have nothing going on with the client, and I will let you know immediately that there is nothing wrong, saving you valuable time and money by not working on non-fruitful cases. Other cases still have diagnostic dilemmas that need resolving. For those cases, I will be suggesting that the client be seen by me as a Plaintiff IME, or a second opinion. I am not seeking to care for that client just as an Insurance IME is not seeking to care for the client. What the client will get is a thorough examination and recommendations for testing, if clinically indicated. I will also determine if there are any persistent functional losses that clinically correlate to the bodily injury and causality, and document those losses, as shown in the sample narrative.”

 

The next is my personal statement and you have to make a business decision about what you choose for your practice.

 

“I charge $400 for my service of examining the patient and rendering the report that I just showed you. I will happily lien the fee and if the client does not prevail in the case, I forgo my fee.”

 

This is a no lose for the lawyer and their client. My experience for practicing in this system has netted my collection close to 90%.

 

I then conclude by saying:

 

“When would you like to set up an appointment for me to come into your practice and review both the medical-legal educational sheets and some of your charts?”

 

#’s 1-6 is coming to the plate in getting the referrals. The last statement is swinging the bat. Unless you take a swing and ask, you will be hard pressed to get the referral. Over time, you will be forced, based upon the demand of the legal profession of you, to have the lawyer gather up their records and staff and come to your office. It really works if you work it…

 

The next consultation will be on how to triage the lawyer’s cases once you are in their office and have it documented in less than 10 minutes per case.