Lawyers PI Program
From the Desk of:
Mark Studin DC, FASBE (C), DAAPM, DAAMLP
Strategies to Get Lawyers to Know That You Are the
The most challenging part of this entire program is getting the lawyers to engage with you. This isn’t the hardest part and the most time consuming part of the program. It is, however, the most critical component.
Someone once told me, “If you don’t toot your own horn, who will?” This is the part where you have to start tooting and don’t stop until everyone notices. The tricky part is you have to toot without anyone realizing you are tooting away! Another mentor had a great line, “March without appearing to march.” That means you have to do what you need to do without looking as if you are doing so.
The hard rule in the success of a PI program is to never ask for the referral; that is usually the death sentence in the relationship with the lawyer. Why?…Because every schmuck in the profession is begging and pleading for patients. I know because I was the biggest schmuck out there and the biggest loser in the history of building a PI practice. That fact has been well chronicled in the previous consultations.
Having a successful practice (as gone over in previous consultations) is dependent on a sound infrastructure. You have to have:
- An outstanding CV with formal coursework in diagnostics to have results that are admissible
- An outstanding narrative
- Be a specialist in Spinal Pathology as taught in the PI Bootcamp or similar courses
- Notes that are legally defensible, as verified by a formal audit
If you do not have the above 4 requirements handled at a very high level, be prepared to become a “1 and done.” Your PI career will be short lived and please don’t blame me, as I warned you!
THE PARADIGN SHIFT
HOW TO GET THE LAWYER TO
RUN AFTER YOU
With the exception of the new practitioner, we all have or have had patients that were in an accident. Most, if not all, of those patients have, or have had legal representation. Therefore, the first place you start is with your existing patients that are still active, from the lawyer’s perspective. Go to your charts and identify every patient that has been in an accident over the last 2 years. Call the lawyers to determine if their cases have not yet been settled.
If a case has not yet been settled, bring the patient back in (see consultation #14) for a “final examination” and create a narrative using the format I taught you to clinically correlate causality, bodily injury and persistent functional loss. I would not charge the patient and would attribute it to a marketing expense.
If the patient still has diagnostic dilemmas (based upon your current examination and your new understanding of the pathology), order any necessary tests or render the referral to a specialist that is clinically indicated, to answer those questions. Once an accurate diagnosis is determined, ensure that the correct care has been recommended and the lawyer is now called.
Let the lawyer know that you have “significant new information” regarding the status of their client. This gives you leverage over them as you already have the patient and they need your documentation (narrative) in order to prevail in their case. They will meet with you. When together, before you review the case, inform them that you are part of a national medical-legal research organization. Then present them with an educational binder and make sure that your CV is there, as they will need that to prevail in the case. You can then review the narrative, and make sure you underscore that your focus, if clinically present, is to clinically correlate causality, bodily injury and persistent functional loss. If you use those exact words, the lawyer might start to salivate at the breakfast table in front of you (or have other bodily functions turn on that I will not put in writing). At the end of the meeting, make sure you offer to meet with the lawyer monthly to explain the 2 new bi-monthly educational fliers with the research. Also, ask them to briefly look through the ones you have brought and ask what research they would like, so you can make arrangements to get it to them.
This is another compelling reason for you to meet with them sooner. You do not mail, nor e-mail them, but make the time to drop it off in their office or they can come to your office.
You are relatively new to practice or your practice has very few to no personal injury patients. This scenario will necessitate reaching out to the medical-legal community to meet with lawyers you do not know yet.
Repeat from Consultation #69
Getting a law office to pay attention to you is about leverage and when cold-calling, there is inherently very little. There is, however, one area that you have leverage over the lawyer and if you position yourself properly and have an effective communicator making the calls, you can consistently win in “cold-calling.”
First, let me tell you about the art of negotiating. Being a New Yorker has exposed me to some of the best negotiators and negotiating tactics in the world. There is a street in New York called Canal Street. It is located adjacent to Chinatown and it is the street hawker’s capital of the world. You can buy anything from a shop, which is actually a booth inside a storefront, that sells pocketbooks, purses, jewelry, perfume, computer peripherals, hardware, etc., at severely discounted prices, as much of this stuff is sold through secondary markets. A Fendi purse, normally sold for $400 can go for $60 with the understanding that some of these are “knock-offs,” SO YOU HAVE TO BE CAREFUL. However, the asking price, as an example, is $60. This is a technique I have taught my daughters well. You offer $30 initially, they say $50. You then say $35 and they say no, $50. You take $35 and put it in their hand while they are still saying no. Once the money is in their hand, they rarely let go and sell you the product for that price or very close to it.
The tactic is 2-fold. One, it’s always about the money and second, it’s the “3 No Rule.” For me to take “no” in a negotiation, I have to hear it 3 times. However, I will ask the question a little differently each time and when necessary, I will soften my position and offer a little more each time in understanding the other party’s position, in a compromise effort. There are times when I know I am being unreasonable or an ass and cave in. That doesn’t happen often.
Now you know my “Canal Street” tactics of negotiating that have served me well throughout life; you are probably thinking I am nuts, as what does this have to with lawyers, cold calling and getting past the secretaries in their offices? The answer is everything!
Let me introduce you to a widget. A widget is absolutely nothing and everything. A widget is a universal concept that can be substituted for any notion or gadget in the world. Therefore, it doesn’t matter if it is purses on Canal Street, lawyers in Kansas or margaritas in Aruba; selling and negotiating are the same no matter what widget you substitute for the deal.
Now let’s tackle the lawyers and cold-calling. The concept I have realized is that in the past is that we were offering “cutting edge educational material that would help the lawyer prevail in his/her cases” and offered to sit with the lawyer to give him/her the research. That is like saying to a longtime friend you haven’t seen in years, “It’s great to see you. We should get together for dinner some time.” The reality is that you rarely get together for dinner with that person; if you intended to have dinner with him/her, you would already have done so. The conversation with the lawyers is no different.
You need a person who gives very good “phone.” You cannot have a shy, non-aggressive personality perform this task. When calling, the caller should introduce himself/herself by giving his/her name and stating what office he/she is calling from. Then they should inform the lawyer’s office of what you have for them and when rebutted, should not take “no” for an answer. Remember the “3 NO Rule.”
Show Spelled Pronunciation[lev-er-ij, lee-ver-] Pronunciation Key - Show IPA
- Power or ability to act or to influence people, events, decisions, etc.; sway:Being the only industry in town gave the company considerable leverage in its…negotiations.
Leverage is the difference between success and failure. What ability or act do you have to influence the lawyers’ offices to want to work with you? The answer quite simply, is knowledge. The field of law is about leverage in an argument and knowledge is the tool that renders leverage in order to prevail. You now have to convey, in a very aggressive manner, that you have the tools the lawyer needs, in a very specific format, versus the previously generalized format.
The 3 hottest topics in personal injury, based upon a survey of 1000’s of lawyers nationwide are:
- Age dating the onset of herniated discs
- Pre-existing arthritis does not mean all bodily injury is pre-existing
- Their clients do get injured in “no damage crashes,” as documented by the insurance company’s own research
The first, although a very hot topic, cannot be used, as there is no research published on this topic. I have been working with a nationally acclaimed neuroradiogist trained in Columbia and Harvard on this subject over the last 2 years to get research published. Although the information is dramatic and will change the landscape of the medical and medical-legal community, it is still not yet published. Until then, there is nothing to give the lawyer, so we will take that off the table. As a note, this is part of what I teach when I lecture to lawyers nationally and a very powerful motivator. The other 2 topics are just as powerful and lawyers will clamor to get your research once you get past their secretaries and the information gets to them.
When calling, your telephone person, notice I said telephone person and not your staff. If your staff is not aggressive, get someone else for this project! I don’t care if it’s your mother or a high school or college student. That person has to give “great telephone” and be bold enough not to take no for an answer using the “3-No Rule.” When calling they have to be specific and now offer something definable that will enable the lawyers to prevail in their cases. This is called leverage, as it will give you influence over those making a decision!
To get further details on how to make these cold-calls and what to plan for the meetings, please call our program coordinator, Allison, at 631-626-0406. She will set up a time with you to train you and your staff. She will provide you with a script and other communication materials. The training takes about 30 minutes.
Repeat from Consultation #68
You are either on the outside of the medical-legal community looking in, with your face pressed against the window, or you are in the inside looking out at everyone else attempting to get in. If you are on the outside looking in, you are taking lawyers to breakfast, lunch and dinner, wining and dining, or buying theater and ballgame tickets, and always asking for the referral. The whole process is tantamount to begging and pleading and we know it doesn’t work, past the first referral, as a rule. If you are on the inside, you are a respected member of the medical-legal community and a resource for lawyers to constantly communicate with you regarding cases and personal issues, and are hearing their pleas for your support on a myriad of issues. That is how you create that paradigm shift.
Getting in has always been a challenge for chiropractors nationwide. I know, because I spent 20 years with my face pressed firmly against that window trying to figure out whose ass I had to kiss to get in that door. In fact, one of my colleagues had a great saying, “I will contour the shape of my lips to the referrer’s ass in order to gain the referral.” He said that many, many times to me.
On a historical note, that same chiropractor, after 20 years in practice, had to sell his office for financial reasons, and now works as an associate for another DC for very little money and no respect. His method of ass-kissing proved to be an abject lesson in failure philosophy of personal injury practice building. Actually, I just hung up with his employer no more than 5 minutes ago, and he is being fired the week after Thanksgiving (in 3 weeks). The reason, he still doesn’t get that what caused him to fail in his personal practice is the same philosophy he is using in his current employment and failure philosophy has the same results, no matter whose roof you reside under.
Getting into the “club” of personal injury lawyers requires that you become a fixture in their face and they see you as an expert and accessible. There are many methods of accomplishing this goal and the easiest, quickest method is to use your local county’s Bar Association. The main reason is that is the common denominator for where lawyers converge on a regular basis and you can target any type of specialty you want. In our case, we are focused on the plaintiff’s lawyer and each bar association has a plaintiff’s bar that has meetings on a regular basis.
Unlike medicine, law literally changes daily. There are rules of law in the constitution of the United States and in each state, as well. Each of these rules is subject to interpretation and that is done through the courts, with rulings on every case that comes before them. Those rules get further defined daily, and lawyers arguing a case today with one set of rules might not be able to argue the same set of facts they did on a previous week because of the more recent precedents set in the courts. As a result, lawyers constantly attend continuing legal education courses at the bar association to stay current on rulings and interpretations.
Through the years, I have been a regular fixture at my county’s bar association, first in the form of a sponsor and then as I became expert in spine, a lecturer. Getting in is easy. The only credential you need a checkbook, and we all qualify. As I have told you for quite some time now, it’s always about the money…cynical, but true. Call the executive director of the local bar association and offer to sponsor a meeting at the plaintiff’s bar. They usually meet monthly or quarterly. Most meetings serve food and the cost should be nominal. I usually paid $200 per meeting and a doctor in Florida, who sponsored meetings recently, was asked to pay the same $200. The fee will gain you entry into the “club.”
Your participation will be limited to handing out information about your practice, and that is an acceptable trade off for sponsorship. The bar associations all allow that. At the meeting you need to have educational binders with your curriculum vitae in the front. Understand that the most looked at document in the binder will be your curriculum vitae. Your goal at the meeting is to explain to every lawyer present that there are 2 new educational fliers produced monthly, and if they would like, you will arrange to meet with them briefly each month to give them the 2 new ones to place in their binders.
You will have a short amount of time before the meeting commences, to chat with the lawyers, as your time will be limited to their eating a quick dinner or lunch prior to the speaker. After the meeting, 90% want to go home immediately, but a few will linger for a few minutes, so your time has to be spent judiciously, not staying with 1 person too long.
You should request a copy of the attendance from the bar association, and they will accommodate your request. In addition, pay attention at the meeting, as what is being said will shape how you look at a future patient. Bar association meetings were a revelation to me about many of the procedures in my office regarding triaging and treating the injured, as the courts in every state clearly define the parameters for documentation requirements.
After a few sponsorships, the lawyers will get to know you and expect you to be there. They will start interacting with you more and before you know it, seeking counsel from you. You will then become part of the “club” and be watching others with their face pressing up against the glass, wondering how you got “in.” The insider gets the business at the end of the day, provided that he/she is clinically excellent and his/her work is admissible. That is the rule!
WARNING: E-mail is a very effective tool. However, there are numerous spam laws and some lawyers will use this as a way of earning a living at your expense…so be careful and follow the laws in your state, as I do not know all of the laws. Please accept this as a formal disclaimer of responsibility, and I request you to defer to legal counsel for all local, state and federal regulations regarding communicating with lawyers via e-mail.
E-mails are a great way to communicate and if you are creative in the subject line and content, the lawyers will look forward to getting your e-mails. In fact, my last few years in practice I communicated on a daily basis with numerous lawyers. This was a great way to stay in touch. Now more than ever, e-mail is the preferred method of sharing information.
As always, you should start where it is the easiest. Begin with your patients, both old and new. Have your staff pull the charts of every PI patient as far back as possible and identify those lawyers that have represented your patients and already know who you are. The first step is to go on the Internet and see if you can find the lawyer’s e-mail address. If it is there, you do not need permission, as you have already established a business relationship with the lawyer and correspondence is not considered spam, as a result.
Should you not be able to find the address on the Internet, a phone call should be made to the lawyer’s office and a request should be made for an e-mail address. Inform them that you have treated their clients in the past and are now part of a medical-legal research organization. You have significant research that you would like to share with the lawyer that will help him/her prevail in his/her cases. Let them know it is a free service.
This is a “no-brainer.” You are not asking to meet with the lawyer; you are not even asking to speak with them. You simply want an e-mail address. 99% will accommodate you. The other 1% are assholes (Oops, can I say that?) and you don’t want to work with them anyhow!
Once you have exhausted all of your previous business relationships, you should reach out to those who you don’t know. I suggest that you use the same format and form we have provided in acquiring the fax numbers. Call each individual office and request the e-mail address. During that call, document the date and name of the person that gave you permission to send the e-mail. In your language, be specific and state that you want to e-mail the lawyer some current research, as you are part of a national medical-legal research organization. Maintain this list, so you have records if ever challenged in the future. I would not limit my calls to only personal injury attorneys, as I have shared previously, most general lawyers take PI cases.
In the subject line of the e-mail I would put:
Bodily Injury Research – Dr. Studin
It renders motivation to open the e-mail and it puts your name in front of them on a regular basis. Once the e-mail is opened, they should see the topic and an opening statement that never changes.
It is my commitment to bring you current research in the medical-legal arena that positively impacts your cases. The topics are targeted on issues of the courts so that an argument doesn’t overturn the truth of your client’s bodily injury. Every week there is a new topic and during the year, I will be creating a library of timely research for you to compile. I will be sending you a synopsis of the research article with a graphic. Should you want the full research article associated with the topic, please contact me.
This week’s topic:
Increase Bodily Injury
New Research (2008)
I look forward to sharing information with you.
Mark Studin DC, FASBE(C), DAAPM, DAAMLP
Stony Brook Spine and Injury Center
123 Main Street
Stony Brook NY 11790
Should you do not want this e-mail to be sent weekly,
please respond in kind and we will gladly remove you from the list.
On the flyer, make sure you customize the bottom for your office. Here you can add office hours, the languages spoken and the name of your clinic, along with your name. If the name of your clinic is wellness or family related, I urge you to not include that. It creates a mixed signal for the lawyer that can equate you with a family medical doctor. The primary care provider has been destroying cases for lawyers for years and you do not want to be in that league. It is better to not send then create a negative image. When, not if, the lawyer requests the accompanying research, do not e-mail it. This is your leverage to meet with the lawyer. Explain in an e-mail that for the first research paper needed, you would like to briefly meet with him/her.
Here is the trade off. If you meet with the lawyer and give them the educational binder, he/she will have all of the back topics and will not look at your e-mails. It is for this reason I suggest you rotate sending a previous flyer on the odd weeks and the new flyer on the even weeks (I just made up the “odds and evens submission,” as every kid understands that). This way, you can still meet with the lawyer, render the entire educational binder to overwhelm them with your knowledge, include your CV, show them a sample of your narrative and keep your focus on the goal; meet with the lawyer monthly to teach them the topic on the flyer. Lots of steps, you bet, but very effective.
At the end of the day, the leverage for the lawyer to want to meet with you will be the research and your knowledge. The leverage to want them to send you patients is your narrative and the leverage for them TO SEND YOU patients is your curriculum vitae. It always comes back to your infrastructure and credentials. Without the credentials, your work becomes inadmissible.
The most important part of a case for a lawyer is to determine if they have a case or not. Early determination is often the difference between a lawyer having a successful practice and one that is doomed for failure. Imagine being a lawyer, meeting with your client and thinking that you have a case worth $250,000. You urge your client to keep all of their appointments with their doctors, meet with their client regularly, have your staff send for records often at a cost of $500-$1000 per report and spend additional time and money filing papers in court.
It comes time for trial, you pay your experts $3000-$10,000 for testimony and you have to take a loan out to fund the case. At the end of the case, you lose because you didn’t understand the true nature of the injuries and your client was inflammatory in their complaints, hoping to score a huge payday. After you lose, you are left with your reputation tarnished and a loan to re-pay, with no income against the loan, as your client is not in a position to pay the loan and you co-signed the note.
This is a very familiar scene in the legal arena. Once burned, a lawyer becomes very smart. They want information immediately.
After a patient is under your care for approximately 1 month, you will have a significant amount of information; the reports, x-rays, MRI’s and neurological test results, all if clinically indicated. It is now that you call the lawyer and request a brief meeting to explain the results. This should be no more than a 15 minute session and it should take place in your office, as you have all of the records and films.
During that meeting you should briefly review the history and clinical findings. What the lawyer is most interested in is the MRI and neurological results. This is called demonstrable evidence. Tangible physical evidence that they can show a jury to prevail in their cases. Therefore, bring out the MRI films and show them the results, not just the report, as you want to overwhelm them with your knowledge. If you feel that you aren’t proficient yet in interpreting the films, take the PI Bootcamp and learn the basics. If you need more help, go back to the radiologist and ask them to show you the pathology on the film until you do understand it.
I have previously spent countless hours in a dark room with numerous radiologists. It’s how I really learned to read MRI’s. The lawyer will be very impressed with your knowledge and now start to understand that you have the capacity to be a very good witness in court. This will create a solid foundation in your referral relationship.
You should also review the treatment plan and any future tests and/or specialist’s referrals that will be considered to create a conclusive diagnosis. Give the lawyer the time frame for care, as they will need to note that for their practice. Make sure that you have a release for the records in your files, as well. If you don’t have the release, ask the lawyer to forward you one.
Once the lawyer has a basic understanding of the case, teach them the chronology of symptomatology, as outlined in Consultation #14. This will get them to know that you understand their needs in an honest and ethical relationship and they will start to regard you in a different class than every other doctor who is begging and pleading for patients. That will not be required, as from here forward, the lawyer will see you as a resource to prevail in their cases. If done properly over time, through clinical excellence, “Game over…you win.”