Lawyers PI Program
From the Desk of:
Mark Studin DC, FASBE (C), DAAPM, DAAMLP
“A Huge Key to Success”
Mr. Parker had an electromyogram (EMG) performed by Sally Smith M.D. at the Main Street Neurodiagnostic Clinic on 1/13/09. The electromyogram confirmed disc herniations at the L3/4 and L4/5 spinal levels.
This is an actual finding, as reported by one of our doctors in his narrative this morning and these few words, if positioned properly, can be the cause of your personal injury practice to explode. First, let’s pick apart this finding. It’s rare that an EMG is performed without an NCV. In fact, I do not recall seeing one in a personal injury setting. Second, the purpose of an EMG is not to confirm a disc herniation; the purpose is to diagnose radiculopathy. The radiculopathy can be concluded to be caused by the disc herniation, but the diagnosis is not the causality. In fact, the electromyogram does not conclude disc issues and was never intended to as you are not measuring anything about the disc…only it’s effect. This is what I have been discussing for 2 years and this paragraph highlights the significance of being the best-of-the-best.
This is EXACTLY what lawyers need. They need a doctor who can tear apart a medical report and show them the flaws in the medical reports because those flaws will be exposed later in their cases and eventually cause them to lose their cases or be significantly compromised, needlessly. When I review a case for a lawyer, the first thing I instinctively do is dissect the other medical reports and look for flaws and false or inaccurate conclusions. There is rarely a case in which 100% of the medical reports are accurate because most doctors do not specialize in trauma related care…You do! Once the lawyer realizes this, you have just made a lifelong friend. Remember, I have been out of private practice for 4 years, yet I received 3 calls just last week from lawyers seeking clarification on medical reports and wanting to know where to send their patients. If I was in practice, I would have had 3 new patients just on other doctors’ mistakes.
In order to get to that point, you have to know...You have to know electrodiagnostics, MRI protocols and interpretation, crash dynamic issues, spine and disc pathology and functional loss issues, and you have to know how to report them all accurately. An accurate finding simply articulated incorrectly can render the wrong conclusion and another doctor making that mistake could be the reason that the lawyer drives his client into your office so that you can articulate the truth in an accurate and admissible format.
The PI Bootcamp, the MRI Certification Course and other courses on www.teachdoctors.com are a good start. There are many, many other courses that will help. This is also one of the reasons I am creating an electrodiagnostics interpretation course, a course on how to interpret eletrodiagnostic tests. It all starts, ends and as a whole, is about your knowledge and being the best-of-the-best. The statement above should have read:
Mr. Parker had an electromyogram (EMG) and a nerve conduction velocity (NCV) performed by Sally Smith M.D. at the Main Street Neurodiagnostic Clinic on 1/13/09. The electromyogram revealed radiculopathy at the left L4 and left L5 nerve roots as a result of the disc herniations at those levels.
The difference is huge and your accurately reporting the findings could make the difference in the lawyer’s case. Again, your job is simply to report accurately based upon the conclusive facts in an admissible format. Once the lawyer understands that you are expert in all facets of personal injury, you will become their go-to person…forever. Really…FOREVER!!!!!! This has been the deciding factor with many lawyers that I have worked with over the years and until I read that statement from the clueless MD, I never realized it.
Another note is that you are not supposed to have all of the answers. Last week, a lawyer called me about imaging an obvious axonal shearing case. It took me 6-7 phone calls to the imaging departments of the largest teaching universities in the Northeast to find the answer. The patient is going to get evaluated tomorrow from a specialist and is then off to get a very specialized test that I didn’t know existed until last week. Did I have the answer immediately for the lawyer? No. It took me 3 days to get the answer and I am going to be tracking the results, guiding the patient through care and will be rendering a P-IME to be formally involved. By the way, I get $1500 per P-IME and the lawyers never blink.
You need a team and I am part of your team. If I don’t have the answer, I know who will. Call or e-mail me your questions and together we will help build your knowledge base and build mine in the process. That is what doctors are supposed to do; collaborate on patients to find solutions.