Doctor's PI Program
From the Desk of:
Mark Studin DC, FASBE (C), DAAPM, DAAMLP
“How Does a Lawyer Measure a Doctor?”
When you want to pick a movie to go to, there is search criteria you use. That criteria was actually chosen for you by an exhaustive and ongoing research process. When a movie is going to be released, an ad firm, or ten of them, first have test screenings to see what audiences like and don’t like. Based on that feedback, they create and release trailers called coming attractions to be played in every movie theatre. Once that occurs, they release information to trade journals and interviews are created by publicists who carefully position the movie’s stars in front of the target audience. Once all of the groundwork has been laid, the advertising starts. By the time you see an ad, you have most likely heard something about the movie if you watch any media. All that is left is to decide if you want to see an action movie, romantic comedy, or horror movie and see what time the given movie is playing because all the groundwork was laid out well in advance. The movie industry pays billions of dollars per year to perpetuate this process because it works.
How does a lawyer pick you? The process obviously isn’t as intricate as promoting a movie nationally, but there is a pattern that most lawyers follow. The first thing you need to understand is that lawyers talk to each other; even adversaries do. When I travel nationally to lecture to lawyers, I often notice the camaraderie of the personal injury fraternity. It’s commonplace that 90% of the people in the room know each other and talk to each other and often that conversation is about you, either in a positive or negative light. Lawyers talk and your reputation is being bantered about around the room.
What does every lawyer have in common? It’s their cases, as they all have the same challenges. Treating doctors are usually a challenge to lawyers because, as a rule, we don’t get it. This is not limited to chiropractic. It includes every medical specialty, as very few medical professionals understand the needs of the lawyer in an honest and ethical scenario. In the spirit of “misery loves company,” there will be more conversation about who bungled a case than there will be about doctors who did a great job. However, when asked in conversation about who is the best expert, that doctor’s name will fill a room in a “heartbeat.”
Just like the trailers in the movies, the educational fliers are your advance groundwork. You are not asking for the referral, nor should you ever. However, the fliers serve the purpose of positioning you as an expert and educator. This will start to create a reputation for you as an expert in the medical-legal community. In a perfect world, lawyers would see your name attached to expert material (research) on a regular basis, as this would build your reputation. Many lawyers I never did any work with meet me in various settings and say, “Aren’t you the guy who sends me all of the research?” They then proceed to ask me clinical questions. That is the purpose.
Think about the buzz in a bar association meeting. A medical-legal question arises and one lawyer says to another, "You should talk to Dr. Studin. He is well-researched on these issues and can help you." This is an academic exercise because the lawyers will not say, “You should refer to Dr. Studin because he knows those answers.” They will recommend you academically based on your clinical knowledge and your accessibility.
When lawyers want to refer a patient, just like once you have decided to go to a movie you seek the movie guide in the local papers or on the Internet, they look at your guide… It’s called your CV. Your CV will tell a lawyer if you have the credentials behind you to get the specific issues admitted into evidence that he/she needs in a particular case. The lawyer already knows if his/her case is a spine, head trauma or shoulder case and he/she wants to win the case. Therefore, he/she will scrutinize a doctor’s CV to see if that doctor can meet the standards of the courts for admissibility. Why would a lawyer want to work with a doctor who, at the end of the day, he/she knows does work that is inadmissible?
Admissible evidence, in a court of law is any testimonial, documentary, or tangible evidence that may be introduced to a fact finder--usually a judge or jury--in order to establish or to bolster a point put forth by a party to the proceeding. In order for evidence to be admissible, it must be relevant, without being prejudicial, and it must have some indicia of reliability.
For evidence to be relevant, it must tend to prove or disprove some fact that is at issue in the proceeding. However, if the utility of this evidence is outweighed by its tendency to cause the fact finder to disapprove of the party it is introduced against for some unrelated reason, it will not be admissible. Furthermore, certain public-policy considerations bar the admission of otherwise relevant evidence.
For evidence to be reliable enough to be admitted, the party proffering the evidence must be able to show that the source of the evidence makes it so. If the evidence is in the form of witness testimony, the party introducing the evidence must lay the groundwork for the credibility of the witness, and his knowledge of the things to which he attests. Hearsay is generally barred for its lack of reliability. If the evidence is documentary, the party proffering the evidence must be able to show that it is authentic, and must be able to demonstrate the chain of custody from the original author to the present holder. The trial judge performs a "gate keeping" role in excluding unreliable testimony. The United States Supreme Court first addressed the reliability requirement for experts in the landmark case Daubert v. Merrell Dow Pharmaceuticals, Inc. 509 U.S. 579 (1993).
As we have discussed at length, the strength of your CV is the groundwork for the admission of your work into testimony and the lawyer will be assessing you as a witness from the moment he/she first meets you. In fact, the criteria that I utilize to know if a lawyer wants to work with me is quite simple. If he/she asks if I testify, I know he/she now respects me as an expert and believes he/she can prevail working with me.
In the last week, I have had doctors from North Carolina, Florida, Minnesota, Massachusetts, New York and New Jersey all tell me that in meeting with local lawyers, once the lawyer realized the doctor knew disc, spine and admissibility issues, the game was over with that doctor winning. One doctor writes:
"She was very impressed with the presentation and my knowledge, which again was what I learned in the PI Bootcamp. The most impressing part of the whole meeting was that before the conversation was finished, she told me, 'We definitely need to get you more cases, and I NEVER ASKED FOR A REFERRAL."
Credentials and knowledge were the deciding factors.
Another doctor writes:
"So, I finished the lunch by arranging to be in his office monthly to educate him, having him send this case file over to me, and I said that I would happily review any cases that were presenting him with a dilemma or any clients that were complaining that they were released from healthcare and were still suffering.
Oh yeah. I was not a schmuck. I did not ask for a referral of a PI case. Not once.
Mark, please get this out to the members. This attorney was very attentive. I told you I was disappointed because he didn’t get up on the restaurant table and jump for joy. However, he was extremely focused and attentive, asked questions, and was very engaged, especially in the CV and narrative (which is the way it should be). We only want the bi-monthly educational literature to be the vehicle to get us in and then we can impress them with the CV and narrative.”
What this doctor did was use his credentials to be invited into the lawyer’s office monthly. He is now on the inside based upon clinical excellence.
Another doctor writes:
"In fact, an attorney is asking me to go to ATP tennis and dinner. It is nice to be the one chased instead of running people down begging for referrals. I am now considered an expert in Cincinnati because of Mark's guidance."
This doctor has built a practice on clinical excellence.
Another doctor writes:
I have…made some solid relationships with 2 good lawyers who, on their own, not only send me patients 1-2 times per month, but they want me to do IME work for them. I didn't even ask, they referred because we came across as the experts and they now want me to review their cases.
One thing I learned was that these lawyers get new patients monthly from all over the place. They would love to send more of them to me, but just can't due to demographics so after two weeks I stopped following up. Just recently I started to follow up again. In one week, I made a huge connection with one of the biggest law firms in the state. Another guy sent me 4 new patients and I developed a relationship with a pain management MD who doesn't have any connection with anyone in this area. This shit is working just like Mark said it would and I am “half-assing it.” I could make this as huge as I wanted to if I put in a little more time and effort than one day per week.
In this doctor’s colorful way of writing, he has won based upon clinical excellence.
I could include another dozen examples, but the question of the day is, “How do you lawyers judge you?” The answer is quite simple. You are not judged based upon how good your credentials are, your knowledge or rhetoric. You are based on how they think you will do as an expert on the witness stand because that encompasses everything you know, everything you write and everything on your CV. That is the “end game” for the lawyers and if they prepare to win in their “end game,” they will prevail all along the way.
For you to have the lawyers run after you, they have to know that you are their best option in court. Every medical specialist is included as your competition for that role. If you want to play at that level, it takes a commitment of time and energy to be the best-of-the-best.