Academy of Chiropractic’s

Lawyers PI Program

#225

 
From the Desk of:

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

Become Indispensable to the Lawyer: Part 1

"Become the Lawyer's Consultant"
Additional Profit Centers

 

Over the years, I have met with many, many lawyers to review their cases and strategies. The last time was recently when the lawyer brought with him the blown-up poster board of the MRI for the jury to visualize at a cost of $300 to the lawyer. Upon not so close inspection, I informed the lawyer that the visual was an outstanding piece of evidence...for the DEFENSE.

His expert had read the films incorrectly and they were arguing the wrong level with a degenerative finding while ignoring the multiple herniations in different areas. This was evidenced on the axial slices and not the sagittals. This 5 minute encounter saved the lawyer $40-50,000 in lost revenue as that is what the verdict was after re-focusing his expert (physical medicine specialist) on the correct traumatically induced lesion. The question is what is that worth to a lawyer? The answer is $750 for 3 hours of my time to review the case and make recommendations.

What are you worth to the lawyers? The answer is zero, nothing, zilch...unless you educate the lawyer to the value of your opinion and guidance and that comes with time, communication and trust. The trust is solely based upon the lawyer's experience with you as an expert on spinal related issues and your credentials. We have a few doctors who are currently consultants for lawyers that charge anywhere from $200-$250 per hour.

Services rendered:

1. Medical report review & interpretation

a. Plaintiff's doctors

b. Defense's doctors

2. Imaging review (x-ray/MRI)

3. Demonstrative evidence (display) recommendations

4. Direct questioning preparation

5. Cross examination preparation

6. Closing statement preparation

7. Functional loss determination

8. Additional tests needed/evaluation prior to trial

9. Permanency determination

10. Research relevance

11. Creating outlines of the entire case - injuries with correlating data

12. Marking films

This past week, a lawyer paid me for 2 hours of my time to review MRIs. The plaintiff's radiologist diagnosed a compression fracture at T10 and the lawyer was preparing to go to trial. The defense radiologist diagnosed a normal spine with no fracture at T10. The cost for the lawyer to prepare for trial, including having the plaintiff's radiologist testify, would have been close to $10,000 in time and expenses. Upon reviewing the MRIs and cross referencing the T10 segment on plain film, I saw there was no compression, not even slightly. The plaintiff's radiologist misread the MRIs. The lawyer was extremely thankful that I saved him $10,000 and happily wrote me a check for $500 for 2 hours of my time.

Another doctor reviewed a case for a lawyer and took that lawyer's case from $20,000 to $250,000 because he supplied him with the relevant research regarding the bodily injuries. The carrier raised their offer in settlement upon the lawyer providing them with the research to refute the defense doctor's IME report (a.k.a. bullcrap piece of fiction). Once the lawyer has independent "peer reviewed" verification, an experienced lawyer will know how to use that as leverage to increase his/her settlement and/or verdict because it is steeped in truth vs. nonsensical rhetoric.

You are very valuable to lawyers both as their expert or as a consultant. The only thing needed to be successful at this is educating the lawyers. If you have 5 lawyers who work with you at this level, you can resonably estimate that each lawyer will work with you on 1 case per month for approximately 6 hours per case, 3 hours spent in background research and obtaining research and ancillary materials, along with marking MRIs and x-rays and creating an outline of the bodily injuries with correlating objective data. An additional 3 hours of direct (face-to-face) time to explain everything. Averaging $200 per hour, that is an extra $72,000 yearly and you are solidifying your relationship for direct referrals. Not bad for "profitizing" your free time using your clinical excellence. The numbers slide based upon the number of lawyers you are working with.

The single best way to accomplish this is through a lawyers seminar where the lawyers get to experience our level of understanding through my handing the baton to you. It is a process that has worked nationally and will continue to do so.

Another avenue is to inform them in your face-to-face meetings that you are available to review cases formally. In the "Forms-Communication Materials" section of the Web site is the following letter that you can download and add to your educational binder when meeting with lawyers:

Printed on letterhead

August 1, 2011

RE: Personal Injury Case Preparation
Assure All Bodily Injuries are Reported and Argued Clearly and Accurately

A typical scenario is that all of the medical results are gathered directly by you or your staff. In that gathering, many times a case will appear either very good, marginal or not so good depending upon the clinical findings, or lack thereof. In the experience of both myself and my colleagues locally and nationally lawyers often miss both the nuances and significant issues that compromise the results of the case.

Your world is res judicata, collateral estoppel and res ipsa loquitur of which those terms and meanings are "systemic" to you and integral to your basic training as a lawyer. Words like stenosis, cord compression and myelopathy are part of the basic training to doctors specializing in spine and trauma and although you have possible argued cases with these findings in the past, their complete understanding and bodily injury implications can often go underreported negatively affecting your case.

Many lawyers also accept the results of radiologists as gospel and according to Lurie, Doman, Spratt, Tosteson and Weinstein in 2009, 42.2% of all general radiologists did not clearly describe the morphology.[1] That means that although some radiologists are clinically excellent almost 50% make errors based upon the research and you are arguing those errors. You need a second opinion to ensure you do not have surprises when settling or arguing in the courtroom after you have spent significant resources to get to that point.

The following services are available:

1. Medical report review & interpretation

a. Plaintiff's doctors

b. Defense's doctors

2. Imaging review (x-ray-MRI)

3. Demonstrative evidence (display) recommendations

4. Direct questioning preparation

5. Cross examination preparation

6. Closing statement preparation

7. Functional loss determination

8. Additional needed tests/evaluation prior to trial

9. Permanency determination

10. Research relevance

11. Creating outlines of the entire cases injuries with correlating data

12. Marking films

Most significantly, I will mark your films and create an outline for you to sit with your expert in preparation of your case as well as question preparation for witnesses.

I look forward to working with you and if you or your staff needs brief answers to any medical related issues, as always, there is no fee.


Respectfully,

  

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


[1]Lurie, J. D., Doman, D. M., Spratt, K. F., Tosteson, A. N. A., & Weinstein, J. N. (2009). Magnetic resonance imaging interpretation in patients with symptomatic lumbar spine disc herniations. Spine, 34(7), 701-705

Being the best-of-the-best means more than knowing the information, it means being able to leverage that information into income because the legal profession is expert at law and not medicine. No matter how experienced the lawyer is, you have to remember he/she is not a doctor. I have heard the erroneous argument from too many of you that the lawyer you are going to have a meeting with is vastly experienced and knows "it all." My answer is clearly, "They don't." They are lawyers and have never studied medicine. Knowledgeable, yes, but expert...NO. You are the expert.