MEDICOLEGAL

MEDICOLEGAL

NOTHING TO DISCLOSEBAGNALLS MAXIM POWERPOINT IS THE VIAGRA OF PUBLIC SPEAKING

DISCLOSURE: I HAVE NO INTEREST, WHATSOEVER, IN VIAGRA.EVER!!

WHO AM I?PRIVATE OUTPATIENT MSK/INTERVENTIONAL PAIN PRACTICE FOR 24 YEARSAAPM&R BOG/ACADEMY WORKTEACH AT THE LOCAL MEDICAL SCHOOLSTARTED MEDICOLEGAL WORK 24 YEARS AGOMY FIRST EMPLOYER OUT OF RESIDENCY INTRODUCED ME TO PI CHART REVIEWS.IMES/DEPS FOLLOWEDPI: LOCAL DOCTOR RUN REFERRAL SERVICE WCI: TREATED PATIENTS, IMES FOLLOWED

PHYSIATRISTS & MEDICOLEGALWE ARE THE PERFECT DOCS FOR THIS WORKWE SEE THE WHOLE PERSON, MANY DISCIPLINES UNDER OUR UMBRELLA OF EXPERTISE, SYNTHESIZING MULTIPLE DATA POINTS (MULTISYSTEM)WE KNOW HOW TO AVOID UNNECESSARY INTERVENTION & (SHOULD) KNOW THE CORRESPONDING LITERATUREWE ARE DISABILITY/ABILITY SPECIALISTS

THE PI ARENAWHAT IS PI?CHART REVIEW VS OCCASIONAL IMERULES OF EXPERT TRANSPARENCY DISCOVERY DEPOSITIONEVIDENCE DEPOSITIONBINDING ARBITRATION VS OCC TRIALMANY SETTLE

THE WCI ARENAWHAT IS WCI?LAWS DIFFERENT (PAIN/SUFFERING)ARBITRATOR/EV DEPTREATED THESE PATIENTSMET THE NCMSADJUSTORS HEARD OF/LIKED ME (?)TREATED THE NCMS, ADJUSTORS &/OR FAMILY

DISABILITY ARENANON-SSDI EVALSMAY HAVE CONCURRENT SSDIUSUALLY DISABILITY INSURANCE COMPANY EVAL (DEFENSE) VS ATTY REQUESTED (PLAINTIFF)OFTEN NO ATTY INVOLVEDINJURY LITIGATION OFTEN N/A OR SETTLED

MEDICAL MALPRACTICE ARENAMESSYCANT AFFORD MEPLAINTIFF OPINION WORK UNTILHOW TO BE A GOOD EXAMINER HAVE AN OPINION (TF)TESTIFY WELL (GET YOUR INTENT ACROSS & HAVE FACTUAL SUPPORT)TRY TO DO PLAINTIFF AND DEFENSE CASESGIVE THE PATIENT BENEFIT OF THE DOUBTDO NOT CHANGE AN IME REPORTADDENDTELL THE TRUTH, BE HONEST IVE LOST BUSINESS FINDING MISSED PATHOLOGYIME STANDARDSSCHOFFERMAN J. PAIN MED. 2007 MAY-JUN;8(4):376-82MARTELL MF, ET AL. PHYS MED REHABIL CLIN N AM. 2001 AUG;12(3):571-85RICH BA. PAIN MED. 2006 SEP-OCT;7(5):460-3BAL S. CLIN ORTHOP RELAT RES. FEB 2009;467(2): 383-391KLEE CH. NEUROREHABILITATION. 2001;16(2):79-85

IME STANDARDS (CONT.)REPORT TO AMA BOARD OF TRUSTEES, B OF T REPORT 5-A-98AMA GUIDES NEWSLETTER NOVEMBER/DECEMBER 2005 EDITIONhttp://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/opinion907.pagehttp://www.cbs.state.or.us/wcd/communications/publications/4913.pdf

MARKETING

MARKETING TO WCISYMPOSIA (CME?)SEMINARS/SPEAK AT NCM ASSOCIATIONS (RING)SEMINARS/SPEAK TO ADJUSTORSSEMINARS/SPEAK TO SPECIAL INVESTIGATIVE UNITS OF INSURANCE COMPANIESDO A GOOD JOB!

WCI CASE MANAGERSGIVE THEM A ROOM & A PHONEAFTER AN IME MEET THEM & DICTATE IN THEIR PRESENCEANSWER THEIR QUESTIONSHAVE AN OPINIONGIVE SPECIFIC RESTRICTIONSREPORT PROMPTLY BE AVAILABLE FOR APPOINTMENTS/CALLS

MARKETING TO PII DONT.PERIODLISTS (PAID VS FREE)LISTING/REFERRAL COMPANIESADSABIME, AADEP CERTIFICATIONS (INCLUDING ACRONYMS AFTER YOUR NAME)IICLE TALKSACTUAL IME REPORTTHIS GENTLEMAN HAS AN EXCESSIVELY NONORGANIC EVALUATION, AS LISTED ABOVE. HE HAS MULTIPLE BIZARRE COMPLAINTS THROUGHOUT THE ENTIRE BODY, WHICH MAKE LITTLE, IF ANY, MEDICAL SENSE AND ARE NOT OBJECTIVELY SUPPORTED.

PAIN DIAGRAM

IME REPORT (CONT)NONE OF HIS TREATERS HAVE ACTUALLY GIVEN HIM ANY MEDICAL DIAGNOSIS OF ANY SIGNFICANCE. HE IS NOT A CANDIDATE FOR ANY FURTHER TREATMENT OR TESTING RELATING TO THESE COMPLAINTS.

TESTIMONY GOALSDISCOVERY: FIND OUT THE FACTS IN THE CASEEVIDENCE: PRESENT THE EVIDENCE IN THE CASE TO A JUDGE, JURY OR ARBITRATOR/SIMPEACHMENT ATTEMPTSOPPOSING ATTY WILL ATTEMPT TO DISPROVE OR DISCREDIT YOUR OPINIONS &/OR YOUR QUALIFICATIONSDAUBERT STANDARD MET

TESTIFYING WELLLISTEN TO THE QUESTION: SINCE YOU SAID THE PATIENT IS RIGHT HANDED, DOES THAT MEAN..?ANTICIPATE EXACTLY WHAT THE ATTY WANTS TO KNOW BY ASKING THE QUESTIONTRY TO ANTICIPATE THE NEXT QUESTIONHYPOTHETICALS: IS IT POSSIBLE THAT A FAIRY SPRINKLED DUST ON THE PT WHILE THEY SLEPT?HOW MUCH ARE THEY PAYING YOU FOR YOUR OPINION TODAY?

TESTIFYING WELL (CONT.)A GOOD WITNESS MUST HAVE CONFIDENCE & FIRM BOUNDARIESDO NOT THEORIZE: IS THE PATIENT HAVING PAIN?DO NOT OVEREXTEND: DENTAL WORK, PSYCHBE CONSISTENT (PRIOR TESTIMONY IS OUT THERE) THIS IS NOT A CONVERSATION (BULLYING)YOU CAN OBJECT TO A QUESTION!IF YOU TEACH, YOU CAN TESTIFY

BUSINESS OF DOING BUSINESSNO SHOW/LATE CANCELATION OF IME=FULL CHARGEI BILL IMES PER BODY PART, PER INJURY, EXTRA FOR COPIOUS RECORDSTRAVEL TIME MAY BE BILLED (PORTAL TO PORTAL)

BUSINESS OF DOING BUSINESS (CONT.)2 HR DEP MINIMUM, NOT COUNTING PREP TIMEDEP CANCELATION=1 WEEK IN ADVANCE, GET DEPOSIT UP FRONTALWAYS GET PAYMENT UP FRONTALWAYS

DID I MENTION? ALWAYS

DID I HAVE AN OPINION?

IS SURGEON IN A BETTER POSITION?DISCREDITED?

AM I A PSYCHOLOGIST?DISQUALIFICATION?

IS HE A MALINGERER?OVEREXTENSION?

DONT DO MEDICOLEGAL IF:CANT ARTICULATE WELL DURING TESTIMONYCANT BACK UP ARGUMENTS WELL WITH RELEVANT EVIDENCE BASED STUDIESDONT FEEL COMFORTABLE WITH TAKING ON DOCTORS WITH DIFFERING OPINIONSCANT TAKE THE HEAT OF UNHAPPY PATIENTS (RATINGS)CANT BE DECISIVE WITH DIFFICULT OPINIONS/RECOMMENDATIONS

DONT DO MEDICOLEGAL IF (CONT.):CANT BE PROMPT WITH (LONG) REPORTSARE BAD/INFLEXIBLE WITH DEADLINESCANT BE AVAILABLE FOR SCHEDULING OF IMES, DEPOSITIONSCANT GET TO RECORD REVIEWS PROMPTLYARE NONCONFRONTATIONALDONT LIKE TALKING TO LAWYERS

DESTINATION: TENACATITA