Subscribe to The Podcast by KevinMD. Catch up on old episodes!

We sit down with Armin Feldman, a medical consultant to attorneys. Join us as Armin shares his valuable insights into the world of medical/legal consulting, where he acts as a bridge between attorneys and treating doctors. Discover how this unique role benefits both legal professionals and medical practitioners, and hear real-life examples of how Armin’s expertise has contributed to successful case settlements.

Armin Feldman is a medical consultant to attorneys.

He discusses the KevinMD article, “Bridging attorneys and doctors: the role of medical/legal consultants.”

Careers by KevinMD is your gateway to health care success. We connect you with real-time, exclusive resources like job boards, news updates, and salary insights, all tailored for health care professionals. With expertise in uniting top talent and leading employers across the nation’s largest health care hiring network, we’re your partner in shaping health care’s future. Fulfill your health care journey at KevinMD.com/careers.

VISIT SPONSOR → https://kevinmd.com/careers

Discovering disability insurance? Pattern understands your concerns. Over 20,000 doctors trust us for straightforward, affordable coverage. We handle everything from quotes to paperwork. Say goodbye to insurance stress – visit Pattern today at KevinMD.com/pattern.

VISIT SPONSOR → https://kevinmd.com/pattern

SUBSCRIBE TO THE PODCAST → https://kevinmd.com/podcast

RECOMMENDED BY KEVINMD → https://kevinmd.com/recommended

GET CME FOR THIS EPISODE → https://earnc.me/WAx1wH

Powered by CMEfy.

Transcript

Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast and get CME for this episode by clicking on the CME link in the show notes. Today we welcome back Armin Feldman. He’s a medical consultant to attorneys. Today’s KevinMD article is titled “Bridging attorneys and doctors: the role of medical/legal consultants.” Armin, welcome back to the show.

Armin Feldman: Hi, Kevin. Nice to see you again.

Kevin Pho: So Armin’s been on multiple times. Go to the upper right-hand corner, to the search bar, look for his name, and hear his story. But today, let’s go right into your most recent article, “Bridging attorneys and doctors: the role of medical/legal consultants.” How did this article come about?

Armin Feldman: Well, I wanted to give your doctor readers something a little different. As you know, I do medical/legal consulting. I’ve been doing it for the last 16 years, after starting this new field of forensic medicine. Some of the typical things we do, for example, are to write comprehensive medical summary reports that attorneys use as part of settlement demand letters. We write reports that answer specific medical questions, helping attorneys to prove up medical theories for cases. But this one is a little different. I wrote the article about medical/legal consultants working as a liaison for the attorney that’s hired them.

Typically, what we’re doing when we do this is that the attorney wants us to meet with a treating doctor that’s involved in the injuries of the attorney’s case. It’s actually kind of hard for attorneys to get to talk with the treating doctors. First of all, they’re all busy. A lot of them don’t want to pick up the phone when they know that an attorney is calling. They think they may be dragged into some litigation that they don’t want to participate in. And so I developed this service where we act as medical/legal consultants. In this particular case, I was asked to meet with a treating doctor to see if they were going to be on board with the attorney’s theory of traumatic causation in the case.

This was a typical bread-and-butter case where the client was rear-ended in an accident. Right after the accident, the client had the onset of low back pain. It was radiating down his left leg, and it wasn’t getting better. Subsequently, an MRI was done, and he had a disc protrusion at L4-5. The attorney asked me to write an opinion letter regarding whether this was related to the accident. So I did that, and it was my opinion, to a reasonable degree of medical probability, that the accident was the immediate proximate cause of the client’s problems. That was after talking to the attorney, reading the medical records, interviewing the attorney’s client, and doing whatever medical research I needed to do.

In the areas of law in which I consult, probably nine out of 10 cases settle. So the attorney was trying to settle this case, and he was getting close to submitting a settlement demand letter. He thought it would be a good thing if the treating doctor in this case, the one treating that low back pain, also wrote an opinion letter. But he wasn’t certain if that treating doctor was even in agreement with our opinion that it was the accident that caused the problem. So he asked me to meet with the treating doctor.

I called the treating doctor, and I explained that I’m working with this attorney and that I do this routinely: “The attorney asked me to call you and see if I could make an appointment to see you. We wanted to talk about your patient, Mr. So-and-so, and specifically talk about his low back pain and the cause of that.” So I set up the appointment to meet at the physician’s office. The attorney paid the physician for the time, and then we discussed the case. Sometimes the physician and I will go back and forth, but in this case, the physician also agreed that the back pain was related to the accident.

The hook in the case was that this client had an episode of low back pain sometime in the past, and he sought medical care for it. So the attorney that hired me was concerned that opposing counsel was going to say it’s just a pre-existing condition. By the way, something you may know is that about 50 percent of all Americans, sometime in their life, will seek out medical treatment for a low back problem. In most of those cases, it’s a single event, and it never comes back as a chronic problem, which was the situation in this case. So the attorney wanted to make sure that the treating doctor also thought it wasn’t a pre-existing condition and that it was related to the auto crash. We discussed it, and he agreed that he thought that was the case as well. After I met with the physician, the attorney called him and said, “Can you write an opinion letter stating that you thought that the auto crash was the cause of the problem?”

Kevin Pho: And it goes to show that, in general, physicians are more comfortable talking to other physicians, right?

Armin Feldman: Yes, absolutely. The attorneys that I work with are confronted with medical issues in every case, right? So they know some medicine, but they aren’t doctors. They didn’t go to medical school. Sometimes they get the terminology wrong, or pronounce the words wrong, or don’t have a good idea of the physiology or whatever. It certainly helps the attorney, the case, and ultimately the injured person when a physician meets doctor-to-doctor with a treating doctor, or with a professional at an agency, or social services, or physical therapy, whatever it is.

Kevin Pho: Now, when you talk to these doctors, do you do it from both the plaintiff and the defendant side?

Armin Feldman: That’s a good question. First of all, I only work on the side of injured people. I have my own issues with working on the insurance side; it’s something that I don’t want to do. But the interesting thing is, even if you wanted to work on both sides, the system will determine where you work. It turns out that the attorneys who know about what I do with regard to medical/legal consulting, and who are interested in my services, are plaintiff and claimant attorneys. Defense attorneys really aren’t interested in my services. Their go-to doctors are doctors who primarily always work on the insurance side.

Kevin Pho: Now, when you talk to doctors and you say you’re representing or working on behalf of an attorney or some type of legal counsel, are these doctors a little bit apprehensive, or is it a more collegial conversation?

Armin Feldman: They are at first. But when I speak with them on the phone to set up the appointment, I let them know, “Look, I’m not there to look over your shoulder, criticize what you’ve done, or argue with you about your diagnosis or treatment. I’m just acting as a liaison to help this attorney try to optimally help their client.” Once they realize that I’m not there in a confrontational way, they are happy to meet with me. They’re cordial. These meetings always tend to go well, even if they don’t agree with the attorney or my opinion.

Kevin Pho: How common is it for attorneys to use physician liaisons like yourself?

Armin Feldman: It’s not that common. The way this works is that if the attorney knows about the kind of medical/legal consulting that I do, or that other physicians around the country are doing (and I’ve trained over 1,600 physicians around the country to do this), if they’ve already been educated as to what it is that we do and what we provide, then it becomes a common service. But out in the rest of the world, attorneys who don’t know about these services don’t use physicians in a liaison way.

Kevin Pho: When I talk to other physicians, one of the biggest fears they have is being dragged into some type of legal case or being dragged into a deposition. Would interacting with a physician liaison like yourself decrease the incidence of them directly testifying in some type of deposition or court hearing?

Armin Feldman: Yes. Again, that’s a great question. The answer is yes, and here’s how. Most of these cases are settled; maybe one or two out of 10 will go to trial. Almost always, the purpose of my meeting as a liaison from the attorney to the doctor is to clarify something that will give the case a much higher percentage of settling. So by my meeting with the doctor, the likelihood that the case is going to go to trial, and that they’ll be in a deposition or asked to be an expert at trial, lessens. I let them know that, and that actually makes them more inclined to meet with me.

Kevin Pho: One of the things that you said earlier was how busy physicians are, and scheduling an appointment, even though it’s paid by the law firm, is sometimes very difficult. I get this question a lot, actually. What rates do physicians typically charge, or what rates are typically compensated to physicians who accept appointments from attorneys or physician liaisons?

Armin Feldman: It’s a good question, but the answer is it really varies. There’s no standard rate for this. First of all, I’m not involved in that negotiation, but the feedback that I get from attorneys is that every doctor has a different rate, and it kind of varies by specialty. If I’m going to meet with a neurosurgeon, who knows what that’s going to cost. No knock on family physicians, but if I’m going to meet with a family medicine doctor, that rate’s less.

Kevin Pho: And if a physician simply says no, or doesn’t want to have anything to do with attorneys or liaisons, do you simply take that at face value? What do you do to try to get a conversation or interaction with the physician?

Armin Feldman: It depends on what kind of physician. If it’s a treating doctor, one of the doctors treating one of the injuries of that attorney’s client, we’re not going to argue, right? Because the attorney has to have as good a relationship with the treating doctors as possible. If it’s someone other than a treating doctor and it’s important to the attorney, I might press that doctor a little bit more to meet with me.

Kevin Pho: Now, speaking from the other end, if physicians are interested in becoming liaisons between attorneys and other doctors, what kind of medical background should they have?

Armin Feldman: The great thing about being a medical/legal consultant is that it really doesn’t matter what your specialty is. As you know, I answer any kind of medical question that comes up in a case. The reason I’m able to do that is that these are cases that are not going to trial. And even if they wind up going to trial, if I write a report for that case, both sides are going to stipulate that I’m not an expert in everything, and they’ll both get their experts. But for the purpose of negotiating and settling the case, what the attorney who hires me needs is medical opinions that are well thought out, well reasoned, and backed up by evidence from the literature. So every time I’m rendering medical opinions for the attorneys who hire me, I’m also doing the medical research so I can back up my opinions with evidence from the literature.

Kevin Pho: Now, for these physicians interested in becoming medical/legal consultants, what kind of legal training should they have in order to feel comfortable in this role?

Armin Feldman: Right. There are things in the legal system that they absolutely need to know, but those would be incorporated in their training to become a medical/legal consultant, like the kind of training that I do. Let me give you a real simple example. By the way, one of the things that I say to the physicians I train, since I was the first one doing this, is that most of the things I’m teaching them are from mistakes that I made early on.

So a simple thing would be: You never, ever want to put anything related to the case, the strategy, what the client said, and so forth, in an email to the attorney, because if that case eventually gets filed and is set up for trial, then everything is discoverable, right? So one legal thing that the doctors need to know, which I teach, is that if you need to say something important to the attorney, here’s what your email should say: “Please call me.”

Kevin Pho: We’re talking to Armin Feldman. He’s a medical consultant to attorneys. Today’s KevinMD article is titled “Bridging attorneys and doctors: the role of medical/legal consultants.” Armin, let’s end with some of the take-home messages you want to leave with the KevinMD audience.

Armin Feldman: I think here’s one of the most important take-home messages. In this day and age, with doctors being employees of big corporations or hospital systems, one of the biggest trends in medicine is for physicians to have a side gig, right? And it helps with alleviating burnout, too. If a physician is looking for a great side gig where they want to do some nonclinical consulting, but they really want to help people, one of the great things is that we get to help these injured people. So if they want something that’s interesting, fun, and actually lucrative, where they get to learn a lot of medicine about a lot of different things, this would certainly be something for them to look into.

Kevin Pho: Armin, once again, thank you so much for sharing your time and insight, and thanks again for coming back on the show.

Armin Feldman: It was a pleasure. Nice to see you.