In my experience, people believe their medical provider will, almost without question, give them excellent medical care. Unfortunately, as an attorney working in personal injury law, I sometimes find this belief to be misplaced. In that regard, I am frequently amazed at the different levels of medical care clients received.
Some providers – be they chiropractors, physical therapists, or medical doctors – are excellent. They monitor their patients’ physical development. They emphasize individualized treatments that work, and they discard treatments that don’t. They take detailed computerized notes. They develop customized home exercise programs. They work with other medical providers to deliver consistent care. There are willing to try different healing treatments even if doing so means sending a patient, and the patient’s business, to another medical provider. The excellent care these providers give helps everyone. The client/patient heals faster and better, and the attorneys and insurance companies are able to resolve legal claims more efficiently.
Some medical providers are less than excellent. They do not adequately communicate with their patients, with the result that their patients often do not know their own diagnosis or prognosis. They keep poor records, making it difficult to understand the nature and extent of their patient’s injuries. They apply a “cookie-cutter” approach to patient care, meaning that they do not tailor their treatment to a patient’s individual needs. They keep applying the same treatment even when it doesn’t work, thereby needlessly increasing a patient’s bills. They will not refer the patient to another medical provider nor try a different approach when their patients don’t improve.
Several years ago, a client told me that his doctor advised him to start physical therapy. My client called the recommended physical therapist, but the therapist was unable to see my client because of a work schedule problem. Ideally, my client and his doctor would have discussed finding a physical therapy practitioner who could have accommodated my client’s job demands. Instead, the doctor was too busy to pursue the issue, and my client, believing he was following his doctor’s lead, did not mention the matter again. Later, my client was shocked to learn that his doctor had written a chart note stating that the client/patient had refused physical therapy and, as a result, was sabotaging his own recovery. The chart note, with which my client vehemently disagreed, devalued my client’s personal injury claim.
I’ve witnessed even more extreme situations. A former client went to a chiropractor more than 80 times over a six-month period. Her chiropractor made a record for each visit, but the record consisted of little more than a series of check marks and illegible scribbles on fill-in-the-blank, one-size-fits-all medical forms. It looked as though no thought went into the chart notes or my client’s care. I could not follow my client’s progress, and I could barely ascertain the diagnosis. While my client dutifully went to her scheduled appointments, at a cost of many thousands of dollars, she received almost no health benefit. From a legal perspective, there was a good argument that his treatment was unnecessary and prolonged. The records certainly damaged the personal injury claim.
Because not all medical care is as beneficial as it could be, I think it absolutely vital my clients and my office cooperate to navigate these issues. We encourage clients to politely ask their medical providers if they use electronic notes, if they are open during non-traditional hours, and/or if they are willing to occasionally meet for an extended appointment. We talk with our clients at least one a month to monitor their care and make sure they are receiving consistent, helpful, productive medical treatment. We encourage our clients to ask questions and to find out if other treatment would be more helpful. When our clients are at a loss, we’ll talk to their medical providers to gain a better understanding of their injuries, diagnoses, and outlook. We’re there to help gain knowledge, with the idea that knowledge will assist in the healing process.
It’s understandable that a personal injury victim may feel, at least initially, somewhat reluctant to be so assertive. No one wants to question his or her doctor, and personal injury victims bear the burden of dealing with insurance companies, carving time out of their lives to rest and heal, earning an income, raising a family, paying rent or mortgages, etc. It’s understandable that a patient would want to cede the entire healing process to the health care provider.
Nevertheless, I think such joint advocacy is crucial. Patients that actively monitor their treatment, that partner with their health care providers to seek the most beneficial care, and that understand what their treatment provider is doing, will most often heal faster and with less cost. If physical therapy, drugs, chiropractic care, or a combination of these is not working, patients should work with her providers to find better, alternate treatment.
