This is a running comment board concerning chiropractic and personal injury. Below were some recent comments: HCPLAW-on@mail-list.com gets you on the list Re: Trial Attorneys Lament High Chiro Bills Date: 11/7/01 Very simply, treat your patient, not what is available from med-pay. There are always those cases that step a bit out of the text book of standards, and for those, documentation is the only way to support your treatment, and your bill. This does not mean running needless diagnostic procedures. Many of these tests chiros use have questionable validity anyway. Be reasonable, and realistic with your patients that it doesn't take forever to treat a soft tissue injury, and your profile will improve with the third party carrier. They have their list of over utilizers, and if you don't think they use it, you are mistaken. The flagged practitioners make settlement for an attorney another hurdle to overcome. This list also tends to adversely effect those "good doctors" as Mr. Sherman describes. Rob, First of all, let's assume (yeah yeah, I know what that can mean) that both clinics did a fantastic job and were well within the Guidelines set by the Mercy Conference. At that point, it appears to be a problem of educating the attorney about musculo-skelatal conditions. A referral to an outside orthopedist looks good if one had been contacted, but personally I'm tired of hearing an Orthopedist just repeat everything I've said just to make a case look good. This attorney asking for help should take a seminar on CAD from either Dr. Murphy or from Dr. Croft. Heck, just sending him an updated copy of his book would be a good thing. Maybe that would be a nice thing to see on this Internet bulletin board. "Attn: all Attorneys who handle Whiplash Cases---We have the book for you! Contact the OSCA if you want the weapons to battle this war against Insurance companies and look good in court!" Sherman Response: Steven - I understant the position of Croft and Murphy and do believe that they - as the experts in this area - obtain great results. I do wonder, however, if there are doctors who obtain consistently good results in light impact cases. My conversations with attorneys throughout the nation tell me that decent verdicts in these cases are rare. They do occur, but not consistenly enough to affect settlements. ___________________________________ >From T Kline: I had just the opposite discussion with a patient, who just happened to serve on a jury, where my deposed statement was used (small town). The patient/jury- member, and fellow jurors thought, that because the chiropractic bill was so low, the injuries must not have been that severe. ___________________________________ >From Dr. M.G. Yanik Rob, The statement above you made in your recent e-mail is, in my opinion, the root of the "Chiropractic/PI problem". The largest PI law firm in the Youngstown area, one that advertises heavily in all forms of media and has been the largest for many years, has never, ever taken one of their clients/my patients to court. They also have never taken a deposition from me in the anticipation of going to court. They will settle out of court and rely on volume to make their third. Additionally, I always receive a call at settlement time asking me to cut my total fee bill no matter what the amount owing is. The insurance companies have adapted to this and know if they come in with a lowball figure that that law firm will probably take it and explain to the patient that the settlement was not very good because the claim was not a good one. I have never, in the many years and with many patients (many referred directly to me from this law firm) met with any of the attorneys face-to-face prior to settlement time, even though I have requested that we do so. If by chance, the patient's MEDPAY does cover the fee bills, this same firm, being the "representative of the patient", will bank my payment in their account while I try like hell to have them forward it on to me. There is another side to this that is important. The other attorneys in our area that do take the same type of claims, same dollar amount and same low impact accident, to court, meet with me prior to, have all the notes, reports, paystubs, take a deposition or ask me to appear in court, etc. concerning the patient, ultimately receive higher settlements and are prompt in their payment to my office for services rendered...if they haven't already forwarded the patient's MEDPAY payment to me. Moral of the story: If an insurance company knows for sure that the law firm will never go to court, why offer a reasonable figure when a lowball amount will suffice.