Episode Transcript
[00:00:00] Speaker A: Foreign.
[00:00:18] Speaker B: Most firms survive. The best ones scale.
Welcome to the Managing Partners podcast, where law firm leaders learn to think bigger.
I'm Kevin. Daisy.
Let's jump in.
All right, what's going on, everyone?
We are recording. I have a really interesting guest today, someone I met in California. I was there for Law de Graw, hanging out with lots of folks that I know, lots of guests off this show.
You know, Bob Simon and Jen Gore, and there's a lot of folks I was there meeting with and ran into this gentleman. We actually hooked up a couple times and connected throughout the days and talked about what he does. And I remember him saying, hey, you got to come to my talk. It's a really interesting talk. It's totally different. And I was like, okay, I'll be there. And, of course, I did get this talk.
So we've reconnected recently, and he's got just a.
A different take here, and something that I haven't really been exposed to myself very much as a marketer for a lot of PI firms.
But I want to introduce you to Kent. So, Kent, welcome to the show.
[00:01:32] Speaker A: Well, thank you for having me. It's a pleasure and honor to be here.
[00:01:36] Speaker B: Yeah.
Appreciate you coming on the show to share today. You know, I guess I want to dive right into the conversation, and maybe we'll have you tell your background here in just a little bit. But, you know, one of the things that Kent brought to me is, like, you know, these medical professionals, and. And he's like, I. I got this topic, you know, how they could be unintentionally, you know, causing problems with the. In your cases.
And so I was like, oh, that's. That's interesting.
And so I, you know, just want you to kind of dive right into it. I know you have a few things to share, a couple things. Three different concepts for us to think about here, but just dive right in. Like, what does that mean?
And what should these lawyers that are listening in, the PI firms out there be thinking about and how they can change their mindset about this?
[00:02:26] Speaker A: Great. Yeah, my background is, you know, I've been a practicing chiropractor for 25 years, and as most of us, you know, rather than getting hospital jobs or maybe working in a big orthopedic clinic, which some of my colleagues have done, we start our own businesses. And when you start your own business, you pretty much let your family and friends know. I open an office here, and as you trek along, you get involved with the insurance companies of taking HMOs, PPOs, worker comp, cases, you'll have some attorneys look for the next person down the street, or maybe they use social media or something to find a reputable chiropractor. I've always worked with the medical doctors from the very beginning, so it was a natural fit for me to be involved with personal injury. So for the first 15 years, I had pretty much a diversified patient base, which comprised a minority of personal injury cases. And for 15 years, it took me 15 years to realize there was something wrong with the whole personal injury lean work business. Meaning I don't know if it was my problem or the attorney's problem or the case manager's problem. I was just someone treating someone, providing whatever medical records I learned in school or from someone else, and just waiting to see if I can get paid. And for the first 15 years, it was pretty brutal.
And I realized after I met some very, very special people in my life. Attorneys, case managers, those that had been very successful in personal injury, that I started to realize I was making a ton of mistakes.
Now, no one's perfect. Whether you're a treating medical provider or an attorney, no one's perfect. But I said to myself, let's identify some things going wrong on the medical side and see what I can do to stop unintentionally messing up. I mean, for lack of a better term. So I picked the brain of a lot of very smart attorneys and paralegals who have had great success helping their clients get good medical care on lean, making sure that the injuries and the complaints were covered. And then also this idea of making sure that the insurance company was able to pay up whatever they felt was necessary to make their client whole, which in most cases, unfortunately in California, since the policies are mostly half of them were like minimum policies. I don't even know what they meant for the first 15 years. But understanding how insurance companies cover their clients, whether it's from the third party or who's responsible to maybe something called underinsured or uninsured bodily injury liability. These are things I didn't even think about the first 15 years, nor did anyone teach me, until I started prying. And then I realized there's a lot of stuff you need to know to make sure that these clients and patients get the best outcomes. And we all want the same thing. We want those people that are injured, no matter how small the car crashes. We want them to get great medical care, proper documentation and diagnoses, and really try to resolve this claim efficiently as possible. No one wants to drag out a injury case that might only have a maximum value of 15,000 or 25,000 or even a hundred thousand dollars unnecessarily, unless there's some hiccups along the way. But I realized what I did for the first 15 years was just kind of drag things out and kind of let the patient or client control what they wanted. And I realized for a patient to get through the process, someone had to quarterback that case. And what I mean by that is, instead of being a bunch of medical providers doing their own thing and just being part of a system that everyone tries to put together like puzzle pieces, those puzzle pieces never seem to fit. And some of the concepts I want to cover today, and hopefully this will be a great teaser for future questions and answers and maybe even as we met over at La de Gras last year, I was on several of the panels. I moderated two of them, and we had a great turnout. You know, in this little room, we had probably over 100 people. And I think it was standing room only.
[00:06:46] Speaker B: I had to stand in the back.
[00:06:47] Speaker A: Right. And the subject matters were, you know, how we can handle these soft tissue, low property damage cases or cases with gaps in care.
You know, even though chiropractic doctors are important part of most PI cases, they have an essential role in my opinion of quarterbacking these more difficult ones. Small property damage, maybe you can't even see it. And then maybe a gap in care where we need to document and explain exactly why the person didn't see something, someone or what they did to help mitigate or deal with their injuries. And so for the last 10 years, I've created a educational program that now involves up to four webinars a week covering all types of med legal topics from A to Z for the last close to eight to nine years.
So with respect to education, not that I'm perfect, but I think I have a lot of great things to offer because I have a lot of medical brain providers teaching them how to do PI better in terms of medical record keeping, reasonable billing, and making sure we have a full, comprehensive team to help these clients get better. And that's very new concept to a lot of medical providers, is let's try to think more like an attorney and think about policy limits and things about limitations to cases. And also when cases have no limitations, make sure we don't leave any stone unturned, make sure we document things properly and not feel like we have to rush through anything, unlike some other cases where maybe there's a cap on it. And these are concepts that all tie in together that hopefully we can throw out there today. And I came up with three concepts that I think are important for any PI case.
Well, love it. And maybe before we even get started, as we were chatting before, the real question is, are providers messing up PI cases?
[00:08:49] Speaker B: Today's episode is brought to you by Answering Legal. Now, I just switched my company Array digital over to Answering Legal and it's made my life a whole lot easier. If I can't get to the phone, their 247 virtual receptionists take the call and take them through a full intake process so we never miss new business again. Now Answering Legal has been at this for more than a decade and they specialize in answering phone calls for law firms like yours. They even have a brand new easy to use app and they integrate with all the top legal softwares and platforms. So from our listeners today, we actually have a special deal of a 400 minute free trial offer of Answering Legal services that you can try out by going to answeringlegal.com array. You can also call 631-437-4803 and use special code Daisy. That's my last name.
S E Y. Go check them out and let's get back to the show.
[00:09:50] Speaker A: Now are there lawyers that say, hey, I know you got rear ended, you got a little bit of neck pain from whiplash, why don't you go to urgent care ER if it's necessary, why don't you go see your primary care, why don't you do pt? Why don't you maybe go to the chiropractor? And most attorneys unfortunately don't have the best experience with chiropractors because they seem to over treat and not refer out and they seem to be very selfish about these cases, which I don't think is right. I think the client is number one and I think our patients are number one. And we need a, a very diversified team of medical specialists to help these people get the care that they need in a very timely fashion.
[00:10:29] Speaker B: Yeah, you were talking about that before, about, you know, doctors not referring out and just trying to keep things within their expertise.
[00:10:37] Speaker A: Yeah, I think what it is is maybe it's inexperience or maybe insecurity where, like when, when we treat patients and we try to help them, we're trying to fix everything. And even though our intentions might be good, the idea of working with MRIs early, with radiologists calling them and talking about what they find on those things, whether they're preexisting or injury related, having those deep conversations is not kind of in the wheelhouse of most chiropractors going out and meeting and referring to pain management physicians when we aren't able to get those patients to the pre collision status in a timely fashion. I truly believe that needs to be done in a four to six week period period and that six to eight month period where that thing just drags out it seems like for the patient. And I'm well connected to neuropsychologists, neuro, optometrists, optometrists, pain management physicians, orthopedic surgeons, audiologists, psychiatrists, counselors, ophthalmologists. So these are all potential providers. Maybe not in every single case, but we need to have that in our Rolodex. For some of you older people, we have that have that in our Rolodex to to able, be be able to turn to that and say here's someone that I trust.
I would send my only my family and friends there. And then they are also hopefully trained to not unintentionally harm PI cases. So the three concepts I wanted to talk about are credibility, causation and consistency.
And those have hours within and hours within subsets of those things. But what I want to ask as.
[00:12:17] Speaker B: Much as we can.
[00:12:18] Speaker A: Yes, but I think it's a great teaser regarding credibility. Now when it comes down to someone that calls an attorney or sees me as a patient, says I was rear ended and I have some neck pain, the whole idea is, is it's a very common scenario where there's a car crash and it should be a simple concept to create a credible claim, which is, why don't you go see some doctors and why don't you let me know after all the doctors take care of you and you let me know how you're doing and I'll do my job as an attorney and ask the insurance company to pay me a certain amount of money. Well, the problem with that is the medical system is broken because there's a lot of primary care doctors that are like, well, you're involved in a car crash. Well, I don't deal with car crashes. Why don't you go to a car crash doctor?
And that can hurt. Because even if they did take them in, the medical record keeping would be maybe a little bit lazy or a little bit like, you'll be okay, take this medicine, get a little physical therapy, you'll be good to go. And now the lawyer's like, how you feeling after like three months? Are like, yeah, I feel better, but I'm still having some neck pain. But then all the medical records show that the person's fine or they reach what's called maximum medical improvement, which I don't believe that word should ever exist. And then now the insurance company's like, what do you want us to pay for? There's not a whole lot of future medical care here. And so it kind of kills the case. But the truth is, is a patient that's injured in a car crash, the natural progression should be go see a doctor, typically a conservative treater. Let's go ahead and do conservative treatment. If it's a non catastrophic injury case, let's get some MRIs early to evaluate the soft tissue structures. Rather than doing X rays that might be mainly for fractures or dislocations and unnecessary radiation.
We do MRIs very early to evaluate that patient, especially as chiropractors, versus maybe a family physician would not really need that MRI because it doesn't affect their recommendations. But chiropractors have a duty to assess the spine if those are types of injuries and complaints they're talking about. And then we move them on to more invasive procedures or doctors to help them get better. So it usually goes from conservative treaters for four to six to eight weeks. Then we try to move them on hopefully naturally to pain management in most cases. And that's kind of where things accelerate very aggressively in terms of costs and invasiveness of treat and treatments. And that's takes holding the hand of the client. That's like, wait a minute, I can't just come to the chiropractor for three months and get fixed and I'm good to go. Well, we hope that's the case. But in most cases, these car crashes cause problems for people that go beyond just chiropractic or conservative care. Then you would hope that to build a credible case is that the lawyer would get a great solid medical record, something digestible, something he could read, something that tells the truth of their client's story, let's say from their family physician, get it from their physical therapist, get it from their chiropractor, get it from a good honest mri, read on a high quality machine and get a good short and sweet pain management report that doesn't have all types of inconsistencies from provider A to provider Z. And you hope that the lawyer gets that on a silver platter and goes, now you gotta pay. Because the only out the insurance company would have is wait, all these four or five providers must be in collusion, all trying to risk their licenses and going to jail to make up some type of story. Well, that's ridiculous. But the problem is, is all these different providers, their medical records are kind of all over the place. And so even the best of lawyers can't look at all these different medical providers and read the records and try to make sense out of it. So credibility gets harmed, even though really the focus is someone did get rear ended and they're hurt. But it's hard to put together puzzle pieces that actually fit. So one of the things that I think is important is if we can get all these medical providers lined up in a row, right? If all these ducks can be lined up in a row from A to Z and create short, sweet, digestible, consistent, neutral medical records, it's almost a dream come true for an attorney to say, what do you got?
Why do you not want to pay this claim? We got all these great medical providers, they tell their story independently. They're not inclusion. They're just trying to help someone that's in front of them that says that they've been injured or hurt after a car crash. And your person's responsible for paying A, B, C and D. And so we don't want to be part of the equation that kind of messes up that one crucial element of a PI claim.
So that's one concept, is let's not unintentionally harm cases by getting a group of medical providers together that intentionally know how to document properly so that it's on a silver platter for any attorney. Now, attorneys that are listening to this are like, there's no way in hell this ever happened. Like, things are discombobulated. I'm really trying to find who's going to harm these cases the least. And sometimes these younger attorneys are just like, look, they call around other attorneys and say, who do you got? That's good. Because they know that if they just haphazardly start letting people go to their own places, it's going to be a kind of a nightmare. And so I've created a system where I educate medical providers at all disciplines and say, guys, we need to help these patients and not create these problems. Let's talk about our medical record keeping and make it short and sweet and to the point. And so we have hundreds of attorneys that have discovered and tasted how good this has been and now they're all in. If anything, there's a lack of those that I train and I teach to be part of the group. And we are now not only through California, but we're spreading in Arizona and Nevada and believe it or not, Missouri, there's like one spine surgeon One pain management physician and eight really teachable chiropractic doctors in Missouri. That's going to blow up probably to 20 or 30 by the end of the year because lawyers are asking for it. We're tired of the old stuff, old dogs. It's hard to teach new tricks. But whether you're younger or older, we want you to educate them because we believe in this system because it's the best for our clients.
The second concept of three, and I'll make this quick, is that we teach providers not to write causation statements and not to use pain scale numbers. The reason is, is because if you're going to create a credible claim, causation statements actually as a causation statement looks like a biased record. So what we teach is we teach when you do your medical record keeping, and we'll talk about that with the third concept with consistency. Right? Consistency in medical record keep.
We make sure that we let the providers know, please just document what the patient states, that they were involved in a crash.
Don't be too detailed with the crash, because across three or four providers, that story will never be the same.
Just say they were involved in a car crash and immediately following this car crash, they experienced some type of pain or discomfort. And that's really a provider's way of talking about causation without in a biased way, writing something separate. So, for example, Kevin, you would see it pretty ridiculous if you went to your primary care doctor and you said, hey, Doc, I just was driving my vehicle and this deer ran in front of me and I totaled my car and my airbags went off and my neck is. My face got smashed and my neck hurts. Dr. Be like, tell me what happened. Yeah, I just, I was. I hit a deer and my airbags went off and my face hurts and my neck hurts.
Well, you're not going to have that doctor knowing that it's an act of God, that some deer ran in front of you. You're not going to have that doctor write in your records causation.
A deer comes out in the middle of nowhere and caused this person to hit it, totaling their car, which caused neck pain and facial pain. That would be kind of redundant. So if the doctor just says patients state they hit a deer and they had face and neck pain, that's. That's very much a direct form of causation without actually writing it separately. But yet we have a lot of doctors out there that are. I don't know why they do it, but maybe because their workers, comp people or whatever. It is. But specifically for car accident cases, they're writing these causation statements, which I think creates bias, non neutrality. And I don't think that's a good thing for a doctor to be non neutral. The other thing is painscale numbers. If we have three or four providers seeing that patient at different stages of their medications or treatment, we don't want pain scales because it's only in any given moment. And once you use a number too high, an insurance company say they're lying. And if you use a number too low, they'll say that's what everyone has, which they're kind of right.
And so if we try to avoid these pain scales and we just talk about this is something they're experiencing they didn't have before, it got a little bit better after a treatment or it got a little bit worse, Whatever. The truth is, we create that narrative running through all providers that no one can point the finger and say, wait a minute, it went from an eight with the chiropractor to a four. And then three days later, the pain management doctor sets to nine. And when they do all the injections, it just, it just doesn't match up. So a good pain doctor trained under me will say, the patient states that conservative care only provided temporary relief over the last month or two, and now they're here to get additional relief. And I'm going to go ahead and consult them as to how I'm going to provide that additional relief. So that looks clean. That looks clean. Without writing causation statements or pain scale numbers, the last concept I want to talk about is consistency.
And Kevin, do you have any questions for me before I kind of move on to this last point?
If you popped a couple Advil that morning, it'd be like a two. If you pop some perpetual meds, it might be a zero. It's just anyone that's evaluating a claim will never use. It'll never be used to help the case.
It's always going to be a point of contention and a point of like, what's up with this? And then it's just an unnecessary evil to deal with. Right? Because the whole idea is the person was harmed, they're trying to get better, and the treatments conservatively only provide a temporary relief now. Then they move on to pain management. Or maybe the pain management will say, I can't fix you. You're going to have to see a surgeon that might fix some of these things that don't look right. Whether it was caused by the crash or not. This is the Fix for it. And ultimately that's what's important, is trying to get a patient out of pain that they didn't have before.
The last point I want to talk about is consistency. Whenever I meet with medical providers and be like, oh, you do a little bit of PI? Yeah, I do some PI here and there. I ask them, show me a paperwork that comes out of initial PI consult, whether you're the guy that hit the deer and says, I don't have health care insurance, I don't have what's called med pay. And there's no lawyer touching my case because I either rear ended someone or I hit a deer and I'm just here about having my neck and back fixed.
Do those medical records look the same whether it's a PI lien case, a cash bait paying patient case, a healthcare insurance case? And the truth is, very few doctors I've met can actually say all my records look the same. They're consistent whether personal injury lien at fault, not at fault, a cash paying patient under the same car accident circumstances. And that to me creates an unintentional mistake. Because if you go to litigation or deposition, a good defense lawyer is going to say, what do you treat? Oh, you treat all types of patients. Oh, that are injured. And then when they know that your medical records for a car accident lean case look crazy different than someone that's paying you a couple hundred bucks for treatment, it just creates this what's going on here moment. And that's not something doctors want to have to go through because they're going to walk out of that deposition with their head between their legs. So are the medical records consistent? That's super important. I think a concept that doctors need to understand, how important that is. Is your billing reasonable and consistent. In other words, a lot of these insurance companies winning these trials and we're getting defensed, or the lawyers are good lawyers are getting defensed because this doctor didn't even give the patient an opportunity to pay out of their pocket a discounted at time of service fee, go through their health care insurance, go through whatever possible payment sources are, but instead they have this ginormous lien bill that's ridonkulous. And then if it gets in front of a jury, defense attorney's gonna basically like, can you explain this crazy old bill? And then you got this plaintiff sitting there going, what the hell? That's a lot of money. I never knew that was happening. Maybe this was my doctor I've been seeing all my life and my insurance is paying him a Hundred bucks a visit. Now they're charging 500 bucks a visit. It just doesn't look good.
So we always want to make sure that doctors have consistency with their billing, whether it's a PI lien case or not. And that's something that takes many, many hours of understanding and discussion with lawyers and fellow medical providers to kind of let that sink in. It's very, very sensitive subject. And another thing is, are your, and this is the last thing, are your records in SOAP note format? We, as the, as a, as a leader and instructor of all medical professional providers, I want to make sure that we have an opportunity to say we learn this in school, all disciplines, chiropractic, acupuncture, physical, very med school, osteopathic school, Pennschool, whatever it is. What's ubiquitous is professors will teach you the most common sense way of documentation, which is the gold standard, is so what did the patient tell you? It's subjective. You have to be very judicious about getting information of the patient and know exactly what to put in there. Because if you put everything they say and they don't say anything, you don't put anything, it could really unintentionally harm a good case. Then the lawyer has to do a lot of work outside the medical record evidence and be like, what's going on here? And try to differentiate what's really valid and what's not valid. So what is the subjective section say? In other words, the patient states A, the patient states B. And we want to minimize any type of hearsay in there, there by saying the patient states, right. Then we want to move and transition from the subjective section to the objective finding. This is when the medical providers focus on what did the patient tell them? What are they responsible for checking out? And let's just do the exam and keep it short, sweet and to the point. And don't do 50 million exams because that just doesn't look, that's not practical. It doesn't look good. And then when we get into the next phase is the assessment. So you go the subjective section. What does the patient do tell you? The objective section, which is the doctor's information. And then the assessment has to do with the diagnoses. Let's not put in 50 million things. In fact, what I teach, especially in these little fender benders and cases with gaps in care, is specific, is terrific, and less is more. So I'd rather have a patient say, I'm just having some back pain, nothing else. We can run with that all day long than someone that Comes and says, I just got rear ended it and there was like a scratch on both cars. And I'm having a million complaints and they have no prior injuries or eggshell situation. It's going to be a dead case. So we really try to hone in on very specific complaints to make that credibility legit. And the last thing we do is in the medical record keeping to not unintentionally harm a case is we take what the patient states, what the examination findings say, what the diagnoses are. And the game plan, right, the plan is we're going to examine, we're going to do some spinal treatment, do some therapy, refer them out to an mri, refer them out to a neurologist, refer them out to a specialist without overdoing it. And so a lot of times these newer providers that I teach, they're like, hey, they need 20 MRIs now because they have 20 complaints. And you have to say just, you got to chill out. Like no, you don't do that. They need to see 15 providers because they're like almost dead. No, they're not almost dead. You just need to get them out maybe to one or two providers or put a list of potential providers and not go overkill because then credibility will flip. Right? Someone's going to try to overdo it. So there's always a sweet spot with the right providers to get everything lined up in a row so that no provider in the system of providers unintentionally or harm a PI case. And we have many, many happy attorneys that are going, this is too good to be true.
It is. Because I've spent 10 years of my life educating providers how to stop messing things up and taking care of the patient and making sure the medical records and the referrals and the case management are done to.
And that's what I've done over the last 10 years. And we're growing very quickly and getting a lot of great feedback from attorneys. So with respect to what you do, helping attorneys get cases through SEO or whatever magic you create, you want to make sure that whatever cases they get, they maximize the outcome of those cases. And this is where I come in. So I think we're a pretty good partnership in that sense.
Yeah.
Yeah. Thanks for that opportunity. So I think we're pretty much Instagram this ichthus.indrury I n j u r y.network. i think we have about 11 or 1200 followers, but we're growing that every week and we're posting good stuff on there about upcoming events.
But really the website is www.ichthysurynetwork.ichthus injury network.com and this is where you'll see who the providers are, what states we're in. And we're not updated with all the providers all the time, but we always ask attorneys that know great providers that need a little helping hand to reach out to me because ultimately we want to make sure that they realize they can do better. But no one's actually guided their hand in the right way. And hopefully I can be that person, be their mentor for ultimately the clients that these attorneys have get just great documentation, great medical care and kind of being put on a silver platter, which is, I think, every attorney's dream come true.
[00:32:09] Speaker B: Sam.
[00:32:49] Speaker A: You mentioned earlier, Kevin, that, you know, you had Bob Simon come on the call. He's someone that I know and respect as well, and he has an incredible community called justice hq. And the Ichthys Injury Network is a preferred vendor in there. In other words, we got screened by the leaders there and they say, you know what, vouch for what he's doing and what it means. So rumor has it that a lot of the members within that system, they communicate with each other in their own private chat to say, hey, what do you think about this provider, that provider and this group? And I think we have a pretty good reputation of providing kind of what we promise to deliver. And we hope more attorneys get involved with some type of fraternity, so to speak, where you can share ideas and thoughts and just work with the best of the best. And hopefully, if you guys are part of Justice HQ already or thinking about joining it, you want to reach out to Bob and then also know that we're a preferred vendor in there and you can connect with a lot of attorneys that support what we do to get the best outcomes for your clients cases.
It's just, it's a great joy to see things happening and growing the way we're growing.
And do some of your guests give out to cell numbers? I'm 247 on my cell. If anyone has any questions or concerns. I do, I do love to connect with attorneys, case managers. It's seven, by the way. This is a, this is a number I've had for you want to take a guess how many years I had this number for?
38 years I've had this number for. It's.
Yeah, so 38 years I've had the same cell phone number. It's 714-6065-3301-4606-5330.
My residence is in south Orange county, near Mission Viejo. And then my offices are in the city of Orange, near Anaheim Stadium in the city of Cerritos, which is known for a famous auto square. So if anyone's in the area and they like to connect, I'd love to take you out to lunch or dinner and chat about this stuff more and maybe help stir the pot a little bit to get these cases going smoother for you guys.
More than happy to do another one if there's a supply or demand for it.
Yeah, I've probably in the last eight years, done, like, over a thousand classes covering everything from A to Z, so there's very few things that I haven't covered. And when it comes to attorneys, they, they, they, they get access to the webinars for free. I only have a fee to the providers to be their instructor and teacher, a very nominal fee. But when it comes down to attorneys, they're pretty much just logging in and listening in and enjoying some of the content and maybe taking it into consideration to get their cases worked up more efficiently.
[00:37:08] Speaker B: Sam.
[00:37:40] Speaker A: I always like to share. Share. Del thank you.
Thanks. Appreciate it.
[00:38:24] Speaker B: Sam.
