How To Deal With A Difficult Doctor (Part 1)

A doctor’s opinion is crucial to every workers’ compensation claim.  Most doctors give honest and rational opinions. As we all know, however, there are some physicians who have a different agenda and either do not take the time to properly evaluate a patient or they intentionally downplay the potential seriousness of the injury.  For attorneys working on a workers’ compensation case, the following steps may help in the search for the truth.

(1)     Check the doctor’s credentials.

It is a strange but true fact that some experts have falsified their curriculum vitae.  If a physician has lied about his qualifications, his expert opinion just went out the window.  One way to verify credentials is to check the American Medical Association’s web page.   Select “Doctor Finder” and then follow the instructions until you get to “Find a Physician” and type in the name, address and zip code.  If you are seeking a specialist, a doctor certification can be checked by phone with the AMA.  For medical doctors call (800) 776-2378.  For osteopathic doctors call (800) 621-1773, ext. 7445.

(2)     Check disciplinary records. 

According to the Federation of State Medical Boards 4,432 disciplinary actions were taken against 3,880 physicians in 1996.  There are approximately 650,000 licensed physicians in the United States.  The Federation is responsible for promoting high standards for licensure and practice, and serves as the primary center for collecting, monitoring and reviewing actions taken against physicians. (A full report can be obtained by calling (817) 868-4000.  The report is also available on their web site.  Sidney Wolfe, a physician who is director of the Public Citizens Health Research Group, a consumer watchdog organization, has analyzed this document and his report can be obtained by calling (202) 588-1000.  A list of “Questionable Doctors” can also be obtained from Public Citizen for each state.

(3)     Communicate, communicate, communicate.

It is important to find out as much as you can about the physician involved in your case.  See if he is listed on the internet.  If he has written any articles, see what the focus is.  Ask other physicians, nurses, hospital employees and others in the community about this person.  Now, with this information in hand, schedule an appointment to talk with the doctor.  Try not to schedule it during his lunch break, or while he is seeing patients.  You want his undivided attention and you will not get it if he is thinking about some medical crisis sitting in the next room.

(4)     Build a relationship. 

Lawyers who specialize in workers’ compensation are likely to see the same physician over and over again, particularly if they practice in a relatively small town.  If you have a private conference with the doctor and you receive a bill, pay it promptly.  I have been absolutely amazed at how many doctors have been stung financially by some lawyer in the past; unfortunately, that physician may then hold a grudge against all lawyers, as though all lawyers are to blame.

(5)     Take your client to the deposition. 

Whenever I have a situation where I am convinced the physician is about to denigrate my client or try to personally attack the client’s credibility, I take the client to the deposition.  It is extremely difficult for the doctor to look his patient in the eye and assert malingering.

(6)     Be honest with the physician. 

There are often serious problems related to the case.  The better policy is to bring these to the attention of the doctor and discuss them up front.  If you don’t, the defense lawyer will.  You will then get a strange look from the physician as you see him wondering why he was never given this information.  It may change his mind about how he views the case in its entirety.  Often you are unable to repair the damage.

(7)     Explain the burden of proof, causation, and the system. 

Although most doctors don’t watch a lot of television, it is hard not to watch any without seeing some type of litigation, and it is usually criminal law.  “Beyond a reasonable doubt” is not the standard used in workers’ compensation cases and you will want to make sure the doctor has a clear understanding about the burden of proof.  Physicians are also trained to believe that something is not true unless blind studies can prove it to an absolute certainty.   We often tell them that the greater weight of the evidence is all that is needed, and that simply means 51% in the medical-legal context.  In some instances, this information has been a revelation to the doctors on causation issues.

Check in again later this week for more tips on how to deal with difficult doctors.

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