"READ WHAT AN ATTORNEY SAID TO ME"
A long time friend of mine connected me with a family member who is an attorney and I had the opportunity to have a virtual lunch meeting with the attorney and his 2 paralegals. The attorney started things off by explaining how they handle medical related cases in his office and introducing his staff. Then he said this, " Although your experience is impressive, my staff are able to identify any red flags, research, prepare reports, and I primarily use MD's for any medical cases so I really don't see the need or value of using a LNC instead of my staff or an MD". How many LNC's out there have heard this before? How many attorneys have had this same thought? So I took a moment, sat up in my chair, and explained that I would like to address his concerns by breaking down my response into 3 separate parts: 1. reports and red flags, 2. research, and finally 3. MD's. Here is how I responded.
1. " I have no doubt that your paralegals can produce excellent reports and timelines. When you are reviewing the records and identifying these red flags do you spend time looking up what words and medical information mean?"
Paralegal #1: "Yes, all the time, especially if there are a lot of records I can spend anywhere from 4 to 10 hours looking up information". " Due to my experience and medical knowledge, when I am reviewing records and writing reports I am identifying not only the "red flags" in the documents but what's missing from the records. I am able to explain why and how this information is relevant to the case without having to spend substantial hours researching medical terminology. In addition, there are so many idiosyncrasies in the hospital setting that can effect a case that one is only aware of if they've worked in Healthcare. Just think of how many hours this could free up your staff to work on the legal aspects of their caseloads.
Attorney: " When you say missing from the records, what are you referring to? " A simple example could be information that doesn't go along with the standards of documentation that are required like responses to interventions. A more complex example might be in regards to the EMR's. Although most hospitals are using some form of EMR, not all documentation is provided within the EMR and it may be on paper. Code sheets, Moderation sedation and anesthesia records, trauma records, and other types of flowsheets are a few examples. Understanding and knowing about these additional records would be very valuable with discovery items.
2. As a LNC my services are tailored to the needs of the attorney and their staff. I have f friends that are paralegals and they are amazing researchers so I can understand your preference in using them for research. As your staff does research for the case, consulting with a LNC can be very beneficial. We can help direct your staff where to find authoritative information specific to the clients' injuries saving them more time.
Paralegal # 1: " There have been times when I didn't really know where to start, so that would be helpful.
3. "Nurses, by nature of their training, knowledge, and clinical roles, are fact finders and gatherers of information. We spend the majority of our day face to face with patients collecting social and medical data, identifying changes in medical status, and documenting responses to interventions and treatment. We then pass all this information on to physicians, via documentation, in order to assist in the diagnosis and treatment of each patient. We work together. I have many physician friends and colleagues who will admit that they are not familiar with nursing standards of care or policies and procedure. This is especially true if the MD's are contract employees and not directly employed by the Hospital. MD fees can also be very expensive. A large percent of the documentation in medical records are provided by nurses. It makes sense to use nurses to review the records and it is more cost effective for you." I concluded by saying, " Overall it's really not about using one or the other, its about collaboration. It's about you as the attorney putting together the best team for your client. A team where each member and their unique skills play a valuable role."
Ok guys, stay with me just a little longer. I know this is long, but the best part is coming. So remember at the beginning I mentioned that there are 2 paralegals in this meeting. Paralegal #1 has been interactive and following along, while Paralegal #2 has literally not looked up from her lunch not once, which was fine, I mean it's lunch time. I've just finished my above statements about collaboration and being a team, when suddenly I see Paralegal #2 raise her head. The attorney and paralegal#1 were both taking a bite of food when:
Paralegal #2 says, "So I guess the question isn't why use a LNC, but why aren't we using LNC's???"
And this ladies and gentlemen was the Aha, light bulb, and mic drop moment all rolled into one!!! Nothing but silence came over the meeting. I said nothing, I just let her words hang in the air and watched them looking at each other. Of course on the inside I was screaming, YES! YES! YOU GET IT! I wanted to reach through the screen, give her a high five and a hug, but after a moment I just simply said, "Exactly!!"
We all began to laugh. The attorney told me that unfortunately he didn't have any medical cases at this time, but that I had certainly given him a lot to think about. I thanked them for their time and said feel free to call me if they have any further questions.
The attorney laughed and said, "I've got a question but be honest." I assured him I would. He then says, "Did you notice my football memorabilia on the wall and come up with that whole collaboration and team idea?"
Me: I laughed and said, " Actually, I can't see it, it must be just outside my screen view, but I wish I had." Attorney: "Oh really, why?" "
Me: Because then I would have just said you're the coach, when the games on the line are you going to put your linebacker in as quarterback just because he knows how to throw a football".
Paralegal #2 , " Not if you want to win you don't." As we laughed
Paralegal #1: " I don't get it."
Which only made the attorney laugh even harder as he explained to her that it basically sums up in 10 seconds what we had been discussing. She thought for a moment and then said, " Oh!!! I get it, just because you can do something doesn't mean your the best person to do it!!!!" We laughed and joked some more and as we were about to end the call the attorney said, I like you, and I'm going to use that "Texas-ism" as he called it. My response, " Sure that ones on the house, but the next one might cost ya" He smirked and said, " I'm sure it will be worth every penny, I'll be in touch".
I've thought a lot about that meeting lately. I decided to share this experience for several reasons. First I wanted to hear from other LNC's and their experiences with similar issues and how they handled it. Second, I thought about what I learned from that experience. Even though I didn't get a case from him, he will think about it. Maybe even share the experience with colleagues and they will start the conversation about using LNC's. Either way its a win. There are a lot of people in the legal community that have no idea what a LNC is, let alone why they might need one.
If you are a LNC, there are over 1.8 million attorneys in the US, its important for us and the profession to continue to educate everyone and anyone about the value and need for using LNC's. And I would love to hear your experiences in this area.
If you are an attorney and you use legal nurse consultants, kudos to you!!! And I would love to hear examples or comments from you on the value or need for LNC's
If you are in the legal community (plaintiff or defense attorney , PI, med mal, toxic tort, workman's comp, criminal, insurance counsel, corporations, etc.) and you are not using a LNC for any type of cases where medical records are involved then ask yourselves these questions:
1. Why aren't you using a LNC?
2. What if the opposing side is using a LNC , could this be a disadvantage?
3. Would my staff benefit from having more time to focus on their legal duties?
And if you're still not convinced, shoot me message or an email to email@example.com and lets talk about it.