How to Go to the Doctor
The following is an excerpt of an article written for paralegals and attorneys by Steven Glass, a retired personal injury attorney from Florence, South Carolina, concerning the lack of attention that attorneys, and their clients, sometimes pay to the client's treating physicians. Mr. Glass points out that the attorneys should be aware of their client's medical treatment, how their injury affects their lives, and help their clients communicate with their doctors.
I always tell my clients to tell the truth to the doctor; it helps the lawsuit and more importantly, helps their health. However, I do instruct them to tell the complete truth to their doctor. Usually the problem I run into is the patient who minimizes his complaints, not the client who exaggerates. Months or years later, when the defense attorney is quizzing the client about their symptoms, the lack of medical record history paints a false picture that the injury or pain was less than it actually was, or worse, was not caused by the accident at issue in the case. Patients only tell the doctor about the bad knee pain, and don't "bother" him about the neck pain that doesn't seem so bad. But six months later when the knee pain is gone, but the neck pain lingers, it appears that it just happened. I've had clients who don't mention back pain to their family doctor, who records "no complaints," because they think he doesn't need to know because they are seeing a chiropractor for the back.
Mr. Glass advocates an even more active roll for the attorney in the medical treatment, with direct communication in person or by letter to the doctor to make sure that these symptoms are recorded and treated. An attorney must balance this strategy with the understanding that any letter may very well end up in the defense attorney's hands and could be used to attack the credibility of the treating physician at trial.
Have you ever had a doctor who continually seemed to minimize the injury in office notes, time after time reporting improvement and minimal difficulty? In many cases in which the injury is minimized medically because of failure to convey sufficient information, the result is inaccurate diagnosis and treatment. After years of practicing law I learned that it was important to teach clients how to go to the doctor. Most clients do not realize it that when the doctor asks, “how are you today”, this is not a social exchange and the reply will be recorded. By making it a practice to prepare a client for the doctor’s visit many potential catastrophes can be avoided, and accurate depiction of the effects of injury can be medically documented. Additionally learning the real day to day difficulties the client is experiencing and having it related to the physician will dictate what medical care is ordered. Having a physician order counseling, or additional testing, or being concerned about continuing employment can add considerably to the value of the case and too often the client does not relate what could be important to the physician for effective treatment. This causes cases to lose value.
Doctors are human too, although lawyers are not sure, and with the little time patients are allotted face to face medical care, the client must briefly be able to communicate to the physician the effects of injury to daily life. The effect of an injury on daily activities tells a doctor more than the normal physician questions of describe the pain, its severity, where it is located, etc. The average physician pressed for time will rarely ask, “ what activities increase pain or maybe more importantly, “ what activities performed over what time period increase the pain level and diminish the ability to perform?” The next question should become “what activity performed over what time period makes it impossible to continue?” The point here is that the physician’s idea of the scope or ambit of what constitutes medical responsibility and time limitations will not result in clarification of the extent of the injury and its effect on the patient. Many attorneys see themselves as separate from medical care and the patient’s limitations and long term outcome can readily fall between the cracks. The solution seems to lie only with the proper training and preparation of the patient.
I have had clients that could not eat with the family as mealtime was either too uncomfortable physically or emotionally. I have had clients who could not sit through a thirty minute television show. I have had clients who could not ride in a car over one hour without getting out and walking or who simply stopped going on outings at all. Learn what a trip to the mall is like, know if the client was able to attend a wedding, help out at a garage sale, attend school meetings. In these crevices is the fodder that will give a doctor concern or compel a claim’s adjuster or jury jump. Learn early signs of depression, these will have no value if not treated and documented.
Given that the above facts are determined and gathered, often times they can be communicated to a physician by letter or in person, either to help determine treatment or in consideration of referral to more specialized or intensive care. The physician simply does not have time to gather this information. As trial attorneys know, physicians have limited time to spend with patients and given the imbalance of power, most patients are reticent about communicating information or are unable to determine what is important for the physician to know. While some physicians might take offense at such communication, such a letter can impart professionalism and lead the physician toward thinking of the communication as forming the basis of essential teamwork leading to the best result for the patient.
-Bradley A. Coxe is a practicing attorney in Wilmington, NC who
specializes in Personal Injury, Car Accidents, Medical Malpractice, Contract and Real Estate disputes, and all forms of Civil Litigation. Please contact him
at (910) 772-1678.