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Is Medical-Legal Consulting Right for You?

— How to bridge medicine and law

MedpageToday
A photo of a stethoscope, a judges gavel and a law book.

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Engaging in medical-legal consulting offers a valuable opportunity to apply your medical training in a nonclinical capacity that genuinely benefits people. Physicians across the nation are increasingly embracing medical-legal consulting as a rewarding part-time endeavor.

Among the array of services that medical-legal consultants offer, one prominent role is that of a liaison between attorneys and treating doctors. Additionally, we occasionally serve as intermediaries between attorneys and families, and more frequently between professionals and various service and governmental agencies. Introducing the concept of acting as a liaison can be novel for the attorneys you collaborate with. Many attorneys who are introduced to this service find it exceedingly beneficial.

I've observed that treating doctors are also open to this concept. Once doctors understand that my intention is not to criticize or micromanage, they readily engage in conversation with me. In fact, I have a succinct standard explanation that I provide to explain why I'm reaching out on behalf of an attorney.

While some liaison work can be conducted over the phone, more often than not, it necessitates scheduling appointments either at the physician's office or via Zoom in current times. Once the groundwork is laid, treating doctors often perceive your involvement as a potential means of sparing them from providing deposition or trial testimony, thereby facilitating smoother case settlements.

A common scenario in which your attorney clients may request you to meet with treating doctors is to ensure alignment between the treating doctor's perspective and the attorney's medical theory of traumatic causation.

You will also be tasked with discussing specific issues with treating doctors. For instance, you might delve into how physical trauma can trigger or exacerbate a particular condition in certain circumstances. Alternatively, you might clarify aspects of the client's medical history that could be interpreted as a pre-existing condition.

Consider this typical illustration: A client of the attorney sustained injuries in a rear-end auto collision, experiencing immediate onset of low back pain radiating into the left lower extremity. Subsequent MRI results revealed a disc protrusion at L4-5 with nerve root impingement. The client's medical record indicated a single episode of past back pain, for which treatment was sought years prior to the accident. The symptoms resolved completely and did not evolve into a chronic issue.

The attorney tasked me with reviewing the case and providing an opinion on the causation of the client's lumbar symptoms and ongoing problem. It was my medical opinion, with a reasonable degree of medical probability, aligning with the attorney's theory, that the auto collision was the immediate and proximate cause of the client's disc protrusion and subsequent lumbar problem.

Recognizing the potential value to the case, the attorney decided to have the treating doctor draft a causation letter to support the proposed negotiated settlement. Prior to requesting the letter, I met with the treating doctor to confirm agreement with the attorney's theory of traumatic causation. Through an in-person discussion, the treating doctor concurred that the auto collision was indeed responsible for the present back problem. Subsequently, the attorney requested the treating doctor to draft a comprehensive report.

Ultimately, the case was successfully settled.

Armin Feldman, MD, is a medical consultant to attorneys.

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