A client fired us this week. We parted ways because I suggested that he should go to a doctor for his treatment instead of a chiropractor. Definitely not a traditional way to begin a week or an article, but, I rarely do anything in the traditional way. Every lawyer in existence has had a client fire them at one time or another.
I just hope that something good can come of this experience by sharing what I have learned with you.
To be completely honest, it really bothers me whenever any client transfers a case away from my office because we work very hard to communicate with our clients and to foster a strong relationship. For that reason, losing any client, to say the least, hurts.
We only represented this particular client for a month. Was this client dissatisfied with our legal efforts, the extent of our communication with him, or our level of aggressive representation? The answer is...No.
Within weeks of taking on this client, I recognized that the insurance company for the at-fault driver was going to act stubborn and unreasonable. Even though my client suffered significant facial injuries and a large emergency room bill from the accident, the insurance company refused to disclose their coverage limits. Insurance companies refuse to disclose policy limits because they want to keep injured victims in the dark and uninformed about how much they can recover from the at-fault driver.
At my firm, whenever an insurance company refuses to disclose the coverage limits, I sue the at-fault driver right away so I can force the insurance company to disclose these limits. I never understand why insurance companies try to hide this information from me because it just results in their insured staring down the barrel of a lawsuit. Maybe this approach works with other personal injury law firms in the area, but it never works with us.
After a detailed conversation with my client, he gave me permission to file suit to assure the best possible outcome. I filed the lawsuit and served the at-fault driver the week before Thanksgiving. We were armed to the teeth and ready for battle with the insurance company. So why did we get fired?
It turns out that we got fired because of a recommendation I made during the conversation about my client's chiropractic care. My client told me that he was seeing his chiropractor as much as 3 times per week. I told my client that he should consider treating with a medical doctor for his injuries and reduce his visits to the chiropractor.
I honestly thought that this recommendation was well-received. Unfortunately, rather than consider my advice, the client's reaction was to report my sentiments to his charismatic chiropractor. Thereafter, because the chiropractor felt professionally threatened, he called one of his lawyer buddies (with whom he trades patient/client referrals) and asked this lawyer to take over my client's case (kind of a reverse coup d'état). Shortly after that, we received word that we, and not the chiropractor, were the folks who got sacked.
First of all, I realize that we are not always going to be everyone's cup of tea. It is possible that my words to this client about his chiropractic care may have seemed cavalier to him due to the relationship he had formed with his chiropractor. Perhaps I should have better utilized my communication skills or tried to more fully understand the issue from my client's perspective. Nevertheless, while my bedside manner many not have been at its peak, the sincerity of my recommendation and the sound legal reasoning behind it is unwavering.
Because my client insists on treating solely with a chiropractor instead of a doctor, he is going to suffer a poorer net settlement recovery and a greater risk of recovering no money at all. I'm sorry that my client fired us. At the same time, I'm not sorry that I tried to steer him away from the chiropractor's emotional grip.
1) What We Don't Do:
If you are injured and looking for an attorney who will automatically refer you to chiropractors, legal finance companies, or physicians that sign patients to medical liens, there are many personal injury firms that you can hire. We, however, are not one of them.
We have a policy at my firm that prevents any direct referrals to doctors or chiropractors. Beyond that, we maintain no particular relationship with medical finance companies. Instead, we insist that our clients use their health insurance (if available) to treat for their injuries to avoid working with physicians who insist on our clients signing liens. We only send our clients to treat on liens in the most dire of circumstances.
We believe that we should zealously represent our clients, not the doctors or chiropractors who treat our clients. We never blur that line by maintaining favorable business relationships with companies that seek payment from our clients' settlements or verdicts. When a client's case resolves, our sole focus is to ensure that our client ends up with as much money as possible from the settlement or verdict, not the doctors or chiropractors who treated our client.
The doctors and treating providers in your case should be paid fairly for their work, but only at the usual and customary rate. If your lawyer is trying to preserve a relationship with a chiropractor to get more client referrals in the future, she may overpay that chiropractor from your settlement to your detriment. Consequently, maintaining a favorable business relationship with doctors, chiropractors, and medical finance companies creates an unhealthy conflict of interest.
2) Telling You Straight?
With the distance that we maintain from medical providers, we have the freedom to talk straight with our clients. Other firms don't share that same freedom because they have to be careful what they tell their clients and play politics with their doctor and chiropractor pals so that they do not lose business. Nevertheless, despite our straight talk, once or twice a decade, we are fired by a client who is enraptured by a charismatic chiropractor. We see this as an acceptable occupational risk because it ensures that our clients' cases do not simply end up being a payday for everyone else but the client.
3) What Is So Wrong With Chiropractors?
It's really a twofold problem.
A) Image Problem:
Don't get me wrong, I'm not speaking about the science behind chiropractic care. If pressed, I would admit that chiropractors offer a useful service. Personally, when I suffer pain between my shoulder blades, I will sometimes go see a chiropractor. With that, while I hold no grudges against chiropractors, it is my belief that chiropractic care does nothing to add value to a personal injury case.*
I hope that no client of mine has ever sought chiropractic care with an eye towards increasing the value of a case. My clients should treat with the sole intention of recovering from their injuries. However, it is my job to properly advise a client in a way that avoids potential pitfalls. If a client can benefit equally from chiropractic care or physical therapy at the direction of a medical doctor, my preference for my client would be the latter.
The unequivocal truth about chiropractic care in a personal injury case is that insurance companies and their lawyers often successfully focus on beating down the value of cases where the plaintiff treats with a chiropractor instead of a medical doctor. By and large, jurors do not trust chiropractor testimony and do not trust their patients. Thus, over-treatment with a chiropractor is a primary explanation for good cases turning into bad verdicts and poor settlements.
B) Chiropractor Liens Strain Limited Settlement or Verdict Proceeds
Beyond the fact that a client chose a chiropractor over traditional care, the death knell in many cases is the way chiropractors elect to get paid for their services. Instead of billing a patient's health insurance, the vast majority of chiropractors avoid health insurance altogether and sign new patients to liens so that they can ultimately pocket more money.
By signing new patients to a lien, a chiropractor agrees to seek payment at an incredibly inflated rate only once a case is settled. To most clients, that arrangement sounds great. No payment now, no co-pays, and no deductible payments have to come out of their pocket until the end of the case. Unfortunately, as the saying goes, there is no such thing as a free lunch.
Insurance companies know that chiropractors run up their charges when they treat a patient on a lien. Instead of paying increased settlement amounts to the injured claimant for the overpriced care from the chiropractor, the insurance companies use the overcharging as a way to attack the claim. The insurance company uses the lien arrangement to justify to skeptical jurors why they should disregard any opinions the chiropractor holds about the patient's injuries. The insurance company can effectively argue that the chiropractor is severely biased and cannot be trusted because the chiropractor's inflated charges will only get paid if his patient wins the case.
Even worse, once a settlement is reached, it now becomes time to pay the piper. Chiropractors expect to be paid hundreds of dollars for each session that they provided to the client. These rates are unconscionable because these same chiropractors are charging cash paying patients only $30-$50 per session for identical care.
Furthermore, at this point, chiropractors become bitter. They argue that my clients should have held out for more money and not settled for so little. They complain that they shouldn't get paid less because they waited years to get paid. Chiropractors refuse to accept that it was their overtreatment and overcharging that weakened the overall case and reduced the likelihood of recovery.
Consequently, after the settlement, the very compassionate chiropractor becomes a ruthless and vindictive capitalist looking to take the lion share of the remaining settlement proceeds. Like I said, no free lunch.
Let's recap...the chiropractor adds nothing to your case and then wants to be paid above market rate for treating you on a lien. Are you starting to understand why I don't send my clients to chiropractors? It is simply an untenable situation and ultimately results in unhappy and under-compensated clients.
Speaking with complete honesty and without any concern as to how my words affect referrals that I might get from these professionals (I will happily continue to receive none, as usual), I assure you that there are two main problems with chiropractor care in an injury case.
First, because insurance companies are generally successful in convincing skeptical jurors that plaintiffs who treat with chiropractors are not really hurt, this approach results in smaller verdicts and smaller settlements. Second, because chiropractors refuse to bill health insurance, charge higher rates, and wait to get paid, the smaller settlements do not go very far.
After the settlement, my client's interest in pocketing more money directly conflicts with the chiropractor seeking payment for the services provided. At that point, either the chiropractor has to agree to take a bath on the charges, or the client receives little or no settlement proceeds beyond simply paying for the chiropractic care.
I'm sorry that my client fired me this week. I'm not sorry that I gave the advice that I did. I still believe that the nature of chiropractic care and the way that this care is financed runs contrary to the interests of injury clients. I think that most lawyers hold this view but are too afraid to express this view out of fear that they will lose business.
At Anderson, Hemmat & McQuinn, we believe that we should zealously represent our clients, not the doctors or chiropractors who treat our clients. If you have been injured, please call and speak withone of our attorneys today.
*Chiropractic care and its regular use as part of a multidisciplinary approach to care can be useful both to a personal injury case and to the patient receiving the care when it is overseen by a medical doctor. The issues of this article pertain to the chiropractors who insist on liens, refuse to bill health insurance, and indoctrinate their patients to believe that inflating their bills will at some point prove beneficial in the settlement or resolution of their cases. It is those chiropractors of whom we speak about in this article. We do not intend to indict an entire profession.