This shall serve as a general disclaimer that as of the time of this post that I am not an admitted or practicing attorney in any jurisdiction. Anything written in this post is merely my observation(s) as someone who has been involved in the legal community for nearly a decade, but not to be construed as or mistaken for legal advice. If you have questions or need clarification to anything discussed within this post, I suggest contacting a real attorney, or waiting until I have taken the bar, passed and have been sworn in accordingly.
I’ve worked in plaintiff’s personal injury in Maryland for nearly a decade. When I first began I really didn’t know what I was doing, but was taught very well by someone who thoroughly understood all of the legal aspects of the “game.” Through the years I’ve become more involved, learned a ton, and more importantly have gotten a lot of marketing experience under my belt. Much of this marketing experience has been through networking with other attorneys in similar situations in other states. Sharing ideas of what has and has not worked for each of us, and tweeking advertising/marketing systems in each jurisdiction. In this conversations, we would often talk shop or discuss the practical aspects of the process in these cases. This would involve discussion of medical care, treatment, and the subsequent relationships with the medical providers involved in the core essence of an injury claim: the injury and treatment of said injury.
I was, and continue to be, shocked at the vast difference in medical care provided to patients/victims of automobile accidents from one state to another. My understanding is that much of this is due largely to the differences in the tort laws in each state. In plain English: doctors treat accident patients based on how they will be paid, not based on the care that is actually needed. It’s not just the doctors, though–this is a culture that is perpetuated by the lawyers who work with these doctors, refer cases to (excuse me, I mean suggest the providers to their clients as an option for treatment) and negotiate the payments of those bills, or actually determine what the treatment is worth.
I get it. States like Delaware, Florida, Pennsylvania that have some sort of mandatory first-party medical coverage (usually PIP and/or Medpay) are states wherein their accident victims almost automatically get one, if not two MRIs during the course of treatment for an injury. States with high PIP, like Delaware and their mandatory $15,000 in PIP will not only get the MRIs, but they’ll get a regular course of pain management, including, but not limited to a number of injections that bill approximately $6,000 per procedure!
So my concern is this: Why not in Maryland? What has changed so much in the culture of a personal injury case in Maryland that often times victims may or may not go to the hospital, often go to a chiropractor for 6 or 8 weeks, and then they’re done. Many times they do not even get X-rays, and I don’t know that you can put the percentage of auto accident cases in Maryland where a patient gets an MRI on any chart! Maryland is what is known as a “low PIP” state. That means that a lot of the bills aren’t guaranteed to get paid until the case settles or reaches a verdict. In Maryland it is even possible for a policyholder to waive the PIP coverage, meaning no bills get paid until settlement. When they do have PIP, it is usually only $2,500–which once you leave the hospital is almost exhausted. My assumption and understanding from discussions with other practitioners is that many of these medical providers, doctors, therapists, chiropractors, etc. have become complete whores to the attorneys who feed them cases. This sounds like a great idea, but it seems like they’re driving the value of the cases into the ground, and more importantly, they’re cutting corners on the care provided to the patients.
I’m not not a cynic, or a skeptic. I understand that some of the people that call up injury attorneys are not incredibly hurt. In many cases it is fair to say that they’re barely injured. However, I have observed over nearly a decade that this doesn’t matter one way or another. Someone who gets in a rear-ender at 5mph and has scratches on his/her bumper is treated exactly the same way as someone who gets slammed in the rear and has over $4,000 in damage to the vehicle, or perhaps even a total loss. Maybe they go to the hospital, then to a med clinic or chiropractor only to get 6-8 weeks of therapy and a discharge order.
I know there’s something wrong here. I know it because of all of the times I’ve been on the receiving end of a call for an attorney I’ve worked for from a client who 2 or 3 weeks after that discharge is calling back and complaining that their pain has flared up again. I know this because in any office I’ve ever worked in (and I’ve worked with a number of lawyers over the years) that this call is more or less ignored. The client is told that they’ve been discharged and there’s not much they can do form this point unless they want to take the chance of not having additional medical bills paid.
So my question is why. Why has the culture changed so much in Maryland, or the view of these claims so watered down, than the accident victims are paying the price with insufficient medical attention? I’m not saying that anyone caring for them isn’t doing a good job, but sometimes the provider who has their hands on the patient today will not be the provider to ultimately finish the job. That is the reality of medicine. There are general practitioners, there are specialists. There are all of the other parts that interwork with those parts, and the picture of health is capable of being completed.
When I am admitted, I’m going to do something different. The conversations and dialogues to do different, to do better by our clients and patients, begins now. I am going to continue networking with medical providers within the “industry” and will likely begin to find new colleagues who are not in the “industry” and may not be in the PI industry because of the diminished level of care that has been happening in Maryland. I want to change the conversation. I want to change the culture.
At the time of writing this entry Jobeth Bowers is a 3rd-year law student at the University of Baltimore School of Law. I plan to sit the Maryland Bar in July 2014, and plan to be admitted to practice in Maryland sometime in December 2014. Today, I am not and do not claim to be a lawyer.