RE: Attorney getting involved - oh my!

June 5, 2008

One thing I learned (in the otherwise

toxic environment) at my former practice: When legal matters require

statements, etc. Best to say something like, “I have nothing to offer

that will add to the case”. Received letter recently from attorney

involved in helping patient get disability benefits. I am not convinced she is

fully disabled (is fatigued and has some anxiety issues…has chronic Hep C

but NOT having liver or organ/system failure and I know she could do some kind

of work…). My plan is to simply state the above and let someone else “prove”

she is disabled.

I am not really sure of the right thing in my case, nor yours. Ethically,

legally, it is hard to decide.

Ramona

Ramona G. Seidel, MD

www.baycrossingfamilymedicine.com

Your Bridge to Health

410 349-2250

polis, MD

From: [mailto: ] On Behalf Of Marius Laumans

Sent: Wednesday, June 04, 2008

12:52 PM

To:

Subject:

Attorney getting involved - oh my!

I have a patient that is in some sort of custody

battle with her

husband. she had asked me to produce a letter stating that she has been

stable with regards to her depression (her husband made allegations

that she was not stable). That letter was easy. But maybe a mistake.

Her attorney now asked me to sign a letter stating that my previous

letter to the patient was an accurate statement. Besides that being a

silly proposition (a letter confirming a letter), I really do not want

to get involved with courts and attorneys and the like.

Can I just ignore this request? What would you do?

Thanks, Marius

June 5, 2008

marius i am not sure your letter was a mistakeThe request for a letter to validate a letter is dumb and i would probably not answer it You can always call your own malpractice carrier just for advice i bet they would talk to you Or call your state medical assocation.

As for disability Ramona nails it- it is not our job to determine disbality but another hat i wore of the many in my life, when i first started my practice wasto earn extra money i reviewed cases for this firm that contracted with insurance companies ,which were busy double chekcing on people to see if they really deserved disabiltiy. I found the whole thing somewhat shady and in fact got passively fired the first time i disagrreed with folks and said someone was disbaled when the boss of this firm i worked for kept trying ot get me to change what I said

I had to watch surveillance cd's etcbuthere's the thing once I had to say there was no reason someone could be called disabled when in fact she might have been ==becasue her doc did not documetn anything --he had in her chart well c ontrolled diabete,s htn at goal. I was required to call teh primary docs and in the above case the doc described to me pain behavior he could have put in the chart but did not ,that she could not get to the exam table that she needed assistnce to arise form chair that she was in discomfort. HAd he documented she might have gotten something she needed but I had no records to verify..

a good lesson for us as to putting something funtcional in our charts-- documenting what we SEE -- if they change postion three times in a visit etc write it down!.