The weird relationship between doctors and lawyers in workers’ compensation.
Editor’s comment: We invite our readers’ thoughts and comments on these concepts. In the last week we have learned:
- A treating doctor actively referred his patient to an attorney to insure the doctor’s medical bills were paid.
- There is an Illinois mesothelioma physician who is advertising to seek patients with meso while simultaneously telling the world his son; the lawyer will handle their personal injury claims.
- There is a medical clinic in California that is trying to become a one-stop-shop for workers’ compensation claimants—providing primary post-accident care, recommending surgeons, lawyers, physical therapists, every professional an “injured worker” needs.
- We had a Petitioner’s attorney direct his client not to see one doctor he was referred to, and then quietly call the primary care physician to have that physician refer the patient to a doctor of counsel’s choice.
- We reviewed a Petitioner’s attorney’s website where they are actively recommending and thereby advertising their approved list of physicians.
- We are aware of a number of physicians that donate gifts or money to bar association functions in order to allow their names to be presented at attorney golf outings, dinners or other bar association events.
We note these issues continue to spring up and we want to hear how Illinois business and our various readers think of the many moral, legal and ethical issues raised by these interesting facts. We are certain it is illegal for:
- Lawyers and doctors to split fees or otherwise “kickback” monies to each other in handling the needs of a client/patient.
- Doctors to own diagnostic, physical therapy or other medical facilities and send all their patients to such facilities, and then receive secondary compensation.
The rest of this falls into a strange ethical netherworld. We have no true idea if any or all of this may be both ‘legal’ and ethical—whatever that may mean.
Do you feel:
- A doctor should be ethically able to refer a patient to a specific attorney to allow the doctor to get his bills paid?
Please assume there is no fee-splitting agreement in practice or in principle
The doctor is simply telling all his patients to go to a specific attorney for their legal needs and one of those needs is to get their bills paid.
Please note the attorney may be able to advise the doctor how to get monies for interest consistent with our Act. A sharp Illinois attorney may also be able to get penalties and fees on unpaid medical bills in a fashion considered punitive for the employer or insurance carrier.
- A doctor should join with a lawyer to jointly advertise their respective services for patients/clients with a specific medical condition.
- A doctor or medical clinic should be able to create a list of preferred providers for post-surgical physical or occupational therapy, legal work, vocational counseling or other services?
- It would be a conflict of interest for an attorney to take an active role in recommending physicians/surgeons their clients treat with?
Again, assume the attorney is not making any money in the process but is actively directing patient care. Please also assume the patient and primary care physician is not asking the attorney for such services.
- An attorney can create and promulgate an approved physician panel and advertise such doctors on their firm’s website? Can the same attorney “require” or actively encourage their clients to only treat with certain doctors?
- Physicians can ethically donate to bar association functions to advertise their practices?
On these issues, we don’t have the answers, we just know there are very troubling questions. The defense industry should address all of them and consider rule-making to insure your interests are protected.
We hate to see doctors actively befriending attorneys and then both work together to treat patients in the image and likeness of what the lawyers want done. We also dislike the spectre of treating doctors fomenting litigation against Illinois employers in the workers’ comp setting.
On the other side, we truly feel it is a conflict of interest for attorneys to actively guide or direct medical care of a client by telling them not to see one doctor and then seek referrals to specific physicians or surgeons who are not IME providers. It is no surprise that extensive medical care leads to higher awards and settlements.
Please reply with your thoughts and comments.
