Letter from a lawyer, is this a deposition request

[thecentral09]

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Hello, new private practice owner here.
Was previously working at a rural health system, with an extremely busy practice. Hospital continued to not adequately staff or support what staff remained post covid and the writing was on the wall it was going downhill quickly. I then left in favor of starting private practice, riding out non compete now.
I just got a document from a lawyer regarding a patient I treated at prior hospital, currently not a patient at my new LLC. In short, younger patient, prior car accident, laminectomy, second car accident, with MRI evidence of moderate to severe central and neuroforaminal stenosis at L5-S1, had seen multiple neurosurgeons, and due to young age (27) suggested against fusion surgery. We did 2 or 3 epidurals which were largely ineffective, all the standard neuromodulators, not offered opioids due to young age, and ultimately implanted SCS. Upon follow-up, 80% improved with spinal cord stimulation and last I know doing very well.
The legal request is asking for me to provide a narrative report confirming that the automobile accident was the cause of his injuries, treatment, and limitations in asking me to prepare a document regarding his case.
I understand that this is a request for deposition. Am I correct in that assumption? as I am new to this but interested in this line of work going forward, what suggestions would you have regarding how to proceed. Thank you all for all your help and wisdom.

 

[cowboydoc]

(
Hello, new private practice owner here.
Was previously working at a rural health system, with an extremely busy practice. Hospital continued to not adequately staff or support what staff remained post covid and the writing was on the wall it was going downhill quickly. I then left in favor of starting private practice, riding out non compete now.
I just got a document from a lawyer regarding a patient I treated at prior hospital, currently not a patient at my new LLC. In short, younger patient, prior car accident, laminectomy, second car accident, with MRI evidence of moderate to severe central and neuroforaminal stenosis at L5-S1, had seen multiple neurosurgeons, and due to young age (27) suggested against fusion surgery. We did 2 or 3 epidurals which were largely ineffective, all the standard neuromodulators, not offered opioids due to young age, and ultimately implanted SCS. Upon follow-up, 80% improved with spinal cord stimulation and last I know doing very well.
The legal request is asking for me to provide a narrative report confirming that the automobile accident was the cause of his injuries, treatment, and limitations in asking me to prepare a document regarding his case.
I understand that this is a request for deposition. Am I correct in that assumption? as I am new to this but interested in this line of work going forward, what suggestions would you have regarding how to proceed. Thank you all for all your help and wisdom.

NO. They are asking for a written statement indicating your opinion re: causation. You can answer these questions in your own language after getting a pre-payment for your time. I make them pay $500-1000 up front, depending on how extensive the questions/record review.

This could certainly lead to a deposition, or they may settle. If it's straightforward, it's less likely to go that far. Then again, there is a stim, and the case is expensive, so it may go that way.

At any rate, get paid BEFORE doing any work.

 

[RoloTomassi]

No they are requesting a narrative, which is basically a written summary of who you are and your entire treatment history with this patient. Set your rate, cash the check before even thinking about doing it. Be objective, say what you honestly feel. Make them provide you all records. It's written similar like an IME report.

 

[thecentral09]

Please DM me what a fair rate for this is?
According to the file sent to me, there are approximately 20 questions they want me to answer in the narrative

 

[nvrsumr]

1000/hr of your time. Sounds like 2 hours.

You will likely have to defend what your answers in a deposition that you again charge 1000/hr. 2 hour min. done at you office

 

[RoloTomassi]

Be sure to understand the forensic spine literature when formulating your opinion regarding whether the MVC caused the injuries. If you don't know the literature then you should state that you don't know.

Do you have any resources for this literature?

 

[bedrock]

Be sure to understand the forensic spine literature when formulating your opinion regarding whether the MVC caused the injuries. If you don't know the literature then you should state that you don't know.

please post or pm us this literature. want to be as ready as possible

 

[chibadriver]

I do a lot of these and a lot of disability work. Don’t brush up on the literature. Your opinion is based on your previous training, what you see in your practice and your knowledge of the patient. Don’t spend more time on this thing than you have to. $1000 is reasonable and be crystal clear in stating: if the patient’s pain could be the result of their accident/work/trauma, if you think the persistence of pain affects their daily life, and if they require ongoing treatment. Being clear (but concise) here can prevent you from subpoenaed for deposition or to appear for testimony. Also, send these lawfirms a standing contract with your rates. They can refer back to these when discussing costs with their clients and they may not want your opinion as often accordingly. $1000 for a written statement, $1500 for first hour of deposition and $1000 for every 1-30 minutes thereafter. They will send the check with the request.

 

[chibadriver]

Be sure to understand the forensic spine literature when formulating your opinion regarding whether the MVC caused the injuries. If you don't know the literature then you should state that you don't know.

Careful. The more you claim you know, the more you are accountable for elaborating upon. “I don’t know” or “I’d have to look it up” saves headaches and confusion in a deposition or testimony. Starting your statements with “In my experience/practice” is the most appropriate way to limit what you are accountable for.

 

[psyguru]

For testifying on a patient I do not charge but that is because I am a forensic psychiatrist and when I testify about a patient I make it clear I am a fact witness. I will testify based on my own records or the records I used for clinical purposes. When I render an opinion within reasonable medical probability as an expert witness, it would entail 3 to 4 hour interview, collateral interviews, review of 1000 pages of records and a 20 to 80 page report. I don't believe on being an expert witness on your own patient as it is a conflict of interest and is not independent. However it is ok to do it as a fact witness. It probably is ok for non-forensic psychiatrists to charge extra...I don't and just insist the work is done during my clinic time and I block it off.

 

[Doctodd]

For testifying on a patient I do not charge but that is because I am a forensic psychiatrist and when I testify about a patient I make it clear I am a fact witness. I will testify based on my own records or the records I used for clinical purposes. When I render an opinion within reasonable medical probability as an expert witness, it would entail 3 to 4 hour interview, collateral interviews, review of 1000 pages of records and a 20 to 80 page report. I don't believe on being an expert witness on your own patient as it is a conflict of interest and is not independent. However it is ok to do it as a fact witness. It probably is ok for non-forensic psychiatrists to charge extra...I don't and just insist the work is done during my clinic time and I block it off.

You’re crazy

 

[psyguru]

You’re crazy

Are you "diagnosing" the fact that I do not charge for my fact witness work on my patient or the amount of work I do for an IME?

 

[Doctodd]

no I was joking

 

[Ferrismonk]

On a semi-related note, if you do get a deposition request, can you simply decline it? I recently had a request for a deposition on an old patient (last seen several years ago at a prior employer) but I really have zero interest in legal work and would like to pass. Can I do that?

 

[nvrsumr]

Yes but they can then subpoena you and make you read your chart back(fact witness) to them for free...

 

[RoloTomassi]

On a semi-related note, if you do get a deposition request, can you simply decline it? I recently had a request for a deposition on an old patient (last seen several years ago at a prior employer) but I really have zero interest in legal work and would like to pass. Can I do that?

Just give them a high price for your time, that will usually dissuade

 

[NickPetti]

did you ever end up contacting the lawyer directly to clarify what they wanted? I’ve seen similar situations where people get freaked out, thinking it's a deposition right away, but sometimes it's not that formal. Curious how it turned out or if anyone else has had updates with stuff like this since then.

 

[Status Sciaticus]

$2000 retainer/initial submission. $2000/hr after that for deposition, further review, trial prep. In person trial depo is 10k/day.

 

[buddababa]

$2000 retainer/initial submission. $2000/hr after that for deposition, further review, trial prep. In person trial depo is 10k/day.

pretty high, double what i charge, do they pay? if so, i should increase my prices

 

[cowboydoc]

pretty high, double what i charge, do they pay? if so, i should increase my prices

How much you value your time/alternative activities and what the market will bear should be the primary determinants of your rate.

I’m at $1500/hr for depo, 2 hr minimum, so those rates aren’t outrageous, but higher than my rates.

I try to make >$500/hr for any medicolegal documentation, often $750. I can only think of one case where the requesting party scoffed at the charge.

 

[paindoc007]

I’ve always just ignored them in The past. But this seems lucrative….

 

[Laryngospasm]

pretty high, double what i charge, do they pay? if so, i should increase my price

I charged that much ten years ago when I still did it. How much is a day of your time doing something you don’t like while getting grilled by slimy lawyers worth? Let’s not pretend the PI space is filled with altruistic angels. How much do you lose missing out on a day of clinic? Not to mention they often cancel the day before and you don’t have time to fill a clinic day.