Personal injury
Started by PMRorBUST
Get help with your application
Use all the free resources available to you from SDN: articles, guides, expert advising, forums discussions, and school research.
richest pain docs in town are PI pain.
I personally do not have the moral laxity to do PI work.
Good luck to you if you decide to go this path.
Good luck to you if you decide to go this path.
Advertisement - Members don't see this ad
“Moral laxity”? Care to explain? Genuine question as I’m not sure what morally is very different than the moral field mines of pain medicine in general. What specifically about personal injury makes it different?
I once worked for a pi heavy practice owned by a d bag doctor. The main ambulance chaser in town had the cahones to send me a form with what he wanted me to fill out highlighted. When I didn’t fill it out as what he wanted he complained to my boss and I had to hear about how this slime ball lawyer didn’t “ like me.” So glad I had already put in my notice.
PI is about malingering and money. Patient care comes in a distant third.
The problem with PI is that the goals of treatment are not aligned with actually getting better. The goal is to get as big a financial settlement as possible. This happens by "proving" significant disability from the injury and by inflating cost of treatment as much as possible.
The patient and lawyer do NOT want the patient to get better and go to work, they want hundreds of thousands of dollars in medical treatment which was ineffective. The best way to string this along is to give narcotics and do lots of procedures (which will all be ineffective).
Most of use go into medicine to help people. In pain management, we usually want to provide the necessary (not excessive) treatments to help the patient become functional again. To go to work and participate in activities they enjoy. Juicing the system for cash and encouraging our patient to be a slug isn't usually our bag.
The patient and lawyer do NOT want the patient to get better and go to work, they want hundreds of thousands of dollars in medical treatment which was ineffective. The best way to string this along is to give narcotics and do lots of procedures (which will all be ineffective).
Most of use go into medicine to help people. In pain management, we usually want to provide the necessary (not excessive) treatments to help the patient become functional again. To go to work and participate in activities they enjoy. Juicing the system for cash and encouraging our patient to be a slug isn't usually our bag.
We get paid, a significantly higher amount…eventually. Patients are mostly unreliable/no shows frequently.
20%…maybe 10%, I’m just spitballing numbers here, need/benefit from our care.
20%…maybe 10%, I’m just spitballing numbers here, need/benefit from our care.
You are not specifically working for the benefit of the patient. You are working for the insurance company or in close conjunction with a law firm.
Lawyers hate me. What is best for patients is usually not compatible with what is wanted by attorneys.
Lawyers hate me. What is best for patients is usually not compatible with what is wanted by attorneys.
Thread resurrection:
For anyone that does PI work at a PI clinic separate from your practice, does your practice claim your PI revenue? If you move jobs but stick with the PI work, has anyone successfully negotiated to work 0.8 FTE (for example) to allow you to continue that PI work so as to keep that per diem for yourself? Just wondering what others' experiences have been.
For anyone that does PI work at a PI clinic separate from your practice, does your practice claim your PI revenue? If you move jobs but stick with the PI work, has anyone successfully negotiated to work 0.8 FTE (for example) to allow you to continue that PI work so as to keep that per diem for yourself? Just wondering what others' experiences have been.
What about the courage of your convictions to stand up for people who have been legitimately harmed?
You mean that .1 percent? Sure go for it
Do you think that only 0.1% of PI claims are with merit? The rest are not real victims of drunk/impaired drivers, professional negligence, road rage, personal assault, criminal behavior, etc?
i take care of them as any patient - ie irrespective of their insurance.
i just dont get paid for PI work. and yes, it is a financial loss to me, but its not about the money.
Advertisement - Members don't see this ad
There are lots of threads in the past about this.
PI is far worse than WC, because PI is managed by lawyers and WC is managed by case managers first, lawyers second.
Proof is in the deposition - You'll find civility and professionalism in WC cases, while the PI cases are straight mud slinging and personal attacks.
I do a fair amount of PI, and I have no clue how the billing works for it. I just do it for the sake of our practice and don't think about it. I'm sure it pays well or else we wouldn't do it. Pinch my nose, go in the room and basically tell 95% of them they have an aggravation of a pre existing condition, and they'll be better with PT, Robaxin and my patented 15x4 heat/ice treatment (15 min heat, 15 min ice, 15 min heat, 15 min ice - that's 60 min with no breaks in between - you can do that at work).
Proof is in the deposition - You'll find civility and professionalism in WC cases, while the PI cases are straight mud slinging and personal attacks.
I do a fair amount of PI, and I have no clue how the billing works for it. I just do it for the sake of our practice and don't think about it. I'm sure it pays well or else we wouldn't do it. Pinch my nose, go in the room and basically tell 95% of them they have an aggravation of a pre existing condition, and they'll be better with PT, Robaxin and my patented 15x4 heat/ice treatment (15 min heat, 15 min ice, 15 min heat, 15 min ice - that's 60 min with no breaks in between - you can do that at work).
Sounds like an ad lol .. no seriously
I would say its probably 1 in 3 car accidents will have some sort of pain-resulting injury, anecdotally.
So you take PI patients, but dont get paid by the PI settlement? Are you doing this work pro-bono?
the hospital system bills for services rendered.
whats a PI settlement?
whats a PI settlement?
When a personal injury litigation settles, or an award is provided to the plaintiff, you collect your billed charges. Typically a reduction is taken similar to an insurance based rate.
For example, you bill 5k for an epidural. the patient is awarded 100k for the lawsuit. lawyer gets paid 40k. you take a 50% reduction because the lawyer doesnt want to pay too much of that 40k out and you want to keep those referrals coming in. still get 2500 for the epidural compared to the 250 medicare rate.
Dot forget dealing with slimy attorneys who try and weasel their way out of paying after they settle for pennies on the dollar after using inflated figures to increase the settlement amounts and their fees. 🙂⬆️
PI lawyers are scums and 99% scams. Docs who associate with them are no better. Our EM practice have said No to them many times when approached and Money is not worth your ethics. They will always find docs to "join" the network because it pays generally well.
If you want to rationalize it as real care b/c a fraction actually needs help, go ahead. But 99% sent from PI are scams. Here is a typically pt,
Pt - I have neck pain
Me - when did the accident happen
Pt - A week go. I was rear ended.
Me - So why are you coming in today and how does your car look
Pt - My PI lawyer told me to come and get a CT of the neck. Car had minor bumber damage.
Me - Is your neck pain worse
Pt - Its not worse, I was told to come for a CT
Me - here is an xray and your neck strain diagnosis
Why do you think 99% of pts are those that was Tboned/rear ended. I can't think of a pt that was liable for the accident.
If you want to rationalize it as real care b/c a fraction actually needs help, go ahead. But 99% sent from PI are scams. Here is a typically pt,
Pt - I have neck pain
Me - when did the accident happen
Pt - A week go. I was rear ended.
Me - So why are you coming in today and how does your car look
Pt - My PI lawyer told me to come and get a CT of the neck. Car had minor bumber damage.
Me - Is your neck pain worse
Pt - Its not worse, I was told to come for a CT
Me - here is an xray and your neck strain diagnosis
Why do you think 99% of pts are those that was Tboned/rear ended. I can't think of a pt that was liable for the accident.
That is the approach that I use. I see about 5-6% PI patients. There are some scams like anything but a fair percentage are hard working people who were unfortnately involve in an accident.
I dont know about that. I would rather see 8-10 PI patients vs 1 WC patient. Not because of the patient. Because of the bureaucracy.
This is really state dependent. We have conservative juries and minimal payouts. Therefore, there are not many overt lawyer advertisements. Don't get me wrong, you'll get loads of mail if involved in an accident. There are still bottom-feeders, but when there isn't that much juice, the PI infrastructure doesn't exist in the same way.
There aren't any "PI docs" around here. A few chiros do a lot of this, but they do all kinds of things.
That said, I also find that most all of the patients with injuries were not the at-fault party.
People here are doing well to get actual medical expenses and vehicle loss reimbursed. These medical expenses are regular and customary, not inflated "PI clinic" numbers.
There aren't any "PI docs" around here. A few chiros do a lot of this, but they do all kinds of things.
That said, I also find that most all of the patients with injuries were not the at-fault party.
People here are doing well to get actual medical expenses and vehicle loss reimbursed. These medical expenses are regular and customary, not inflated "PI clinic" numbers.
I found it fun to do PI procedurally. Saw some more acute cases. Weird shots got paid for. See some of the forum members doing endoscopic or lots of regen.
Had a mentor years ago tell me young docs do plaintiff work and old defense
I may start doing some ime work now
Had a mentor years ago tell me young docs do plaintiff work and old defense
I may start doing some ime work now
80% of the billboards in my city are personal injury lawyers. It's obnoxious.
WC in Georgia is pretty easy, pays well too.
Advertisement - Members don't see this ad
Sounds like NOLA
I thought you were in Texas but I could be wrong about your location.
Because of laws, Texas is the PI capital of the world. There are more PI pain docs set ups here than just about any other place that I know.
It’s pretty bad in New Orleans.. which has an income adjusted average of one of the highest rates of insurance for autos in the US. A six month policy averages three times the national average and keep in mind this is a poor city. If you stand on any given overpass you’ll see at least 10 billboards for PI attorneys.
I used to be. When I moved there, I was blown away with the commercials for “The Hammer” and the attorney ads plastered on every billboard, bus and bench.
The Hammer
The 4's (Davis Law)
Thomas J Henry
And even some of the minor ones dominate the airways and also dominate most of the suites at the sports arenas.
Better the 4 wheelers and PI than us docs
Caught in a wreck? Get your check!
Girrrrrrl I just got hit! You better go to I just got hit dot com
or...call the 4s..
512-444-4444
or
210-444-4444
There is only one number to remember and that's 4
interestingly....
tetraphobia
noun [ U ]
(also quadrophobia)
fear of the number four:
Tetraphobia is mainly suffered in China, Vietnam, Korea, Japan, because the word for the number four is similar to the word for death in their languages.
Tetraphobia results in many people avoiding referring to 4 in phone numbers and so on.
tetraphobia
noun [ U ]
(also quadrophobia)
fear of the number four:
Tetraphobia is mainly suffered in China, Vietnam, Korea, Japan, because the word for the number four is similar to the word for death in their languages.
Tetraphobia results in many people avoiding referring to 4 in phone numbers and so on.
Davis law doesn't seem to think that exists.interestingly....
tetraphobia
noun [ U ]
(also quadrophobia)
fear of the number four:
Tetraphobia is mainly suffered in China, Vietnam, Korea, Japan, because the word for the number four is similar to the word for death in their languages.
Tetraphobia results in many people avoiding referring to 4 in phone numbers and so on.
They are riding the 4s stick.
What about the PI patients who get in a car accident and now need a craniotomy? Are they faking it? Should they just pay out of pocket for someone else's screwup?
How about those that cant walk from a hot disc extrusion?
thats what PI should be for, right?
unfortunately, the money grab is all too real.
unfortunately, the money grab is all too real.
PI is built around defrauding insurance companies with made up injuries, unnecessary treatments, and preying on the patients 99% of the time. Just because 1% may be appropriate does not mean that the who industry is downright dirty. If you can justify an industry because they go "good" 1% of the time, then good for you. But 99% of the time, pts are used as pawn for the PI guys can make 40%.
There is a whole industry of chiro, PT, lawyers, neurologist, ERs, NSG, Pain whose livelihood depends on the majority of pts who would have done just as well with resting a day and 2 Motrin. Ask yourself why the vast majority is the not at fault drivers.
Classic pt who was rear ended at 30 MPH with no more than a sore neck 3 dys ago after getting a call from a PI
1. ER - CT scan of whole spine and head, maybe labs and neck pain diagnosis +/- radiculopathy, concussion
2. Goes to PI associated "injury specialist clinic" where they go through a Neuro eval for concussion, NSG eval for radiculopathy, PT for 6 wks, Chiro for 6 wks adjustments, Pain guy for 6 wks.
I was in a 40mph rear ended accident a few yrs ago. Next day, mild back soreness, didn't need any meds, knew I would be fine in 2 dys. I got called no less than by 5 PI guys telling me how they can help me with my injuries. Guess what, I was fine in 2 dys or I could have gone through 6 wks of "rehab" so I could get my 10K while the "clinic" billed 50K to the insurance companies.
Last edited:
I agree that there are large ecosystems developed for this but there are also hard working people who were injured. I think that 99% to 1% ratio might be a little steep. I see 5-8 percent LOP patients and for me that is fine.
I am not talking about docs who do some LOP, take care of injured pts, or provide standard of care.
I am talking about docs who live in the PI ecosystem, confabulate diagnoses, and practice medicine set forth by the PI guidelines. This is just insurance fraud. There is a reason why half the billboards in Texas and late night commercials are littered with them.
I am talking about docs who live in the PI ecosystem, confabulate diagnoses, and practice medicine set forth by the PI guidelines. This is just insurance fraud. There is a reason why half the billboards in Texas and late night commercials are littered with them.
Advertisement - Members don't see this ad
Great discussion.
I love it. It's ying/yang. What we know about the yin and yang, is that it isn't constant. That there is constant ebb and flow.
I love it. It's ying/yang. What we know about the yin and yang, is that it isn't constant. That there is constant ebb and flow.
I do agree that some of the "PI outfits" have different standards that aren't always based on standard practice guidelines.......mainly because they do not have to authorize with insurance in the typical manner.
In another thread we complain about WISER and their is a lot to complain about but on the same note some of these docs in the PI world are showing that they cannot act in the patient's best interest if there are no guardrails.
Its sad.
Here is a "Pain specialist" clinic that is in bed with PI dropped by a flyer at our ER.
1. Head to toe Compassionate Accident & Injury care - OK, sounds ok
2. Service - Pain, ortho, neuro, chiro, counseling (PTSD?), rehab. - OK, sounds OK
3. Injuries they treat - TBI, whiplash, spinal cord injury, fractures, PTSD, neck pain - OK sounds ok
#4 We specialize in Motor Vehicle accidents in BOLD!
No mention of falls in home, sporting injuries, etc.
They essentially want car accidents only and it better be someone else fault. Call one of the PI lawyers up and tell them you were in an accident where you were at fault. You will hear the phone drop so quickly it will make your whiplash hurt.
1. Head to toe Compassionate Accident & Injury care - OK, sounds ok
2. Service - Pain, ortho, neuro, chiro, counseling (PTSD?), rehab. - OK, sounds OK
3. Injuries they treat - TBI, whiplash, spinal cord injury, fractures, PTSD, neck pain - OK sounds ok
#4 We specialize in Motor Vehicle accidents in BOLD!
No mention of falls in home, sporting injuries, etc.
They essentially want car accidents only and it better be someone else fault. Call one of the PI lawyers up and tell them you were in an accident where you were at fault. You will hear the phone drop so quickly it will make your whiplash hurt.
Yep because there is no case.
Sounds like same story with my sister-in-law but probably 25 mph. It's not just the money, it can be real harm in getting a bunch of unnecessary shots and being told by a bunch of specialists you have a problem with your spine
Similar threads
