September 29th, 2009

Defensive Medicine or Medical Greed (Dr. Turkewitz Responds)

One of my brothers is a doctor. Internist. Geriatrician. You may not have expected that given the many decades both my father and I spent prosecuting medical malpractice claims, but thems the facts.

Today he guest blogs in my humble little corner of cyberspace. He wrote this letter in response to an NPR broadcast on defensive medicine. They didn’t air his views, but I will. (My prior comments on Defensive Medicine v. Medical Greed are here, so that, if you choose, you can compare some of the intra-family views on the subject.)
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By Stuart Turkewitz, M.D.

I listened with interest to your NPR interview regarding the estimated portion of health care costs attributable to malpractice expenses, and especially to the practice of defensive medicine. Both you and the host, Robert Segal, made repeated reference to unnecessary “tests and prescriptions” before arriving at a conclusion that a “very small portion” of the total health care bill results from practicing defensively.

Unfortunately, your reference to “tests and prescriptions” omits a major component of unnecessary health care expenditures: hospital admissions of older adults, and particularly adults with chronic medical problems.

I am an internist and geriatrician, and my patients occasionally go to or are sent to the emergency room, usually because a test is needed to urgently rule out a condition: a CT scan to rule out subdural hematoma, a lower extremity Doppler to rule out deep venous thrombosis, cardiac enzymes and EKG to rule out a heart attack.

Once a dangerous condition is ruled out, there is every reason not to admit an older patient to the hospital: people do best in familiar surroundings with familiar caregivers and food. The hospital subjects them to multiple new faces, irregular sleep cycles and sleep deprivation, risk of infection, and relative immobility, often precipitating a substantial decline in function.

Once in the emergency room, however, patients are confronted with physicians and other staff with every incentive to admit the patient, and little incentive to send him or her home. The infection, confusion, and insomnia that often accompany admission are at least a day or two in the future , and are not a consideration of the ER physician. On the other hand, the ER physician feels that he or she will be held to account for any misfortune that befalls the patient sent home from the ER. In addition, chronic medical problems can often look acute to physicians and staff unfamiliar with a particular patient’s “baseline.” The urge to recommend admission is overwhelming. The attending physician (that would be me), often at the other end of the phone, however skeptical of a true change in condition, is ill-prepared to argue against the physician who actually saw the patient moments earlier.

There is no question that the fear of malpractice suits influences physicians, particularly ER physicians, to admit patients unnecessarily, and I believe that the magnitude of this dwarfs the “tests and prescriptions” that you mention. This not only drives up the national health care bill enormously, but is detrimental to the health of most patients.

I believe that if the true “costs” of a hospital admission, including temporary and permanent decline in function, were truly and fairly accounted for, then it would be more evident how much the fear of lawsuits was truly costing us all.

Links to this post:

Defensive Medicine – Rob Sachs
Mr. Sachs makes a good point about defensive medicine in a recent post on his lawyer blog. Personally, I don’t think he understands what defensive medicine is, based on some of his back-handed comments. Here’s a little piece of that …

posted by Shawn Vuong @ October 16, 2009 7:03 PM

Unnecessary hospital admissions cost money and can harm patients
Unnecessary hospital admissions cost money and can harm patients. When the elderly go to the emergency room, more often than not, they are admitted to the hospital. Stuart Turkewitz, a geriatrician posting at his platintiff attorney …

posted by Kevin @ October 16, 2009 7:00 AM

Defensive medicine and hospital admissions
Unnecessary testing and prescribing is often the first example that comes to mind in discussions of defensive medicine, but Stuart Turkewitz, MD, explains why needless hospital admissions, especially of older adults and those with …

posted by Walter Olson @ October 01, 2009 7:51 AM

July 11th, 2009

The Summer of 1969 – A 40th Anniversary Look Back

On July 16, 1969, Armstrong, Aldrin and Collins sat atop a Saturn V and blasted off to history. And our imaginations lit up regarding what was, and what could be. Woodstock and the improbable worst-to-first Amazin’ Mets followed shortly.

New York Appellate Lawyer Jay Breakstone takes a look back to the summer of ’69 today, as we take a break from posts on Judge Sotomayor…..
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The strong flow of events is like a river. It can carry even the most wayward leaf along for the ride. In the summer of 1969, I was surely that wayward leaf. A disastrous freshman year at an upstate New York college had uncovered two primal truths. The first, was that I was not to be a doctor like my father; the second, that you don’t take a city boy from East Flatbush and put him in a town where Andy Hardy takes Polly to the prom. I was depressed and lost, with no center to my universe and no direction known.

Enter Neil Armstrong. I had spent most of my then 18 years living with the American space program. I had dawdled in front of the TV when I should have been running to school, hoping that there wouldn’t be any holds so I could see a Mercury or Gemini launch live. Inevitably, the primitive digital clock on the screen counted down and the worst thing imaginable would occur – – the voice of Col. John “Shorty” Powers in Mission Control announcing a delay and sending me off to school unsatisfied. But as the summer of 1969 approached, I realized that all those unrequited mornings would soon be vindicated. The Russians had failed and we had succeeded. We were going to the Moon. Maybe I was mired in failure, but Neil and Buzz were not.

Somewhere along the way, though, I had decided that I didn’t want to look like Neil and Buzz. The John Glenn crew cut didn’t work for anyone other than astronauts (and those kids in that upstate town). I had attended New York City’s Stuyvesant High School, hotbed of intelligence and activism. I had marched for equality and to end the war. In a culture that still required its high school students to dress appropriately, we at Stuyvesant did not. We wore sandals (if we wore shoes at all) and carried knapsacks. Most important, we had long hair and more respect for Mark Rudd and Johnny in the basement mixing up the medicine than for Richard Nixon.

Necessarily, this caused just a bit of friction at home. My doctor father had flown B-24’s in World War II. He had that John Glenn crew cut. He believed in Vietnam because he believed in America. He was a hero. I, however, was none of these things. Moreover, I had just demonstrated that I was not much of a student either. We talked a lot that summer of ’69 and, like a huge ocean liner, my father began a slow turn. Vietnam ceased to make sense to him and Woodstock suggested that perhaps his son might have a different way of looking at the world that was not quite as foolish as he had once believed. If there is a time for every purpose under heaven, that summer allowed me to ride the good vibrations of Woodstock into my father’s heart, a place where I had never really left in the first place.

The pulse of the times can substitute for the vitality of the individual. All you have to do is be clever enough to hop on board. The summer of 1969 was a veritable freight train of optimism. We could stand on the Sea of Tranquility and we could stand in the mud of Max Yasgur’s farm. It was all good. A small town college could give way to a large city university. Science and math could surrender to writing and literature. The dream of medical school could disappear and be replaced by “maybe I’ll go to law school.” In the summer of 1969, anything was possible. How did I know? Because the New York Mets were on their way to the World Series.

My life then had been short, but not so short that I hadn’t sat in the stands of the Polo Grounds in 1962, where the woeful Mets played before Shea was built, wondering whether anyone on my team could play this game. Off in the distance, beyond the hills of Coogan’s Bluff, sat the Palace of the Hated, Yankee Stadium. There, a real baseball team played. To them, it wasn’t a game. Baseball was serious business there. Tell that to Marv Throneberry, my first baseman, who made every pop fly a cosmic experience. Would the gods let Marv catch it or wouldn’t they? It seemed to have nothing to do with Marv. I was born and bred in Brooklyn. My mother had been a crazed Dodger fan, so much so that my Bronx-born father was never permitted to say the “Y” word in our house. By the time I was old enough to go to a ballgame, my team had left for California. I was rudderless on the sea of sports fandom. My early years were taken up by watching roller derby instead.

In that summer of 1969, however, anything was possible. I sat in the old Dodger Bar and Grill on the corner of Flatbush and Fulton, watching the games on the color television propped high in the corner. It was hot that year and the coolness of the dark bar calmed me. So did the cheap beer on tap. I sat and tried to figure out what to do with my life and watched the Mets do the impossible with theirs. Me, the Mets and three old guys who had not left that bar since the Dodgers won the World Series in 1955. They had waited in that very bar since then for the lightning to strike again. They had grown old waiting. Their families had lost track of them; written them off as dead. Detectives had closed Missing Persons files and shelved the boxes in closets marked “Unsolved.” Yet, here they were, like Macbeth’s three witches. For all those years they had been conjuring, stirring their Four Roses with a Rheingold back, invoking the baseball gods. In the summer of ’69, when anything was possible, it happened.

I know that these things happened, because I was there. In the summer of 1969, I was born again. I floated along on that river of the impossible and let it take me where I didn’t have the strength to go by myself. We kept going back to the Moon, the Mets won the World Series and even the Jets won the Super Bowl. Woodstock became synonymous with a better place where better people lived a better idea. I guess I was lucky. The time warp had opened, but only for a moment. God had smiled for an instant. Within a year, it would all be over. There would be four dead in Ohio, my mother would tell me that I shouldn’t worry about the draft because she wasn’t letting me go anyway, and my father would be dead. Oh, and I would be well on my way to law school, but I didn’t know that at the time either.

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Jay Breakstone did, indeed, make it to law school, and was sworn in eight years after this legendary summer. His current email is NYAppeals [at] gmail [dot] com.

November 10th, 2008

The Blogger’s Wife Sits Jury Duty

Mrs. NYPILB with her knight in shining armor.

Mrs. NYPILB sat jury duty last week She joins us today with a guest blog on her experience, with my occasional comments. That’s her pictured at right with her knight in shining armor.
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Last week was civic duty week. On Tuesday, November 4th, along with a record number of Americans, I cast my vote for a new President. On Wednesday, along with a few hundred of my fellow county citizens, I showed up for jury duty in White Plains, NY.

Eric — the guy who normally writes this blog — made fun of me as a I walked out the door at 8:00 am to arrive at 8:30 am in White Plains, as the summons proposed. He assured me that I would be the first juror there. [As my brother-in-law Dan was when he sat.] I chose to ignore him being that I’m always early in whatever we do and, well, he’s always late. To my punctual dismay, I walked into a full room of prospective jurors listening attentively to a woman giving instructions about the jury selection process. I secretly couldn’t wait to go home and tell Eric, “I was right and YOU were wrong!”

An elderly judge came in to tell us more about the process and the cases. He was quite genial and cracked some jokes — most likely the same ones he uses 365 days a year. Then he told us of two interesting cases on the roster; one case was criminal in nature and could take up to three weeks and the other was a Med Mal case that could take four. You could feel the tension in the room as we all made silent prayers not to be picked for one of those. When the judge stated that anyone with vacation plans could be excused into the other room, I seriously contemplated lying. But, being the complete dork that I am, I became convinced that they would ask me for proof and then I’d be screwed into serving some Grand Jury case that would take months. So, I sat still, squirming in my seat.

My get-out-of-a-long-trial for free card came when the judge also excused anyone with children 12 and under.

Within 30-minutes, I was called into a separate room to undergo the voir dire process on what was described as a short civil case. I wasn’t picked with the first round of jurors to be questioned but was asked to stay in the room. I listened to the Plaintiff’s attorney methodically question each of the 12 potentials, at first with interest and then with cynicism, annoyance and finally complete and utter boredom.

[ET note — Keeping it interesting after the first few is always a challenge. When I sense the boredom come on, I’ll ask the next juror, “You’ve heard all the prior questions, what do you think I should know that is interesting?” When the jurors question themselves, the answers can be interesting.]

The case was simple. The Plaintiff was Verizon. The defendants were two contractors. One a GC and the other a sub-contractor who specialized in boring holes under the ground for excavation work. In a nutshell, while boring, the defendant(s) clipped a Verizon cable. Verizon said the contractors were negligent. The contractors claimed that Verizon was negligent due to the improper demarcation of where the wires in fact lied underground. It was the jurors’ duty to assign blame.

Out of the first group of potential jurors questioned, the lawyers nixed a handful, which meant that more of us had to undergo a round of mundane questioning, including me. The lawyer handling Verizon’s end of the argument was painful to listen to. I’m convinced it was his first case. He asked the same series of “yes” or “no” questions to each and every juror. When it came to my turn I had to bite my tongue not to say “Let me save you some time here. Yes, I have Verizon services. Yes, I’ve had problems with it. No I don’t think my past problems with Verizon will prejudice my judgment in this case. Yes, my husband is a Med Mal/PI attorney but I don’t think it’s relevant in this case. Yes, I have little kids but my Med Mal husband has agreed to be home to get the kids off the bus this week so I can serve. So, take me, I’m yours.”

[ET note: Yes and no questions in voir dire, are, of course, some of the worst. You learn virtually nothing about the potential juror. In such a situation, the question I would start with is, How do you feel about Verizon? And with yes or not questions, the lawyers can never conduct the Turkewitz Beer Test.]

Of course I didn’t do that. While questioning me, the Verizon man seemed to want to find an excuse for me to not sit on his jury. After saying to me “well, won’t your kids be upset if you don’t put them on the bus,” I looked him in the face and said, “they’ll live for 2 days. This is a good time for me to do my civic duty and I’d be happy to serve.”

I got picked. It was going to be a breeze. One to two days at the most.

Right before entering the courtroom, I found out I was an alternate. After taking the first seat in the front row, the Judge started reading us procedural directions. When I say “reading,” I mean reading. All I could think of was Snoopy and the “Wa, wa, wa, wa, wa, wa” one would hear when an adult talked to Linus, Charlie Brown or any of the other Peanuts characters. In his closing directives, the Judge did the same. What’s the point in reading us the directives if we can’t understand what the heck is being said? My guess is that it’s just to avoid any appeals based on improperly directing the jury.

I can’t remember a single other situation in my life where I have been forced to be “taught” something and not allowed to interrupt with any questions. This was the hardest part of sitting on a jury. Every 10 minutes, I wanted to be like Horshack in Welcome Back Kotter — “ooh, ooh, ooh” with my hand waving high in the air! Instead, I had to listen and decide who was liable without having all the information I needed. Hmm…maybe I shouldn’t have cancelled those LSATs after graduating from Michigan.

[ET note: Some judges have experimented with having jurors ask questions, via a written submission to the judge.]

The funniest part of the day had to do with an incident regarding the court reporter. As he was typing away, every word uttered in the courtroom was magically transcribed onto a computer screen. This screen happened to be facing the juror box. There was one 30-second period where there was a pause in the dialogue and we all saw the Reporter check his email on AOL! Granted, it was the fastest email check I’ve ever seen in my life. Was he looking to see if his horse won the race? If his stocks were down? If he was gonna get laid later?

In the end, the trial was over in just a few short hours. I found the whole thing to be fascinating and was completely and utterly bummed that I was told to exit the courtroom and leave the building because, as an alternate, I was not needed anymore. I was not invited to deliberate. I had so much to say and nobody to say it to. I left with my tail between my legs. But once outside my tail started to wag when I realized that I wouldn’t be called to do this civic duty again for six long years. Phew.

March 14th, 2008

Jury Duty in New York: A Guest Blog

My brother Dan, a screenwriter, sat jury duty this week in New York. He live-blogged the experience, for publication when it was over:
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Tales From The Juror
Thoughts, observations, and ramblings, from the jury room at 111 Centre Street.

8 AM
In an effort to make sure I’m there on time, I get there before the building is even open. Big mistake. Have to wait out on the sidewalk. The day is not off to a good start.

9 AM
In my seat in the holding pen, verify that there is indeed free wifi access. The day gets slightly better.

9:30 AM
The woman running the show, giving instructions:

“You’ll notice, on my right, are vending machines, where you can buy snacks. We do not own these vending machines, so if you put your money in, and your snack does not come out, we are not responsible. And there is no number on the machine for you to call. But if it happens, we do allow you to shake the machines a little.”

9:45 AM
Ed Bradley (who died 16 months ago), and Diane Sawyer narrate the introduction film, which is supposed to make us feel better about being here. But it’s March 12, and half the people here are sniffling, wheezing and coughing. It’ll be a miracle if I get out of here alive. I think it was jury duty that did in Bradley.

10:00 AM
There is a severe lack of hot-looking women in this room. All those years of watching courtroom based TV shows, I was lied to! How could TV let me down so badly? There will be no amusing stories to tell my children years from now about how I met their mother while we sent some guy to the chair. (Do we still use Old Sparky in this state?)

If I get picked on a criminal case, and the A.D.A. isn’t smokin’ hot, I’m going to kick Dick Wolf’s ass.

(For those, like my brother, who probably don’t know who he is, Dick Wolf is the creator of “Law & Order,” a show which usually features an actress playing an A.D.A who looks like she was cast from a Victoria’s Secret catalog.)

10:05 AM
My brother e-mails me the following note:

“DO NOT TELL ME ANYTHING ABOUT DETAILS OF THE CASE IF YOU ARE PICKED UNTIL IT IS DONE!”

Apparently my brother thinks I’m an idiot. I’d find him guilty so fast.

10:16 AM
First call for criminal jury selection.

10:18 AM
I didn’t get called. Bastards.

10:23 AM
A cell phone goes off in the room. We were told to turn them off. The offender doesn’t get yelled at. Damn. I thought it might be the first chance at some drama here.

10:28 AM
Civil selection call.

10:33 AM
Not called

10:35 AM
Next call. This group is going to another building. 60 Centre Street.

10:39 AM
Not called. Good. Don’t feel like moving. If I’m going to be asked to hand out justice, let me do it without having to put my coat on.

10:40 AM
The guy behind me is loudly crunching through a bag of potato chips. He’s driving me nuts!

10:41 AM
Civil panel being called.

10:45 AM
Not called again.

God help me if I every have to rely on some of these folks to decide my fate.

10:53 AM
My bit to help the system run smoothly includes instant messaging with my 18 year-old niece on spring break in Florida. How did people ever stand jury duty without computers?

11:17 AM
Working on my latest screenplay. The guy behind me is starting to read over my shoulder. He thinks I don’t notice, but I do. Time to cause a scene? Humm…how bored am I?

11:21 AM
Taking a break from writing to do what jury duty is truly useful for: preparing for my upcoming rotisserie baseball draft!

11:29 AM
Another criminal panel call.

11:31 AM
I’m picked!!!

1:53 PM
Back from lunch. It’s amazing how easy it is to get out of serving. The judge asks “is there anyone here who can’t be impartial?” and 1/4 of the people raise their hands. All they have to do is say their name and declare “I can’t be impartial,” and they’re gone. Wow. Of course most of them are full of it. You end up hoping those people get arrested for something and have to rely on a jury some day.

There is one prosecutor, and he is not hot. Dick Wolf, watch your ass.

11:00 PM
Home.
So I was sitting there in the voir dire, one of 16 in the box, and we find out what the case is. It’s a drug case. Two Hispanic males from Harlem are caught in an apartment with 20 kilos of cocaine. That’s a lot of coke. There’s also an unloaded gun and a minor in the apartment, both of which add to the charges. Some jurors have already been chosen, they’re looking for more.

All the lawyers seem determined to remind us this isn’t CSI or Law & Order, it’s real life. I’m not sure if they’re being prudent or treating us all like idiots.

When the two defense attorneys started to question us, I was toast. One was hung up on the concept of using “entrapment” as a defense. Do we think it’s a legit defense? My response was, it’s meaningless as long as the cops followed all the rules they’re supposed to follow, and didn’t break any laws. At the end of the day, each person, no matter what situation they find themselves in, gets to decide if they’re going to be honest and law abiding, or dishonest and crooked. I pretty much knew that would get me tossed. Not that it was my goal to get tossed, I just didn’t like this guys’ angle, and felt like speaking my mind. The other defense lawyer was pushing the line that the cops went in without a warrant, how did we feel about that. Of course it was mentioned that this was an issue for the judge to decide, that if he says the cops didn’t need a warrant, then it was OK. But he got some people to say they felt funny about it.

Midway through the questioning, one of the court officers, an older gentleman, dozes off, with his hand on his gun. It did not inspire confidence. A few of us joked about it at lunch break, while waiting to go back in.

In the end, of the 16 of us questioned first, two were selected. I was not among them. So it’s back to the holding pen tomorrow.

The good news is, we don’t have to show up till 10 AM. Hot damn!

Day 2

9:50 AM
The holding pen is packed, but I find a seat in the front row. Time to sit and wait. Finally finish off the Sunday Times Magazine.

10:22 AM
They take attendance.

10:26 AM
Attendance over. They didn’t call me, and a bunch of others who were in my voir dire yesterday. The woman says they’ll try and track down our juror ballots. You do that.

10:45 AM
The missing juror ballots are found. I am now officially here. Oh boy.

10:54 AM
Casting my first jury duty vote: Snickers or M&M’s?

10:56 AM
Rotoworld.com says Orioles pitcher Adam Loewen was scratched from his scheduled start Friday because of a sore shoulder. The team president says it’s a normal result of his having undergone elbow surgery 9 months ago. I don’t care, I’m still not going to buy him at the draft.

Such is the excitement of jury duty.

11:01 AM
It’s amazing how quiet a room with well over 100 people can get. Reminds me of taking tests back in college.

The first day of jury duty, you actually look forward to getting selected. (at least I did) A little bit of excitement. A chance to do your civic duty. A chance to throw a bad guy in the slammer, or decide who really cheated who in some business deal gone bad.

The second day, all that crap goes out the window. Please, oh please don’t call my name. Just let the clock run out and let me go home.

11:36 AM
First panel called. 19 people. Not me. Good.

2:25 PM
Back from lunch. The immediate area definitely needs a better selection of eateries.

Only a couple of hours to go, and my time as a good citizen is over. Which is great, as the guy behind me in the packed jury holding pen is snoring something fierce.

4:00 PM
It’s over! With only one panel called all day, they’ve decided to cut us all loose. The guy setting us free decides to work on his standup routine.

“Some of you will be sad to be going home. (big laughs) Some of you will be glad. Just remember this: the last two days you had two-hour lunches. Tomorrow, it’s back to grabbing a sandwich at your desk. Today, you strolled in at 10. Tomorrow, it”s back to getting up at 7 AM.”

So there it is. My two-day odyssey through our judicial system has come to a close. I didn’t get to send any bad guys to the old gray-bar hotel, like I hoped. Nor did I set free any wrongly accused innocents, as my brother reminded me was also a possibility. No courthouse romances, no shootouts, nobody in handcuffs, no weeping family members, no mobs of reporters looking for courthouse steps sound bites. No courthouse steps, for that matter, at 111 Centre Street. All in all a thoroughly boring two days, interrupted briefly by a quick story about 20 kilos of coke.

And to think; sometime soon, some lucky jurors will get to sit in the box and hear about the ex-governor’s whoring around. I bet that won’t be a boring jury duty experience. Why couldn’t I get called then?

March 3rd, 2008

A Doctor, Sued In Insurance Company RICO Suit, Responds To The Charge

Last night I posted about the just-filed Allstate RICO suit, that includes charges that doctors and medical exam companies conspired with Allstate for “independent” sham exams and reports designed cut off treatment for patients. I also had written of a similar suit against State Farm.

Now, one of the defendant doctors responds:

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By Anonymous

Part of the problem with McGee’s case is that he is under investigation by Allstate, Geico and State Farm for insurance fraud. This was explained to us by the carrier I am on the suit with. They further explained to us that by law they have the right and have exercised the right to freeze his payments since he was not cooperating with the investigation. They felt this is a retaliatory suit. If he felt so strong about his claims why did he not contact the attorney general? (I will answer that)….Because this case is about money….it is a civil case..bottom line dollars and cents.

I would also like to point out that Dr. McGee was on the DD panel for some time also performing IME’s. Personally, I feel that although I am named, I dictate all my reports, one by one verbatim. While they might sound a like and look a like, they are all done by me, my voice recording saved to back this up. As for the fee splitting every IME company in the industry uses the same method for payment.

As someone who performs IMEs I also treat a large amount of patients with private insurance and no fault (unsolicited). I apply my standard of care in my office setting to my IME setting. Over the past 15 years, I have gotten more praise from my patients then one doctor deserves. This is because I think I have always advised them to stay active with walking and swimming. I generally do not recommend physical therapy for more then a few months at a time. I find that staying fit, walking, swimming, home exercise programs and stress management are very useful tools for soft tissue injuries mainly neck pain and back pain. As an electro diagnostic consultant I do refuse to do EMG’s that do not enhance patient care; That was not popular with my partner(s). As an IME provider I have called claim reps over some serious issues. My most memorable being a man with a damaged prosthetic from an accident who on my 2nd IME still did not have it fixed due to the claim rep not approving it. I also have had to send claimants to emergency rooms more then once for possible cellulitis for surgeries a few days prior for injuries alleged to be from the accident I was evaluating them for. It certainly was not the popular thing to do but, first do no harm is the oath I stand by…I had 1 claimant who saw her doctor a day before who reported bowel and bladder issues and then when I examined them they had no rectal tone…I am sure you know what that means-another medical emergency!

I do admit that I do recommend no treatment after about 5 months only if there are no positive findings on physical examination. So many times these claimants are mislead that if they quit there jobs and feign pain that they will get a large amount of money. TO me this just breeds laziness. I would hope at that time there treating physician offers them encouragement, home exercise programs, healthy lifestyle tips etc…So many times I hear that there physician has literally dropped them.

No one has ever, ever, ever, asked me to change an opinion. The allegations of false reports is bogus and coming from John McGee who is famous for owning Bill Mills to me has no merit. Furthermore, on the Allstate summons page 34 paragraph 95 he mentions that the documents to prove this have not yet been discovered. That will not fly in a RICO case. I have already had the case reviewed by a half a dozen attorneys familiar with RICO who all agree that the elements needed for a true RICO case are not there. There needs to be a crime within a crime with hard evidence-not assumptions. This case has no concrete evidence just a bunch of assumptions.

I have a years worth of voice recordings to show my reports are authentically mine and I know that I have never excepted a bribe or for that matter have been offered a bribe, ever. I have done IME’s on claimants who have then asked for me to treat them…..I do admit I make more money from IME’s but time wise I spend more time treating. That is probably due to that fact that I take medicare whose reimbursement for time is about a 1/3 of the time of an IME and my medicare patients all have co morbidities. So I see and treat more patients by a measure of time but dollar for dollar I get paid more per IME. But on top of that I make more money from investments outside of medicine so how much I make in medicine would be moot as money is not the only motivator for doing IME’s in my case.

Also as a doctor who performs IMES, I ironically find that the large IME companies, mainly the ones named in the suit really could care less about if I continue or discontinue treatment. My recommendations have been questioned by smaller companies and not to my surprise I never got work from them again..That is not a problem for me. It might be a flaw in the system but I would not want to work with a company that put me under pressure to change my reports. I would also like to give you my opinion on causality after reading Harvey Goldberg’s testimony. I do very few liability exams so causality is usually not a problem in the no fault sector. There are a few carriers that never ever want it addressed. Then there are companies that always want it addressed. I feel that in No fault causality is really a legal term. That is because I was once deposed and asked how I could feel that a cause and effect relationship existed with no police accident report was reviewed or AOB form. I had based it on the claimants history of the accident. To me when I have to start analyzing the insurance documents…I have left the field of medicine and have entered into the legal arena.

I would never omit a CR statement based on the outcome of an exam but if I was asked to leave it out regardless of my opinion prior to the exam I cannot see the fault in that as a physician. I have been told sometimes to take it out of my report as the directions I was provided with indicate that “causality has already been established” or some other believable statement. To me the most important merits to the report are that my history and physical examination remain my opinion. After that M&S, apportionment and CR can be addressed at any future time since it is based on those elements.

To conclude in my opinion Dr McGee is not going to be credible for so many reasons. Besides for owning so many bill mills, being under investigation himself and also being on IME panels his claims are just not how it is done with these companies. Maybe that was his experience on a panel which makes me question his integrity and intent even more. Of interest, there is a case now involving RICO which involves personal injury attorneys referring claimants to the same doctors over and over….we should all stay tuned for how that one ends……

One more experience I want to share. I was recently asked to testify in a civil courthouse on a bill for a diagnostic test in dispute. To my surprise the insurance carrier produced as a witness the claimant who denied even having the test…It was settled in 20 seconds….I was paid for the day and home before 10 AM!

Comments:

Eric,

Was the Dr’s response sent to you directly, or what is its source?

# posted by Anonymous

Joe D’Addario : March 03, 2008 10:24 AM

Guest blogs that have appeared here, including this one, have been sent to me directly.

# posted by Blogger

Eric Turkewitz : March 03, 2008 10:27 AM

He should have asked his lawyers whether or not making a statement on the interweb is a good idea.

# posted by Blogger

. : March 03, 2008 6:13 PM

I verified this doctors claim that Dr. Mcgee is under investigation. According to State Farm at 1981 Marcus Avenue, SIU, this is true. I called DD and spoke to an older woman who admitted McGee was on ther panel a long time ago but did not know to the extent he did exams and offered no further information. Thank you dotor for shedding light on this matter. May the judge see the transparency of this case and absolve the pawns swiftly. I have never heard of Bruce Rosenberg and after reading the allegations I am not sure you doctors are the target of this cat and mouse game. This seems to be some kind of extortion for you hard working stiffs to finance his upcoming legal bill with State Farm et al. Has anyone tried to settle with him? I am sure 5K can “buy” you out of this mess.

# posted by

Anonymous : March 06, 2008 4:37 AM

It is a sad day for our legal system when the crooks get to call the shots..I am familiar with McGee and he is the one who should be the defendant – “State Farm vs McGee”. It is absurd to see those doctors who have been my witnesses and very good ones named as defendants strictly for a “shake down”. Does anyone know if State Farm indemnified them or are they paying up the %#$%^ to defend this matter? I hope the judge gives it to Plaintiffs counsel for wasting time bringing this case forward. Did anyone even read the summons? He is suing the acupuncturists for performings IMEs on claimants because the term is deemed Independent “medical” exam and they do not have medical degrees. Unless I read that wrong….Eric, please let me know if I am crazy or is this summons filled with manure…
NYNFattorney

# posted by

Anonymous : March 06, 2008 2:48 PM

why are such upstanding citizens anonymous. Could they be PR reps for the carriers.

# posted by

Anonymous : March 06, 2008 8:25 PM

please let me know if I am crazy or is this summons filled with manure…

Having never spoken with the witnesses, and having no personal knowledge as to the facts, I’ll withhold judgment.

My only guess is that this won’t go away soon and that there will be a lot of discovery that needs to take place.

# posted by Blogger

Eric Turkewitz : March 06, 2008 8:49 PM

I have been reading this blog and have been hesitant to post. I was named in the suit. All I can say is that there is not even a grain of truth to any of the allegations. I am an honest and ethical doctor and would never in a million years deny someone treatment in some alleged, purported scheme. It simply does not happen at all. There is nothing to “discover.” I regularly recommend coninued care and treatment.

But, what I find most amazing is that someone who has never met you, does not know anything about you can just make up blatant lies about you, sue you in a court of law and smear your name. What a great system we have…

# posted by

Anonymous : March 06, 2008 9:22 PM

i am named in the suit as well and have been hesitiant to post.If discovery were not so burdensome in cost I would welcome them to come and take want they need from my office to vindicate myself. But given the cost I can only hope this goes away soon or I will be mortgaging my house to finance this BS. Eric, would it be more appropriate for claimants who have been denied care to bring a case forward for no coverage vs. a doctor alleging he could not make a living b/c he was denied 3rd party benefits? I have never examined one of his patients that NEVER had an EMG or 3 MRIs. How about the patients that say they are going to therapy because they were told “they had to go”. I sure that was a slip of the tongue… How can a 3rd party have the right to bring this case foward? BOTTOM LINE-there is nothing to discover…anyone who knows McGee’s work “Slimy McGee” knows that truth. But I guess eric, since you are not privy to that and you have never met his patients you could not understand how grossly injustice this is. You have also never met the doctors but knowing about half of them they are some of the squeakiest clean practicing gentlemen and women I have known. I know firsthand that Drs Cole and Wendy Cohen and Isaac Cohen are excellent practitioners as well and also well known for there high standard of care…Isaac Cohen, I thnk just started doing IMEs 3 months ago…explain how he was involved in this conspiracy since 1998. Eric Baron and Joseph Cole were probably still in training when McGee thinks this charade began…They cant be more then 35 years old. Many of the allegations just do not make sense. Bottomline, you just do not know McGee to understand the irony in this case. FYI-I have not even been served yet so maybe this will be resolved with the SF named docs before I even lay out a dime…

# posted by

Anonymous : March 07, 2008 7:05 AM

I have just started following this blog as well as a wife of a named defendant. I am sure a few readers know who I am and I request that you do not invade my request for using the anonymous feature.

I have one point I want to get off my chest. Frivolous lawsuits not only cost money but they hurt families. They take wonderful people and parents and turn them into distant creatures. My husband was wrongfully named along with a bunch of other wonderful practitioners. I cannot wait to the day of vindiction so I can have back the man I married and my children can have there usually fun and cheery daddy back. I wish this as well for all the other named mothers and fathers who were wrongfully named. Stay tough, stay strong!
I have one question for you Eric, if these doctors were guilty do you think you would have such an open forum like this with so many people with so much to say about this? No, because they would have too much to hide.

# posted by

Anonymous : March 07, 2008 7:33 AM

Peter Stark, NYS health and education law. It is sad that so many “good” doctors have not given the required attention to their business and professional conduct rules and responsibilities. Don’t these “good” doctors know that they are not allowed to work for non professionals, Split or share fees with anyone other than equally licensed professionals, disclose Doctor patient HIPPA information or not follow NYS and Federal law with regard to charges for services rendered. I can’t recall the cliche about lying down with dogs or something about stones and glass houses. If you all haven’t realized it by now their is a new Sheriff in town for professionals and it’s name is COMPLIANCE. All are supposed to be equal on the scales of justice. JUSTICE IS BLIND.

# posted by

Anonymous : March 08, 2008 11:18 PM

Peter,
You are assuming that the alleged charges only apply to these doctors; however, this is the way every IME company pays every doctor on there panels. So is it a problem with these doctors or with the system? That would make every doctor who has ever performed an IME guilty of the same crime…..does common law ring a bell here….

# posted by

Anonymous : March 09, 2008 11:06 AM

Only the healthcare professionals, “IME” co’s and the insurance industry can answer the question posed. Why should healthcare service providers that care for injured citizens be held to a different standard. They have families too. So far it appears that it is “slimy” to use skills to help real people than cater to the industry that bailed out on the people hurt by “Katrina” taking record profits and bonuses while at the same time shedding risk by cancelling homeowner contracts because the risk is too great.

# posted by

Anonymous : March 09, 2008 3:07 PM

http://money.cnn.com/magazines/fortune/fortune_archive/2003/12/08/355094/index.htm

see link to learn more of what McGee is part of….People in the “know” know this is what McGee is about and that is what makes this suit infuriating….

Mr. “Waiting to be served”

# posted by

Anonymous : March 09, 2008 4:25 PM

I did not see any mention of McGee in that four year old Fortune article.

# posted by Blogger

Eric Turkewitz : March 09, 2008 5:24 PM

Reading blog today…becoming laughable. The bottom line is this, this has nothing to do with Katrina, HIPPA, etc. It is a specific claim that IME docs named and the IME companies and Insurance companies are in some “scheme.” Utter nonsense. People, it does not occur or exist…it is as simple as that. That is why the case will eventually be tossed out with all of the other frivolous, nonsensical law suits filed everyday in this country.

In fact, the law states that insurance carriers are allowed to have their claimants examined by a doc of their choice. It is not a crime to render a professional opinion within ones specialty.

As for McGee, anyone with half of a brain knows the reality…how long will you people continue to deny and distort the truth?

Oh, and btw, HIPPA does not even apply to No-fault, WC, etc. I mean for gods sake, how could it…did you not ever see cases with identifying data posted on the net about patients and cases. If you would like I can supply the government webpage where WC, disability, and No-fault cases are specifically considered exempt from confidentiality regulations.

# posted by

Anonymous : March 09, 2008 5:37 PM

I think what he was trying to say with the article reference was that anyone that knows “of McGee”, knows that these are the types of things he is engaged in, which I would assume is why all the major carriers are investigating him and had froze all payments to him for lack of compliance with the investigation.

# posted by

Anonymous : March 09, 2008 5:51 PM

One last comment for me…about this issue that the IME companies engage in fee splitting with doctors. One thing that confuses me is why then does the State of New York fully acknowledge the existence and legitimacy of these IME companies at the NYS WC Board website in which the state requires such entities to register with the State of New York:
www.wcb.state.ny.us/content/main/imedocs/ime_entity.pdf

I guess they should add the State of NY to the law suit as well….good night all.

# posted by

Anonymous : March 09, 2008 7:54 PM

Kind of like how Florida wouldn’t let Allstate write ANY new policies based on Allstate’s failure to cooperate with Florida’s investigation.

No one has ever responded to a lawsuit with “yeah, you got me.”

# posted by Blogger

. : March 09, 2008 7:59 PM

Actually, that may not be true. I think that dry cleaner openly acknowledged losing that guys pants, but I think they just felt that 10 million for a pair of slacks was just a bit too high. Finally, after all of these years, I get the joke, what do you call 100 attorneys at the bottom of the ocean?

# posted by

Anonymous : March 09, 2008 10:27 PM

BTW, Eric thanks for letting me post my sarcastic attorney joke. In fact, I actually like most attorneys…just thought I would let you know that.

# posted by

Anonymous : March 09, 2008 10:55 PM

In reference to the Fortune article, in case you don’t know or remember State Farm conspired with Pete Smith then Assistant Atty General of Suffolk (who has since long ago resigned due to this fiasco)to indict over 500 MD’s, and clinics that had anything to do with NF.
90% of the cases were thrown out of court. However, MD’s reputations were tarnished by this clown who was deified in the Fortune article. Slime you State Farm!

# posted by

Anonymous : March 09, 2008 11:50 PM

hey, even my 6 year old knows the answer to that joke….

# posted by

Anonymous : March 10, 2008 5:13 AM

“90% of the cases were thrown out of court”

Yeah, because that means anything. Are you suggesting that what the article talks about does not occur at all at least to some degree? Denial aint’ just a river in Egypt

# posted by

Anonymous : March 10, 2008 8:33 AM

I am a Dr with a practice focused on treating people injured in automobile accidents.
I have been saying for years that insurance companies and the doctors that perform IMEs are dishonest.
We always read in the papers that treating doctors/chiros/lawyers are committing fraud by helping people injured in accidents.
Finally someone with guts are going after the big insurance companies.Lets face it 99 percent of my patients who have been sent for an “IME”have been cut off from care.Even people with documented disc herniations.This is a corrupt business.The doctors who perform IMES know that if they give additional care than the IME companies will not use them anymore to do exams.(This is an unwritten rule)
I believe that that the plantiffs will win this case once a jury sees that the ime doctors denied 99.999 percent of the patients they examined and never allowed an EMG,MRI,supplies, etc when conducted a peer review.Its laughable when people on this site say dr mcgee was under investigation by allstate/state farm.EVERY SINGLE doctor who does PI has been investigated by them.I believe these IME doctors should be criminally prosocuted in additon to being sued civil court.
They have the nerve to say they are impartial???

# posted by Blogger

todd : March 11, 2008 9:04 PM

Well, Todd you read that in the paper because it is true….As for your assessment of IME docs, that is your opinion. But, remember in this case, there is an allegation that there is an overt conspiracy between insurance companies and IME docs, etc. That does not occur at all, which is why the case has no merit. An IME is nothing more than a professional opinion. As for myself, I regularly recommend continued treatment and have not been “cut off” from performing IME’s, as you claim. What is amazing is that, McGee is complaining about this, but where are the claimants complaining that they have been cut-off? Could it be that the patients don’t care? I have been conducting IME’s on a part-time basis for many years. I can recall only one complaint letter from a claimant for discontinuing treatment – hey not a bad track record.

I remember once I was in an accident, and my neck hurt pretty bad – I had a whiplash injury. I never sought treatment or put in any claim – never had any PT, accupuncture, chiro, neuro, PMR, MRI’s, NCV studies, medical supplies, no pain meds, etc. Six (6) days later my neck pain resolved and I felt fine…fancy that…

# posted by

Anonymous : March 12, 2008 7:59 AM

IN response to the last comment.
Patients don’t care if they are cut off because most doctors will treat them for free after the cut off date.So the medical office has to sue the insurance company to get paid which can take 6months to a year.So most people do complain and say”IM in pain and the IME doctor spent 5 minutes with me, how can he cut me off”Also, just because you got in an accident and felt fine after 6 weeks doesnt mean everyone feels that way.You are obviously biased.You basically just said that since you felt fine after 6 weeks than obviously everyone should be fine.Thats ridiculous.YOU KNOW THAT THERE IS AN UNWRITTEN RULE THAT THE IME COMPANIES AND INSURANCE COMPANIES EXPECT YOU TO CUT OFF CLAIMANTS OTHERWISE YOU WILL NOT GET ANYMORE WORK AND YOUR INCOME WILL BE AFFECTED.Doesn’t that affect “your professional opinion”We all know it does, you are not fooling anyone.I would love to get you on the stand in a court room and present 500 of your reports cutting people off and maybe about 10 reports giving people additional care.

# posted by Blogger

todd : March 12, 2008 11:49 AM

Todd, nothing you say at least as it pertains to me, is true. For starters, I felt perfectly fine after 6 days, not 6 weeks. Obviously, that is not typical, I was merely pointing out that some patients are just a bit “overtreated.” Do you think that patients are not ever overtreated or overtested? I also never heard of your “unwritten” rule either. I have been conducting IME’s for many, many years and have recommended continued treatment in literally hundreds and hundreds of cases. You are just like McGee, you know nothing about me, never met me, and know nothing of my practices. Yet, you pass judgment. But, I guess you are entitled to your opnion. But, remember, in this legal suit, McGee is alleging RICO, which is an allegation of criminal activity and conspiracy…do you honestly believe that this is true? I know the answer, there is not even a singe grain of truth to it at all.

As for patients complaining, that is not totally true. A patient can complain and request a different IME or second opinion. That has happened with me where one doctor conducted an exam the claimant did not like, so the lawyer requested a second IME within my specialty, and the carrier ganted it without a problem. Lastly, as for patients that are in continued pain for months after a soft tissue injury is complex and not as simple as you think. I believe there are complex factors at play there and simply blaming the “evil” IME doc is the easy way out.

# posted by

Anonymous : March 14, 2008 7:49 AM

Todd, an “unwritten rule” does not constitute conspiracy. In a court of law there needs to be evidence. Especially in a RICO suit. There is a very high burden of proof on plaintiffs side to prove this conspiracy theory. Without any proof the most there is in this case is a bias and there is no law broken. furthermore, i refer you to read the posting on this site called NY’s no Fault law problems with “serious injuries” it is in the March 2008 archives.

# posted by

Anonymous : March 14, 2008 11:15 AM

Hmm,
In response to the last post.I was talking about IME doctors in general.I dont know who you are so I was not commenting on how you practice.
Im assuming you were named in the suit.I agree that some patients are receive too much treatment and testing.The whole system is corrupt in my opinion.

# posted by

Anonymous : March 14, 2008 2:25 PM

How can anyone with a clear conscience try and defend the
Insurance IME exams Sure,I will
agree that they have the right
to monitor abuse but so many people
are being cutoff who are in need of care

Before I had my exam I was told expect to be cutoff My surgeon told
me they are paid 600 and exam

I was subject to a 2 minute IME exam by a doctor who did not even address my 3 herniated disks and that I was seeing a pain specialist and on constant pain meds

I timed the exam

The final report was clearly a
boilerplate one size fits all fill in the blanks report

Can any of the attorneys explain to
me why an IME doctor can not be sued on a personal basis when the
report is so contrary to the factr

# posted by Blogger

karl : March 17, 2008 5:55 PM

Karl
that is a lot of money for an IME. do you know what company set that exam up? Was that for a liability examination or for a no fault case. Who is your insurance carrier that they pay such a premium to do IMEs? Chubb?

# posted by

Anonymous : March 20, 2008 12:00 PM

“Can any of the attorneys explain to me why an IME doctor can not be sued on a personal basis when the
report is so contrary to the fact”

Because it is just a professional opinion. The same way that it would be ludicrous to sue a plaintiff doctor solely for an exaggerated opinion regarding a patient’s injuries. Thus, if you could sue the IME doctor for his or her opinion, then it would only be fair that you could sue the plaintiff doctor for his or her opinion.

BTW, I am not an attorney

# posted by

Anonymous : March 22, 2008 7:53 AM

Who ever the attorneys involed in the case HURRAY for you. I am an educated professional who was an innocent passenger — If someone has cervical herinations pressing into the spinal cord would you push down their head as hard as you could? THE MEASLY settlement I will proably get out of this case isn’t enough for the pain and humilation I have suffered at these IME’s. If you are a neurologist would you mock a patient with speech and lanuage problems whom is already in anguish about it? Would you grab a person leg with lower lumbar disc’s herination and pull it as high and fast as you could. OH IS JUST TO SEE IF THE MRI WERE RIGHT or is this for your AMUSEMENT! What goes around comes.

# posted by

Anonymous : March 26, 2008 8:16 PM

You had a “bad” IME, so now you support a systematic and frivolous law suit filled with lies? Whatever happened to “Two wrongs don’t make a right?”

# posted by

Anonymous : March 26, 2008 11:07 PM

TO TWO WRONGS DO NOT MAKE A RIGHT try 4 out 5 IME DOCTORS and then there were the 2 out of 2 for the defense. I filled out the intial forms in all the offices involved and asked for copies — I also verbally told the DOCTORS about my DISC’s HERNATIONS but in my denials my conditions in and besides the DISC HERNATIONS are never mentioned — SURPRISE SURPRISE. Do all these doctors have ADD, NEED READING GLASS or an English literary test. One DOCTOR went as far as I do not want to know what is wrong with you. THEIR MEDICAL LICENSES SHOULD BE REVOKE.

# posted by

Anonymous : March 27, 2008 5:15 PM

I have a client several months post disc fusion surgery, who was then involved in a serious car accident. Diagnostic tests confirm that he now has a compression fracture in the lumbar spine area. He has been in bed, and on heavy pain medication for months. He is being treated by one of the top NYC spine surgeons. That didn’t stop one of the doctors named in the suit from concluding, after a 3 minute exam, that my client was able to go to work, and terminating his lost wages. He charitably gave him 6 additional weeks of PT. I say a pox on all their houses. Let them give back some of their ill gotten gains.

# posted by

Anonymous : April 01, 2008 4:35 PM

Wait, let me get this straight. So, the doctor who is supposedly in some conspiracy with insurance companies to deny claimant’s continued treatment, recommended addtional physical therapy…hmmm.

# posted by

Anonymous : April 02, 2008 7:42 AM

The insurance industry has confused and manipulated the system by obfuscating NY Workers Comp Law and NY No Fault law.Since there is no such exam under the no fault law the consent a patient gives is defective and there is a DR. patient relationship established. Maybe there is a claim for malpractice after all.

# posted by

Anonymous : April 17, 2008 5:18 AM

The worst situation is where there is no arms length transaction between the insurance carrier and the doctor. That exists in its most blatant form at a location on Maiden Lane that goes under the name Med-Eval. It is a direct connection to Countrywide Insurance Company. Countrywide has marketed this wonderful service to unsuspecting carriers including Praetorian, QBE, and Ocean Harbor Insurance. This is a pure cut-off mill that is operated directly by the insurer with transcriptionists shuttling between this office and their main office at 40 Wall Street a few blocks away. The claimants go through at such a rapid clip that no one can get any examination. They have one doctor “practicing” at this location who must be 90 years old and cannot speak in full sentences. Not only is his speech unintelligible, he is probably demented. The cut-offs go out like clockwork and all three examiners the chiropractor, neurologist, and orthopedist always agree. Give me a break. Why are we paying for insurance? The State of New York whose governor was chasing call girls should have been chasing down these criminals.

Anonymous

# posted by

Anonymous : April 18, 2008 9:30 AM

Can we address this fee splitting garbage? Who is splitting fees? The IME is valued at a particular number and the physician is paid in accordance with that. Each physician is paid a different amount of money and agrees to a specific dollar amount. THERE ARE NO BILLING CODES FOR AN IME nor are there any laws pertaining to the amount of reimbursement each physician should have. An “IME” company gets paid for the management of the file. YOUR INSURANCE POLICY waives your right to privacy by the way. The IME company then selects a physician for various reasons.

Also, each of these entities are registered with NYS and have never been closed down as illegal. A physician is not WORKING for ANY IME company. They are sub contracted. So before you begin to state these types of accusations Mr Education Department, perhaps understanding the full parameter of the subject would behoove you.

THE TRUTH of the matter is, most physicians have been asked to reduce their fees BECAUSE there is SO MUCH FRAUD in the industry that a cost containment is required. MOST doctors doing IME exams are not getting a fantastic compensation for it and they still have to pay rent, staff, malpractice, etc.

Regarding the physician who responded, the experience he described is the experience of most physicians. I am sure there are some unscrupulous ones out there (like Dr Smith in the 90’s) however, with the paltry compensation the IME vendors provide for each evaluation, NOBODY is getting rich off of these and certainly has no reason what so ever to make up a negative exam.

IF ANYTHING the opposite would be true. IF ANYTHING, you would see MORE positive evaluations guaranteeing another physical examination because of the low fees if someone were unscrupulous.

# posted by

Anonymous : April 24, 2008 5:11 PM

Who are you kidding? The IME business is a multimillion dollar racket. There are a number of doctors that do only IME’s and are making a bundle. And what overhead are you talking about. Some patients are being IME’d by inept,half dead/half abrasive doctors in converted garages with one person at the front desk!

# posted by

Anonymous : April 27, 2008 2:32 AM

“The IME business is a multimillion dollar racket.”

Well for starters, any business or service in its entirety is “multimillion.” I mean selling paper clips is a multimillion dollar business – does that make it wrong? As for it being a “racket” – you would need to be more specific – I am assuming it is only a racket in cases in which further patient care is denied. When further treatment is recommended, I guess then it switches to being legitimate.

Not too mention – the only reason there are IME’s is because there is no-fault treatment. They are both inherently correlated. Like in 2003 when all the mills were shut down and docs indicted, since there was less treatment, there were less IME’s. It is not rocket science.

Doing “only IME’s may not be right, but it is not criminal. Just like there are plenty of treating docs that only accept no-fault cases and work in “mills” – who cares? I know I don’t. These are not crimes on either side. That is why ALL attorneys think this case stinks.

“Abrasive docs in garages….” Never met any doc that does IME’s in coverted garages, but I am sure it may have happened. Again, not criminal….lastly, I do not like grouchy people either.

But, so far I have not heard any legitimate “criminal” or “fraudlent” activities.

# posted by

Anonymous : April 27, 2008 5:18 PM

Recently at a IME by a Pain Management Dr. I was told to move my neck, after showing limited movement and seeing the reports of a herniated disc in my neck causing impingment upon the nerve root, I was deemed “cured” and not to have a permanant injury! I bet my life, if I went to this mans office,with the same reports he was shown, first he would require to see the actual films of the MRI, then he would say I needed further treatment! This whole No Fault system is a scam, But with the money the insurance companies have Not one thing will be done to reform the industry!

# posted by

Anonymous : April 28, 2008 9:33 AM

Speaking of the Garages – I looked up each and every DOC (excepting one) that saw me and intersting enough all of them have private pratices or work in hospitals no where near the IME Mills you are examined in – they are simply there to make a fast buck — they themselves are causing the HMO mess because when no fault denies your health insurance winds up picking up the bill… sure they can subrograte but how much is this costing the HMO? I think also realizing the cost of healthcare (paid lots of bills myself) I myself will be more likely to sue a DOC if anything happens to me under there care because I am in fear that my health insurance will not coverage complications and I will not be able to pay for help. My healthcare due to my accident is costing me a mortage payment every month. My health insurance will not coverage certain MEDS OR treatment.

# posted by

Anonymous : June 13, 2008 9:00 AM

Iam a physician in Florida directly affected by sham IME’s. How can any doctor take $1200 for an IME which involves NO treatment, liability, decision making, follow up or any other patient care issue then recommend the treating physician get $89 for patient care?

In all my years in this business I’ve seen a few reports stating there is an injury of any kind. Rarely are any of them related to the accident. Maybe twice have they actually stated it was. Almost never is there future care needed or long term disability. The reports are laughable and completely disregard or misstate facts.

Recently the reports have become accusatory. I believe we are close to lawsuits in our area. These are the ones that disgust me.

# posted by

Anonymous : July 08, 2008 9:13 AM

The case of Sundahl vs. State Farm was just dimissed by a federal judge. It was a very, very, similar bogus suit like the Allstate one – and guess who filed it? You guessed it, good ol’ Brucey!

What is even more funny is that Rosenberg referenced an article in the NY Times to “support” the frivolous lawsuit with Allstate. Where did he get his law degree from? From a cracker jack box?

# posted by

Anonymous : April 13, 2009 11:00 PM

Hey anonymous, why are you questioning Mr Bruce integrity, at least he has the guts to stand up to these insurance companies..and how do you know the Sundhal case was dismissed?

# posted by

Anonymous : June 04, 2009 4:24 PM

I see you posted twice…hmm, could this anonymous be the infamous Bruce himself? I wonder?

Well, as you may have already read, the Sundahl case was dismissed by the judge on 3/31/09. It is PUBLIC RECORD that is how I know. The Allstate case will 100% be dismissed because I know for a fact that every allegation in the suit is false and completely without merit. BR wasted everyone’s time with these “cases”, including the courts, doctors, insurance carriers, and even McGee…it is the attorneys choice to accept or not accept a case.

BR does not have “guts”, as you say…he is a heartless soul that cares only about himself and his selfish motives. What comes around goes around…his day will come…sleep well.

# posted by

Anonymous : June 05, 2009 9:20 PM

Eric said: “My only guess is that this won’t go away soon and that there will be a lot of discovery that needs to take place.”

After the dismissal of the Sundhal case with prejudice (which is essentially identical to the Allstate and State Farm cases), how confident are you in that statement a year later?

# posted by

Anonymous : June 07, 2009 10:39 AM

After the dismissal of the Sundhal case with prejudice (which is essentially identical to the Allstate and State Farm cases), how confident are you in that statement a year later?

I haven’t read the decision yet. But assuming that both are dismissed prior to discovery, let me say this:

If it is the only time I am wrong in my career than I’m living a charmed existence.

# posted by Blogger

Eric Turkewitz : June 07, 2009 9:51 PM

The problem with BR is that he makes such outlandish claims and accusations, that it borders on incompetence. I mean to go in front of these federal judges and to say there is no such thing as an “independent” medical exam..c’mon.

Then to claim that there is this big RICO conspiracy going on, but to not present a SINGLE shred of factual evidence to back that up…that is someone who is desperate with an ulterior motive -at least that is my impression. Personally, I would not make up lies about anyone and then present that in a public forum, especially in a court or legal setting. In plain Enlgish, it is immoral and unjust.

Then he claims that it is fraudelent to mail an appointment letter to remind the claimant that they have an appointment…what? I mean, as I said earlier, him wasting the time of the courts, doctors, attorneys, etc. is just pathetic and he is the lowest of the low in my opinion.

Anyway, thanks for your input Eric…take care

# posted by

Anonymous : June 07, 2009 10:45 PM

Ok bloggers whats the update on the allstate Rico suit? What is the website so I can look at it? I’m wondering how BR did.

# posted by

Anonymous : July 11, 2009 7:13 PM

The “update” is that there is none…with it being the summer, I guess not much will happen at this point. However, the last desperate attempts of BR were back in April in which he provided “supplements” to the suit by submitting irrelevant newspaper clippings and information about Hurricane Katrina. I know it is funny, but hey, you asked 🙂

# posted by

Anonymous : July 11, 2009 8:51 PM

There is an update:

The State Farm Case involving the IME docs, Carriers, and IME vendors was dismissed today with prejudice by the Federal judge. I have a copy of the order in front of me. Since this case is identical to the Allstate case, one would assume, that the Allstate case will be dismissed next. It is nice to see the justice system actually work. Personally, I feel that there should be a consequence for attorneys that bring frivolous lawsuits to the court systems…my two cents.

# posted by

Anonymous : July 14, 2009 9:34 PM

Some have commented that the initiation of the law suit way back when was due to McGee and others being pursued by State Farm….apparently that is true…below is a copy of an order of a federal judge affirming a prior judges decision.

What is interesting is that apparently McGee did not want to be deposed because he felt that the information provided in a deposition would result in disciplinary action by a licensing board…hmmm…now why would he NOT want to be deposed? What is McGee afraid of? I know…here is the document:

http://royamura.googlepages.com/StateFarmv.CPTMedicalServs..pdf

# posted by

Anonymous : September 21, 2009 7:27 PM

It is interesting to note that Rosenberg claimed in his lawsuit that peer review or IME entities are “adjusting” claims, etc. and therefore illegal, bogus, etc….this was actually addressed by the NY State Insurance Department back in 2004.

It was concluded by the Department that “An organization that functions as a mere conduit or intermediary between no-fault insurers and the healthcare professionals performing utilization review is not itself “performing utilization review.” See N.Y. Ins. Law Â§ 4901 (h)-(i) (McKinney 2000); N.Y Pub. Health Law Â§ 4901 8-9 (McKinney 2002). Since the organization is not engaging in the actual utilization review, it is not a utilization review agent and therefore not required to report to the Superintendent of Insurance pursuant to N.Y. Ins. Law Â§ 4901 (McKinney 2000).

N.Y. Ins. Law Â§ 2101(g)(1) (McKinney 2000) defines “independent adjuster” as “any person, firm, association or corporation who, or which, for money, commission or other thing of value, acts on behalf of the insurer in the work of investigating and adjusting claimsâ€¦” It is further noted that, “Past opinions have indicated that the determination of whether the proposed activity constitutes investigating and adjusting claims hinges upon whether discretionary authority is exercised in investigating and adjusting claims rather than simply performing ministerial functions…Since data processing is a ministerial act and the organization will not be engaged in either investigating or adjusting, it will not be acting as an independent adjuster. Therefore licensure pursuant to N.Y. Ins. Law Â§ 2108 (McKinney 2000) is not required.

It is amazing what you can learn from just reading. Maybe if Rosenberg read this, he would not have filed the frivolous lawsuits, but not likely.

The actual document can be found here for those interested:

http://www.ins.state.ny.us/ogco2004/rg041001.htm

# posted by

Anonymous : December 01, 2009 9:23 PM

I was unfortunate enough to had been scheduled an IME with one of the doctors that Mc Gee had accused of falsifying medicala records.

To make a long story short, I record all my medical sessions with any IME doctor that the insurance carrier send to me (For my own personal record of course). Sure enough, this one doctor reported to the carrier that he had performed numerous examinations, etc during our one session together. None of this was true..I never participated in any exam during the one and only appointment I had with that particular IME doctor..and I have a recording to prove it.

What Im unsure of is what to do next. Should I wait until I actual take my claim to court and wait for him to lie and then bring forth the recording or should I send a copy to the DA’s office and Medical board…?

# posted by

Anonymous : January 10, 2010 4:26 AM