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View as PDF (download free Adobe Acrobat Reader here )
Thursday, May 22nd 8:00 a.m. - 5:00p.m.
Cost: $40.00 per person
4 Continuing Education Credit hours
Program will include:
Sumner McAllister, M.D.
Ammon Strehlow, D.C.
Jeffrey States, D.C.
Lance Rowlands, M.D.
Jan Watts, P.T.
Bryan A. Larson, Esq.
A panel discussion on chiropractic IMEs
Questions/Reservations
Call Amanda at 801-446-646
On Thursday, May 22, 2003 we will be having another seminar designed to assist chiropractic physicians to become better physicians and more profitable in their business. We have a unique and unusual variety of presenters. Willing to sacrifice their time and effort to make a presentation of value to those that attend. We have been awarded 4 continuing education hours for your credit to attend the seminar. As in the past, we anticipate the seminar to be of high caliber and content. Each of the presenters has been selected for a variety of different reasons. It would be helpful at this point to explain some basic views of ours concerning seminars. The mere fact that someone is requested to give a presentation at the seminar is not necessarily a rubber stamp of our endorsement on the programs, projects, research or view points of the presenter. It's our belief that positive intellectual growth can occur by being exposed to a wide variety of different ideas. As always, we invite suggestions or recommendations for future seminars. We encourage you to come and see if the seminar will be valuable to you in your practice.
Of unique note, in the upcoming seminar is the fact that we're having a physical therapist give a presentation. We recognize fully that some chiropractic physicians believe that no physical therapist could possibly teach them anything. In the case of Jan Watts, you would be sorely mistaken. Her presentation will be a memorable one and filled with useful information that you can borrow, use and incorporate into your practice. Furthermore, it's always good to find out what the physical therapists are offering since often times physical therapists are in direct competition with chiropractors. The mere fact that we have asked a physical therapist to come to present at seminar does not mean that we are suddenly choosing physical therapy over chiropractic. Again, nothing can be further from the truth. However, Jan Watts' presentation will be particularly powerful and you will see the value in coming when listen to what she has to say.
Also, the upcoming seminar we will be having a panel discussion by three very brave physicians who in the past have done chiropractic "IMEs". We very much know how extremely volatile the issue of chiropractic IMEs being performed in Utah is. We promise to have a couple of very big Tongans present to restrain Dr. Knight's enthusiasm on the subject. Nevertheless, because we will never eliminate the right of an insurance company to review and evaluate the work that you perform, it's our belief that the independent examinations are better when performed by a chiropractic physician than they are when they're performed by certain neurologists and physiatrists which we could name. Each of the physicians that are going to be participating in this panel discussion have actually lost significant work doing "IMEs" for insurance companies because of their pro-chiropractic positions taken in their reviews. Nevertheless, it's an important topic for the profession to discuss to learn what reviewers are looking for, how reviews occur, and ways of producing a better result when your file and bills are reviewed by an insurance company. It's our hope that this discussion can be constructive, positive and respectful by all the participants. Having said that, we're confident that this discussion will be another event that you will not want to miss.
In short, please take a good look at the seminar and give us a call with your reservations. Please notice that the method for taking reservations has changed somewhat. We have a registration cut off date which will be strictly enforced.
We enjoy doing the seminars and acknowledge the gratitude that many of you have kindly expressed concerning our efforts to try to build the chiropractic profession in Utah. We believe in chiropractic and we hope to see you there!
Would you like some help on getting your P.I. files going and turning the work into money? If so, give us a call and if you would like, we will set up a time convenient with you to come in and perform an audit on your P.I. files. From this audit, we will know how to help you improve and/or increase the cash flow on your P.I. files.
This can be done confidentially and won't cost you anything. The audit should only take about 1 to 2 ½ hours, depending on how many files you have. Give Bruce Davis or Bryan Larson a call at 801-446-6464. We will spend time reviewing the files and the paperwork. Then we'll meet with both Doctor and staff for training in your office.
The following article is from Utah Trial Lawyers Association
Volume 25, No.3 Fall 2002 Page 6-10
By Paul M. Simmons
Part 1 of 2
On at least three occasions in the last thirty years, the medical-insurance industry has blamed dramatic increases in medical malpractice insurance premiums on so-called runaway jury verdicts and has used the myth of the runaway jury to lobby the Utah Legislature for protections from lawsuits for health-care providers.
The first occasion was in the mid 1970s and resulted in Utah's first medical malpractice statute, the Utah Health Care Malpractice Act, enacted in 1976. See 1976 Utah Laws ch. 23 (codified at UTAH CODE ANN, 78-14-1 through - 11 (1996)). The principal features of the 1976 act were a shortened statute of limitations (two years instead of the usual four-year statue of limitations for negligence actions, without any tolling for minors' claims), see UTAH CODE ANN. 78-14-4; a presumption that a patient consented to treatment, id.; 78-14-7; and a requirement that the plaintiff give the defendant at least ninety days' notice of his claim before filing suit, id. 78-14-8.
The Utah Supreme Court rejected jury verdicts as a cause of the medical malpractice crisis of the 1970s in Lee v. Gaufin, 8678 P.2d 572, 583-89 (Utah 1993), which held unconstitutional the Malpractice Act's statute of limitations as applied to minors' claims. The court noted that, "whatever the case was in California and the nation as a whole," "there was no evidence of increased malpractice lawsuits or of greater verdicts in Utah." 867 P.2d at 585.
The second crisis occurred in the mid 1980s and resulted in the 1985 and 1986 amendments to the Malpractice Act. See 1985 Utah Laws chs. 67, 237, 238; 1986 Utah Laws chs. 170, 205. Among other things, the 1985 amendments limited attorney fees in medical malpractice cases, see UTAH CODE ANN. 78-14-7.5; abrogated the collateral source rule in medical malpractice actions, see id. 78-14-4.5; and provided for prelitigation panel review of medical malpractice claims, see id. 78-14-12 through - 16. The 1986 amendments authorized the court to require deferred, periodic payments of future damages in medical malpractice cases, id. 78-14-9.5, and capped damages for non-economic losses in medical malpractice cases at $250,000, id. 78-14-7.1.
The third crisis is occurring now.
Perhaps not coincidentally, our nation has also experienced three major periods of recession in the last thirty years-in the mid 1970s, the mid 1980, and currently. One could conclude that the real cause of the recurring so-called medical malpractice crisis is not runaway jury verdicts; instead, as Bill Clinton reminded us in the 1992 residential campaign, "It's the economy, stupid." After all, malpractice insurance is not the only line for which insurers have been raising rates in these poor economic times.
Nevertheless, to determine whether juries in Utah are really out of control, I reviewed all medical malpractice verdicts and settlements I could find for the last twenty years (from 1982 to July 2002). I used two sources -- primarily Rocky Mountain Verdicts & Settlements, available on-line at www.rockymtverdicts.com , supplemented by Westlaw's JV-ALL database. I reviewed some 421 cases.
Admittedly, 421 cases over a twenty-year period may not give an accurate view of medical malpractice cases in Utah. According to the Utah Medical Insurance Association (UMIA), one of the largest medical malpractice insurers in Utah, its claim department opened 394 new claims in 2000 alone. Presumably, not all of these claims resulted in litigation, but the number still suggests that the reported cases may only be the tip of the iceberg. For the ten years from January 1, 1991, through December 31, 2000, UMIA received 3,263 claims. Of these, 825 closed with a payment, and 2,438 closed without any payment being made. To try to get a more accurate picture of medical malpractice cases in Utah, I asked UMIA and the Utah Medical Association (UMA) to see their data on settlements. UMA responded that it did not keep such data and referred me to UMIA. I have not had any response from UMIA, so the figures in this study are necessarily incomplete.
Of the 421 cases I reviewed, 164 (about 39%) settled for undisclosed amounts. Twenty-six others resulted in summary judgment for the defendant or dismissal. Two cases were referred to arbitration without any further report. Of the remaining 229 cases, 173 (some 76%) resulted in some recovery for the plaintiff, and 56 resulted in defense verdicts or settled for nothing.
Among the cases that went to trial, however, the figures were reversed. Plaintiffs prevailed only 34% of the time. Still, Utah plaintiffs fare better than their national counterparts. Nationally, malpractice plaintiffs win only about 25% of the time, the lowest rate for any type of personal injury case.
The recoveries ranged from $0 to $9,711,100.
The term "recovery" is misleading, however. In those cases that resulted in a verdict for the plaintiff, the plaintiff did not always actually recover the amount of damages the jury determined. For example, in the $9.7 million verdict, the jury apportioned fault 70% to the defendant hospital and 30% to the defendant doctor. The doctor had settled with the plaintiffs before trial for an undisclosed amount (presumably less than his $2.9 million share of the plaintiffs' damages), and the hospital settled with the plaintiffs after trial, also for an undisclosed amount.
Plaintiffs did not recover their full damages in many cases for other reasons as well.
As noted above, in 1985 the Malpractice Act was amended to require the court to reduce the amount of damages awarded "by the total of all amounts paid to the plaintiff from all collateral sources which are available to him," with certain limitations. See UTAH CODE ANN. 78-14-4.5 (1). Thus, if a plaintiff recovers a substantial sum for past medical bills but the bills have been paid by his health insurance and his health insurer either has no right of subrogation or has waived its right of subrogation by failing to serve written notice, as required by the statute, the defendant is not liable for those written notice, as required by the statute, the defendant is not liable for those past medical expenses, even though the jury may have included them in its damage award. See id. 78-14-4.5.
Also, as noted above, since 1986 the Malpractice Act has capped damages for "noneconomic losses to compensate for pain, suffering, and inconvenience." UTAH CODE ANN. 78-14-7.1. The cap was originally $250,000 but was increased in 2001 to $400,000 and is adjusted for inflation each year thereafter. See note 1. If the cap were applied in the $9.7 million verdict, the total verdict would be $2.7 million, since $5 million of the jury's award was for general damages. On the other hand, in at least one case where the jury awarded substantial general damages ($500,000) the trial court declared the cap on noneconomic damages unconstitutional. See Vanderbloom v. Oldroyd, Civil No. 950300053 PI (3d Dist. Ct., Tooele County). The unresolved issue of the cap's constitutionality may have led malpractice insurers to pay more than the cap for noneconomic damages in some cases.
Also, since 1986 the legislature has required that future damages of $ 1000,000 or more (less costs and attorney's fees) "be paid by periodic payments rather than by a lump sum payment." UTAH CODE ANN. 78-14-9.5(2). The second largest recorded verdict in Utah history-for $8,157,542-included $6,607,542 in future care costs, which under the statute could be paid over time. Moreover, the statute provides that the obligation to make periodic payments (except for lost future earnings ) ends on the death of the plaintiff. Id. 78-14-9.5(6). Thus, for example, if the plaintiff who obtained the verdict for over $6 million in future care costs were hit by a car two weeks later and killed, the defendant would essentially be excused from ever paying the $6 million. So what was an $8 million verdict could become a $2 million verdict.
In addition to these peculiarities of the Malpractice Act, there are the usual forces at work in any lawsuit that may prevent the plaintiff from ever recovering the full amount of his verdict-such things as the unavailability of insurance, the instability of the insurance company, the likelihood of an appeal, the desire to avoid a lengthy appeal and possible re-trial and the plaintiff's need for immediate payment.
On the other had, a plaintiff may have recovered more than the reported amount in some cases. For example, in some of the cases where the plaintiff obtained a recorded verdict, the plaintiff also settled with other defendants for undisclosed amounts.
To be continued
Dr. Cracker has learned from several of his more reliable State Farm informants that the good neighbor is pulling up stakes and closing the neighborhood claims offices in several Utah communities. Apparently State Farm hierarchy has recently shocked their already weary troops by announcing plans to close Utah claims offices in St. George, Cedar City, Richfield, Orem, Logan and Ogden. The Centerville office closed some time ago. Yikes. For now, the Sandy and West Valley City offices will not be closed, although those that work at those locations may still get the axe. With this decree, many former loyal State Farm employees will join the ranks of the unemployed without any severance packages being offered, we understand. Once devoted adjusters, some with more than 18 years with the company, are being arbitrarily thrown over the side of the ship as dispensable ballast. Some might say that State Farm is now merely treating their own adjusters and claims support staff with the same disregard that they've dealt with some claimants and policyholders in times past. In what is being labeled as a corporate re-structuring and consolidation, those few claims handlers that may survive the cut will probably be forced to work out of their homes, as State Farm sells off its claims offices to be converted to corner convenience stores, Auto Zones and Jiffy Lubes. State Farm's new national slogan, "We live where you live" takes on a whole new meaning. The local claims office in your town may now be in the basement of a house just down the street from your home.
We know that there is supposed to be a second part of the article "Health care records: books open to abuse". After careful review of the second part, we thought that it was just too boring to put in.
We are accepting referrals for both personal injury and workers compensation. For personal injury, have-your patient call 801-446-6464 and ask for a member of Bryan Larson's staff and for workers compensation, have your patient call and ask for Cindy Stonebraker.
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