Who's Looking Out for You? | Dr. Scott Hickey & Dr. Shawn Borich (Maximum Medical Improvement)

Clients getting hurt for the first time in a significant way often don't know where to go, not just for legal advice but for medical advice. 

Not only does it impact their health and their recovery, but it impacts the strength of their case. Without the right medical treatment, without the right supporting doctors and experts, insurance companies just don't take the claims as seriously.

Because at the end of the day, they're looking at our clients, and they're not necessarily seeing them as people, but as numbers on a spreadsheet.

How can a client find the appropriate medical care that improves their health and their legal case?

Dr. Scott Hickey and Dr. Shawn Borich are the physicians behind Maximum Medical Improvement, which helps people find not just a medical specialist, but the right specialist, from the right subspecialty who understands their specific case. 

MMI then works with lawyers to help strengthen the legal argument from a medical perspective, by being able to answer specific questions about the specific situation that their client has found themselves in.

A resource that advocates for lawyers and patients: MMI is bridging the gap between medical care and legal support.

"Patients need an advocate because they don't know the questions to ask. And that's what we can provide, since we know the questions they should be asking" - Dr. Scott Hickey

In this episode, we discuss:

◼️ How gaps in treatment can negatively impact both health outcomes and legal cases.
◼️ Why the role of emergency physicians is unique in understanding various specialties.
◼️ Why finding an advocate is essential for patients to receive the care, and legal support, that they need.
◼️ How the healthcare system has shifted towards billing and coding over patient care.
◼️ How to encourage collaboration between medical and legal professionals.

Chapters

00:00 Navigating the Healthcare System
05:00 How MMI Partners Fills a Gap
09:55 Getting Early Medical Intervention
20:00 The Evolution of Patient Care
25:00 The Emergency Room Experience
27:12 The Dynamics of Emergency Medicine
35:39 Getting Support to Navigate the Bureaucracy
44:01 Ethically Connecting Clients and Patients 

Courtroom Stories & Tactics | RVA Trial Lawyers
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Based out of Richmond, Virginia, Courtroom Stories & Tactics by RVA Trial Lawyers exists for lawyers who try cases to juries on behalf of people. Through our podcast, we hope to learn from them, support them, connect them, inspire them, and preserve their work for future trial lawyers.

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Thank you!

Sharif Gray and Nael Abouzaki

Transcript

SPEAKER_03 0:00

It's extremely difficult to navigate on your own. And it's really surprising from a patient perspective that there aren't firms already that work to help people navigate to the healthcare system.

SPEAKER_02 0:14

Truly, the system is not set up to advocate for patients. On an individual level, patients don't generally have an advocate for themselves and a navigator for themselves.

SPEAKER_01 0:26

This is Courtroom Stories and Tactics by RVA Trial Lawyers, hosted by Sharif Gray and Nial Abuzaki.

SPEAKER_00 0:36

All right, before we get into today's episode, I want to take a minute and thank Maximum Medical Improvement Partners, MMI, for supporting the podcast. As many of our listeners know, one of the biggest drivers of case value for our clients isn't just proving liability, but it's whether the client actually gets the right medical care and recovers from their injuries the right way. As we all know, when their treatment is delayed or incomplete, their cases lose value. And Maxim Medical Improvement Partners helps solve that problem.

SPEAKER_02 1:08

You're right, Sheree. My name is Dr. Stavniky, and I'm with MMI Partners. Our mission is to connect injured clients with the right clinicians and quarterback the clients' medical care from day one, leading to stronger recovery, clearer documentation, and increased case value.

SPEAKER_00 1:26

Thanks, Scott. For our listeners who are interested in getting in touch with you all, how can they find you?

SPEAKER_02 1:31

You can visit us at MMI.partners. Again, that's nmi.partners.

SPEAKER_00 1:38

All right, we're back. And today we've got two good friends of mine. We've got Dr. Scott Hickey and Dr. Sean Boric, which I always say Boric, and I know that's incorrect, right? That's right. That is great. Boric is the right way. Yeah. Okay. Well, I screwed that one up. Even though I was the old country. I like it. Even though I attempted to get it right. I messed it up this time. Well, anyways, let me introduce both you guys. So I've known Sean for a while. We met at CrossFit Addict, which is an addictive place, right? If you like pain and torture, it's burpees, sweating, uh, getting yelled at, lifting weights. But you feel good about yourself afterwards, right? Just like everything that's hard. That's right. That's right. And then through Sean, I uh met Dr. Scott Hickey. And I remember the first time you and I met beforehand, I was doing my research, and I think I learned that you had won a bedside manor award at some point. Is am I right? Sure. Okay. And I've seen there's been a few of those. Sure. Well, I've since met you, and I've paid a lot for those. I can tell. Um because we've met a few times. I mean, clearly you've got some Northeast in you. So, like, but anyways, it's been fun getting to know both you guys. Happy to have you guys on the podcast. And what brings us all together is a few months ago, you all had this idea and this issue that you're trying to solve of you deal with people who get hurt, and it's their first time in the medical system, and they get lost. They don't know where to go, they don't know who to call. And ultimately, they're not putting themselves in the best possible position for them and their family members to get the health care that they need. And we see it, at least on the personal injury side, where we have clients who are also getting hurt for the first time in a significant way and also don't know where to go. Yet not only does it impact their health and their recovery, but it also impacts their cases. Because without the right medical treatment, without the right supporting doctors and experts, insurance companies just don't take the claims as seriously, right? Because at the end of the day, they're looking at our clients and they're not seeing them necessarily as people, but rather because of the system and the amount of claims, insurance companies wanted to do things to spreadsheets. And so by doing so, they see who do they see? What do the doctor's notes say? What are the amount of the bills and all that stuff? And if a client doesn't know to go get the appropriate care, well, then their case is going to suffer as well. So all of that said, we've come together and started MMI Partners, which is maximum medical improvement partners, in an effort to try and fix that gap and add value to the clients, the people who've been hurt and don't know where to go, and at the same time add that value to their legal cases and in turn providing a resource for their lawyers. So I'm super excited about it. I think it's something that's fairly unique in the legal medical world. Oftentimes kind of we're not against each other, but there can be some friction between the medical world and the legal world. And I think the goal of this is to try and bring both of those worlds together to be value added. So why don't you guys start off by, I mean, I mean, what tell us a little bit more about what you all have seen over the years when it comes to patients getting hurt and then just not knowing where to go. And I forgot to mention this, but both you guys have spent a number of years in emergency rooms. And so you know what it's like, of course, to see those people get hurt in significant ways and just not know where to go next.

SPEAKER_03 5:11

Yeah. I mean, Scott and I are both emergency physicians. We actually met during residency. And so we've known each other for 20, 25 years, 26 years now. And one of the things that we notice really early on is that when people get injured or even when they have any sort of significant health problem, the health system's very difficult to navigate. And so a lot of times, even you know, within our own family, if something happens or someone gets cancer or they get injured, you know, they go to the emergency department, they might get some discharge instructions, which says follow up with this one person or so, but it's not comprehensive. And so we would have family members or friends saying, Hey, this happened to me. Who do I go see? What do I do? And so originally I think this whole concept was really one of we've been asked this question repeatedly about what do I do when I'm sick? Who do I go see? How do I get a second opinion? Who should I even see for a second opinion? And so we tried to figure out a way to capture that and to help people navigate the system, which, you know, a a lot of times because medicine's so complex, people have an injury or people have a problem, and they don't even know who they should see at all. You know, like I look at my parents, for example. My father, my father's very smart, he's got a PhD, my mother has a master's degree, and they will call and they'll say, Hey, who do I see for this problem? What types of doctors should I see when this is going on? And so that's kind of the whole basis.

SPEAKER_00 6:45

And it's amazing to me like how specialized the medical profession is. Whereas people like me, who I I mean, I have still very much a layman's knowledge of what doctors do, right? But I just assume, well, you're a doctor, you should kind of know, right? Meanwhile, doctors can be very much pigeonholed in their specialty. And we get the same, and they may not know that, hey, actually, you should also be seeing this group as well, right? And we get the same thing as lawyers. I get questions all the time. Hey, you're a lawyer, you what do I do here? And I'm like, dude, like you're asking like a trust and estates question. Like, I'm as helpful as a Google search. And frankly, I would rely on Google more than I would rely on what I know. Because just also with lawyers, we're specialized too. Like, I don't I don't know how to advise somebody about a will. Maybe I can at least know somebody who they can call.

SPEAKER_03 7:31

And that's the same exact way it is with medicine.

SPEAKER_00 7:34

Yeah.

SPEAKER_03 7:35

Especially as people go on in their careers, you know, psychiatrists after 10 or 15 years out of residency isn't really going to be able to give you that great advice on orthopedics or vice versa. And so it's really important that you have people that can bring all those specialties together. And that's why emergency medicine is kind of unique in that, because when you're working in the emergency department, you have to know a little bit about everything, as well as you know each specialty, you have a connection to each specialty because you're always making referrals, you're always calling people in the emergency department to get advice on patients. And so we're very unique and specifically set up to be able to advise people on who they should see and the time frame that they should see people to.

SPEAKER_00 8:19

Yeah, because earlier is better, right? I mean, Scott, can you talk about that? Like you were helping us out with a case not long ago involving a pretty traumatic brain injury. And I remember one of your comments was like, this guy needs to be seen by this person, this person, this group, like now. This is not something that you wait.

SPEAKER_02 8:36

Yeah, the navigation has to happen immediately. And as Sean said, people don't know who to ask. And if they don't have someone that's quarterbacking the care for them and getting them to the places they need to go, their recovery is going to be delayed. And there's example after example of that. It could be the traumatic brain injury that had neurologic deficits in the hospital already that needed rehab immediately after they get discharged from the acute injury, to the folks that maybe have an extremity injury, that well, it doesn't require surgery. It does require some intensive physical therapy or occupational therapy. And that the sooner that begins, the better the recovery is going to be for the patient. Otherwise, it's going to drag out over time and limit their ability to do the tasks that they need to do, whether it's caring for their children or providing an income for their families.

SPEAKER_00 9:26

And we see it at least on the legal side, right? I mean, I'm sure all the personal injury lawyers listen to this are probably like, yep, uh, those cases where the client comes in, they're hurt, they go to the ER, but then they don't really treat. They don't really follow up. And the phrase that's used in our world and the insurance world is, well, there's a gap of treatment. So what happens is once there's that gap, and let's say it's a six-month gap, well, then the argument is, well, hey, it's not related to this car crash, it's not related to that incident. And because there's such a long gap, it's actually degenerative or it's related to something else. That's another obstacle, at least for the legal case. And certainly I expect is also an obstacle for the client's health because they're not getting the treatment that they need.

SPEAKER_02 10:10

And that's a gap that we should be working to close. So the the sooner you get the case and you're able to share it with us and have us meet with your client, which would be our patient, to talk about their situation and to review their records and the care they're getting, we can direct them further to where they need to go to next. But you're exactly right. When there's a large gap of six months, eight months, even 12 months in care, that is going to either delay how long it takes for them to recover, or it may inhibit them from getting a full recovery. So certainly the sooner we're involved, it was suggested to us not long ago in having a conversation with another lawyer that, well, it really sounds like this is something for our seriously injured clients more than others. And really it's not true. It's for all your clients. Sure, the serious ones have really obvious significant trauma, but even folks that maybe don't appear to have significant trauma, like a gentleman who's holding a steering wheel and his hand gets torqued after he gets broadsided by another car, has a significant injury to his dominant right hand that imperils his ability to provide for his family. And like in the situation that we're aware of, there was a gap, him getting the treatment that he required, which we could have closed that gap for him sooner if we had been involved more quickly.

SPEAKER_00 11:31

And that guy, I mean, we're certainly not going to mention his name, but that guy, I remember him basically hitting a dead end. And the providers that he saw said, Linton, not much we can do for you. And you guys were like, uh, that's ridiculous. Like, no, you can go see either this person or this person or this person. And they did, and finally at least got better guidance through that process, which was critical for him. So we actually had a recent jury trial, and we've had two in the last month. The first one we had was actually a case similar to what you just mentioned. It was two cars on 81 north by Blacksburg. And our client is in the left-hand lane behind a lady who's in front of him, and she's going a little too slow. He starts to move over to the right to pass. She then merges into the back left side of his vehicle, like a pit maneuver, unintentional pit maneuver. At least that's what the police call. That's what I learned through the case. When they like try and spin somebody out, and so hits him, he starts to spin, is able to correct himself. But in the process, shoulder, left shoulder, the torque on the left shoulder leads to a tear. He sees urgent care a couple days later. He doesn't get medical treatment for that shoulder for nine months. The best offer in that case was$20,000. We couldn't settle that case for meaningful value. I mean, he ended up having a shoulder surgery, and that was only partially successful. And then he had to have a shoulder replacement surgery. Now, the reasoning for the gap was the guy had a pre-existing hip surgery scheduled. So the hip took priority, but he didn't have meaningful treatment for the shoulder in the days or weeks or months after the incident. And so it put us as the lawyers in this almost impossible situation of like, I mean, we can't convince this insurance company to put real value on the case. We tried it, we got a good result, a very good result. But more often than not, like, I lose those cases because the gap in treatment is so long. And the defense has a great argument. Hey, if he was really hurt, why didn't he get help? Right. And I mean, I think the jury, rightfully, in those cases feels the same way. Like if it's really bothering you, then you got to go get the medical treatment. To piggyback off your point about why it's so important to get that treatment early. I mean, again, from the legal side, it's important, but what's even more important is from you're just not going to get better. You're not going to get the help that you need to ultimately recover. Because the goal, right? I mean, MMI is maximum medical improvement. We want to get, well, anybody in this profession, we want to get our people either 100% or as close as they can to 100%. So would you guys mind sharing just what does MMI do? What's the point of MMI partners?

SPEAKER_02 14:23

So the point of MMI partners is to provide the law firms, the attorneys, a resource to help their client navigate through the healthcare system. And the work product that we would produce for the attorneys would be something that is non-branded and that they're able to use in their discussions with the insurance companies. And so it would be we obtain the patient's medical records, we review those with the patient, and then we prepare a document that summarizes their injury, the course of treatment that they've received, where they're at at this moment in time of their recovery, and where we expect them to go moving forward in the coming months to years in their recovery, or in what, for lack of a better word, percentage of disability they may have as a result of the injury that they sustained. And that is the work product that we're offering to attorneys so that that piece of the work that they typically would have to do, we take care of that for them. We provide a resource to them to ask all the questions they want about this client and the care that they've received. And we provide a resource for that patient, they can contact us throughout our engagement to help them get the care that they need, to answer the questions that they have, to help them get referrals that they would want so that they do get maximal medical improvement.

SPEAKER_00 15:43

Another thing that I think is critical and is what I believe is like the distinguishing value add for what MMI Partners is trying to do is the quarterbacking of the treatment, right? Kind of what we talked about earlier, right? Like person gets hurt, they go to the ER, who knows, maybe they get a referral, say follow up with your primary care. They do, and they just don't know what's next. And right, so to be able to talk with people like yourselves to say, hey, this is what I'm dealing with, right? Because you're not their treater. You're not there to actually develop a patient-doctor relationship, right? You're there really just kind of as a consultant to say, well, I mean, let me pull out my Rolodex and you need to go see this provider or this place has a great reputation. Go check this out if you're dealing with these symptoms. And in doing so, I mean, for lawyers, right, like it's great because the case has now continued treatment and hopefully the right treatment that will continue to support the claim. And then for the client, I mean, not only are they getting the legal representation, but they're like, wow, I also have a firm that cares about my health so much that they connected me with this group who's put me with doctors who are um one willing to actually like take the time to listen to me, which is an issue in the medical field, right? I mean, from my understanding now, primary care, you get six minutes with a doctor, you're doing great, right? Which is unfortunate. But in addition to the listening and being a sounding board to that guidance, which is different from because we all get the medical records. Like us as lawyers, our firms are getting medical records, we're summarizing them. Now we use AI all over the place to do that stuff. But what's different, I think, about what you what we're trying to do, or especially what you guys are trying to do, is that trying to add value by getting them the right treatment that they need. And not necessarily forcing it on them, right? It's just like, hey, here are your options. This is what you should consider doing based on kind of what you're dealing with now.

SPEAKER_03 18:39

Yeah, I think the healthcare system sometimes isn't set up to catch some of these gaps that people fall into. Your example with the gentleman that was in the car accident. If you look at his record and you're not necessarily focusing on his shoulder, you can easily say that his care was complete because he was going down the route of care and he was engaged with certain providers. But unless you really have an engaged, a really engaged primary care doctor, a lot of times they don't have the time to go through every single issue. Things can get missed and missed not in a medical malpractice way, but just missed in the best path for treatment.

SPEAKER_02 19:20

This dovetails with the idea of adequacy, which is patients need an advocate because they don't know the questions to ask. And that's what we can provide is we know the questions they should be asking, and we can ask it of them, and then we can get them to where they need to be, or at least direct them to where they need to be. Because, for instance, in your example of going to the urgent care or going to the emergency department, that's one point in time. That is not the beginning and the end of care. That really is just the beginning of care. And there is going to be additional care required once you leave those places moving forward. Neither of those places, neither the emergency department nor the urgent care, are designed to provide definitive care for really anyone. It's to ensure that we acutely manage you now. We make sure you don't have a life-threatening problem, we make sure that you can be managed safely as an outpatient, that you don't need to be admitted to the hospital, that you don't need a surgery right now at this moment. And then when you leave these doors, you're gonna have to go out there and still find someone else to help take care of you.

SPEAKER_00 20:27

Was it always like this? And when I say that, was there a point in time where the healthcare system was maybe a little bit more involved and maybe more proactive? And I say that, and I mean if I'm being fully candid, like I have gotten to the point now where I agree with you in that you need to have or be your own advocate when it comes to your health. It's not enough to just do your actually, I had my annual check-in today, actually, with my doctor. It's just that's just not enough anymore. It's it's just not, right? Have things changed.

SPEAKER_03 21:07

You know, I I I think that there was a time, and not to date myself, but you know, back when I was in high school, I followed around some doctors. I didn't have any doctors in my family, so there's a local community doctor that that I went to his office and followed him around. And that one community doctor really provided complete care to people. And I think back then there wasn't as much emphasis on creating a chart for billing purposes, you know, for insurance companies. There's more of an emphasis on creating a chart that actually tells the story of the patient. Right now, you know, in emergency medicine, Scott and I were both quite involved in the administrative aspects of it. And we would go to conferences, talk to providers, talk to physicians, and we talked to them about charting. And one of the things that we would always tell them is you have to put ink in every box because we had these paper charts and the charts had different boxes, and each box represented an element of the chart that you would get reimbursed for. And so I think even in the electronic medical records, those electronic medical records are still designed to get, quote, ink in every box, which is a tool for billing and coding as opposed to a tool for really telling the story of what's going on with the patient. And I think that that kind of goes to something that I wanted to mention that you mentioned earlier about AI, and that I think AI is really good at summarizing and seeing, seeing what's there in the chart and summarizing it, but it's not that great at drawing conclusions from information that's not available to it. I know when you and I first became friends and we were talking about different things, you know, you showed me a chart. And just from being an emergency physician, Scott and I can pretty much look at any chart and find multiple errors in it. And whether that's really errors in treatment or errors in charting. It's probably most likely errors in charting because the way that the electronic medical records are set up right now, the charts still don't flow as naturally as they would if we were having a conversation, if we were writing. But there's things that a physician can take and look at this chart, like this was admitted, this wasn't admitted. They probably did this and meant this, but they really said this, the chart says this. And those are all things that AI just can't take and generate because it can't really backfill. And so I think that's one really unique thing and difference about what we generate at MMI partners, as opposed to what just Chat GPT can generate for you.

SPEAKER_00 23:33

Yeah. Yeah. ChatGPT is scary good, but I think kind of like our profession, at least, like that human element is still critical. Like having that conversation, understanding what are the symptoms. And because uh you're right. I mean, we look at medical records every day, and one, they're voluminous, it's insane. And two, they're 15 pages for one chart. Yeah.

SPEAKER_03 23:55

And in for the emergency department, emergency department, 15, 20 pages for one chart. Whereas, you know, back when we started, we had like a double-sided piece of paper.

SPEAKER_00 24:05

Yeah, I mean the whole thing. I mean, we're talking about like we have cases that have thousands of pages of medical records. Yeah. I mean, even just like the discharge instructions for people from the hospital, I mean, that's like 30 pages, which is just insane. It doesn't really tell you anything either. That's correct. Which is kind of just nuts. I guess it's all maybe are we the problem? And you don't have to answer that.

SPEAKER_02 24:24

But when I say we being the lawyers, it's it's like it's meeting regulatory requirements and meeting what's needed to code a chart to submit a claim and to get reimbursed for that claim. I mean, it it's probably good stuff to talk about on another podcast, but in emergency medicine, you come in with a heart attack. I probably see you for three minutes, maybe four minutes. That's my entire encounter with you face to face as the patient. The entirety of the rest of my encounter is interfacing with a computer, ordering all the tests you need and the medications you need, and then getting all that data coming back to me and then synthesizing it into the chart and moving you on to the next step of care. Because that's the majority of what we do in emergency medicine at this point. The actual physical providing of care to patients and talking to patients is very brief, even though the patient might be in the emergency department for two to three hours. Our time with them is really brief. The rest of it is spent interacting with the computer. And that that's just how it's gone. I mean, we that's way outside of our control. And as Sean mentioned, the old school primary care docs that took care of generations of the same family and really knew about them, they were able to do that because they were not focused on charting and generating claims to insurance companies. And that's why your primary care appointment today probably lasted five minutes, what you're checking for your annual visit, because they got to move on to their next patient and they've probably got them all blocked every 10 to 15 minutes.

SPEAKER_00 25:57

I've noticed too, like a more of a push to providers who only take cash. I've seen that become more and more common with like the concierge services or even like, like, for example, with the I I have a physical therapist, I love him, and I'm sure he loves me because he may have a boat by the time in a few years, based on how many times I have to go see him. Because I I'm very good at getting hurt. It's a skill that I've developed over the years. But he doesn't take insurance because if he does take insurance, he's stuck in a certain model that just isn't one, it's not enjoyable for him, and then two, he just doesn't think it leads to the best care for the patient.

SPEAKER_03 26:36

Yeah, I have a few friends that do direct primary care, and essentially what that is is that you pay a certain fee a month, and it doesn't necessarily need to be a lot. It can be around, I think he charges around$96 a month, but you get access to him, and he takes uh his panels about 600 patients, and he doesn't deal with any insurance. His charts are completely different than the charts that you would have in a primary care doctor's office that's submitting claims to Anthem, let's say. And he books off appointments where sometimes his appointments last an hour talking to the patients, getting everything. And so, I mean, it's a different way of looking at medicine. A lot of people, like on the patient side, they don't take insurance. They feel well, I'm paying for this insurance. I'm I don't want to pay an extra, you know, twelve hundred a year or whatever it is to get that added value. But it's something that's growing, it's growing with good reason because it doesn't allow charting and the insurance company to get in the way of the physician-patient relationship.

SPEAKER_00 27:37

I want to take you guys both back. I'd love to hear this. This is just out of my own curiosity. But what is it like being in an emergency room, getting the call saying, hey, there's been a bad crash or a bad incident? Get ready, right? Somebody's coming in. And uh for say it may could be a future personal injury client of a law firm, right? Like, what is that like? I mean, is it I mean, you've been trained for this. Is there an adrenaline rush? What is that like? Can you share that?

SPEAKER_02 28:09

At least for me. So both Sean and I have worked in large emergency departments. You know, for your audience, the average emergency department in the United States sees 35,000 patients, maybe 40,000 patients a year. We've each worked in emergency departments that size, and emergency departments that are 75,000, 100,000, 110,000 patients per year, and that provide different levels of care. So that's scenario that you're describing. At a place that I used to work here in Richmond, that is an everyday occurrence. It's just what you do. It's part and parcel of what you do. It's bread and butter. There's no adrenaline rush. You have a very standardized way of how you approach those patients. At the place where I work at currently, it is a smaller, very traditional community emergency department. So that staff that works there is maybe not as efficient and knowledgeable of managing those patients and the pitfalls with those patients, whereas another hospital would be. So you, as the doc, as the leader of the team, really has more responsibility sometimes in those environments because you really got to make sure that you're moving the ball forward for the patient and getting all the studies that they need to have. And I can't say that there's been one time that I've thought about, well, I'm taking a patient that, oh boy, this guy's gonna have a huge PI claim. That's never occurred to me. No, it never occurred to you. But we just see that we, you know, we see people with bad injuries and bad things happen.

SPEAKER_00 29:38

Yeah, it's kind of crazy. I occasionally have these like really dumb kind of light bulb moments where I remember thinking, man, like there's a lot of people who get hurt. And then I was like, well, Sharif, like, that's why there's hospitals. Like this is why they're I mean, there's people who get sick and then people get hurt. Like that's what they're for, right? And then I was like, man, like my livelihood and the food that I put on the table for my wife and kids, right? Like, it's dependent on people getting hurt at no fault of their own. And and I remember at one point when I used to do criminal work, it's like it's dependent on people like breaking the law and committing crimes. And I'm like, yik, that's a scary profession to be reliant on that. And then I realized, well, shit, like plumbers, I mean, they're relying on pipes to break. It's like everyone, in some respects, if they're making a living, is solving some sort of problem. And so that makes it tracks. I mean, at the end of the day, like you the problem that you guys are trained to solve is those life-threatening emergencies. I know Sean, you and I have talked a few times about your experiences with gunshots, right? I mean, Detroit, right? I mean, there are certain places where you worked where it's just that's just kind of what you see.

SPEAKER_03 30:46

And I mean, it a lot of it comes down to experience and training. And so if you train and do your residency in a place where you're gonna get a lot of experience taking care of really a multitude of different injuries, then when you're done with residency and you're out in the field, you're comfortable taking care of anything. And that that was actually, you know, when I was 18, I started working in an emergency department right outside Detroit. And the the question that you asked is one of the questions that I asked one of the attending physicians, he was actually the chief of emergency medicine in that department. And I said, you know, why, you know, I I I look in how you do things and you're calm, and then I look at in some of these other docs and they can be more frazzled. You know, why is that? And obviously it has a lot to do with personality and and such, but he's like, you know, you need to make sure that you train in a place where you're gonna get all the experience that you need with someone that's at your side or backing you up because when you graduate and you leave and then you're ready to work on your own, you want to have all that knowledge and all that experience in your pocket.

unknown 31:51

Yeah.

SPEAKER_00 31:52

No, you got I mean, I can it's funny, every time like I watch Grey's Anatomy, I'm like, I can be uh I used to be a massive fan. Dr. McSemy, isn't that what uh Dr. McSteenie? Yeah, I used to be a massive fan. I'll be like, uh, I'd be watching an episode. My wife was on, and now she's on this thing where she watched like Love Island, which is complete garbage, by the way. I've strongly vote to go back to Gray's Anatomy if if I my vote mattered. But I remember I'd be like, I'll watch the TV show, like I can do this. This is sounds great. And then I get to the part with like the blood, I'm like, ah, I'm good. Like I can't, I can't do it anymore. So, anyways, I could not imagine being in a situation where like you're dealing with people's lives. But at the same time, I've also heard the inverse for us like people don't know what it's like. I mean, can imagine, like when I did the criminal defense work, what's it like to represent somebody you think's innocent? Or what's it like, at least when you're dealing with somebody with a catastrophic injury and the difference between them having the resources to actually get the help that they need versus kind of being left with nothing is on our shoulders. And it it's just it's not easy.

SPEAKER_02 32:56

As part of that, as part of taking care of these really sick folks and these injured folks that we've done over the decades. That's where we learn the skill of talking to other physicians in other specialties and referring patients onto those specialties and learning over time from those other physicians about X, Y, and Z, other problems that can occur down the road with what's wrong with that person at that moment in time, allows us to help provide navigation to patients now because we've seen a good portion of a lot of most of this stuff already and know where folks need to go.

SPEAKER_00 33:32

Yeah, and I think that's the ad benefit with your guys' experience with MMI. You're not pigeonholed. At least you weren't pigeonholed with the emergency physician practice. I mean, you're seeing a little bit of everything. Correct. Uh, which is huge. Because I also imagine, I don't know, I imagine the surgeon is probably more apt to think the solution's surgery, right? I imagine the on the other end of the spectrum, the person who's all about herbal medicine and all that, like thinks you should never take a prescription drug or something like that. And and so the point that I'm trying to make is like I would expect that without having more of a broad experience like you guys have, sometimes maybe patients aren't necessarily getting the advice that they actually really need because it may be colored by that provider specific specialty.

SPEAKER_03 34:19

I think that the complaint that you have that's pertinent to their specialty is the most important complaint that there is.

SPEAKER_00 34:24

Yeah.

SPEAKER_03 34:25

That's another kind of unique thing about emergency medicine, is because you know, not only are we looking at the patient as a whole, but we're trained to try to pick through a lot of the baloney and get to the heart of the problem. And would I say baloney, I'm I'm talking about maybe a non-life-threatening issue. And some other physicians and some other specialties may just kind of concentrate on their own specialty and and not necessarily be as concerned about what's going on with other specialties. And like, you know, the big joke is always orthopedic surgery. You know, orthopedic surgeons are some of the smartest guys when they're med students around because it's so highly competitive. So you have to get great grades in everything. Then once they kind of become an orthopedic surgeon, the the big joke, and whether this is true or not, it's just it's a joke, but they kind of forget a lot of the other parts of medicine. So they forget what a stethoscope is used for, they forget how to read an EKG, you know. It's because they're not in that's not their job anymore. Their job is to see broken bone and fix it. So, you know, once you've been in that sort of practice for a long time and you just kind of specialize in your one area, it's hard to remember what the other specialties are all about.

SPEAKER_00 35:36

Yeah, it makes sense. That makes sense.

SPEAKER_03 35:38

So it's I'm sure it's the same way in law school too.

SPEAKER_00 35:40

Yeah. No, I'm sure. I'm sure. Well, people get great grades in law school, go to these things called big law firms, and then they make a lot of money and realize they hate their lives and who they've become, and then they go teach yoga or something. Yeah, and then they then they quit and have a what is it, uh quarter life uh panic attack or crisis midlife quarter life crisis, what are they called? And yeah, we go to uh an island in the Caribbean and and teach yoga. So um perfect. That's that's what we do. But anyways, uh no, um I'm sure there's many who listen to this podcast who can relate. I I was one of them. I didn't do the whole yoga thing, but I did go to a big law firm. And while the resources are great and the people were great, I mean it it was very clear to me very early on that this was not the top of the legal mountain that people sometimes think it is. But well, anyways, this has been a lot of fun. I've got a couple more questions. And I'd like to ask two more questions for both you guys. If there's one thing that you could tell someone who just got hurt in a car wreck or uh slip and fall, trip and fall, any sort of incident, they're hurt at no fault of their own, what would you tell them from a medical standpoint? Or what is the advice that you'd want to give them? This is if they presented to us as a patient. Let's well, no, let's take a step back.

SPEAKER_03 36:57

You know, that but your question is great because Well, thank you. Sorry, what did you say? I think your question is great. I could probably not get a lot of phrase right now. But you know, the the reason that it's great is that in a setting that we're not talking about legal framework like we're talking about now, there isn't necessarily anything set up to help people navigate the system. I mean, the best that we can do is we'll follow your discharge instructions. Which we all know the discharge instructions are 14 pages of gibberish. And one thing that says, here's a doctor, follow up with them, that half the time the patient calls and they can't even get in with them for a couple of weeks anyway. A couple weeks, sometimes months. Yeah, yeah, depending on what it is. Yeah. And so when you ask that question, it's like, what's the best thing that someone can do that's having residual problems? And it could be multifactorial besides follow the discharge instruction. As a physician, it pains me to say this, but it could be call an attorney and then get set up with someone like us that can help you navigate through the system. Because, like I said at the beginning of the podcast, it's extremely difficult to navigate on your own. And it's really surprising. Well, it's not surprising, but it's surprising from a patient perspective that there aren't firms already that work to help people navigate through the healthcare system. But the reason that there aren't that many of those firms is that it's hard to monetize because people don't want to pay for it.

SPEAKER_02 38:29

Truly, the system is not set up to advocate for patients, particularly when it involves you having to interface with a hospital. That's truly not what it's set up for. I mean, a hospital is a business that's trying to drive volume through it. On a individual level, patients don't generally have an advocate for themselves and a navigator for themselves.

SPEAKER_00 38:53

Yeah. And I imagine most doctors kind of when they say, Oh, let me put on that white lap coat. I want to go be a doctor and commit the next 40 years of my life to school before I can finally see a patient, right? I'm joking. Not 40 years, but it's it's forever. No, but it's I mean, you basically, if you want to be a doctor, right, you basically need to make that decision as like an 18-year-old, more or less, right? I mean, you because you go to college, you have to do some level of biology or some sort of prerequisites for med school. Then you have med school, then you have residency and fellowships and all this stuff. And it's depending on what you're choosing, right? It's 10 years. Correct.

SPEAKER_02 39:31

And physicians have very little influence or control over the system.

SPEAKER_00 39:35

Which is what must be frustrating, right? For a physician to think I did this job because I wanted to help people and to have the constraints of the charting for billing purposes and the insurance and all that. Uh that that's got to be frustrating.

SPEAKER_02 39:52

It's very frustrating. And it leads to people changing careers, leads to people changing jobs and leaving places they were at because of that, because there is that conflict.

SPEAKER_00 40:01

Yeah, and I guess, and the worst part of it, right? It leaves the people in a position where they don't necessarily know where to go next to get the help.

SPEAKER_03 40:10

Yeah, you know, now that we're having this conversation, I think maybe the best answer to your question is for the person who has a health issue, is to find an advocate. Whether that advocate is an attorney or whether it's a a family member that's gonna be relentless and and fighting for you to get the type of care that you need or you deserve. You know, if you can't advocate for yourself, then you need to find someone, whether it's your daughter or your mother or a very close personal friend that can advocate for you. In much a way like you guys advocate for people who are you know injured through no fault of their own or hurt through no fault of your own. I think that everyone needs to have an advocate when it comes to healthcare and the healthcare system, because if you engage in it and you're passive, then you most likely won't get the outcomes that you want.

SPEAKER_00 41:04

You know what's interesting, and actually this is a really good segue to the to the next question I have, but you'd mentioned like we'll find an attorney. And really your the answer was find an attorney is going to connect you with a group like MMI Partners, which to my knowledge, they're you guys are it. This is it, right? Like I'm not aware of other groups, frankly, in the country that do what you all do and try and fill that gap. So it's great value added work. Us as attorneys, we're not doctors. So I mean, we have patients, or excuse me, wow. I just say we're not doctors, and now I say we have patients, but we have clients all the time, like, uh, what do I do? Who do I go see? It's very uncomfortable for us to make those recommendations because we just don't know, right? We don't know. I mean, for my default, is like, well, just go to Ortho Virginia, right? Like, oh, Ortho Virginia, you're welcome. That was a free sponsorship. So you're well, I'll give you the uh the address. You can write a check. But yeah, so we're like, just go there, right? Like maybe they'll figure it out, right? What's also interesting, and I don't know if you guys are aware of this, but there is somewhat of a, I don't know if a debate, but there are different types of firms. There are firms who have a very heavy hand in who the clients go see. And there are firms who refuse to make any sort of recommendations. I think our firm, I mean, we recognize our role and our boundaries, and we're not doctors. We're not gonna tell people who to go see. We will connect people with those who may be able to provide guidance, right? Whereas we know of firms, and we've got some inside knowledge on some firms who they've got their doctors. You get hurt, doesn't really matter what it was, you're gonna go see that doctor. And that doctor most likely is gonna do A, B, C, and probably recommend that you have to have this surgery or that and da-da-da-da. And the question that people should be asking themselves is do they actually really need it? And so then we're talking about ethics. And what I think is important about what you guys are trying to do, this is not a project that exists just to create medical events and treatment just for the sake of it. The goal is to ethically connect clients and patients with the tools and the resources and the connections that they need to actually get better.

SPEAKER_02 43:18

I think that's very important that we point out we have no stake in the outcome of your client's case in the legal system. Our role is to advocate for them and to navigate them towards the care they need to get. And your example of you just need to go see the local orthopedic group. It may be true that they need to go to the local orthopedic group, but they need to go to a specific person in that group because even within your local orthopedic group, there are probably six, seven, eight sub-specialties of orthopedics within that group. And you need to go to the right one that takes care of the pinky finger for your problem versus the guy that takes care of the big toe. And I mean, that's really seriously the case, is you've got to see the right person because as we talked about earlier, the patient who had a hand injury, he was seeing an orthopedist. He wasn't seeing the right kind of orthopedist. And ultimately, we got him to the right kinds of orthopedists that he should be seeing for his injury to get him back onto the road of recovery. So that is what we can provide to patients.

SPEAKER_00 44:22

Last question. So, similar to the question about what would you want someone who's recently hurt to know? What advice would you want to give them? And really what I took from your answer is at the bare minimum, you need to find an advocate, be it uh a family member, a friend, whoever, right? Or a group like MMI partners. What's one thing that you all want attorneys to know, trial lawyers to know, people who do this type of work on the personal injury side? What's one piece of advice you'd give them about how to deal with patients and help them navigate this mess of a healthcare system?

SPEAKER_03 44:57

No, I think that your clients look to you for guidance and leadership. And you're helping them make decisions that are not only going to impact their physical health, which is really what we've talked about almost exclusively on this podcast, but but also their mental health and their mental well-being, which also has a huge role in what we can evaluate and what we can do. So the thing that I would want to tell attorneys is that your responsibility may be to try to get as much money for them during the trial so that they can use the money to try to recover to a level that's close to where they were prior to the injury. But there's also medical aspects besides the legal aspects that you guys just aren't trained about. And so I think if you're questioning what type of care someone needs, which I think every single time, unless it's such an easy, straight case that it may not even be of interest to you because it's so easy and straight. But I think that you just need to think about how can I help this person navigate the system and reach out to someone that can help you because you know you guys are attorneys, you're not physicians.

SPEAKER_00 46:10

Yeah. And it's also on that note, right? It's like what may be a small case in our eyes is still the only case for that client. Even if it's just uh soft tissue injury or case. I'm sure trialers, whether they're willing to admit it or not, but there's a part where it's like, I don't know, I don't know how much attention we want to give a case like that, right? Like, but the reality is that's still injuries that's taken somebody out of work. That's still injuries that's impacted their relationships with their family and their friends. It's still something that's messed with their mental health. It's still been a setback, it's been a major disruption to that person's life. And even though it is on the spectrum, maybe a smaller case or not as significant of injuries, it's still very significant to that person.

SPEAKER_03 46:57

Right. I mean, one of the things that any good emergency physician learns, and this is something that both I think Scott and I learned because we had some fantastic teachers where we did our residency down at VCU, is that the patient in front of us, it may be one patient of 15 or 16 we may see in a shift. And so for us, it's one of many. But for that person, the experience that they're having interacting with us, you know, that could be the worst moment of their day, most likely the worst moment of their month, their year. It could be the worst moment of their life. And so that's always something that you need to keep in mind is that although you're kind of turning and seeing a bunch of people, to that person, the interaction that they have with you is extremely unique and it can be extremely impactful on how they continue to live the rest of their life.

SPEAKER_02 47:50

As I'm sitting here listening to Sean's answer to your question, I'm thinking to myself, you know, great question, right? It is a great question. Thank you. Thank you. And you know what? My answer is going to have a little bit of judgment in it. Okay. And that is maybe take this as a call to arms for attorneys and personal injury attorneys specifically, to say, you know what, we need to do better for our clients and to maximize their improvement, to use it for the catchphrase, but it's serious because your case is going to be over, but that patient is going to have to live with the consequences of whatever their injury was for the rest of their life. And we provide an opportunity to quarterback their care, at least initially, and hopefully get them on the right path. And that's currently not something that's being offered. That's not being provided to folks. Most PI attorneys are relying on the records that they get and the care the patient has already received. And maybe they're doling them out for a couple of specialty consults that may be a one-time visit, but it's not providing longitudinal care for that person that they're going to need for the long term.

SPEAKER_00 49:00

It's been a lot of fun. Thank you guys. Scott, in terms of getting more information about MMI partners, how can people find out more?

SPEAKER_02 49:07

The easiest way is mmi.partners. And no.com, right? No.com, just straight MMI.partners, and that'll take you to our website. All the contact information is there. Of course, there's a a form you can fill out for information. You can also call the number or text the number that's there, and we will reply to you. I love it.

SPEAKER_00 49:27

I love it. In a way that maybe earns you another, what is it, bedside manner award? Sure. Absolutely. Okay.

SPEAKER_02 49:33

Because your reply will actually be from me almost immediately. I love it. I love it. So well, thank you guys. It's been a lot of fun.

SPEAKER_03 49:39

Thank you.

SPEAKER_01 49:40

Thank you. Thanks for listening to Courtroom Stories and Tactics by RVA Trial Lawyers, hosted by Sharif Gray and Nial Abuzaki. Please subscribe and leave us a review on Apple Podcasts, Spotify, YouTube, or any major podcast platform. Together, we're building a tribe of trial lawyers to remind the world what human life is truly worth. One verdict at a time.