Medical-legal consulting as a side gig [PODCAST]

Listen and followApple PodcastsSpotifyYouTubeMore apps · Browse all episodes

This episode is sponsored by Athelas, the number one provider of remote patient monitoring.

“Medical-legal consulting is a great way to use your medical training in a non-clinical field that helps people. I started this field 14 years ago and have trained over 1,600 physicians to be medical-legal consultants. Most physicians do medical-legal consulting as a part-time side gig. All of the work is pre-litigation and pre-trial. I don’t act as a medical expert, and I don’t participate in medical malpractice cases.

There are over a dozen services and types of consultations I offer attorneys. One service we frequently provide is to give our opinions regarding specific medical questions that arise in cases. Usually, these reports help the attorney to prove a particular medical theory for the case.”

Armin Feldman is a medical consultant to attorneys.

He shares his story and discusses his KevinMD article, “Medical-legal consulting as a side gig.”

Reflect and earn 1.0 AMA PRA Category 1 CME for this episode.

This episode is sponsored by Athelas, the number one provider of remote patient monitoring.

That’s because RPM is the fastest-growing segment in health care today. And for good reason:

RPM boosts patient outcomes through preventative care. In fact, a recent study by the VA showed that implementing RPM at a practice can reduce hospital readmission rates by as much as 25 percent, saving more than $20,000 per patient in medical costs.

If you’re not investing in RPM, you’re missing out. Luckily, Athelas can help you roll out RPM end-to-end. They provide devices to your patients, handle 100 percent of billing, and even provide a team of nurses to monitor patient vitals for you. All at zero net cost to your practice.

Try out RPM for your practice by going to KevinMD.com/tryrpm.

Did you enjoy today’s episode?

Rate and review the show so more audiences can find The Podcast by KevinMD.

Subscribe on your favorite podcast app to get notified when a new episode comes out.

Do you know someone who might enjoy this episode? Share this episode with anyone who wants to hear health care stories filled with information, insight, and inspiration.

Hosted by Kevin Pho, MD, The Podcast by KevinMD shares the stories of the many who intersect with our health care system but are rarely heard from.

Transcript

Kevin Pho: Hi, welcome to the show, where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Today on the show we welcome back Armin Feldman. He is a physician and medical consultant to attorneys. He wrote the KevinMD article “Medical-legal consulting as a side gig.” Armin, welcome back to the show.

Armin Feldman: Hi, Kevin. Pleasure to be back. Nice to see you.

Kevin Pho: So again, we’ll get into your article in a little bit, but for those who didn’t get a chance to listen to our first episode, which was more than a year ago, if you can just briefly share your story and journey to where you are today.

Armin Feldman: Sure. So my background is that I’m trained as a psychiatrist and psychoanalyst, and almost by accident, my specialty wound up being mild traumatic brain injury. I wound up owning outpatient head injury rehabilitation clinics around the country, with a treatment program of my own design, and I was fortunate enough to sell those. After I sold them, I was thinking about what I wanted to do next. As part of my work, I’ve testified as an expert witness more times than I want to remember, on behalf of my patients who were either being cut off from their medical care or offered some pittance of a settlement.

So I was thinking about what I wanted to do next, and my background also, my internship was in internal medicine. And I thought, well, maybe what I could do is just consult to attorneys on any kind of medical question that they have in a case. That turned out to be an unfulfilled niche. Now it’s 15 years later, and I’ve developed that really into a new subspecialty of forensic medicine that involves civil cases, not criminal cases. So I work with personal injury and workers’ comp attorneys, helping them to better negotiate and settle those eight or nine out of 10 cases that they bring to settlement and don’t take to trial. And since that time, I realized that other physicians could do that. For the past 14 years, I’ve been training other physicians on how to do this kind of work.

Kevin Pho: So we’ll certainly talk about that in a little bit, but before we get into that, tell me some of the rewards that you get from being a medical consultant to attorneys.

Armin Feldman: Yeah, I think the biggest thing is that this is a great way to use your hard medical knowledge in a nonclinical field, but the key is knowing that you’re still really helping people. I think we all get into medicine to help people, right? So it’s a way to help people that desperately need this help and didn’t have this help, apparently, prior to my starting to do this. And you can see the tangible results of working with the attorney and helping that attorney to increase the case value and get the appropriate medical care for their clients.

If I could give you a really brief example, there are doctors, obviously, I’m sure you know, that do independent medical exams, and they’re great doctors that do great IMEs. What we also know is that in most communities across the country, there’s always a group of physicians that do IMEs and kind of know what the outcome is going to be before the exam. I was the first physician, I think I was the first physician in the country, to actually physically sit in on these IMEs, putting myself in a position to help the attorney and write an IME rebuttal report. So now you could balance it: When a physician is hired by the insurance company to do the IME, now the client, the injured person, can have a physician there at the IME on their behalf and put them in a position to refute that IME if it’s appropriate to do so. So that’s just one way out of many ways that we can help people that really weren’t helped before.

Kevin Pho: So let’s talk about your KevinMD article. It’s titled “Medical-legal consulting as a side gig.” Now, for those who didn’t get a chance to read your article, can you just walk my audience through it and share the story of why you decided to write it?

Armin Feldman: Yeah, so I think the why is fairly obvious to you and anybody listening to this. There’s been this massive shift in the way physicians practice medicine. We all know about the death of private practice, and so almost all physicians now are employees of big corporations or hospital systems. So what’s the natural outcome of that? I saw in a recent survey that over 25 percent of all the physicians practicing clinical medicine are looking for a side gig that they can call their own, something that they control, that they want to do, that is outside the purview of somebody looking over their shoulder with them as an employee. So side gigs are probably the biggest trend for physicians today. There are all kinds of things physicians can do, but one thing they can do is become a part-time medical-legal consultant.

When I train physicians to do this, some physicians do it full time, and some do it instead of retiring, but the vast majority of physicians that do this do it as a part-time side gig, in addition to whatever else they’re doing. It gives them that opportunity to be independent, have a lucrative income, do something interesting, help people, and have something that’s all their own.

Kevin Pho: Now, for those physicians who are interested in doing medical-legal consulting as a side gig, take us through some of the common questions that these medical consultants are asked about.

Armin Feldman: Yes. So as I said, the two main areas of attorneys interested in this are personal injury attorneys and workers’ compensation attorneys. A physician in any specialty can learn how to do this, and I’ve trained physicians soup to nuts in terms of specialty, but these are primarily injury cases. So the service that is actually the most requested is to provide comprehensive medical summary reports with our medical opinions that attorneys use as part of settlement demand letters. When a case is settled, in every state there’s kind of a set format for these letters, and obviously one of the things that needs to be put in these letters is what the damages are. In most cases, the biggest damages are the medical damages.

And so what we do as medical-legal consultants is we look at the entire case. We talk to the attorney, we read the medical records, we interview the client of the attorney, we do the appropriate research, and then we’re looking at every injury in the case, and we are giving our medical opinions on what the injuries are. We’re talking about causation, mechanism of action, and functional losses, backing that up with evidence from the medical literature. We’re talking about future medical care and costs, things that have a monetary value in these kinds of cases. And the consistent feedback through the years, for me and the physicians I’ve trained, is that with attorneys using these reports, they are in fact settling their cases for better value, more money, and less attorney time, and they’re getting the appropriate medical care for their clients.

Kevin Pho: How many hours would a physician need if they wanted to do medical-legal consulting part time and still have it as a viable side gig?

Armin Feldman: Yeah, that’s a great question. You need, at a minimum, about eight hours a week in order to do this justice and make it fly. Now, the majority of those eight hours need to be during the regular workweek, because you need time to meet and talk with attorneys, who obviously are your clients, and talk with their clients, the injured person. So about eight hours a week is the minimum, and many physicians will start at that and then build that up. They may go to 15, they may go to 20, whatever suits them and what they enjoy.

Kevin Pho: Are physicians able to do this nationwide, or are they limited to their local attorneys that they have to work with?

Armin Feldman: Right, and again, it’s a really great question. The answer is almost all of these businesses are local businesses, by the nature of the business, the marketing for the business, and the fact that there is such a high demand in every place in the country. It doesn’t really make sense. It’s not really even practical to try to do this on a wider basis than that. Plus, one of the keys to being successful at this, from the business side, from the marketing side, is you want to establish long-term relationships with your clients, and you’re much better able to do that when you’re working with attorneys in your local area.

Kevin Pho: Now, don’t attorneys already have lists of physicians they typically go to? If you’re a physician just starting out with medical-legal consulting, how do you break in and meet these attorneys when they probably already have established relationships with other physicians that they go to?

Armin Feldman: Yeah, again, you’re asking such great questions. So when doctors and lawyers think about lawyers hiring doctors, they really only think of one thing, and that’s hiring experts, expert witnesses, medical experts. And so one of the things that we do and that I teach is you need to educate attorneys as to what it is that we, as medical consultants in legal cases, as opposed to medical experts, bring to the case. When you do that, it’s not uncommon that the attorney will say, “Well, I’ve never heard of a doctor doing this.” And so you really need to educate your potential clients on what you do, how you do it, and what the services are that you provide. Oftentimes when you do that, like with the cartoon character in the balloon, you could almost see the light bulb going on on top of their head.

And so now they will use medical experts when that’s indicated, but they’re much more likely to bring you on as a PRN part of their team on cases. Some attorneys will have me on every case, if I would want to do that. But that’s the big difference, and so it’s just a matter of helping the attorneys to understand how you can benefit them, the case, and the client.

Kevin Pho: So realistically, how long does it normally take for a physician to learn the ropes and have medical-legal consulting as a viable part-time side gig?

Armin Feldman: Right. So through my training program, one of the things is a detailed, step-by-step business launch plan that’ll take you from zero to up and running with your business. Up and running is defined as now being in a position to start soliciting business from attorneys. If you put your mind to it, you can get through that in about three weeks. For physicians doing this on a part-time basis, it’s three to six weeks. From the time that you start soliciting business from attorneys to the time that you should start seeing some cash flow, if you are average with other physicians around the country doing this, it’s about three months. And from that point forward, you’ll make money, see clients, and have cases, and the amount of money you make is completely related to how many hours you put into it.

Kevin Pho: Now, other than the training, are there any other upfront costs that physicians have to consider?

Armin Feldman: Well, you’re starting your own business, but one of the nice things about this business, and what I tell people, is the costs up front are minimal. The biggest cost up front is elbow grease, and that’s for the learning, and it’s for marketing. It’s more of a person-to-person business. Then there are some upfront costs. I mean, you need to buy some domains, and you need to get basic stuff like stationery and an accounting system and all that, but minimal, minimal cost.

Kevin Pho: We’re talking to Armin Feldman. He is a physician and a medical consultant to attorneys. He wrote the KevinMD article “Medical-legal consulting as a side gig.” Armin, you mentioned that you had a training program. Can you talk a little bit about that, as well as other resources physicians can utilize if they wanted to get started with this?

Armin Feldman: Sure. So right now, physicians have two options with regard to learning this. I do have a new course coming out in March. It’s an online course, pretty much self-directed. It’s an eight-week course, but at the end of each two-week module, I do a live Q&A. That’s one way. And then I have a more intensive, obviously, one-year training program, my medical-legal consulting coaching program, and that’s on the business side, it’s on the medicine you need to know, and of course it’s a year of coaching with me. So those are the two ways. I’m sure most of your physicians listening to this are probably getting emails about the new course coming out, emails from me. And of course the coaching program now is in its, I think, 12th or 13th year.

Kevin Pho: Are there any downsides that you could see from expanding a practice into medical-legal consulting?

Armin Feldman: Yeah, you know, I don’t really see any downsides. By the way, this is maybe related, but the biggest reason why physicians, if they fail at it, fail at it is they don’t take it as seriously as anything else that they do in their professional lives, or they don’t carve out the minimum number of hours. But I mean, if you don’t do those things and just follow the system, follow the recipe, it works for physicians all over the country.

So it’s interesting. You get to solve a lot of medical puzzles. I’ve learned a tremendous amount of medicine, and I’m in no position to do any orthopedic surgery or neurosurgery, but I’d put my knowledge base of spine injuries, rotator cuff injuries, and other things up against anyone’s. For me, that’s been a lot of the fun of doing the work. I love medicine, and I know I’m a better, more well-rounded physician based on all the research I’ve done over the years.

Kevin Pho: And my final question, what are some of your take-home messages that you want to leave with the KevinMD audience?

Armin Feldman: So I think the biggest message is, if you’re like at least a quarter of the physicians in the country, and you’re looking for something to do in addition to your main job, and you want something that’s interesting, lucrative, helps people, and actually is fun, I would suggest you consider this. I’m happy to talk with anybody who’s interested.

Kevin Pho: Armin, thank you so much for sharing your time and insight, and thanks again for being on the show.

Armin Feldman: Thanks, Kevin.

Listen and followApple PodcastsSpotifyYouTubeMore apps · Browse all episodes