Legal - Medical Justice

New Year’s Resolutions

August 15, 2024January 3, 2011 by Jeffrey Segal, MD, JD

By now, holiday libations are a fading memory, and the time has come to buckle down and get back to work in this new year. There will be ample challenges ahead for each of us. While there has been positive motion in the past year, it seems there’s always more to come.

New Year’s Resolutions are often forgotten when the first week of that new year commences. Though made with the best of intents, we simply become too busy, too embroiled in the day to day aspects, or too distracted by new events, to focus upon them and turn them into meaningful changes. But those resolutions were worthwhile, and deserve a fair attempt. Whether yours was to lose weight, be more conscientious about getting ample sleep, to be more considerate of others, to put away more savings, to be more careful about something… no matter what it may be, we can all benefit from a few strategically placed reminders.

Time: Your Most Valuable Resource

August 15, 2024December 16, 2010 by Jeffrey Segal, MD, JD

The most valuable asset any physician has is time. This is true in terms of both his or her personal income, and also as pertains to the ability to help the community around him. So time management is amongst the most significant ways in which one can improve one’s practice. But neither doctor nor patient wants to be short-changed in an office visit. Here are a few suggestions on ways to optimize your time:

As a Doctor I’m Thankful for … Doctors

August 15, 2024December 3, 2010 by Jeffrey Segal, MD, JD

Doctors are also patients. If you’ve not been a patient, you will. My family and I have been patients. I am thankful for the doctors who have taken care of my family. This year, while finishing our dinner, my 13 year old son had a generalized seizure. Josh had been seizure-free for eight years. I … Read more

Promotional Guidance – FTC Update on Advertising Applies to Physicians with Online Presence

August 15, 2024December 1, 2010 by Jeffrey Segal, MD, JD

Florida Medical Magazine Winter Volume 2010, Number 1; Pages 29 to 31 By: Jeffrey Segal, MD, JD, FACS Michael Sacopulos, JD

Cell Phones, Heath Information and Physicians

August 15, 2024November 18, 2010 by Jeffrey Segal, MD, JD

Recently the Pew Internet and American Life Project released results of a study it had conducted by Princeton Survey Research Associates between August 9th and September 13th of this year. The study looked at the use of cell phones to access health or medical information. Here’s what they found: 17% of cell phone users have … Read more

From Subprime Loans to Financing Lawsuits

August 15, 2024November 17, 2010 by Jeffrey Segal, MD, JD

Here’s history in the making.

At one time, before many of us were born, plaintiffs had to bankroll their own lawsuits. There, they would pay the attorney for his time and counsel. The plaintiff bore the entire risk for the outcome. But, if he won, he kept the entire pile of money, minus his expenses paid to the attorney.

The next – and dominant – paradigm: contingency fees. There, the risk is transferred to the attorney. In exchange for accepting that risk, the attorney keeps a healthy portion of any settlement / judgment after expenses. That amount is generally 33 to 40%. Naturally, the plaintiff’s attorney must diligently assess the risk / benefit for each opportunity. If the attorney loses, the plaintiff does not go bankrupt.

Enter the modern age.

Third party financing of lawsuits, as reported in the NY Times on November 15th:

More About Being an Expert Witness

August 15, 2024November 9, 2010 by Jeffrey Segal, MD, JD

By Joseph Horton, MD (This is a follow up to Dr. Horton’s earlier blog Patience is the Hunter’s Greatest Weapon) When I began my academic medical career, Chuck Kerber was with me when I was going over a talk I was about to give. I was understandably nervous about it. I set up the slides … Read more

Patience is the Hunter’s Greatest Weapon

August 15, 2024November 2, 2010 by Jeffrey Segal, MD, JD

by Joseph Horton, MD

I was raised by a pair of criminal lawyers in New Orleans. Being raised by wolves is not intrinsically pleasant, but it does give one a certain sense of being invulnerable to specious attacks—like while being on a witness stand. The inevitable education about courtroom and trial procedure doesn’t hurt either.

Of the two, my mother was the litigator. Tiny in size (I’m 5’3” tall and I dwarfed her), in court she stood, oh, about 11 feet tall, breathed fire, and was bulletproof. It was not a good idea to cross her there—or anywhere else, come to think of it.* One of the things that she drilled into my head was the First and Second Laws of cross-examination.** The First Law is never to ask an opposing witness a question you don’t know how he’s going to answer. The Second Law covers what to do on the very rare instances when it is OK to ask a question you don’t know how they’re going to answer: refer to the First Law.

It always amazes me how many opposing attorneys missed that lecture. Probably half the time I’ve been to trial as an expert witness, I get asked a question that there is no way they can know how I’ll answer. My best guess is that they believe that, since I really am physically small (and gray and nebbish-looking), I can’t possibly help anyone’s case but theirs. Best bet is to look as unassuming as you can, and wait for the opening. (Remember that patience thing?) Then overwhelming force usually stops the attack.

A couple examples:

Curbside Consults are Kosher: A Breath of Fresh Air

August 15, 2024October 29, 2010 by Jeffrey Segal, MD, JD

How often are we told as doctors? You can’t do this. Don’t do that.

We are sometimes made to feel as if we are two-year-olds.

Now for the good news. An article published by Victor Cotton, MD, JD* pushes the opposite position. Curbside consults. If you follow the basics, you’re on safe ground. A breath of fresh air.

As a neurosurgical resident, we were cautioned to avoid curbside consults. Attending physicians admonished us to get the formal consult. At Ben Taub County Hospital, our service was busy. The internal medicine service was busy. Everyone was busy. The one commodity we did not have was time.

I was forced to use the following strategy to coax an internist to see my patient – one suffering from a head injury, in the Neuro-ICU, with a gazillion lines penetrating his skin and a blood sugar of 450.

“I know you are really busy and I hate to bother you. I have a patient with severe head injury and a blood sugar of 450. Do you give one amp or two amps of insulin?”

“What! Don’t do anything. We’ll see your patient in a matter of moments.”

Mission accomplished. The more stupid I sounded, the easier it was to get a consultant to the patient’s bedside.

That made no sense to me then. It makes no sense to me today.

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