Interview with Dr. Armin Feldman

In today's episode, Dr. Armin Feldman returns to update us on creating a medical legal consulting business, and new resources for learning how to do so. He first appeared as a guest on Episode 227, which was released a year ago. 

Dr. Feldmman attended the University of Colorado Health Sciences Center for his psychiatric residency after graduating from the University of Wisconsin Medical School. For more than 20 years he practiced psychiatry and ran outpatient head injury rehabilitation centers around the nation.


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Medical Legal Consulting Business vs. Expert Witness Consulting

Dr. Feldman started formal consulting of this nature 15 years ago. His unique pre-litigation/pre-trial consulting aids attorneys in managing the medical elements of cases, raising case value, and saving time.

By supporting medical opinions with documentation from medical literature, he assists attorneys in helping their clients negotiate and settle legal disputes. In most cases, this enables patients to obtain necessary medical care.

Launching a Medical Legal Consulting Business

You need two skill sets to successfully pursue this career.

First, you must be able to research the literature regarding evidence-based medical care and explain your medical knowledge and experience to others. Second, you will need the business skills necessary to launch and sustain a long-term medical consulting firm.

During our interview, Armin describes how to obtain those skills.

Additional Resource – Dr. Feldman's Podcast

Armin and a former student, Dr. Michael Bummer, also produce Physicians Helping Attorneys (Helping Patients) a podcast that helps attorneys understand this new medical forensic field. It is also a great place for physicians who are interested in studying this type of work to learn more about it.

Dr. Feldman's Advice

If you love medicine and you want to… help people, injured people that really need this help… this is something you should consider.

Summary

In today's interview, Dr. Feldman helped us to understand this burgeoning new medical field.

He also describes his new online course, Start Doing Medical/Legal Consulting, which opens later this month. In it, you will learn how to start your own medical legal consulting business. The 16-video course is divided into 4 modules, each lasting two weeks, with a live Q&A with Dr. Feldman following each module.

If you want to begin this lucrative nonclinical full- or part-time consulting business, learn more by clicking this link. (This is NOT an affiliate link.)

NOTE: Look below for a transcript of today's episode. 


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Transcription PNC Podcast Episode 281

Why You Must Consider Starting a Medical Legal Consulting Businesses

- Interview with Dr. Armin Feldman

John: About exactly a year ago, I had today's guest on my podcast for the first time, and I was really interested and enthralled by the conversation because what he discussed was something I had never really been aware had existed. And since that time, he's been doing some new things, he's been increasing the availability to teaching other physicians to do what he's done. So, I want to welcome back Dr. Armin Feldman. Thanks for being here today.

Dr. Armin Feldman: It's a pleasure, John. It's always good to see you and it's always fun to be on your podcast. Instead of just listening, I actually get to do one.

John: Yes, I always find it fun to be a guest on another podcast. It's just like a normal conversation, just getting to know somebody. So, it's a lot of fun. You were on last time, about a year ago, and we were talking about this career that you have had for the last 15 or more years and a career teaching others to do it. So just tell us what that is and then you can segue a little bit into what's kind of new with what you've been doing.

Dr. Armin Feldman: Okay, great. As you know I do medical legal consulting. And what that really means is I work as a medical consultant in legal cases. I don't work as a medical expert. I'm working pre-trial, pre-litigation on those approximately nine out of 10 cases that these attorneys negotiate and settle. So, we work as medical legal consultants on the strategic development of medical issues in legal cases. And we're primarily working with personal injury and worker's compensation attorneys who work on the claimant side.

Now, although I'll say that any physician in any specialty can learn how to do this work. As you know, I owned outpatient head injury rehabilitation clinics around the country. I was fortunate enough to sell them. Thinking about what I wanted to do next. This was 15 years ago. I had testified as an expert witness more times than I want to remember, and I was thinking about what to do next, I thought maybe I could consult attorneys on any kind of medical question that comes up in a case. And I guess now the rest is history.

I've done over 3,000 cases. 13 years ago, I started training other physicians how to do this kind of work. And I've now through my coaching program, my conferences, my online training, I've now trained a little over 1,600 physicians around the country. We always work on the side of what I call the little guy going up against the insurance companies. These are injured people, injured no fault of their own, who then need to acquire legal counsel to get the appropriate damages and more importantly, from our point of view, to get the medical care that they really need. And this kind of consulting, really, in a formalized way was not done until I started doing this years ago.

John: Okay. That is definitely a different kind of animal from the usual expert witness consulting. And so, I want to tell you the way I look at it, some of the differences between this medical legal consulting and expert witness. And you can tell me if I'm right or you can add to it. So, let's do that. The expert witness generally is going to be involved in either a chart review, case review, and or a deposition rarely, and then even less rarely, testifying in court. And from my understanding the second two of those never happen in medical legal consulting that you do. Is that correct?

Dr. Armin Feldman: Yes, that's right. Another big difference is obviously if you're working as a medical expert in a legal case, you're working in your specific field. As a medical legal consultant, you're a generalist. You're answering any kind of medical question that comes up in a case. And our legal system allows and actually encourages this. A physician can answer medical questions in legal cases. And what makes what we do viable in many ways, is not only are these cases negotiated and settled, but we always back up our medical opinions with evidence from the medical literature.

In fact, when I first started doing this, my reports would go over to opposing counsel and the opposing counsel would call the attorney that hired me and say, "Why should I pay any attention to this? Dr. Feldman isn't an expert in, whatever, rotator cuff injuries." And the attorney would say, "Well, Dr. Feldman acts as a medical consultant for me in my cases, and if we can't get this negotiated and settled and you forced me to take it to trial, when I hire my retained orthopedic specialist, they're going to say exactly what Dr. Feldman said in his report. In fact, Dr. Feldman is relying on the same medical literature that my medical expert will rely on."

John: Yes. Very interesting. So, let me distinguish another thing here. Medical experts generally are still in active practice, not a hundred percent, but most of them are. And it's usually sort of expected. In this situation, do most of the people doing this, the physicians doing what you do, are still in practice? Still in practice, not in practice. Some are, some aren't. What's that like?

Dr. Armin Feldman: Some are, some aren't. But I'll tell you the majority are. Some physicians do this full-time. Some do it in lieu of retiring, but the vast majority of physicians do it as a part-time gig and they continue to do clinical work, and then they add this piece of nonclinical work to what they're doing. So, most of them are practicing.

John: Okay, good.

Dr. Armin Feldman: It makes a nice transition too for people that want to transition to nonclinical medicine. You can do it on a part-time basis. What I always say is you really need to have a minimum of about eight hours a week in order to do this justice and make it fly. And then from there, you can do it as many hours a week as you see fit and as you enjoy it and build up your medical legal consulting business.

John: Now, it seems that for the physicians that I know that do expert witness consulting, the rate of pay is significantly above their usual clinical pay unless there's some very subspecialized thing. A lot of them, when they do the expert witness, they will like you said, do that part-time too, work fewer hours, generate enough that they can cut back on their clinical. Would you say the same is true of this aspect?

Dr. Armin Feldman: Yes.

John: Okay.

Dr. Armin Feldman: Both things are true. Yes. The remuneration is handsome, and it does allow you to cut back on your clinical work.

John: Okay. Now I know that you have been teaching this and coaching people and so forth. I'm kind of interested in maybe a high-level view of what it would take for a physician to do this. What kind of training, what do they need to learn to do this? You can obviously get into much detail, but what kind of things are important in doing this kind of career?

Dr. Armin Feldman: Yes. I think for me and for the physicians that do this, this is what makes it interesting is that there are really two skill sets that you need to learn. One, of course, is you need to learn the medicine that you need to know to do this. Now you can do that as on the job without training. And when I say the medicine, you also need to understand how the legal system works, how law offices work, what things to do, what things to watch out for.

And I often tell physicians that are in my coaching program, my training program, almost everything that I teach is based on mistakes that I made over the years that you won't have to make. That's part one. And part two is you have to learn how to successfully not only start up, but successfully run a long term medical legal consulting business.

And the training is really on both of those things. So how do you go from zero, no business to up and running with your medical legal consulting business? How do you market that business? Meaning how do you get your attorney clients, how do you keep them long term? How do you operate your medical legal consulting business on a daily basis? That kind of thing. And then on the other side, how do you write the reports? What goes into the reports? What are the services that you're going to offer? Medical service, medical consultation services you're going to offer, and so forth.

John: Yeah, there's a lot of nitty gritty in there. I think I gathered from our last conversation and from listening to your podcast, which you can mention here in a minute. As a physician, we can understand what goes into a particular case. Doing this, you would've to research and oftentimes share that with the attorney you're working with. But like you said, it's something that each case is a little different. And so, I think the training that you've done in the coaching shows people how to do that too, how to collect that and put it together for the attorney.

Dr. Armin Feldman: Yes, yes. There are actually 15, 16, 17 different types of services that I've developed for attorneys over the years. And so, every case is a little different. Every kind of service you're going to offer is different. So, for example, one attorney may want you to put together a comprehensive medical summary report that talks about the entire case, the medical damages in the case, the future medicals that are going to be needed and so forth that they'll submit with a settlement demand, a letter.

Another attorney may want you to do liaison with a treating doctor. Let's say the person develops severe migraine headaches after being rear-ended in the accident. And you get to the medical records and they had some headaches five years ago. And so, you might need to talk with the injured person's PCP or gynecologist or whatever, and say, "Hey, that headache that you treated them for five years ago, is that really a preexisting condition? Was that something different than what, well, I would call them a client, but their patient is experiencing now?

John: Okay.

Dr. Armin Feldman: A client of the attorney. There are a wide variety of services that you can provide as a medical legal consultant. That will depend on what the attorney wants, what the case indicates, and so forth. You're speaking about medical expert work. One thing that makes it different is our average case takes maybe somewhere between five and 12 hours. It's not as involved as being a medical expert. I would say probably maybe 80%, 85% of the time you're going to be writing a report. And that report, it's not behind the scenes. They'll be seen by insurance adjusters. They'll certainly be seen by opposing counsel in every case. They're often seen by judges treating doctors, IME doctors and others.

John: Very good. You are kind of really filling an important niche, an important step in this process. And like you said, most of the time they don't go to any kind of trial which most attorneys try to settle, almost every case at least in my recollection. One of the things I want to mention or ask you earlier, because you're so passionate about this, you spend so much time developing this, it's like a new specialty. And so, why do you love this so much? Why do you like this? You seem very enthusiastic.

Dr. Armin Feldman: Yes. Well, that's a good question. And I think the absolute bottom line on that is, I think as physicians, one of the big reasons we all get into doing this is we want to help people. And this is a way that you can really, really help injure people in a way that they never had helped like this before in a nonclinical setting. And you get to see the tangible results of that help. The other thing is, if you love medicine, when you were in medical school, if you were enthused about it and you love medicine. This is a way to get involved in all kinds of various aspects of medicine and learn. Of course, the attorneys are paying you to do your research, but learn about all kinds of very interesting things.

Now, obviously, I'm in no position to do any orthopedic or neurosurgery, but I would put my knowledge base of spine injuries, rotator cuff injuries, complex regional pain syndrome, you name it, up against anybody because this is what I do day in and day out. I learn about various things that have come up in accidents and then what are the conditions? How do you treat them and stay up to date on all of the medicine?

I'll tell you a very quick story. I was talking to an attorney client last week and he said, "Hey, I have a case in which a woman developed a very bad hiatal hernia and esophageal reflux after being reared. She had two surgeries. She still can't swallow properly. Is that accident related?" And I said, "Well you don't know this, but I've done over 3,000 cases. Nobody has asked me that before." And so, I said, "I don't know if that's the case or not, but I'll go do some research for you."

I did that research, and sure enough it's well documented in the medical literature that trauma, and sometimes in some of these articles specifically, auto accident trauma can cause... I thought it would have to do with physical wrenching, but actually has more to do with internal pressure that's developed in the abdomen and pushes on the diaphragm and tears it.

And so, I was able to go back to this attorney and say, "Hey, yeah, you got a case here. Let me do some more research on this and write it up." And I was kind of thrilled because I learned something new, that physical trauma like this could actually cause these kinds of problems. And that was a damage in the case that this poor woman needed to be compensated for and get treatment for.

John: I bet even though your family and other friends know that you're maybe not practicing, I bet they still come to you with all the medical questions.

Dr. Armin Feldman: My sister-in-law flew in from Minneapolis for the annual Christmas cookie baking experience here in our house with my wife and her other sister who lives in Boulder. And she showed me, she twisted her ankle before she came. She asked me to take a look at her ankle. And I had some suggestions for her.

John: Of course, you did. Yeah. Excellent. All right, now I want to learn more about how we can learn more from you in various ways. And let's talk about the podcast for a minute. I believe that was developed really for attorneys, perhaps, but I think it can be useful to anyone who's thinking about doing this kind of work.

Dr. Armin Feldman: Yes. I developed this podcast with one of my former students who is Dr. Michael Bummer in Pittsburgh. He is just going gangbusters. I'm doing medical legal consulting, and he's a smart and awfully nice guy. We teamed up and we're doing this podcast. It's called Physicians Helping Attorneys Helping People. The URL is physicianshelpingattorneys.com or any place where you listen to podcasts. But it was initially intended for attorneys so they could understand this better because like you said, it's a new field. But what I've learned is that there are a number of physicians that actually also tune in to the podcast and as you suggested, John, particularly physicians that might be interested in learning to do this kind of work.

John: Yes. The podcast, it's not been out all that long, but I had at least a dozen episodes that I listened to while I was on a recent trip. Yeah, it really helped clarify for me really what you do. And it was nice hearing the cases that you described in the podcast because it just makes it more real. If there's someone listening, and again, my audience typically are physicians thinking about various nonclinical careers or pseudo clinical careers, part-time side gigs and all that. So, this definitely fits into that. And just listening to the podcast will give you a much better understanding of what we're talking about in this short interview today.

Dr. Armin Feldman: Great.

John: Yes. But now you also have an even more direct way of helping us learn how to do this. I know you've been sort of coaching and teaching for a long time. Tell us what's new in that venue.

Dr. Armin Feldman: Right. Yes, that's right. I do have a training program, coaching program that physicians have been participating in for years. Last year I started a new online course, and this is really a crash course in how to do medical legal consulting. It's all online, do it at your own pace. And the next run of this course is coming up on January 30th, 2023.

The course is 16 videos. The course is broken into four modules of two weeks each. So, only four videos every two weeks. It's really tailored for a physician schedule. You can certainly watch four videos in two weeks. And the associated downloadable materials for each topic is there for you.

And then at the end of each two-week module, I do a live Q&A where everyone participating in the online course can save up their questions over those two weeks and I'll answer questions for an hour. The course is worth 15 category one CMEs.

John: That helps.

Dr. Armin Feldman: Yeah, it does help. I'm happy to say that the first two rounds of the online course were well received. I'm happy to say the technology actually worked. No problems there. And so, I'm expecting a nice turnout for run number three starting in January.

John: Well, I can't wait because I did sign up for the course.

Dr. Armin Feldman: Yes, you did.

John: If you knew that or not. But I'm going to tell my listeners, look, I'm going to put my money where my mouth is and I'm not an affiliate for this thing. I just think it's so interesting that I'm going to take the course and ask you a few questions. So, if anyone wants to join me, just let me know that you've joined and we'll be in it together.

Dr. Armin Feldman: Oh, that's just great. That's just great. When you're running an online course like that and it's on-demand videos, it's so nice to do a live Q&A because you actually get to interact with the physicians that are in the course, answer their questions and get to know who's actually taking the course.

John: Yeah, that's great. And I've got some courses online, but I'm currently not doing a live version of any of it, including a Q&A. That sounds like it's definitely a value and will help the students immensely.

Dr. Armin Feldman: Yeah. In fact, one thing I say right at the beginning is when you finish this course, you will have all of the tools and all of the instructions that you need to go out and actually do this. It's not just a cursory introduction. It's, "Hey, here's how you do it."

John: Yeah. I think that people, professionals that have made a decision to change and to do some coursework or something, they really want to get into the details. They want to know "Do I have everything I needed? If I truly want to do this, I can do it." And so, I know other course creators that do the same thing, and it's always well received. So, I've got to hand it to you.

Dr. Armin Feldman: Good.

John: All right. Is there anything else you need us to know? We talked about the podcast, the course. Either any other information or just advice for us? You've talked to a lot of physicians who've done transition.

Dr. Armin Feldman: Yeah. I think if you love medicine and you want to learn a lot about medicine, help people, injured people that really need this help, I don't want to sound too grandiose about this, but help the lawyers and help our legal system to some degree who are looking for some kind of nonclinical work, that you can sink your teeth into, and know that not only is it going to be helpful in terms of the income, but also helping people and something that's fun and you can enjoy, then this is something that you should consider.

John: I get a lot of people that are just early in the course of trying to find something new to do and they feel like "I've wasted my education or I'm not going to be helping people." But this is another really excellent example where "No, you are going to be using your education a lot." Reading these research papers, trying to figure out which ones really apply to this case, learning something new, because we're not all experts in every field, but we have that medical background and you're helping somebody. It's not so much that you're helping the attorney, it's the next level, which there's a patient behind that attorney that maybe has been unjustly denied certain services or treatment. Again, it's just a great thing to do and it keeps us still the mind going and using our medical skills.

Dr. Armin Feldman: Yeah. Right, right. That case I mentioned earlier, her medical bill so far to date had been denied by her own insurance company. And that's why she had to hire the attorney. And now that attorney is going to help her to say, "Oh, no, no, this was accident related."

John: Excellent. Yeah. And I bet you had a real sense of accomplishment when you discovered that, in fact, that's a real thing.

Dr. Armin Feldman: Yeah. Right. That's true. Yeah.

John: All right. Well, I really want to thank you again for being here, Armin. This has been fun. I'm going to get the word out to my listeners about this and we'll see what happens. But I hope all the best for the coming year with this iteration of your course, and I'm sure it gets better every year.

Dr. Armin Feldman: Yeah. Thank you. Thank you, John. You always ask such good questions too.

John: All right. That's because I'm really interested. So, thanks again and I'll be looking forward to seeing how things go with your course.

Dr. Armin Feldman: Great.

John: Bye-bye.

Dr. Armin Feldman: Bye.

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