Tuesday, June 29, 2010

Please follow me at my new location

My blog has moved and is now integrated into my website, http://www.caseconsultant.com/blog.

Parts II and III of "Tuning up and toning down your website presence" are there, and more posts are on the way.

See you there.

Tuesday, June 22, 2010

Tuning up and toning down your website presence - Part One

This blog entry (Part One) is not about choosing the technical format of your website...html vs php vs flash…this blog is about presenting yourself in a professional manner to those who would contract for your services.

When I launched my first website, I believed that merely making my presence known would be the catalyst my business needed.

That was four years and four websites ago. I have learned that word-of-mouth trumps any form of print advertising. The odds of someone stumbling onto a website called elizabethcrownmorgan.com are slim, but if an attorney hears about Elizabeth’s services, he will want to know more about her. For those that know you, or have heard of you, a website presence is invaluable.

If you need a reason to slow your rush into the internet marketplace, this is it: invariably, you will later groan at something you have written and want to change it. It is really quite simple. I may not know how to write the next great novel, but I certainly know how to recognize it when it comes across my desk.

Your goal is to have your website represent you in a professional manner. Concurrently, you want visitors to:

• Remain on the site for an extended period to read your information
• Click through the pages of your site to have a full understanding of your services
• Understand your professional goals and objectives
• Return for updated information on a regular basis
• Recommend that others visit the site

General Recommendations

I. Graphics make the first impression, but if those Google image downloads appear on other sites, using them will not product-differentiate you from other legal nurse consultants.

There are resources for making your website look professional and aesthetically pleasing.

I highly recommend istockphoto.com. There, you will literally find thousands of professional photographs that touch every concept in marketing. You can search by profession, city, theme, color – the choices are extensive. It is a painless way to make your site unique. Choose the smallest and least expensive size since the small .jpg’s are perfectly adequate for site usage.

II. Visit the websites of large law firms. Most are tasteful and understated, reflecting the serious business of hiring legal representation. This is the tone to strive for – elegance and sincerity. I realize as I say this that there are many who would disagree with me.

But this is my blog. Stay tuned for Part II.

Friday, June 11, 2010

Just what kind of attorney are you working with?

This is a question that we as legal nurse consultants should ask ourselves when we embark on a new attorney-client relationship. I am not referring to the attorney’s area of specialization or their orientation towards defense or claimant work. I am speaking about their business and personal preferences, their personality, their quirks. Despite having your own (dare I say strong) personality, you must adapt yourself to the communication and business style of your client.

I have a good relationship with all of my attorneys and a close relationship with a select few who share anecdotes, snippets of family life, do not begin emails with salutations nor end them with good wishes. We save our grammar and formatting skills for professional reports and forgive the incomplete sentence, lack of capitalization and generally casual style of email. When I consult on their cases, there is little if any direction given to me. The records appear as if by magic, sometimes with a dolly. We have a telephone conversation; they are open about their knowledge of the case, but often hold back their own impressions until they have mine.

There are also those attorneys who are very formal. You will recognize them immediately by their communication style and you should respond to them in the manner they address you. If their emails address you by title, respond accordingly and do not dangle your participle. These people may have a sense of humor but they are not ready to share it with you.

They often have a very specific idea of what they want from your reports. They may want a detailed chronology and your personal opinion, but they may not want to share it with colleagues, experts, or their own client. They may want a second chronology that does not have your name on that report, or your opinion in that author's column. They want to keep you as their private resource and they want the opinions of others to be based on clinical facts, not your intuition or experience. They may not want anyone to know you exist. This is where software like Casemap truly shines, by the way. This type of attorney is not for the nurse who uses MS Word for tables.

There are also those attorneys who simply do not know what they want. This may be a case that falls outside their comfort zone. They will call you and ask you how to proceed with experts, or if you think their reasoning is sound, and they are generally open to input. While this may stroke your ego, it is the trickiest case to manage because you cannot cross the line between nursing and the law. Their neediness rapidly translates into blame if events do not proceed as expected.

Be comfortable with yourself, and never accept demeaning or verbally abusive behavior. But...you must also put aside your ego for your attorney-client. I can tell you that this is a challenge for most nurses. We are an opinionated bunch and our opinion is what gives us value. Nonetheless, remember that no matter how close your affiliation with an attorney may become, it is first and foremost a business relationship. Their chief goal is to advise and satisfy their own client. Your primary assignment as a legal nurse consultant is to help them achieve that goal by asking them what kind of report, what kind of information, and what type of presentation they expect of you. And then deliver.

Friday, May 21, 2010

The Deposition Experience

Today I sat in on the deposition of a woman whose medical records I had analyzed.  She was being deposed by the large company against whom she is bringing suit. To any legal nurse consultant who has never participated in this exercise, I highly recommend it. Of course, being neither the deponent nor the one taking the deposition, I was free to sit back and enjoy the show.

What was fun about this deposition? When you hear your observations being quoted directly in a question to the deponent, it takes your analysis out of the world of paper and connects it to the reality of the person involved. Even when you are sure of your work, you still hold your breath waiting to hear the reply you know should be forthcoming.

This deponent did not disappoint. She was an attorney representing herself, a choice I would not have made were I in her place. She was a master of obfuscation and passive aggression, managing to sound and seem concurrently ignorant, forgetful and clever. I actually admired her a bit.

I would never have the temerity to repeat a phrase six times that I knew the opposing counsel did not want to hear.

I would certainly never have asked opposing counsel to hand tally my medical bills if he wanted the sum that badly.

I would not have set the "land turtle-speed" record for timely responses. No answer was given directly. No opportunity was missed to appear confused and uninformed. No reply was given in under two minutes.

That particular shade of red in opposing counsel’s face would have alarmed me to no end.

This was nothing like the many deposition transcripts I have read, with compliant claimants whose attorneys have told them to “stick to the facts” and answer as briefly as possible.

I could not stay for the whole deposition, which my attorney-client assured her would take the entire seven hours allowed by Georgia law, given her style of response. She blamed him for this observation. She refused to allow her picture to be taken because she did not like the way she looked today. She offered a cell phone picture that was more flattering, but of course, the phone was dead and alas, the picture could not be retrieved.

Yes, it was an eye-opening event. I can’t wait to do it again.

Sunday, March 28, 2010

Here’s (Who’s) Lookin’ at You, Kid

Legal nurses, like expert witnesses, attorneys and politicians, are only as credible as their public image. While we have faith in the integrity of our friends and fellow professionals, we are not immune to the intentional harm inflicted by someone whom we would rather not have riled.

Most of us unwittingly sow the seeds of our own demise. We engage in light-hearted email bantering back and forth with friends and colleagues. We know to screen our Facebook friendships and confine our LinkedIn connections to business, but still…

We do love voicing an opinion when asked, and even when not asked.

Our professional listservs allow ample opportunity to hone our critical thinking skills and play beat-the-buzzer at guessing elusive diagnoses, arcane abbreviations and other mind-teasers thrown out by our colleagues.

We might even voice a private opinion on an expert’s skill level. Woops.

What we say today will be here tomorrow, and the next day, and the year after that, forever circulating and percolating in cyberspace, molded into sound bytes that hardly represent the original intent.

In fact, this was recently done to me, by me. I wrote a short article called “It’s not life… it’s social media” (http://www.caseconsultant.com/Social%20Media.pdf). I still support most of what I wrote, but I now have 75 Facebook friends and attend Martindale Hubbell online conferences. My article lingers on.

Recently, a fellow LNC posted several sites that construct an image of you based upon your shopping habits, public profiles, emails, etc. The images were not accurate portrayals, but there are people who use their free time to make mischief for the rest of us.

As the NYPD day sergeant would say, “Let’s be careful out there” as we fall in love with the sound of our voices and the sight of our words.

Wednesday, March 17, 2010

Hold Nothing Back

I work with attorneys.  I know that they provide medical experts with selective records targeting their area of expertise.  Some of this is cost containment and some of it is shaping the view of the expert. This practice of selective omission and inclusion does not work for me as a legal nurse consultant. I want everything.  

An expert witness works within a narrow window and focuses upon rendering an informed opinion.  This expert is critically important, but how many will you need in a complex medical action? 

You only need one legal nurse consultant to work your medical case.

If that person is me, send me every scrap of data in your possession.  I am a bloodhound. If you omit information, I will know it.

In asking for the entire file, I have a targeted, cost-efficient yet comprehensive system for discovering critical information, discarding irrelevant data, and knowing what is missing.  My chronology clarifies the diagnostic picture and directs me to the authoritative research that will support my recommendations and conclusions.

The most relevant data is often the most elusive. That chicken scratch that passes for cursive writing may be at odds with the typed dictation. The casual comment to the ER nurse or EMS may not be admissible as testimony, but is no less relevant to the case.

In dealing with this abundance of information, I find the the pleading, affidavits, interrogatory and responses to be critical. These documents reveal the mindset of the claimant and the temerity of the attorney. I need that.

If  I am working a defense case, I know that an over-reaching complaint is an open invitation to investigating past medical care. Discrediting one specious charge will cast doubt on others. It is a rare individual who enjoys perfect health until an unwitnessed slip and fall in the drugstore.

If this is a plaintiff case, I am equally wary of the client who casts a wide net of complaints, or the nondisclosive client who selectively provides data.

In this world of healthcare litigation, we cannot truly function knowing this thing but not that thing.  The practice of picking and choosing data will come back to haunt both plaintiff and defense attorneys…particularly if the opposition has me on their team.