Is your customer always right? In the legal nurse consulting world where the customer is usually the attorney, we know the customer is not always right. The customer is not always right in the world beyond either.
As Adam Toporek said in my podcast with him (LNP 112), the original intent of the idea was to put the customer first above almost everything else. The phrase was designed a long time ago to shift to a mindset of customer service.
Is the customer always right?
Understanding of case
A plaintiff attorney calls you to describe a potential medical malpractice case. As you listen to the facts, you think, “I can’t believe it happened that way.” The attorney asks you what you conclude about the case. You point out that you must see the medical records in order to offer an opinion.
When you receive the chart, you realize that the description of the case in the medical record is very different from the description the attorney gave you. The disparity may be due to the way the plaintiff presented the facts to the attorney, or the way the attorney interpreted the medical record.
Understanding of medicine
The defense attorney is getting ready to take the deposition of the treating physician. One of the issues in the case is the diagnosis on the death certificate. Your client wants to challenge the diagnosis because he thinks it is harmful to her theory of the case. After analyzing the medical records, you realize the diagnosis is justified, and in fact, helps your client. You explain that point to your client.
Remember the book, The Emperor’s New Clothes? Everyone in the kingdom pretended the emperor was wearing fine clothes as he paraded naked down the street. A little boy made the obvious statement that the emporoer did not have anything on.
Attorneys hire us because they need a medical perspective to guide them in their legal decision making.
You can almost see the steam coming through your phone. Your client just received an invoice. “You billed me 4 hours for organizing the medical records. They were already organized before I sent them to you!” You realize the attorney and you have a very different concept of what organized medical records mean.
You are the expert when it comes to understanding how a chart is assembled. An attorney’s concept of organized medical records may mean that the chart has a cover sheet identifying its source, not that it is broken into sections.
Other sources of underestimation of hours: how long it takes to review a record, how long it takes to prepare a report or for an expert witness to get ready to testify. I’ve even had an attorney who used Mapquest to cut down my billed travel time. He figured out how long it should have taken for me to drive to a deposition (not taking into account that it was rush hour traffic).
In my experience, billing issues represent a large potential source of dissatisfaction.
Be firm, fair and clear when communicating with attorneys. When you are tempted to avoid conflict by wondering, “Is the customer always right”, remember your responsibility in setting expectations and using your medical expertise.
And don’t fall for another often repeated phrase, “If you didn’t chart it you didn’t do it.”