Today, Fortune printed the best story (CNNMoney.com) regarding the Las Vegas Medical Mafia, that I've read, which summarizes what has been happening in Las Vegas for 20 years and has been occurring aggressively for the last decade relevant to the legal community.
OK, so we all know about the Medical Mafia in Las Vegas. Please read the Fortune story before you go much further here. We have Las Vegas reporters to thank for their hard work and reporting. But, sorry George Knapp, this article at Fortune really lays it down with clarity.
So, for you young kids, this is not news, this is Las Vegas. I've been in practice for a long time here. I've experienced a lot of these things reported in the article, either directly or indirectly. Turner and Hall are spot on the mark. They are not crazy. However, because I've spoken about this kind of thing often, I've often been referred to as a "conspiracy-theorist" and "insane". So, why has no attorney spoken out about this before now? The reason no attorney does anything about the Medical Mafia-ish activity in Las Vegas is for two reason: first, look at what happened to Dr.'s Thalgott & Venger, they told the truth and they have been destroyed...period. Even the media has been influenced and attacked them for telling the truth; second, the Medical Mafia is good at what they do.
The City of Sin's legal community gave birth to the Medical Mafia. So this is not a story of any unique measure to anyone in the legal community. The actions undertaken by the Medical Mafia are not unique to the Medical Mafia. This is how the legal community, the government community and like-minded faces in Las Vegas operate. The Medical Mafia is more a product of their overall environment, than they are an independent anomaly. In the Las Vegas legal community (when I refer to the legal community I'm talking about government, law firms, judges, clerks, police, etc.) we are bred to find ways around the legal problems. Specifically, as lawyers we must find solutions for our clients...any solution is acceptable. The same goes for all things Las Vegas. As a result, we have the payoff, the kickback, the favor, the relationship, the support, the backroom, the donation, the unspoken jesture and the 'I'll ruin you'. This is our motivation. This is our unique twist on law. This is our system of justice.
Whether this was imported here via the New York & Chicago Mob Families, whether it is the perceived religious secl
usion of the Mormons, whether it is 'native Las Vegans' and the envy of outsiders, whether it is the 'small town feel' of a small town exploded into an economic giant or whether it was always part of us, it is here. Everyone has their 'take', everyone has their opinion, everyone has their view of the 'way it is in Vegas' and any subsequent 'blame' on another group. Usually, the 'blame' is part of an 'I'll ruin you' threat and correlates directly to the amount of power, control or influence a person possesses. In other words, if you are 'in' in Las Vegas, you are safe. It is a lot like gang warfare. Even the gangs make alliances with each other over control for parts of the city. It is a sort of civilized Afganistan here. OK, back to the Medical Mafia. The background is important to understand that, in truth, the Medical Mafia is just part of an overall larger Las Vegas reality.
The Scheme
All the best cases, money-wise, are those involving 'clear liability', which is usually a car accident & surgery. However, juries must believe that the surgery was necessary. A big settlement is not possible with an insurance company unless the insurance company believes that a Las Vegas jury will provide a large award. Thus, in trial, it is nearly impossible to convince a jury that a person did not need surgery when the doctors all say the person needed surgery. Common sense. The inherent trust & justice in our legal system is a reliance on the jury's ability to assess truth. Part of the jury's view of truth is a heavy reliance that the doctors are not lying about the Plaintiff's need for surgery. While there is a certain amount of reliance on the lawyers not being liars, everyone accepts that the lawyers are "advocating" for their clients and the system accepts a certain amount of dishonesty in the name of "advocacy". The amount of dishonesty is often a measure of zealously in argument and relates to each lawyer differently.
The evidence from the doctors that surgery is necessary, however, is a fact that is of the utmost importance to the jury. If surgery is actually performed on the Plaintiff, the trust that the doctor is correct and truthful is overwhelmingly in favor of the Plaintiff and against the Defense. Thus, when the jury deliberates, if they believe that the need for surgery is questionable, they usually don't want to take that out on the Plaintiff, especially if the surgery was performed. Any belief that the surgery 'may have been questionable' is usually overlooked and the Plaintiff recovers...whola...you have the indefensible piece of evidence to make your case. Now just mix this with a little Las Vegas 'juice' (really 'influence' and 'kickbacks' for the rest of the world) and you have created the magical scheme that is called the Las Vegas Medical Mafia.
Since the best defense in any Plaintiff's case for future damages (medical treatment or disability), if they have not received surgery, is the fact that they have not received surgery, the only cure to overcome this defense is to have the surgery, as mentioned. Most reasonable people would not ask for surgery. For years most surgeons would only recommend surgery as a last resort. However, the drive for money has changed that perspective and it has liberalized many medical opinions about the need for surgery. I'm sure the Las Vegas 'juice' helped loosen those opinions.
Certainly, from a legal perspective, Plaintiff lawyers want to see the surgery happen before trial. Then there is hard evidence of an injury, the dollar figure is HUGE, but most importantly, a jury has an almost impeccable record in awarding large sums of money to the Plaintiff if the surgery has occurred. Why? Juries can't believe that a person would get surgery unless it was necessary and they were actually in pain. Thus, when a case proceeds to trial and surgery occurred prior to that trial, the Plaintiff's make money, end of story.
The real trick in creating a money making machine of Plaintiffs that are injured (or potentially hurt) is finding a person to locate the Plaintiffs, finding an attorney to coordinate the treatment and the medical liens, finding a doctor to recommend that a client needs surgery (liberally), to perform the surgery and to testify convincingly at trial, and then convince the client to have all the treatment performed, including the surgery. The only way to do this on a mass scale and make a lot of cash is to collude. Competition in the marketplace would otherwise prevent the overwhelming scale of compensation from being limited to merely an elite few.
However, what about when the patient does not want the surgery? It becomes clear quickly, that the patient MUST be 'out of the loop' or they would say 'no' to the surgery, which is the key to the big jury award. The doctor and the lawyer MUST be 'in the loop' so that they can coordinate the cases, the treatment, the surgeries, the payouts, the kickback (that make it worthwhile) and any necessary cover up. The importance of the "need for surgery" before the trial and the "need for quality testimony from the doctor" (thus the doctor practicing testifying) cannot be over emphasized. They both must withstand the scrutiny of the defense attorneys. If done properly, a defense is impossible.
This collusion makes a defense impossible because the system it set to trust the expert witnesses & the treating doctors. Our legal system (the jury) relies upon their judgement. In order to alter the outcomes, you have to alter the opinion of the doctor. This is where the Medical Mafia really succeeded. They aligned doctors, lawyers and the 'middle man' to find the cases, to take all medical fees on liens, to beef up the medical fees by creating 'liberal' surgical recommendations and then by taking the cases to a jury. Settlement was not good enough. Once the juries continued to award large sums for these surgeries, it was as if the Medical Mafia owned a casino and regulated themselves.
As time went on, the result, likely unintended, of the Medical Mafia's actions was that the number of settlements increased and the amounts increased in Las Vegas. They would still take some cases to trial to maintain a level of high consistent jury awards. All the while, everyone made money, money, money. The only person left out in the cold, though compensated, was the patient who had an unnecessary surgery (well, insurance carriers have paid through the nose, too).
Interestingly enough, even the defense attorneys were getting paid by the insurance carriers and defense law firms were being built as a result of trying to defend this scheme. Some even claim that, because of the Medical Mafia, the need for out-of-state counsel increased. It was no secret that many insurance carriers believed that the only reason for many of these huge verdicts was because of incompetent Nevada attorneys. The same people claim that this was the birth of the out-of-state law firm in Nevada and the subsequent Supreme Court rule change with regard to law firm names. I believe that they merely contributed to an already growing economy and that certainly it was the reason for some of the out-of-state firms being brought into Las Vegas.
All Things Vegas Legal
Now if you think this begins or ends with the Medical Mafia, you are dead wrong. This Medical Mafia-style of business is how the Las Vegas legal system works. In fact, one thing you can be sure of: if a judge is hated by a lot of attorneys, it is likely that this judge refuses to play this game. Remember Thalgott and Venger? They are the surgeons that came forward and broke rank and told the truth about these meetings, these arrangements and the unnecessary surgeries. What happened to them? They are done, reputation destroyed, plain done.
The same is true for ALL THINGS VEGAS LEGAL. As the Fortune story explains, there were bags of cash given to wives in the restrooms at parties, crystal bowls full of money were given to judges to keep them on the bench and, as Venger put it, he had trouble accounting for all of the money that was coming in, so he tried to fake that he owned another company with income.
ALL THIN
GS in the LAS VEGAS LEGAL community are the same. The Medical Mafia is not unique. This occurs in government, this occurs in the courtrooms (state & federal), this occurs in clerks' offices, this occurs in law firms, it is every where in the Las Vegas legal scene.
The only thing that has happened since the federal government has gotten involved, the attorneys and doctors have become more protective, more scared, more cautious. However, when the Noel Gage dismissal occurred, it began again. What I call the New Medical Mafia has emerged. Las Vegas has seen how much money is to be made off of this scheme and more attorneys and more doctors are lining up to get on board. The only difference now, it is like a lot of little gangs running the city, instead of one big mafia. It is very reminiscent of the days after the federal government finally broke up the Chicago & New York Mafia strong-hold on the Las Vegas casinos. There was no center, there was not focus on the organized corruption, however, the corruption still prevailed all over in pockets. The Medical Mafia became the target of federal investigation because they got sloppy, a big mafia no-no. They went after a government entity in a car accident which increased the scrutiny.
Where Are We Know?
Some would believe that the worst is over. Some would believe that there is no Medical Mafia. Some would believe that this is all make-believe. Many think I'm crazy. I can tell you this, the medical/legal scheme is as real as Las Vegas itself. It has gone on for years. It will continue. Whether by a lawyer, by a judge, by a doctor, by a plaintiff or by a defendant, one thing is certain, the lies, the payoffs, the kickbacks, the favors, the backroom deals, the parties, the fundraisers, the donations, in essence All Things Las Vegas Legal, will continue.
So, for you young kids, this is not news, this is Las Vegas. I've been in practice for a long time here. I've experienced a lot of these things reported in the article, either directly or indirectly. Turner and Hall are spot on the mark. They are not crazy. However, because I've spoken about this kind of thing often, I've often been referred to as a "conspiracy-theorist" and "insane". So, why has no attorney spoken out about this before now? The reason no attorney does anything about the Medical Mafia-ish activity in Las Vegas is for two reason: first, look at what happened to Dr.'s Thalgott & Venger, they told the truth and they have been destroyed...period. Even the media has been influenced and attacked them for telling the truth; second, the Medical Mafia is good at what they do.
The City of Sin's legal community gave birth to the Medical Mafia. So this is not a story of any unique measure to anyone in the legal community. The actions undertaken by the Medical Mafia are not unique to the Medical Mafia. This is how the legal community, the government community and like-minded faces in Las Vegas operate. The Medical Mafia is more a product of their overall environment, than they are an independent anomaly. In the Las Vegas legal community (when I refer to the legal community I'm talking about government, law firms, judges, clerks, police, etc.) we are bred to find ways around the legal problems. Specifically, as lawyers we must find solutions for our clients...any solution is acceptable. The same goes for all things Las Vegas. As a result, we have the payoff, the kickback, the favor, the relationship, the support, the backroom, the donation, the unspoken jesture and the 'I'll ruin you'. This is our motivation. This is our unique twist on law. This is our system of justice.
Whether this was imported here via the New York & Chicago Mob Families, whether it is the perceived religious secl
usion of the Mormons, whether it is 'native Las Vegans' and the envy of outsiders, whether it is the 'small town feel' of a small town exploded into an economic giant or whether it was always part of us, it is here. Everyone has their 'take', everyone has their opinion, everyone has their view of the 'way it is in Vegas' and any subsequent 'blame' on another group. Usually, the 'blame' is part of an 'I'll ruin you' threat and correlates directly to the amount of power, control or influence a person possesses. In other words, if you are 'in' in Las Vegas, you are safe. It is a lot like gang warfare. Even the gangs make alliances with each other over control for parts of the city. It is a sort of civilized Afganistan here. OK, back to the Medical Mafia. The background is important to understand that, in truth, the Medical Mafia is just part of an overall larger Las Vegas reality.The Scheme
All the best cases, money-wise, are those involving 'clear liability', which is usually a car accident & surgery. However, juries must believe that the surgery was necessary. A big settlement is not possible with an insurance company unless the insurance company believes that a Las Vegas jury will provide a large award. Thus, in trial, it is nearly impossible to convince a jury that a person did not need surgery when the doctors all say the person needed surgery. Common sense. The inherent trust & justice in our legal system is a reliance on the jury's ability to assess truth. Part of the jury's view of truth is a heavy reliance that the doctors are not lying about the Plaintiff's need for surgery. While there is a certain amount of reliance on the lawyers not being liars, everyone accepts that the lawyers are "advocating" for their clients and the system accepts a certain amount of dishonesty in the name of "advocacy". The amount of dishonesty is often a measure of zealously in argument and relates to each lawyer differently.
The evidence from the doctors that surgery is necessary, however, is a fact that is of the utmost importance to the jury. If surgery is actually performed on the Plaintiff, the trust that the doctor is correct and truthful is overwhelmingly in favor of the Plaintiff and against the Defense. Thus, when the jury deliberates, if they believe that the need for surgery is questionable, they usually don't want to take that out on the Plaintiff, especially if the surgery was performed. Any belief that the surgery 'may have been questionable' is usually overlooked and the Plaintiff recovers...whola...you have the indefensible piece of evidence to make your case. Now just mix this with a little Las Vegas 'juice' (really 'influence' and 'kickbacks' for the rest of the world) and you have created the magical scheme that is called the Las Vegas Medical Mafia.
Since the best defense in any Plaintiff's case for future damages (medical treatment or disability), if they have not received surgery, is the fact that they have not received surgery, the only cure to overcome this defense is to have the surgery, as mentioned. Most reasonable people would not ask for surgery. For years most surgeons would only recommend surgery as a last resort. However, the drive for money has changed that perspective and it has liberalized many medical opinions about the need for surgery. I'm sure the Las Vegas 'juice' helped loosen those opinions.
Certainly, from a legal perspective, Plaintiff lawyers want to see the surgery happen before trial. Then there is hard evidence of an injury, the dollar figure is HUGE, but most importantly, a jury has an almost impeccable record in awarding large sums of money to the Plaintiff if the surgery has occurred. Why? Juries can't believe that a person would get surgery unless it was necessary and they were actually in pain. Thus, when a case proceeds to trial and surgery occurred prior to that trial, the Plaintiff's make money, end of story.
The real trick in creating a money making machine of Plaintiffs that are injured (or potentially hurt) is finding a person to locate the Plaintiffs, finding an attorney to coordinate the treatment and the medical liens, finding a doctor to recommend that a client needs surgery (liberally), to perform the surgery and to testify convincingly at trial, and then convince the client to have all the treatment performed, including the surgery. The only way to do this on a mass scale and make a lot of cash is to collude. Competition in the marketplace would otherwise prevent the overwhelming scale of compensation from being limited to merely an elite few.
However, what about when the patient does not want the surgery? It becomes clear quickly, that the patient MUST be 'out of the loop' or they would say 'no' to the surgery, which is the key to the big jury award. The doctor and the lawyer MUST be 'in the loop' so that they can coordinate the cases, the treatment, the surgeries, the payouts, the kickback (that make it worthwhile) and any necessary cover up. The importance of the "need for surgery" before the trial and the "need for quality testimony from the doctor" (thus the doctor practicing testifying) cannot be over emphasized. They both must withstand the scrutiny of the defense attorneys. If done properly, a defense is impossible.
This collusion makes a defense impossible because the system it set to trust the expert witnesses & the treating doctors. Our legal system (the jury) relies upon their judgement. In order to alter the outcomes, you have to alter the opinion of the doctor. This is where the Medical Mafia really succeeded. They aligned doctors, lawyers and the 'middle man' to find the cases, to take all medical fees on liens, to beef up the medical fees by creating 'liberal' surgical recommendations and then by taking the cases to a jury. Settlement was not good enough. Once the juries continued to award large sums for these surgeries, it was as if the Medical Mafia owned a casino and regulated themselves.
As time went on, the result, likely unintended, of the Medical Mafia's actions was that the number of settlements increased and the amounts increased in Las Vegas. They would still take some cases to trial to maintain a level of high consistent jury awards. All the while, everyone made money, money, money. The only person left out in the cold, though compensated, was the patient who had an unnecessary surgery (well, insurance carriers have paid through the nose, too).
Interestingly enough, even the defense attorneys were getting paid by the insurance carriers and defense law firms were being built as a result of trying to defend this scheme. Some even claim that, because of the Medical Mafia, the need for out-of-state counsel increased. It was no secret that many insurance carriers believed that the only reason for many of these huge verdicts was because of incompetent Nevada attorneys. The same people claim that this was the birth of the out-of-state law firm in Nevada and the subsequent Supreme Court rule change with regard to law firm names. I believe that they merely contributed to an already growing economy and that certainly it was the reason for some of the out-of-state firms being brought into Las Vegas.
All Things Vegas Legal
Now if you think this begins or ends with the Medical Mafia, you are dead wrong. This Medical Mafia-style of business is how the Las Vegas legal system works. In fact, one thing you can be sure of: if a judge is hated by a lot of attorneys, it is likely that this judge refuses to play this game. Remember Thalgott and Venger? They are the surgeons that came forward and broke rank and told the truth about these meetings, these arrangements and the unnecessary surgeries. What happened to them? They are done, reputation destroyed, plain done.
The same is true for ALL THINGS VEGAS LEGAL. As the Fortune story explains, there were bags of cash given to wives in the restrooms at parties, crystal bowls full of money were given to judges to keep them on the bench and, as Venger put it, he had trouble accounting for all of the money that was coming in, so he tried to fake that he owned another company with income.
ALL THIN
GS in the LAS VEGAS LEGAL community are the same. The Medical Mafia is not unique. This occurs in government, this occurs in the courtrooms (state & federal), this occurs in clerks' offices, this occurs in law firms, it is every where in the Las Vegas legal scene.The only thing that has happened since the federal government has gotten involved, the attorneys and doctors have become more protective, more scared, more cautious. However, when the Noel Gage dismissal occurred, it began again. What I call the New Medical Mafia has emerged. Las Vegas has seen how much money is to be made off of this scheme and more attorneys and more doctors are lining up to get on board. The only difference now, it is like a lot of little gangs running the city, instead of one big mafia. It is very reminiscent of the days after the federal government finally broke up the Chicago & New York Mafia strong-hold on the Las Vegas casinos. There was no center, there was not focus on the organized corruption, however, the corruption still prevailed all over in pockets. The Medical Mafia became the target of federal investigation because they got sloppy, a big mafia no-no. They went after a government entity in a car accident which increased the scrutiny.
Where Are We Know?
Some would believe that the worst is over. Some would believe that there is no Medical Mafia. Some would believe that this is all make-believe. Many think I'm crazy. I can tell you this, the medical/legal scheme is as real as Las Vegas itself. It has gone on for years. It will continue. Whether by a lawyer, by a judge, by a doctor, by a plaintiff or by a defendant, one thing is certain, the lies, the payoffs, the kickbacks, the favors, the backroom deals, the parties, the fundraisers, the donations, in essence All Things Las Vegas Legal, will continue.
.
20 COMMENTS:
I like the things you're posting. I'd like to see more info about the judges.
I like the things you're posting. I'd like to see more info about the judges.
You are exactly right on to this one. It is not tough to say, attorneys and doctors were FOR SURE have been coluding for years. This is how they make their money. This is now the defense attorneys make their money. I know it is illegal, but how else do you want Vegas to work. I've been a legal assistant for 40 years for all kinds of firms. It seems like you guys are all doing this. But I have to admit, It pisses me off when i get a deposition set up with out expert and they testify against us. It always confused me when my attorney would return from the deposition and say "Awand got to him first, now we have to get a new expert." Now I get it. That is a lot of power. No one should be able to do that.
PS I'm surprised you don't have more comments on this, this is HUGE. Maybe you need more traffic. This is a REALLY good site, if you wanna know the real issues. Your articles are a little long for my breaks though. I'm up late with a sick kid and though I'd hope online. Whew, a lot of reading.
I'm curious, how do "insurance doctors" fit into the "medical mafia" scheme? Isn't it true that defense firms were using the same doctors over and over in defending cases long before Howard Awand came to town? Why were insurnace companies using the same doctors for IMEs? I kid not when I say that I saw an IME report from Dr. Elkonich that stated that the plaintiff should not have been considered a surgical candidate because she was too fat at the time of the surgery and that her "weight" was the real cause of her back pain not the MVA. Amazingly, the Plaintiff is 5'5" and weighed 128 pounds at the time of the surgery. Hardly a porker. Could somebody shed some light on why there isn't an investigation into Dr. Serfustini's or Dr. Elkonich's medically unsupportable opinions?
Thank you for your candor. I am a fan. There is not just one legal mafia is there? I have heard that there are several different "legal mafias" in sin city. Have you ever heard of one that deals with land, one that deals with old or dead people and one that deals with home owners associations? Do they ever overlap? Does one ever call the other in for certain aspects...kind of like a cameo appearance if you will? Please...enlighten us.
What do you thing about the fact that Ruth Cohen is no longer with the US Attorneys Office. Do you think that the prosecutors were too late?
@10:17
I agree fully. I think they do factor in. Though there is a difference in a doctor stretching (liberal/conservative) his medical opinions and a group of doctors and lawyers realizing the "magic" in "getting the surgery" to increase believability for a jury, then creating a system (racket)whereby patients get surgery they don't need & then provide "protection" for all those that participate. That is what makes the Medical Mafia, soo Mafia, its the "protection".
I have spoken to a nurse that 'claims' Dr. Kabins has actually cut-open a back, joked about 'la-la' I'm doing surgery (while toucing nothing), then closing her back up...urban legend? I don't know. Could be a result of the drama, who knows. If true, though, it is insane!
@ 12:01
Very legit statement. "I have heard that there are several different "legal mafias" in sin city." TRUE.
This IS NOT an isolated problem. If you are paying attention to legal activity in LV, it is my opinion, you know that Construction Defect law works this way, that Gurdianships work this way, that virtually everything to do with land works this way (buying, selling, zoning approvals, etc), that elder & probate law works this way (though this usually is prevelant in guardian situations), and that bankruptcy law works this way.
YOUR QUESTION: "Do they ever overlap?"
ANSWER: Rarely, these are all usually different law firms & different judges, though the generation is from law firms. In fact, I can't think of one that overlaps, except for some bankruptcy and guardianship firms. This is an overall prevailing culture here in Las Vegas. There is a culture of 'juice' that is considered legal. You take care of me, I'll take care of you, always at the expense of someone, usually someone that can do nothing about it.
YOUR QUESTION: "Does one ever call the other in for certain aspects...kind of like a cameo appearance if you will?"
ANSWER: NEVER. That is the Golden Rule in Las Vegas. This is invisible. That is why I'm called a 'conspiracy theorist'. Many young associate or unconnected partner doesn't want to believe it and any partner 'in the know' wants to keep it buried. Disbelief does not equate to falsity. Just as @ 10:17 is correct about the defense response, this prevailing coordination of 'outcome' is constant in various legal areans in the city.
@ 12:03
I think the fact the Cohen is no longer with the U.S. Attorneys office is immaterial. The truth is that the Federal Government is VERY late to this game; it is a joke. This is not only a situation where 'this has been going on for a long time' so who cares. This activity is sewn into the fabric of Las Vegas Legal. If anything, Cohen's departure bolsters the claim that good attorneys never stay employed in government jobs. In that regard, the Medical Mafia has nothing to worry about, because attorneys like Don Campbell eventually leave government jobs to make money and the good ones won't spend a lifetime chasing 'wrong-doings'.
I think we all have more to fear that she left, I don't think it is a commentary on 'what side she is on'. If Insurance was behind the whole thing & if Insurance was crooked (here), Cohen would still be on the case getting a back-door stipend.
I'm not saying the Ins Industry is honest. I'm a huge critic. But what the Medical Mafia has done takes dishonesty to a whole new level.
My opinion is that it is true, given what I've seen, heard and merely read (my 3rd source of information).
The CNNMoney story on the "medical mafia" is based largely on allegations by the US attorneys. After the Duke lacrosse players media fiasco, I would think that the media would be more careful not to lap up everything the prosecutors say as if it's the God given truth.
I as the following questions:
First, the CNNMoney story reports that the prosecution begins with an accident involving a US attorney, who does not like the way that the plaintiffs lawyer ratcheted up the claim. Stop here. Does the prosecutor have a motive? Does the word "vindictive" come to mind?
Second, the insurance companies help the prosecutors because why? Because they were getting beat? So, if you can't beat them, you sic the feds after them? Are the insurance company motives untainted? If you think not, why simply believe what the prosectors say?
Finally, take the Gage case. He got it dismissed because the Government refused to allow a favorable witness to testify. Sounds like hardball, doesn't it? And the very nature of the supposed crime is hard to believe. Supposedly he gave up a valid, valuable claim against the doctors - the bird in the hand - for some vague promise of future referrals which could not have had any provable value - the two in the bush. Why would a PI lawyer give up a certain fee for the promise of a possible future fee?
The CNNMoney article illustrates how poorly the media understands legal matters. The shame is that they do not bother to seek real expert help in these matters.
Thank you LEGALLY UNBOUND for responding. I am ABSOLUTELY paying attention to the legal activity here...and all its SICK, PERVERTED EXPLOITATIONS of justice.
Legally UnBound, I think you would agree that "conceptually" there really is not a difference between a "plaintiff" doctor testifying that an "unnecessary" surgery was really "necessary" and a "defense" doctor testifying that a "necessary" surgery was really "uncessary." Whether a surgery is "necessary" or not involves a level of subjectivity, no doubt. That being said, the legal community needs to be careful before drinking insurance propaganda that mass "unnecessary" surgeries were being performed by the "medical mafia." Why? Because these "mafiosi" seemed to cross all their Ts and dot all their Is with regard to each patient's objective findings. I have yet to see a case where one of the "mafiosi" performed a surgery without MRI confirmation of objective findings. And, the overwhelming majority had discograms with CT scans. The bottom line is that the system is adversarial for a reason. In these cases, the cynic in me believes that both the plaintiff's and defendant's expert witnesses tend to balance each other out. Ultimately, the jury has to base its decision on credibility and the objective findings.
@ 12:38 AM
"Whether a surgery is "necessary" or not involves a level of subjectivity, no doubt."
Agreed.
However, I don't agree that the legal community is believing "insurance company propaganda".
Let me be clear. There has always been a degree of argument in the system. Of course. There have always been doctors willing to say a lot of thing, "within a degree of medical probability". However, the problem Medical Mafia is the 'liberal surgery' combined with the 'protection from malpractice lawsuits'. Is that clear enough.
To me, the 'liberal surgeon' (meaning he will employ aggressive treatment such as 'cutting open the back', over passive treatment such as physical therapy)is a bad quantity for Las Vegas. We depend on the honesty of the doctors. If they are liberal surgeons for the sake of money and protection from malpractice claims, therein lies a crime, in my eyes.
What do I mean by "for the sake of money"? I mean a doctor knows, via colusion with the attorney, that surgery makes the lawsuit indefensible. The jury will never leave a plaintiff with a zero verdict, even if the doctor is a complete fraud. They don't want to punich the plaintiff. Guess what, the doctor will always get paid.
I agree with what you said, "Ultimately, the jury has to base its decision on credibility and the objective findings." However, they will not be objective if surgery occurs. They will award $$, period.
Well said LU!
9th Circuit Reversal = Reinstatement of Indictments!
http://money.cnn.com/2009/08/28/news/economy/vegas_medical_mafia.fortune/index.htm and http://www.lvrj.com/news/55668842.html
Quoting LU:
To me, the 'liberal surgeon' (meaning he will employ aggressive treatment such as 'cutting open the back', over passive treatment such as physical therapy)is a bad quantity for Las Vegas. We depend on the honesty of the doctors. If they are liberal surgeons for the sake of money and protection from malpractice claims, therein lies a crime, in my eyes.
Not so fast there. First, the "protection" claim is really a misnomer. The legal community cannot project the alleged protection Gage gave the "medical mafia" to the rest of the med mal plaintiff bar. There is absolutely no evidence that top tier Plaintiff med mal attorneys ever refused a valid case against the alleged "medical mafia." In other words, even if true, Awands small network of lawyers isn't much "protection" against med mal lawsuits when none of the top tier med mall attorneys are involved in the alleged conspiracy. protection argument doesn't really fly.
Second, and more importantly, the "liberal surgery" certainly is not a crime. Plaintiff's get exactly 1 bite at the apple. I cannot fault a plaintiff for electing to undergo a "liberal" surgery because he/she cannot re-open up the case 5 year later when the surgery may become a necessity.
LU, assume that you where a plaintiff with a 2-3 mm disc protrusion. You can "live" with the pain. You've undergone injections with marginal success. You probably don't "need" the surgery right now. But, you may (or may not) need the surgery 5-10 years from now. However, 5-10 years from now, your case will be closed. You will not be compensated for the pain/suffering/medical expenses/lost income, etc in 5-10 years. Can you honestly say that it would be "criminal," "illegal," or otherwise "unethical" for a surgeon to operate on you under those circumstances? Under those circumstances, isn't actually more prudent for the surgeon to do the surgery now while the recovery can me made?
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I have gone through the whole lousey process. Found an attorney, been placed with a medical factorer put on liens even though I had medical insurance, Had surgeries, some were maybe not needed, but with a leg gone and an arm gone not much I can do about it now. Then the settlement, and the medical lien holder and attorney took most of the money and wouldnt let me see the bills I paid for out of the settlement.
How long will this be allowed to go on. I was run over by a car in LA, had a lawyer in LA who hooked me up to a medical lien holder who arranged all doctors visits, hospitals, and surgeries. I had a $2 million settlement and lawyers and medical lien holder took most of it.I went through the pain and fear, then found out I may not have needed some of the drastic surgery I had. You guys need to expose more of this and stop those greedy lying attorneys in LA. Keep up the good work maybe you will make a difference, just keep it up.
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