Author: Richard H. Adler

The Medical-Legal Committee of the King County Medical Society and Seattle-King County Bar Association recently completed an extensive revision of the Medical-Legal Liaison Pamphlet, the introduction to which states that it is "designed to guide King County physicians and lawyers in matters requiring their professional interaction and mutual cooperation".

The most common recurring dispute between attorneys and physicians relates to fees charged by physicians. The pamphlet's section on "Fees For Services Of Physicians In Medical-Legal Matters" notes that many fee disputes could be avoided:

If physicians and attorneys would approach each other with sensitivity, common and professional courtesy, and communicate from the outset about what is needed and why, the time constraints involved, the fees to be charged for each service and the party responsible for payment.

The specific guidelines for attorneys and physicians regarding fees are as follows:

Guidelines For Attorneys

1. An attorney requesting a physician's services is responsible for initiating discussions at the outset and for reaching an agreement in advance as to the fees to be charged and payment obligations. Such agreement should preferably be confirmed in writing.



2. An attorney should recognize that a physician is legitimately entitled to charge a reasonable fee for canceled court appearances, conferences, or depositions, if cancellation comes so late that the physician cannot productively utilize the time already set aside. Therefore, an attorney should be prompt and diligent in informing a physician of scheduling changes, cancellations, continuances, or settlements, so that the physician may reschedule other productive use of his or her time.



3. An attorney should never charge a fee to a physician for the collection of an unpaid bill for medical services received through medical-legal litigation for the patient.



4. An attorney should never suggest that the physician's fee be wholly or partially contingent upon the outcome of the medical-legal case.



5. An attorney should cooperate in every way legally and ethically possible to assist the physician in securing payment of fees from the attorney's client incurred in connection with the medical-legal case.



6. An attorney should make clear to the physician that the attorney's client is ultimately responsible for payment of the physician's fees, even if the physician's services are requested or paid in whole or in part by the attorney.

Guidelines For Physicians

1. A physician should realize that the attorney's client is ultimately responsible for payment of the physician's fees, even if the physician's services are requested or paid in whole or in part by the attorney.



2. A physician's fees for records, reports, examinations, conferences, depositions, and court appearances should be reasonable and commensurate with the nature and quality of work performed and the services rendered.



3. A physician should never charge an unreasonable fee so as to avoid involvement in a medical-legal matter.



4. A physician should never suggest or agree to accept a fee wholly or partially contingent upon the outcome of the medical-legal matter.



5. A physician should inform the attorney in advance of fee schedules and billing policies and reach an agreement preferably confirmed in writing, with the attorney regarding payment of his/her fees.



6. A physician may ethically require payment in advance of reasonable charges for services to be rendered. If the physician fails to provide the service, or the request for services is canceled in a timely fashion, the physician should refund the advance payment.

Our experience tells us that guidelines like these, when implemented and followed, go a long way in preventing disputes regarding physician fees for health care services rendered and time expended in medical-legal matters affecting your patient.

At Adler Giersch, P.S., we are aware of and sensitive to the many time demands placed on your professional day. When we represent one of your patients, we will exercise professional courtesy, communicate clearly, ensure your services are reimbursed in a reasonable time period, and remain accessible to assist you and your patient in any way we can.

If you have any questions about these new guidelines, please do not hesitate to contact me, one of our attorneys, or a member of our staff.

Very truly yours,

Richard, H. Adler
Attorney at Law