“Nick” is a recent graduate Palmer College of Chiropractic in Davenport, Iowa who returned to his home town in Southern California, opening an office.

“After I hung out my shingle, it was clear that I needed to attract a patient base–preferably personal injury, auto accident victims as that’s where the money is and why I am calling you.” Can we discuss my ‘How to get business plan?”

I have always had a great relationship with chiropractors and was happy to help, as Nick needed my advice more than he could ever realize.

The Pay to Play Business Plan

“I have friends who come in contact with auto accident victims, such as ambulance drivers, EMT’s, E.R. nurses, police officers and lawyers. My idea is to give them my business cards and encourage handing them out to these people, telling them that I will help them get better, and a nice insurance settlement.

“Naturally, I will pay very well for these referrals, either per referral or a commission – a percentage of fees I earn on the case. Or, if they did not want to be paid, I could arrange for a great weekend in Las Vegas, a dinner at a nice restaurant, just ways of showing my appreciation for their help.

“Does this make sense?” he asked.

On the Surface it Makes Sense, But….

“Most people, looking at Nick’s business plan would say, ‘Yeah, that seems reasonable. People refer cases to him and he gives them a little something by way of showing appreciation,’ Southern California-based attorney Shawn Steel told me.

“However, what Nick wants to do is clearly illegal,” Steel points out, and he knows, for in addition to practicing law, he has developed a niche specialty, educating chiropractors in laws which apply to them. He is on the faculty of Palmer West Chiropractic College in San Jose California, Life-West Chiropractic College West and Southern California University of Heath Sciences.

Getting Paid for Referrals Violates State and Federal Rules

You can’t turn on the TV without seeing ads for law firms who want your personal injury case. Millions of dollars are spent on television ads by a handful of lawyers – which is a good indication of how valuable auto accident cases are.

Large, personal injury mills have sprung up, taking virtually any case where their client is the innocent party, as the firm will be paid, on average, from 25 to 50 percent of the settlement.

“Today, insurance companies pay very little with minor auto accidents, so these mills are looking for the million dollar case out of thousands of small cases. Very often, their clients are financially worse off for hiring them as they could have done better dealing with the claims adjuster by themselves.

“While these ads do not paint a very good picture of the legal profession–typically a couple of nasty looking lawyers saying, “We’ll fight for you!” what they are doing is legal,” Steel observes.

“But when a lawyer, chiropractor or other health care professional pays to obtain a referral, this violates the law. Technically it is called ‘capping.’

“Also, lawyers are prohibited from hiring non-lawyers to seek out clients. 

“Attorneys sometimes attempt to hire paramedics, police officers, nurses, as ‘runners’ to pass out business cards to people who have recently been in an auto accident. This practice often occurs in the lobby of hospitals!”

Not a Victimless Crime

On the surface I think most people will ask, “So what’s the harm in a little kick back to the person who brought you business?”

Steel agrees that it appears harmless, “But this is not a victimless crime. Paying for personal injury cases means that you are providing an incentive to exaggerate a claim against an insurance company.

“Were it not for the referral to the chiropractor, the person might just go to urgent care, once. But if brought in by a capper, now the chiropractor has to make money off of this patient and it is done through over-treatment. And when M.D.’s are involved, there have been many cases of unnecessary surgeries performed, just because insurance was available.”

Be Good at What You Do, Asking Patients to Refer their Friends

“Patients love their chiropractor,” Steel notes. “The surest way to build your business is by being good at your trade and asking patients to refer their friends. You’ve got to be a good doctor and slowly build your own book of business. Avoid ads. You want referrals from satisfied patients.”

Concluding his advice, Steel underscores the need for chiropractors. “This is an undeserved profession. We need more chiropractors, and as many are retiring, buying an older doctor’s practice can prove to be an excellent way to have a large practice, quickly.”

Dennis Beaver practices law in Bakersfield and enjoys hearing from his readers. Contact Dennis Beaver.

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Today’s story will not only be of special interest to health care providers —physicians, chiropractors, physical therapists, and psychologists, who treat auto accident victims on a lien basis — but will offer suggestions on how not to deal with a deadbeat lawyer who is supposed to protect your bill.

And if you are wondering how often this happens, just ask Southern California attorney Shawn Steele, “Nationwide, over three-quarters of lawyers who handle personal cases on a lien basis flagrantly refuse to honor the lien — and in my experience, especially those attorneys who spend millions of dollars on television ads. Far too many health care professionals just don’t know what to do when they are stiffed, or their bill is cut to shreds.”

Reputation Matters

The last paragraph of an article I wrote several years ago, A Lawyer’s Reputation Begins in Law School, dealt with my classmate who tried to deny the entire first year Loyola law School class an important final exam study aid, and reads:

“Our reputation — with classmates who will become colleagues, partners and the judges before whom we will stand — is one of the most fragile things we possess. Handle it with care. Across my years of practice, I’ve found that most do.”

In the City of Good Neighbors — also known as Buffalo, New York — resides “Eric” an attorney who doesn’t care much about protecting his own reputation as much as fattening his wallet by attempting to steal personal injury settlement funds intended to pay for his client’s medical treatment.

Eric finally agreed to pay, a result of the doctor’s new office manager “Kitty’s” outrage upon discovering Eric’s deceit. In researching how to deal with a thief who is a member of the New York State Bar Association, she found my Feb. 8, 2019 article, When Lawyers Refuse to Pay a Doctor’s Bill.

She phoned me — and to quote from the 1980s TV show The A-Team, “I love it when a plan comes together.”

Because typically when a lawyer, or in my case, a lawyer-journalist, calls someone who has not performed under their contract, things happen afterward. I told Kitty that I would phone Eric and talk to him, as the bare fact of my call should prompt him to either pay up or provide proof of payment.

Lack of Medical Insurance – Letter of Protection

In mid-2019, “Rocky” was stopped for a red light and rear-ended by a driver found to be at fault by the Buffalo Police Department. The collision resulted in a worsening of his spinal stenosis, and extreme pain. He had no health or auto med-pay insurance, but hired Eric, who was able to get pain specialist “Dr. S” to treat him based on a “Letter of Protection.”

The letter read:

“Our office will protect the interests of all medical providers who agree to wait for payment until such time as the case is settled.”

Case Settles – Where’s Our Money?

As often happens, the insurance company representing the at-fault driver refused to make a reasonable offer, the matter was litigated and along came COVID-19, postponing a final settlement until mid-2022. Then things got interesting.

Kitty sent me correspondence and phone messages from Eric’s office claiming that the bill had been paid, but no proof — no canceled check — was produced.

“We were given a host of excuses and promises to have payment next week, and next week and next week, until I was fed up and filed a complaint with the New York State Bar and called you, Mr. Beaver,” Kitty said.

“Hi, Eric, I’m doing a story on lawyers who stiff doctors — can you help me?”

What motivated me was Kitty’s sense of fundamental morality, right and wrong, plus my contempt for members of the legal profession who are just plain thieves.

And when I phoned Eric, explaining that I was looking into what appeared to be a case of a lawyer who failed to keep his word, it was clear I was dealing with an indignant thief who got caught.

He was laughable.

His excuse? “It’s the patient’s bill. The doctor should get his money from Rocky.”

But Rocky spoke with you and you promised to pay the bill, months ago, so where’s the doctor’s money?

Eric then said, “Well, possibly we overlooked payment but I will take care of it next week and you can tell them that. But don’t dare use my name in a story!”

“I never use real names, without permission, so don’t worry, Eric, and certainly don’t worry one bit about the fact that I am looking at letters from you promising to pay the bill next week. Several letters all saying the same thing.”

Kitty phoned me after that phone call. “He called my boss, and promised to pay us. But if he does not, what should we do?”

“You have lodged a complaint with the State Bar, so file against his law firm in Small Claims Court. Lawyers hate both things, and a check should magically appear. I also recommended following the suggestions in the previously mentioned article.”

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“I just joined my father’s medical practice as an internist. The first day on the job he sat me down and said, ‘At some time you will make a mistake. Every physician has. Our reputation for honesty precedes us wherever we may go. Never forget that. Learn what to do – and especially what not to do – in the event someone claims that you have committed medical malpractice.’

“Mr. Beaver, I have read your column for years and I’ll bet you know the right attorneys who can provide that guidance. Thanks, ‘Aaron,’ Southern Florida.”

Plaintiff, Defense Attorneys Answer Aaron’s Question

I ran this important question by two of the nation’s most respected medical malpractice attorneys, both based in Southern California:

Gary Gelfand represents plaintiffs in malpractice cases and is an adjunct professor at Loyola Law School in Los Angeles teaching the fundamentals of malpractice litigation.

Dennis Thelen defends physicians and other health care providers in civil litigation, and he has tried over 100 cases to successful jury verdicts.

They gave me a by-the-numbers list of a few of the things that healthcare professionals should never do in the event they are accused of or sued for medical malpractice – which is failing to meet the appropriate standard of care resulting in injury to a patient.

Never Alter or Change the Record

Gelfand: Never change the record. Many states have Health and Safety Code rules that prohibit the doctor from lying in medical records. They have to be truthful. When this occurs and is discovered, it can be considered a crime and even if there may be an explanation for what went wrong – how the patient was hurt – that clears the physician, the fact of altering the medical record can destroy their credibility.

Thelen: It is not illegal for medical professionals to make honest updates to records, as long as they properly mark what they are doing, do this promptly and do not hide information. Accessing the patient’s chart days later and making an after-the-fact entry – even if labeled as a “late entry” is highly suspicious. When this happens, it looks like you are attempting to forge or alter the medical records.

In a malpractice context, if you do label it as late entry, it invariably involves the subject matter of the suit and looks as if the doctor is making a self-serving entry. So there is really no good time for the physician who thinks they are about to get sued to go to the patient’s chart and add additional content.

Both attorneys stressed that, “Today, almost all medical and hospital records are electronic. If a suit is filed, and there is a question about the reliability or veracity of the record, an audit trail of the electronic record is easily obtainable. It can always be learned who accessed the record and when.”

Lie to the Patient

Gelfand: A physician who lies to the patient or the patient’s family about what happened, what he did or didn’t do, invites trouble. Additionally, trying to push the blame off on someone else, such as, “I checked this but Dr. X failed to keep tabs on …” runs a great risk of it backfiring. Juries respect the truth and not someone who tries to wiggle out of responsibility.

Thelen: My advice is to not create an excuse or begin a scenario, such as “God took your husband,” or “It was his time,” in the hope that the family will accept that and do nothing.

Honesty has never gotten a doctor in worse trouble than being dishonest.

Should the doctor call the patient, admit the error and apologize?

Gelfand: The New England Journal of Medicine found a large correlation between physicians who admit the malpractice, and the patient or patient’s family excusing the doctor because of their honesty and that they were told the truth. However, the obvious downside is that admitting the error can be used against the doctor in subsequent litigation.

Addressing that problem, many states have passed what are referred to as “I’m sorry laws” that encourage full disclosure of mistakes or errors in judgment by eliminating physicians’ and hospitals’ fear that their admissions will be used against them in court or other disciplinary proceedings.

Thelen: There is a huge difference between calling and expressing sympathy or apologizing for a complication and telling the patient that there was malpractice that is both a medical and legal determination. When these calls are being made, it is usually when everyone is emotional, grieving, experiencing great sorrow including the physician.

So you are advised as a doctor not to make expressions of responsibility because that is so often yet to be determined.

Patients Still Respect, Trust and Protect their Physicians

Certainly malpractice does occur, but I learned in speaking with both attorneys that studies looking back over the past 20 years of jury verdicts show that nearly 80% of all physicians who allow a jury to decide their cases come out winning.

The take away is that jurors will protect competent, hardworking doctors who make a mistake that is a reasonable mistake. That is the difference between being negligent and simply being human.

Jurors are instructed that a reasonable error is not malpractice. If it was, the standard of care would require perfection which is impossible to achieve.

Dennis Beaver practices law in Bakersfield and enjoys hearing from his readers. Contact Dennis Beaver.

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If you were to ask any physician, these two questions:

(1) “What are the goals of the medical profession?”

(2) How important is trust among doctors?

No doubt, you would hear: “The prevention of disease, relief of suffering, care of the ill, and avoidance of premature death. These goals are attainable only when there is a high level of trust among physicians.”

Unlike the legal profession – where trust is not a given – doctors trust each other for the benefit of their patients. That said, there is a time when trust should have no role in a critical decision a physician must reach – even when dealing with another doctor – and that is when they are handed an employment contract and asked to sign it.

In my over 40 years of law practice, I have seen the results of misplaced trust by physicians in our age of corporate medicine, and especially where physicians become CEOs of HMOs, and act more like lawyers. I have seen them become more of a Dr. Jekyll and Mr. Hyde – than caring physicians.

Not Hanging Up My Stethoscope

But there is one more issue that is central to today’s story and has a real impact on the delivery of health care services. It is a fact that many older physicians are hesitant to retire and do not want to hang up their stethoscopes.

They know that retirement is often dangerous to one’s health. They want to work fewer hours, not take “calls” at three in the morning, and be able to just slow down while still treating patients and not see their brains and bodies atrophy or become victims of age discrimination.

Larry is one of them.

82 and Still At the Office

“Dennis, I am board certified in both general surgery and urology, and have practiced for well over 50 years in my agricultural community that is recognized as being short of physicians. I want to slow down, and for the past year, worked out an agreement with our HR manager which means that:

(1) I work three days.

(2) Am no longer doing general surgery, just practicing urology.

(3) Do not have to “take calls.”

(4) My malpractice insurance is paid for, including coverage for when I leave the organization.

“Everything was fine until the HR manager left due to a family emergency and was replaced with someone far less accommodating. She immediately handed out new contracts to everyone and asked me to sign it that day. I politely said that I wanted to review it with my family and would get right back to her next week. She agreed.

“This contract lacks the things that her predecessor agreed to. Dennis, I am a very non-confrontational person and do not want a fight. What should I do?”

Don’t Assume the Worst, Allow Yourself to be Bullied

So, how do you deal with important contractual issues that are not addressed and avoid getting into an ugly situation? I set up a conference call with Larry and two of my colleagues who specialize in advising physicians in employment disputes.

They recommend three things:

(1) Can Larry get a job at another facility – say, the county hospital – on his terms? Before even speaking with the HR manager, talk with the people over there, be up-front, and ask them if he could work there if things here fall apart. This is his Plan B.

(2) “Don’t assume this new HR manager is acting in bad faith,” they cautioned. “Was she even aware of the earlier agreement? But even if it was not reduced to written form, his work schedule, pay records, and no evidence of taking call is convincing proof.”

(3) Refer to Higher Authority. If you are told, “No, we can’t do this,” then your response should be, “My wife has grown accustomed to me working less. I love working here, but just can’t do this to her. Why don’t you discuss this with the CEO as I am pretty sure he does not want to lose me – and I want to continue calling this my second home.”

Establish an Attorney Client Relationship

While there are other issues here – possible age discrimination, for example – Larry’s situation is a good example of why physicians, especially young docs out of residency, need to establish a solid relationship with both a lawyer and CPA who understand the employment challenges facing them and never hesitate to ask for their advice, which is just what they would tell their patients.

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“Hearing our name when said in a friendly, non-sarcastic or negative tone of voice is one of the sweetest sounds as it creates a chemical reaction inside our brain which then releases the feel-good hormones, dopamine and serotonin, demonstrated by functional MRI studies,” observes psychology professor Dr. Luis Vega of Cal State Bakersfield, whose professional interests include methods of persuasion.

He points out that, “Being on a first name basis creates clan connections — a circle of trust — for harnessing the good, psychological benefits such as seeing the other person in our tribe, giving us a sense of belonging, safe space, and expediency as in I can trust you to look after my interests, to scratch your back as you mine.

“It is why in North America, sales professionals are urged to establish a sincere first-name basis as soon as possible. And today, we are finding that many physicians are inviting their patients to call them by their first names, which has the benefit of reducing anxiety when visiting the doctor’s office.

“But never forget the power of a first name used in manner to provoke a needed, urgent response,” Vega adds.

And then there’s “Mrs. Dr. Gee”

In my town, when professionals meet — physicians, lawyers, CPAs architects — it is common to use first names. It is extremely rare to find a physician who insists on being called Dr.

But Dr. “Gee” was the exception.

As I would learn, his wife was even more title obsessed.

She is Refusing to pay for the Repairs!

With the police close to being called on his wife — who refused to pay for major automotive repairs on her European car — and tried to drive off (the dealership was my client) because “I am the wife of “Dr. G. …”

I phoned Dr. Gee, warmly addressing him by his first name. He replied: “Counselor, address me as Dr. “Gee” as I am a physician having spent more years at university and in training than you lawyers ever do. If my wife refuses to pay an outrageous bill for something that should be covered by warranty, I stand behind her.”

Continuing to use his first name, but in a far-less calming tone of voice, I replied, “This car has been out of warranty for a long time. Neither you nor your wife purchased an extended warranty and the dealership accomplished extensive repairs — many of them safety-related and which she signed for and agreed to pay upon completion.

“Your wife has stated that, as she is married to a brilliantly skilled physician, she should not have to pay for the repairs.”

It was clear that on the scale of people considering themselves entitled, Mrs. G — who insisted on being addressed as “Mrs. Doctor Gee” was at the top of the list. The dealership put her on the phone with me:

“Do you care about your husband’s reputation in the community if you are arrested for attempted theft of services? It is time to realize that everybody pays for car repairs and no one owes you a thing because of your husband’s position.”

A few minutes later, speaking with Dr. Gee, again using his name but in an increasingly urgent tone, I said, “Perhaps your wife’s overblown sense of entitlement works elsewhere, but it is plain wrong, as wrong for you to operate on a patient, save their life, and then not pay for your professional services.”

Preserving His Own Reputation

The key to a win-win outcome was in motivating Dr. G to understand that his reputation was minutes away from being tarnished by his wife.

“Now, this is not the first time that she has embarrassed you like this, refusing to pay for something she ordered. Right?”

“Yes, that’s true. But how can you know that, Mr. Beaver?”

“I’ve got a deal for you,” I said in a softened tone of voice. “You call me Dennis, I call you by your first name, and let’s talk about your life at home. You’ll see, I am a good listener.”

I am now speaking with a man who admits that he is so unhappy at home, trying to please a woman whose life is a whirlwind of never-ending dramas, “And there is nothing I can do that’s right! I am so afraid of the future, of what kinds of nightmares she will create next! Dennis, I am in a loveless, cold marriage and I’m afraid.”

And I heard him sob. It was so unexpected.

“Doc, here’s what we are going to do. You have your office manager go to your bank and obtain cash — not a cashier’s check because she could stop payment on it — bring it to my office and I will go to the dealership, pay them, and your wife will be given the keys to her car and drive off.”

And that is what we did. His office manager handed me an envelope filled with $100 bills, I drove to the dealership, was introduced to Mrs. G, paid her bill, and addressed her by her first name. But instead of thanking me for the help, she exclaimed, “How DARE you call me by my first name! To you, I am Mrs. Doctor G and don’t you ever forget it!”

By that time, both I and the service manager had enough of this arrogant woman who put her husband’s reputation at risk. It was time for “Mrs. Doctor G” to get an earful.

‘”Madame,” said the service manager, “you may have grown up when no one ever said ‘no’ to you. And so you became a selfish, self-centered, entitled monster caring only about yourself and willing to damage your husband’s good name as a physician.”

The moral of the story circles back to what Professor Vega said. When I persisted in using Dr. Gee’s first name, he stopped being defensive and felt safe enough to tell me his troubles. That circle of trust allowed me to negotiate a way out of the problem Mrs. Gee had created. The car dealership got the money it was owed, and Mrs. Gee wasn’t arrested (this time).

Dennis Beaver practices law in Bakersfield and enjoys hearing from his readers. Contact Dennis Beaver.

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Serendipity played a role, too, in Albert ‘Bert’ McBride’s rise from poisonous-snake expert to urologist. At 85, he’s still in practice.

There are many things we can be proud of as Americans. One is using our wealth to foster education, as you will see in today’s story.

If you are like most people, just reading the headline on this article really got your attention. Snakes! Psychologists believe humans have evolved a tendency to fear them, as well as spiders, which leave me heading for the exit!

But that’s not the case for Albert “Bert” McBride, who grew up on a ranch near the small town of Grants, New Mexico, located along Route 66 (which author John Steinbeck referred to as the Mother Road in his book The Grapes of Wrath), 78 miles west of Albuquerque at an elevation of 6,460 feet.

This rugged part of New Mexico has a large population of rattlesnakes, and from the time he was 12 years old, McBride — who could have been nicknamed Fearless — earned money by trapping rattlers and other venomous snakes and milking their venom for laboratories that developed antivenom, aka antivenin.

“Atkinson’s Cobra Gardens,” McBride said, “was located near my town and the owner had all sorts of snakes — including boa constrictors — which the tourists driving on Route 66 happily paid to see. When I was 15, I lectured about the snakes, going into the pits and milking them as tourists looked on. I did this every summer throughout high school. One day, due to inattention, a rattler bit me. I was given antivenom and recovered with no ill effects, but my interest in snakes attracted the attention of the science teacher at high school. He suggested that I enter a science fair and do an exhibit on venomous snakes. I did, and talk about serendipity, I won first place — which was a scholarship to Arizona State University!”

Life Sciences department has a request

While at ASU, McBride’s knowledge of reptiles came to the attention of the Life Sciences department chair, and he was asked to work in the Poisonous Animal Research Laboratory, “where I milked Gila monsters, cobras and rattlesnakes, scorpions, you name it. We had the deadliest of snakes in this amazing place. I got bit again when I was 19, milking a big rattlesnake, and one of its fags entered my thumb below the nail. Again, antivenom was administered, and I fully recovered.”

We’ve all heard the expression “do good things and good things happen.” Happen they did, McBride explained, as he was accepted by several medical schools based on good grades and wonderful recommendations.

And serendipity had greater plans for him.

‘I had nothing to lose’

“Since the sixth grade,” McBride said, “I knew that I wanted to be a doctor and help people. Among others, the nation’s most expensive, George Washington University School of Medicine in D.C., accepted me. But my parents were of modest means and could not help pay the expenses. And then I saw an article in the Arizona Republic about a millionaire in Scottsdale, Walker McCune, heir to the Pennzoil fortune, wanting to donate $20 million to establish a medical school in Arizona. I had nothing to lose, so I sent a letter to the gentleman via the Arizona Republic, asking if he had a scholarship or loan fund I could apply to.

“About a week later, his lawyer replied, ‘We have reviewed your impressive résumé, and Mr. McCune has decided that you are to be our very first recipient of what will now be known as the Medical Student Scholarship Fund. Please find enclosed checks for your tuition and living expenses for medical school in Washington, D.C., which will be renewed yearly.’”

McBride graduated in 1963 and got a residency in general surgery.

Becomes a urologist, but he’s not finished with snakes

“In residency, the professor of Urology offered me a position in his department, which is how I became a urologist,” McBride said. “I was also contacted by the zoo director in Washington, D.C., who knew about my background with deadly snakes. ‘Dr. McBride, we have no one here who knows very much about deadly snakes. Can you help us set up a program to deal with snake-bite emergencies?’”

Of course, McBride agreed.

It was the first of several snake-bite protocols he helped establish around the country, setting up teams of physicians who would be on call. His protocols are still in use today.

Spends a year on hospital ship in Vietnam

After finishing his residency in 1968, he was drafted and spent one year on board the hospital ship Repose in Vietnam. “I worked with 30 other doctors,” he said, “learning and helping each other for the full betterment of the patient, and nothing else mattered. We were practicing pure medicine — ‘we’re in this for nothing else but the care of the patient,’ totally.”

Following Vietnam, he practiced in San Diego for 26 years, served as an associate professor of urology with UCSD and taught urology at the Naval Hospital in San Diego.

Years later, McBride moved to my town, Bakersfield, where he was on the faculty of Kern Medical Center.

McBride is 85, still in practice and “loves every contact with my patients, all due to my friend, serendipity.”

And I am proud to call McBride my friend.

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“Mr. Beaver, we just received a text from our family doctor that is disturbing,” said “Chelsea,” calling me Monday, Dec. 27 from a small Southern town that has one of the lowest rates of COVID vaccination. “I found your column online and just hope you could tell us if what she said is correct.”

As the cell connection was poor, we used Skype, where the entire family got on the call. She read the text:

‘Unless too young or medically advised to not be vaccinated against COVID, obese and unvaccinated patients are no-longer welcome in my office. You may be turned away if you seek admission to our small hospital unless fully vaccinated with a booster as we are now forced to ration available beds. Almost two years ago I warned all of my obese patients of the need to start losing weight at once because obesity is a major factor in death from COVID. Few paid any attention. Many have died.’

“Our Kids look Healthy!”

“We may be overweight,” Mr. Beaver, “but look at the kids! They are all healthy,” Dad said, adding, “Besides, it is a personal decision to get vaccinated that should have nothing to do with hospital admission.”

This was not the first Skype call I’ve had from families in total denial of their obesity, and the statement, “Look at the kids – they are healthy,” is the exact language that physicians — and judges in custody cases — hear constantly. It is sad beyond words, as parents have lost custody by allowing their kids to become morbidly obese.

Were my readers vaccinated? “No. It is our personal choice,” the parents loudly proclaimed.

There was much more to this story as I would learn from their doctor.

An Angry ER Doctor Shares Her Feelings

I reached their physician “Martine,” who wanted me to share the feelings of “so many people in heath-care just burned out by people like this family.”

She explained that “a crisis management plan with patient triage has been put in place, saving our few beds for patients who we can help, not those who have made life decisions that amount to suicide.”

Compassion and Empathy for Those We Can Help

“We are tired of hearing people say it is their right to remain unvaccinated, in spite of all the news stories about how the unvaccinated are taking up beds, die and put others around them in danger. For their own sanity, I am telling our staff that it is ok and not to feel guilty by devoting their compassion and empathy to patients who merit our help. And yes, this may sound cruel to some,” she acknowledged.

“We hear excuses all the time, especially those based on religion, but I spoke with religious leaders at every house of worship within 50 miles and all have urged their congregations to be vaccinated, all of them!

“Also, this is one of the poorest educated parts of our country, and few here are aware that in the American Revolutionary War, George Washington gave soldiers what amounted to a smallpox vaccination – while many British troops died of the disease. There was little talk of not wanting or refusing the inoculations then, or across all the years of mass vaccinations in our country, until now.

“When we have an unvaccinated person show up who we can’t save and a heart attack victim we can, we are not wasting that bed on the person who chose their own death. We have gone from compassion to anger and no longer have the capacity to worry about someone who rejects science.”

I got the feeling from her that she is describing a major shift in concern about patient care. Was I right?

“I and many of my colleagues have reached the point that the only way to protect society is by not caring as we did in the early days of the pandemic, when people got ill through no fault of their own. Now they are voluntarily exposing themselves to a high risk of death by refusing the vaccines, and not just them, but family and friends. It is selfish and cruel beyond any possible justification.”

A Darwinian “Bright” Side

In 1859, the English naturalist Charles Darwin wrote, “On the Origin of Species,” which was his theory that nature selects the strongest and fittest, who survive to pass on their genes to the next generation.

Health-care professionals are seriously asking if we are seeing his theory in real time, today. Martine put it this way:

“Under Darwin’s theory of natural selection, the human race will be a stronger species in the long run, because only intelligent people who take the vaccine will survive.

The others end up in ICUs and die horrible deaths.

“Physicians will do harm if we allow non-vaccinated patients who we can’t help take beds from those we can. We just do not have the ability of treating everyone.”

So, is Martine way off-base with her analysis? Have our health-care professionals lost the ability to care as they once did, suffering from burnout and compassion fatigue? And, isn’t there a moral duty — to each other — to be vaccinated?

“That’s the real question,” Martine said as we ended our interview.

Dennis Beaver practices law in Bakersfield and enjoys hearing from his readers. Contact Dennis Beaver.

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My paralegal, Anne, buzzed me. “You have a couple on the phone who have Covid-19. They are very upset with their family doctor and want to talk with you about a possible lawsuit for malpractice.”

Now, this sounded interesting.

Just diagnosed with COVID-19 — doctor yelled at them

“Mr. Beaver, our family was just diagnosed with COVID-19, and fortunately no one is sick enough to go to the hospital, but we feel very disrespected by how our family doctor reacted.”

I wondered how long have they gone to this doctor, and why they feel so “disrespected.”

“We have been his patients for several years and never had a problem until now. But when he called us and confirmed that we all had COVID-19, it is what he said that hurt our feelings terribly. He was so angry! We recorded it. (They played the recording.)

“What’s wrong with you all? I told you months ago that you were dangerously obese and that you were not taking your blood pressure medication as prescribed. Don’t you watch TV? Almost all of the faces of the people who died from COVID-19 who you see on the evening news are horribly obese — and you are too, all of you, mom, dad and your four young kids! Don’t you get it! You are sentencing yourselves to death because of being morbidly obese!”

“Mr. Beaver, we aren’t that much overweight and our kids are otherwise healthy, if a bit big.”

Was the doctor correct? Were they all obese? Dr. Skype would answer that question, and so I asked–and the family agreed–to do a Skype video chat. As soon as their webcam was active, it was clear to me that I was looking at an entire family of morbidly obese people in complete denial of their own health status.

What immediately came to mind was what their doctor had told them about the faces of people who died from COVID-19. Almost all were obese.

The message of obesity, COVID-19 and risk of death is not getting Through

I asked if they would call the doctor’s office and authorize him to discuss this with me, and they agreed.  Within minutes I was speaking with a physician I can only described as caring and frustrated who I will call “Dr. Jim.”

“Dennis, obviously the national message is not getting through about obesity and COVID-19. The CDC has stated that obesity was as great a risk factor or even greater as having a suppressed immune system or chronic lung or kidney disease. They also said risk starts with a BMI of 30 and 40% of Americans have a BMI well over 30. At these numbers, there is a high risk of death, more so than related risk factors such as diabetes or hypertension.

“People with severe obesity are about twice as likely to die from COVID-19 as those who are not obese, regardless of race or ethnicity. The risk rises with the degree of obesity. The bigger a person, the higher their risk of a COVID-19 death.

“But this is not a new discovery, as during the 2009 H1N1 influenza pandemic, and flu pandemics in the 1950’s and 1960’s, we found that obese people were at a higher risk of dying.

“There are many reasons why obesity is such a risk factor, and one explanation is that their levels of the hormone leptin are always high, which reduces the immune response to a Covid-19 infection. Leptin is produced by fat cells, and the more fat a person has, the more leptin circulates in their body.

Did he yell at his patients?

“Doc, your patients feel ‘disrespected’ because they claim you yelled at them for not doing a thing about their weight. So, what happened?”

“They are correct. I did yell at them out of total frustration! Months ago when it was clear we were facing a pandemic, I contacted all my obese patients and begged them to lose weight! I explained the risks. No one can justify weighting 350 pounds! We are killing ourselves in this country! Yes, I do get frustrated when these same people return to the office and have done nothing to address their weight issues. And I am not apologizing. I just hope that I finally got their attention.”

Does a poor bedside manner justify a malpractice lawsuit?

Courts have held that a poor bedside manner is not medical malpractice. If a health care provider’s actions do not result in real injury, it cannot be considered medical malpractice.

I explained that to my readers, telling them, “Dr. Jim was trying to save your lives. Instead of being angry, realize that he cares enough to hopefully make you think. He deserves your appreciation, not a lawsuit.”

Dennis Beaver practices law in Bakersfield and enjoys hearing from his readers. Contact Dennis Beaver.

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“Mr. Beaver, I am the victim of a vagus nerve stimulation (VNS) scam.”

Vagus nerve scam?

Most of us know about vagus nerves from high school biology — that they are the longest in our bodies, but not much more.

However, for the past few years, vagus nerves have been the subject of a great deal of investigation in bioelectronic medicine for their ability to reverse inflammation, which is a major factor in a number of life-altering diseases — and, as my caller discovered, fraud.

“While the existence of the vagus nerve has been known for centuries, its potential to treat a variety of serious health conditions has only been seriously studied the past few years by the medical profession,” neurosurgeon Dr. Kevin J. Tracey writes in the just-published, compelling read, The Great Nerve: The New Science of the Vagus Nerve and How to Harness Its Healing Reflexes.

During our interview, Tracey said, “Vagus nerve stimulation (VNS) involves delivering electrical impulses to the vagus nerves to regulate various bodily functions and potentially improve conditions like epilepsy and depression. It can be achieved through medical devices like implanted stimulators the size of a jelly bean.

“Part of my motivation in writing The Great Nerve was to warn the public about the many false claims that are being made about bioelectronic medicine and, specifically, devices that claim to influence functioning of the vagus nerves but in reality do nothing at all except separate you from your money.”

My caller “Sharon” was one example.

Wanted to help her employees

She owns a demolition company “that tears down small buildings, which requires employees to do a fair amount of heavy lifting, and they often complain of back and muscle aches requiring them to take some time off and swallow (over-the-counter pain relievers) as if they were candy to reduce swelling and inflammation.

“A few months ago, I saw an internet advertisement for a vagus nerve stimulator that stated, ‘Is ideal for people who work in construction and often experience muscle aches and pain resulting from inflammation.’ I ordered four of the $500 devices — which had a 100% money-back guarantee — put the purchase on my bank’s credit card and gave them to our employees.

“These things look like earphones, only you attach them to your neck, flip a switch, they start to buzz, and your pain is supposed to vanish. But what vanished was my money!

“My employees all tried the device, and we emailed the company to complain that the devices did not work. They wrote back suggesting that we were not placing them correctly, to try them for at least a few months, and then they would refund us if we asked.

“It has been six months. The devices do not work, and the company refuses to issue a refund. My credit card company says that we are too late to contest the charge. Is there anything I can do?”

These scammers know what they are doing

Each credit card issuer has its own time limit to contest a charge. U.S. law sets a minimum time limit of 60 days. Most banks give cardholders 120 days to dispute a charge.

However, if a customer can establish actual fraud by the seller, this usually opens up the time frame in which to challenge the charge.

With Sharon on the phone, I researched the seller and found a pattern of similar complaints about the device not working and the seller’s refusal to agree to a refund after dragging out the matter for months and then claiming the customer had waited too long.

With that information, I got a supervisor on the line at Sharon’s credit card company, and he agreed to accept her claim.

Had she looked at the seller’s online reputation, it is clear she never would have ordered the device.

We will be hearing a lot more about vagus nerves

I do not recommend that you begin reading The Great Nerve too late in the evening — you could stay up for hours past your bedtime. It is that interesting and reads like a historical novel, only this is real science. Tracey writes in the style of another gifted physician/author we also read in high school English — William Carlos Williams.

He takes us on trips around the world where tiny devices are surgically implanted in patients to treat patients’ rheumatoid arthritis, inflammatory bowel disease, lupus, multiple sclerosis, diabetes, obesity, stroke, depression, Alzheimer’s and Parkinson’s disease, in addition to other inflammatory-based conditions.

Tracey’s research into vagus nerve stimulation, along with his colleagues’ has led to treatments for the most difficult medical conditions, such as stroke, drug-resistant epilepsy, PTSD and depression. And there is evidence that long COVID may be helped by VNS.

Today, at major hospitals and medical centers, VNS is used routinely to give patients, in many instances, a second chance at living lives that are close to what they knew before falling ill or suffering a stroke. And just think of the applications for work-related, painful injuries.

As Tracey makes clear in The Great Nerve, VNS places medicine at the threshold of what was science fiction. His book is testimony to what dedicated physicians bring to humanity.

If you are interested in trying VNS, to avoid being scammed, consult with your doctor for a referral to a recognized medical facility that uses these procedures.

Given that VNS is fairly new, I personally would be leery of anything offered online unless it’s prescribed or recommended by a physician.

Dennis Beaver Practices law in Bakersfield and welcomes comments and questions from readers,
which may be faxed to (661) 323-7993,
or e-mailed to Lagombeaver1 – at – Gmail.com.

The post Scam Alert: Bioelectronic Medicine Is Both Promising and Ripe for Fraud appeared first on Dennis Beaver.

What should you say? What should you do? And, even more importantly, what should you not say or do if involved in a motor vehicle accident?

“Chiropractors, MDs, physical therapists, attorneys, professionals who treat or are involved in the care or legal representation of accident victims have seen the consequences of patients who hurt their own cases by having no idea how to answer that question,” says San Marcos chiropractor and author, Gary N. Lewkovich.

Several years ago he developed a list of mistakes patients make, “That occur from a lack of awareness or a degree of misguided thinking. Whatever the cause, the effect on their personal injury or workers compensation case can be absolutely devastating, and in some instances, it results in a zero settlement.”

We discussed several:

1. Obtaining insufficient information at the scene of the accident

Be sure to get names and phone numbers of witnesses. Take photos of the damage from several angles and of the other driver(s) license and proof of insurance.

Having a well-designed form to capture the critical information is extremely helpful.

Many auto insurance carriers have these forms available that are simple to fill out and should be kept in your vehicle at all times.

2. Admitting liability for the accident

Never say, “I’m sorry! It was my fault,” as this admission can be used against you and severely complicate the case. What if it was not your fault, but you thought so? Often we are not aware of what actually happened, so be polite, but never admit fault.

3. Giving the auto insurance company too much information

All auto insurance companies have their own best interests at heart. Yours are secondary.

Recorded statements can be twisted and edited, especially today with AI, in such a way as to hurt your case.

Therefore, request that all questions be provided in writing. If the adjuster says they only record interviews, then reply, “I am turning on my recorder as well,” as you have that right. Keep your answers short, focused, and don’t downplay any symptoms. Refer questions about your medical condition to your treating chiropractor or physician.

4. Trying to conceal past injuries or conditions

Many patients believe that the existence of past injuries or conditions hurts their personal injury case. In reality, pre-existing problems often increase the likelihood of greater damage from a motor vehicle accident.

Actual patient histories show that more extensive and longer care is typically required when certain problems are already present. By trying to hide the past, remember your medical records will reveal the truth. When that happens, non-disclosure often comes across as deceitful behavior and can sink an otherwise good case.

5. Not seeking care early

A delay in seeking care is often understood to mean a less serious injury. If that occurs, it is imperative to carefully document all the reasons why you were unable to obtain care sooner.

6. Relying upon medication alone to treat the injuries

For the most part, medication used to treat symptoms often does little for the root cause.

Research shows that for most motor vehicle injuries, treatment with only symptom suppressive medication offers a much poorer prognosis than methods that actually restore function.

7. Downplaying one’s injuries

Some people feel uncomfortable and/or hesitant to disclose the full nature of their injuries. They downplay existing symptoms and may fail to report new ones. Auto insurance companies save tons of money when this occurs and the patient suffers unnecessarily.

Your treating doctor should be aware of this possibility and recurrently ask patients about any other symptoms that may be present.

8. Exaggerating one’s injuries

This is the flip-side of the above mistake.

There is a small percentage of patients who amplify their symptoms. If this is suspected by the claims adjuster or defense attorney, the case can take a nosedive rapidly.

Credibility issues poison any personal injury or workers compensation case. The settlement offer could plummet to zero and the patient may have significant medical expenses to pay on their own. For good reason, plaintiff attorneys and doctors run from these patients and clients.

9. Doctor shopping

Changing doctors frequently is a red flag to the defense. It is important to do your own due diligence prior to choosing a doctor or follow your attorney’s recommendations.

10. Failing to have a consultation with a personal injury attorney

Auto insurance companies rely upon the advice of their legal teams when deciding how to handle accident cases. Most injured patients lack the training, experience, and patience to effectively deal with these issues. That is why it is often helpful, and sometimes vital, to get a consultation with an experienced personal injury or workers compensation attorney.

These consultations are usually free of charge or obligation.

Dr. Lewkovich concluded our interview with this encouraging advice:

“Think of your health care providers and your attorney as part of a team. Always feel confident to discuss any issues that come up. We are here to help.”

Dennis Beaver Practices law in Bakersfield and welcomes comments and questions from readers,
which may be faxed to (661) 323-7993,
or e-mailed to Lagombeaver1 – at – Gmail.com.

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