Many attorneys and claims adjusters automatically think that a medical expert is needed to assist with their case. And while this can be true, the fact of the matter is, a legal nurse consultant is likely your best option for analysis of a medical record. A LNC can help unlock the questions, and find the buried information within a medical record. In more cases, than not, a LNC can help to establish the information that can build a case, support or refute a claim, and provide a detailed review of the record-thus often eliminating the need for physician review. My personal practice experience bears this out. I would say that over 98% of the final MKC work products are nurse review cases, though many do not start out that way.
To determine what YOU need, here are a few helpful hints and information:
- Determine what the goal of the reviewer/consultant is. Do you need a summary or synopsis of the entire record? Do you need a detailed chronology? Do you need very pointed answers to a specific set of questions?
- Most physician reviewers are unable to generate a detailed chronology- mainly because it is too time consuming and costly. The cost for a physician reviewer vs. a legal nurse consultant will be dramatically different. It may be cost prohibitive for a physician reviewer to review an entire record. Use a physician advisor for pointed review issues and/or direct peer input.
- The scope of the LNC work product is much broader, yet still captures the important AND many details of the medical record.
- Remember that the most important function of a nurse is to be well-versed in a multitude of skills and knowledge that surround and involve patient care. These areas include anatomy and physiology, medical AND nursing practices, bedside care, medications, ancillary departments, and lab work, just to name a few. This broad knowledge base translates in to an invaluable tool for the litigation team.
- A legal nurse consultant is well equipped to know and understand the workings of a variety of health care settings, how intra-disciplines work together, and better understand the nuances of nursing care.
- A legal nurse consultant will review the entire case in great detail, and provide you with a working road map of exactly what is needed with the case. Obviously, this road map may include input from physician advisors, but the LNC road map will help you pinpoint the most appropriate medical specialty, and provide an overall view of the case.
- A legal nurse consultant review and report will look at the record as a whole, while still detailing specific issues, strengthens and weaknesses. More times than not, there are hidden issues that can dramatically influence a case, and thorough review of the ENTIRE record is needed to bring them to the surface. It is simply not practical to have a physician pour over an entire record/file with a fine tooth comb; using a LNC will help to sort out the important details, and provide direction as to how to formulate and analysis issues.
Make no mistake a case often requires input from multiple sources and specialties. If you have a stack of records and don’t know what is in them, let a LNC sort through the issues, and create a report that will help get you started, highlight the strengths and weaknesses of your file and provide valuable insight of the file. A good LNC should help you determine the best course of action regarding your medical records and file.