Obtaining Life Care Plan Recommendations from Health Care Providers
Obtaining appropriate Life Care Plan recommendations from treating or consulting providers for present and future care requires specific collaboration. The sources must know the patient's history and be qualified to render opinions about the recommended care. This patient-specific knowledge flows from physical examination, treatment, review of records, research, and experience. Documenting treatment into the future, beyond the acute phase, does not seem to be the norm for many providers. For example, surgeons focus on symptoms and indications for surgery, including pre-operative and follow-up services, too, in essence, "fix" the broken anatomical structure. It may not be clinically significant to document projected future treatments or even inform their patients of likely medical outcomes. Medical documentation's general purpose is to memorialize what has happened or is happening in the immediate future, not to forecast possible long-term consequences.
Litigation or the possibility of testifying in deposition or trial can inhibit the provider's willingness to consult with a Life Care Planner. One concern is the potential exposure to the risk of liability for the treater's opinions. The presence of litigation should not affect a provider's medical care recommendations, but unfortunately, it may. Another hesitation to collaborate with the Life Care Planner is the potential time loss from clinical practice to attend trials and depositions. The provider may feel too busy with their patients to lose revenue while attending legal proceedings. Some of the more elusive consultations are with pediatric medical care projections and medical malpractice cases. There is a natural hesitancy to give recommendations or directly critique other professional colleagues.
Much of the success achieved in consultation depends on the preparation and skills of the Life Care Planner. Disclosure of litigation and a thorough explanation of the provider and planner's roles are essential at the beginning of the process to limit ambiguity and reassure the provider. A consultation with the provider needs to be scheduled in advance, with an estimated time required for the consult. It is best to provide signed consent to release medical information forms and potential questions before the consultation to expedite the process. Consultations and the opportunity to discuss the recommendations are preferred to written questionnaires in certain jurisdictions. The exchange of ideas allows the participants to discuss additional issues or information previously not known. If a provider will not agree to a consultation, the use of a completed, signed questionnaire similarly communicates the importance or the validity of the recommendations.
After the consultation, it is recommended that the Life Care Planner summarize in writing the recommendations provided to ensure accuracy and invite the consultant to review the summary and communicate edits. More complex cases may require more than one consult with the provider to account for the dynamic nature of medical needs. The ultimate goal is to produce a thorough, well-researched Life Care Plan built on strong medical recommendations communicated from the treating providers on a more probable than not basis
To strategize with one of our vocational or life care plan experts at Stokes & Associates, please call David Barrett at 504-454-5009, visit our website, www.stokes-associates.com, or e-mail dbarrett@stokes-associates.com.
Larry S. Stokes, Ph.D.
Aaron Wolfson, Ph.D.
Lacy Sapp, Ph.D.
Todd Capielano, M.Ed., LRC, CRC, LPC, CLC
Ashley Lastrapes, MHS, CRC, CCM, CLCP, LPC, LRC
Brandy Bradley, MHS, CRC, LRC, CLCP