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Author: Lauren Ellerman

In 2011, Lauren Ellerman was named "Young Lawyer of the Year" by the Roanoke Bar Association for her work in the community. To speak with Lauren about your personal injury case, contact her at lellerman@frithlawfirm.com.

Who is your primary care doctor?

September 15, 2020

A recent Wall Street Journal article – The Doctor Won’t see you Now, highlights the growing trend that fewer and fewer Americans are actually receiving their primary medical care from licensed physicians. Rather, most of their care is coming from members of the healthcare field who have less training than a Medical Doctor. While this may be news to the WSJ, it isn’t news to anyone who has been to the “doctor” in the last ten years. 

When we get calls from normal people who have experienced a healthcare crisis, we often ask – “Who is your doctor” and they will tell us – “her name is Shelley, and her office is on Franklin Rd.” We then do a search for Dr. Shelley on Franklin Road and find out Shelly is NOT a doctor, but a physician assistant, or a Nurse Practitioner, or a Doctor, but not one who went to Medical School.* (Yes – they exist. Keep reading). 

No surprise as there is a pretty clear movement in primary care provision in the United States – and the movement is from Physician provided care – to Physician “coordinated” care where the actual patient care is given by someone other than an M.D. 

I am happy to address the why first. They why this is happening is MONEY. This is happening because Medical Doctors are expensive, and fewer and fewer go into primary care or internal medicine when they could go into a specialty like surgery or cardiology and make four times as much money a year. Also, even if half of medical school graduates wanted to be internal medicine specialists, it is cheaper for the practices to hire one doctor and three physician assistants – than four doctors, so you get a pyramid model of healthcare with few of the highest trained providers, and too many of the lowest trained and lowest paid ones. 

Here is a completely unscientific definition of who these providers are:

  1. Medical Doctor – the highest trained, and likely most capable person in the office. Will have M.D. after their name on the stationary. Actually went to medical school. Ideally, a medical school in the United States. 
  2. Doctor of Osteopathic Medicine – less trained than an MD – but has all the legal rights of an MD. Likely didn’t get into actual medical school (because of less than stellar college grades or tests) and so went the DO route. Will have D.O. after their name on the stationary.
  3. Nurse Practitioner – someone who has a Masters in Nursing degree essentially – who has the same legal rights to treat, diagnose and prescribe medicine, but cannot work at a medical clinic alone – must work with and under the supervision of a D.O. or M.D. The law says they must consult with the doctor on abnormal findings, and the doctor must review and sign off on their work. **(this rarely happens). *** The laws are changing in many states to expand their powers and lesson the supervision required by doctors. 
  4. Physician Assistant – someone with a Masters Degree, who really should only be the eyes and ears for the doctor and little else. 
  5. Nurse – someone who has an LPN or RN license, and is an actual nurse. Can physically assess patients but cannot ethically diagnose conditions. Must communicate to NP, or DO or MD who is allowed to actually diagnose conditions and treat them. 
  6. Certified Nursing Assistant – someone with 6 weeks of training whose job it is to provide basic care – like assistance with dressing, eating, running errands for nurses. Should not be assessing patients, should not be taking vitals – should really just be getting non-medical tasks done. 
  7. Scribe – no medical training at all, someone who just follows a healthcare provider around and writes things down to get them into the chart quicker, and more accurately – ideally. 

Confused yet? This pyramid of care means that doctors either provide hands on care to very few patients in a primary care setting, and most of their time should be spent “supervising” the care provided by their PAs and NPs… In a nursing home, the doctors aren’t even on site – and they do nothing unless called in by the nurses to address a change in condition. In a nursing home – 99% of the care is provided by nurses and CNAs – sometimes less than 1 hour a day of care is provided by an actual nurse. 

What this means in our world – is that allot of balls are being dropped in this new model of physician coordinated care. Doctors don’t have time to really supervise their lower level staff, and major medical issues are missed. Patients suffer. Sure, a few dollars are saved – but patient care isn’t maximized. 

The take away – if there is one, is the following:

  1. Try to get your care from an actual Medical Doctor. There are some great DOs out there – but if you can, start with an M.D. ‘
  2. If you don’t have access to M.D. provided care, and can only get access to M.D. coordinated care (meaning a PA or NP physically see you and treat you) – be more diligent in your recording of problems – and do what you can to ensure the record reflects those – for example, use MyChart or other online communication tools to communicate with the actual doctor. Ask to speak with the doctor. Demand a call – be an advocate for yourself. 
  3. If you don’t feel like the pyramid structure of medical care is working for you – go somewhere else. There are few places in Virginia where you have no choices for primary care – so, be a consumer and take your business elsewhere. 

While I personally hate to see us go towards a model of physician “coordinated” care – it’s inevitable. Money talks, and so we as consumers need to know how to best protect ourselves in this changing healthcare world. 

All four of our Attorneys named Best Lawyers in America 2021

September 7, 2020

It is with great pride I (Lauren Ellerman) announce that every attorney at our firm, was named to the Best Lawyers in America List for 2021

  • Dan Frith was named to best Plaintiff Medical Malpractice Lawyer (and has been since 2005)
  • I was named to best Plaintiff Medical Malpractice Lawyer (and have been since 2016)
  • Lauren Davis was named to multiple practice areas – including Plaintiff’s Personal Injury, Medical Malpractice, Legal Malpractice and Healthcare Litigation
  • Bo Frith was named to best Insurance Law list

It is an honor to work with such knowledgeable attorneys, but a joy to work with such thoughtful and good people.

If you need a Virginia attorney for Medical Malpractice, Personal Injury, Business Litigation or Insurance Fraud, we would be so grateful to speak with you today. 

Wishing you the best in what is an otherwise difficult year. 

Yours,

Lauren Ellerman – Frith Ellerman & Davis Law Firm, PC

Dan Frith
Bo Frith
Lauren Ellerman
Lauren Davis

How to make the most from your “Mychart” experience

July 12, 2020

If you have been to a doctor in the last year, it is likely someone asked you if you wanted to sign up for the Health System online portal. 

Lewis Gale uses MyHealth One

Carilion / Ballad Health / CVS use MyChart

Each and every provider has their own way to confirm appointments, offer test results, and even directly communicate with providers. 

Admittedly, with new technologies come new opportunities for error. 

We successfully handled a case where a primary care physician and patient were communicating on MyChart about patient’s symptoms – Doctor recommended an ED visit and various tests, and then, even after subsequent in person appointments and MyChart messages, never checked the test results. 

I recently received my COVID test results through a MyChart message. 

I have been scheduled for appointments mistakenly via the same technology and been wholly unable to cancel appointments through the portal despite it stating I could perform such act. 

Often our clients will say to us “I have my medical records and can bring them by.” This, in our experience means the patient has been given some small amount of records and or has accessed a few documents on MyChart and nothing more.

To be clear, it is nice to have a way to communicate with your healthcare providers outside of an in-person appointment, but let us also be clear:

  • MyChart will not give you access to your entire chart, not even important documents like radiology and lab reports, operative reports etc
  • Doctors are not always comparing your MyChart records and complaints with your actual medical record, which leaves room for error and mistake
  • MyChart is just one added task to the daily things to do list for most Doctors – making it a low priority in the patient healthcare world
  • Convenience doesn’t always mean accuracy

So while we certainly don’t advise AGAINST using the portal as a patient, we do advise you use it as it was intended – as an administrative aid, and nothing more

We still recommend the following:

  1. Ask to see all lab and radiology reports, and ask for copies
  2. Ask for in person appointments to discuss concerns
  3. Document your own symptoms and take with you, in writing, asking the doctor to make it part of your patient chart
  4. If you expect further tests or follow up, ask for them – and don’t stop until the care has been provided
  5. Always keep an updated list of medications with you for all appointments
  6. If you feel an issue has not been properly addressed, follow up
  7. Use the MyChart / MyHealth One portals – but don’t rely on them as Medical care.
  8. And finally – ALWAYS BE YOUR BEST ADVOCATE. While doctors may not like to be questioned, sometimes it means the difference between you getting the care you need, or care that could cause harm

So when next asked – “Would you like to sign up for MyChart / Baycare Online / Lewis Gale’s MyHEalth ONE” the answer is yes… but always make an appointment to be seen when necessary. 

Frith, Ellerman and Davis all named Superlawyers in 2020

May 19, 2020

Dan Frith has been named a Virginia Superlawyer for Plaintiff’s Medical Malpractice, for the 15th year in a row. 

Lauren Davis has been named Rising Star Superlawyer for Virginia Medical Malpractice in 2020 for the 5th year in a row. 

Lauren Ellerman was named Virginia Superlawyer for Medical Malpractice, top 100 Lawyers in Virginia, and top 50 Women Attorneys in Virginia. 

And – our youngest attorney Bo Frith was just invited to join Top 40 under 40 – National Trial Lawyers. 

We are proud to work as a team, and proud to serve our neighbors in Western Virginia. 

Bo Frith
Lauren Ellerman
Dan Frith
Lauren Davis

 

 

If I could ask Physicians to do just one thing ….

May 17, 2020

If I, as a daughter, mother, patient, plaintiff’s medical malpractice attorney could ask Physicians to do just one thing, it would be – TELL ME WHAT YOU TELL THE OTHER DOCTORS IN MY MEDICAL RECORDS. 

That may seem like an odd request, but please, if you have a minute, or two, keep reading. 

So often we get calls from families who have suffered a health tragedy, or a loss, and they have so many unanswered questions. So many holes in the story of care and in a vacuum of information they assume the silence is covering up a mistake, or worse.

So often we get calls from people who don’t necessarily think malpractice occurred, but they don’t know what occurred to their loved one leaving them consumed by fears and concern.

So often, only 1/10th of the story is provided to the patient or her family, leaving an incomplete picture of one’s care or health.

So often our investigation provides the answers they needed – revealing not that malpractice or negligent care occurred, but rather negligent and insufficient information was provided about the care. 

This week, I received some truthfully heartbreaking news – my Mother was unable to breathe on her own, and on a ventilator. I assumed the worst. Brain damage. I assumed she could not survive extubation and that she would die. I called and demanded to speak to every nurse and doctor who saw her. I took notes. I asked questions, requested results, and asked for follow up answers. Amazingly – she survived and is at home – praise God. But given what I do for a living, I knew the story I had been told in small pieces over the phone, was not the whole story.

I was told – she had a respiratory event. I was told, they were investigating heart failure as a related cause. I was told very little else. The discharge records state she had been diagnosed with “shortness of breath” and nothing more. 

The records, all 1400 pages of them, reflect a unique story – unlike the one that was provided to my family in bits and pieces. They also reflect she should have been discharged with medications she was not provided. Serious and life changing medications. 

While I know a Physician’s job is to provide the care, it should be someone’s job to explain the care being provided. Really explain it – treating the patients and their family with an element of equality and respect. Assuming that even without a medical degree we are capable of understanding how our health may be in the present and in the future. That is my one wish. Treat me, my mother, my clients and all of us – as equals. Take the time to explain what you are telling eachother in the chart. Take the time to explain what this means for our today, and tomorrow. 

When Physicians are over booked, and paid for numbers of procedures not successful outcomes or phone calls, there is little time for explanation.  As a result, the total picture of care and treatment is left a silent story told only in written medical record, and not to bodies experiencing the care. 

Even patients like me who ask questions – aren’t given the full story. And frankly, if that is the norm in our system of healthcare – the system sucks. And so, I will ask one more time – a favor. Dear Physicians, Nurses, NP’s, PAs, providers of care – talk to us. Tell us what the records say. Tell us the whole story, the good the bad and the scary. When you do, we can be better advocates for ourselves, and help you in turn. 

 

S

 

Lauren Ellerman named top 100 lawyers in Virginia, 2020

May 17, 2020

I am delighted to share I was named to Superlawyers Magazine 2020 list of 100 best lawyers in Virginia, as well as top 50 female attorneys in the Commonwealth. 

I am grateful for the recognition, and can’t wait to get back to work helping clients when our State Courts re-open this summer. 

I was also named Best Medical Malpractice Attorney for 2020, the only female to receive the award in Western Virginia history. 

My ego appreciates this thoughtful gestures – now let’s get back to work!

Cracks in for profit nursing homes exposed during coronavirus

May 12, 2020

On this morning’s NPR broadcast Morning Edition, a young Chicago nursing home employee shares his experience working in a for profit facility before the coronavirus outbreak. He describes lack of gloves, staff, preventative equipment and more. His interviewers explore why nursing home residents are so exposed during this pandemic. To listen, start around the 8 minute mark. 

The journalists bring to light a few important points, points our office has been making to clients, colleagues, the press and advocates for weeks. Namely, nursing home patients aren’t just at risk because of age – nursing home patients are at high risk because the system of for profit care stinks. When we put profit over people, people get hurt. 

When this is all over, we will have data that reflects intra hospital infection rates, v. intra long term care infection rates. And with close to 50% of America’s deaths being linked to America’s nursing homes, the pattern will emerge. 

COUNTER POINT: Now, you may say – Lauren – we know nursing homes are not hospitals, they can’t be compared. True, but if the care isn’t comparable, why does Medicare / Medicaid pay $4,000 – $6,000 a month to a facility for patient care if a high level of care isn’t expected? 

  • Hospitals have infection protocols, which are followed.
  • Hospitals have enough staff to allow time for staff to wash hands between patient interactions, wear gloves, etc.
  • Doctors are in hospitals, and examine patients daily. 
  • Hospitals are designed with patient safety and not staff ease in mind.
  • Hospital staff is often paid for full time work, and provided benefits. This means when a nurse is sick in a hospital, she can likely take a day off – paid. 
  • Hospital staff are provided hours, shifts and earn pay that allows them to work only one job.  
  • Visitors are expected to wash hands, and follow certain infection protocol. 
  • Meals are not communal

Obviously, the list goes on. But here is why nursing homes are so at risk:

  • When a CNA at a nursing home is sick, she often comes to work because she has no benefits, no paid time off, no health insurance and must work hours to pay her bills.
  • When a CNA at a nursing home is given fewer hours, she will often pick up shifts at other facilities
  • When a CNA at a nursing home is assigned to a hall, she is assigned between 20-60 patients to care for AT ONE TIME during a shift
  • When a CNA at a nursing home is assigned these patients, she is expected to dress, feed, toliet, bathe and care for these patients – leaving no time to change clothes, wash hands, and clean up between patient care provision
  • When a patient is taken to meal time – he or she may be eating with other immune compromised individuals with little assistance
  • Visitors are not tracked, and infection protocols rarely apply to visitors

So, a solution might be to simply hire MORE STAFF, pay them better, and give them sufficient time between patient interactions. Yes, that is actually an excellent solution – but that will sure cut down on profits. 

So we as a society need to ask ourselves – do we want to allow for profits over care? Or do we want at least one industry, to put patient care first?

This virus has been devastating – but also illuminating. It has exposed the cracks in a broken system, that has long allowed for profits to prevail at the expense of patient care. 

I for one am hoping when this is over, we won’t tolerate it any longer. 

 

 

Filing a Medical Malpractice Case
is Not for the Weak or Timid

April 30, 2020

This week, I watched a family who had suffered the worst health care crisis imaginable, listen while a stranger told them that settling their lawsuit would give them peace.

I know for a fact, when you lose a loved one, winning or losing a lawsuit does not bring peace. The loss still exists and is in no way alleviated by accepting money from a negligent party.

Medicaid – Anything but Simple in a
Medical Malpractice or Personal Injury Case

April 30, 2020

Everyone who calls our office and has a Virginia injury case (nursing home, medical malpractice, car accident, trucking accident, etc.) is asked a series of questions by our staff.

One of these questions is: DO YOU HAVE MEDICAID?

It is not that we discriminate against potential clients who qualify for Medicaid because of disability or income; rather, Medicaid carries with it some very complicated and important legal issues in a lawsuit.

So Now You Are a Plaintiff In a Lawsuit –
How Long Will This Take?

April 30, 2020

Timing is everything. And yet, when you file a lawsuit and are subject to the Court’s availability and the calendars of lawyers and other parties, the wheels of justice can move very, very slowly.

So How Long Will Your Virginia Injury Case Take? The sad but true answer is, it depends – but likely between 1 and 2 years. Even if our firm only had your case to handle, cases take time. The arch of your case could look something like this: