I appreciated Karen Preston's recent posting. My firm employs and contracts with various health care professionals, including physicians, who maintain active clinical practices and who, by education, training and expertise, are able to offer a broad array of opinions within their various areas of expertise, including, but not limited to, life care planning. Likewise, because we make substantial investments to procure healthcare and related cost data, we may be asked from time to time to offer opinions within a very limited scope when a life care plan is not the requested service. An example of this might be offering an opinion about the prevailing cost for home health care services in a specific geographic domain or even the usual and customary fees charged for a single procedure, such as a specific arthroplasty. Because we have access to reliable data as a component of preparing life care plans, we can offer this opinion without rendering a life care plan when we make it clear that the scope of this opinion is limited to the specific request for expert services. What we have found is that opposing experts may be engaged to offer opinions that we have somehow breached the standards in life care planning by offering such a narrowed scope of service, even when it is clear that a life care plan has not been requested or prepared but the opinion is within our various areas of expertise.
If a physician with my group is engaged to offer an opinion concerning a specific medical standard of care or injury causation, and he or she happens to be a certified life care planner, clearly the expert is being asked to provide an opinion that is outside the scope of life care planning and within his or her area of medical expertise. I have also seen where a plastic surgeon prepares a "surgical life care plan" addressing only his area of specialization from which we can incorporate his opinions into a comprehensive life care plan covering the entire scope of care needs in our life care plan. Therefore, the issue most recently broached about limited life care plans takes on some additional meanings to me and for which I am not sure what concerns are being made overall.
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Dan Bagwell
Medical Case Manager
dmbhome@swbell.net
San Antonio, TX United States
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