As a physician who develops life care plans, I have to chime in on this. I have also presented the physician’s scope of practice during a panel presentation at the 2021 virtual Symposium to refer to if you are able.
I’ll admit that the scope of practice for physicians can be more broad than other specialties, because our physical examination, and ability to order a wide range of diagnostic testing, therapies, referrals, etc., as well as the understanding of indications for a variety of procedures, etc., are inherent to the profession. I don’t always find it necessary to speak directly to a treating physician if their treatment plan is well described in the medical record and the standard of practice and preponderance of the medical literature point toward the typical plan of care for an individual. To me, that is my collaboration, and doesn’t waste both of our times if unnecessary. Having said that, I contact treating providers frequently for life care plans, for clarity.
Additionally, I do not make it a practice to project items or services not discussed or not clearly referred to in the medical record review, but rather may refer to some as potential care in the discussion of the life care plan. That, I believe, is educational for the intended end-users of the life care plan…the evaluee, the family, the treatment providers, case manager, trust officer if applicable, etc. Where I understand some physician life care planners get into trouble is that they either make their own specific treatment recommendations without medical foundation or they disagree with the treating physician’s plan of care and write in their own. I’ve been asked related questions to this in deposition time and time again, and have made sure to note that the treaters are the “boots on the ground” for the individual. Having medical foundation based upon the medical record review, the interview, evaluation, and examination of the evaluee and family, the standards of practice and medical literature supporting the mitigation of known complications of specific disorders is, or should be, the goal of every life care planner.
Kristi B. Bagnell, MD, CLCP
Original Message:
Sent: 3/15/2023 12:30:00 PM
From: Tanya Rutherford-Owen
Subject: RE: Can MD LCP's independently indicate what a plaintiff needs for future care??????
Dear Jennifer,
As usual, the collective input from this group proves to be invaluable. As practicing life care planners, we practice without licensure, so unlike other occupations, we are not strictly regulated by any one entity, including any one certifying body. Rather, we receive guidance from the collective as manifested in peer-reviewed documents and processes. Some of these include the Standards of Practice previously mentioned. These also include peer-reviewed journals and as such I would point you to the Journal of Life Care Planning volume 17(1) which was guest edited by my esteemed colleague Karen Preston. In this issue, the scope of practice for many of the disciplines involved in life care planning (including MD life care planners) was outlined. There are charts at the back of this issue that outline what is within the scope of practice for each occupation.
Additionally, issue 16(4), which was guest edited by Cloie Johnson (who has already provided guidance on this topic) will be useful to you in terms of Consensus and Majority Statements. Both of these documents have long histories in life care planning and for more about their histories, JLCP volume 17(3) is recommended.
All of these issues, as well as other articles that may be useful for you can be found here:
The process of collaboration has been well-documented in life care planning literature. In addition to the above documents, I believe you will find this discussed in the following documents:
1. The American Academy of Physician Life Care Planners Standards of Practice
2. Life Care Planning: A Step-by-Step Guide (Weed & Owen, 2018)
3. Life Care Planning and Case Management Handbook, 4th edition (Weed & Berens, 2018, p. 625)
4. Neulicht et al (2001) Role and function study
This topic has also been addressed in the 5th edition of the Life Care Planning & Case Management Handbook.
As Kenneth Dennis mentioned, in every case it is the judge who serves as gatekeeper so ultimately the judge in this case will decide what the individual life care planner can and cannot do. However, I would strongly encourage your retaining attorney to do their due diligence in reading previous legal decisions where this opinion has been proffered. I believe they will find that the legal community has also disagreed with the assertion you are confronting.
These documents reflect years of work and when taken in totality demonstrate how important the transdisciplinary component to life care planning is. Hopefully, they will be helpful to you when serving to educate the parties involved in your case.
Tanya Rutherford Owen, Ph.D., CRC, CLCP, CDMS, LPC, FIALCP
Owen Vocational Services, Inc.
Managing Editor- Journal of Life Care Planning
Managing Editor- The Rehabilitation Professional
1706 E Joyce Blvd Suite 2
Fayetteville, AR 72703
(479) 718-6631
Fax (501) 421-6043
Original Message:
Sent: 3/14/2023 3:36:00 PM
From: Jennifer B Toles
Subject: Can MD LCP's independently indicate what a plaintiff needs for future care??????
Hello everyone,
I have a defense case that I am working on. It appears the plaintiff LCP is projecting care and indicates he is an MD so he can do so. Is there a clause on this or because he is a MD he can project care with minimal correspondence from other treating physicians. I don't want to sound presumptuous but to my understanding even if one is a MD they would need to seek outside sources (treaters) to utilize for future care.
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Jenn Toles MS CRC CLCP CCM
Guided Life Care Planning Services
info@guidedlifecare.com
Lithia, Florida
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