The Specialties: Part VII – Legal Counsel

Legal Counseling

by Tiffany Cerda.

Dr. Thomas Merrill attended the Dr. William M. Scholl College of Podiatric Medicine. He completed his residency at Northlake Regional Medical Center, which is currently known as Emory Decatur. Dr. Merrill is currently the Mercy Hospital Residency program Director. The questions are based on expanding our knowledge of legal counseling as a Podiatrist. 

I began the interview by asking “How did you start working in this area of podiatry?”

Dr. Merrill said,

“E.Dalton McGlamry, DPM inspired me to improve my documentation and communication skills. He stated that a better understanding of medical-legal issues would make me a better doctor. When I came to Miami, Keith Kashuk, DPM connected me with several attorneys and helped me appreciate the science of the worker’s compensation and malpractice case process.”

I was curious about how someone would get involved in legal counseling so I continued by asking: “Is this area of podiatry something you always wanted to explore, or did your interest slowly progress?”

He stated, 

“I think all of us want to do the best we can for our patients. Choosing the right diagnosis and treatment has a textbook component and a patient interaction component. They go together. This is true whether the case has no litigation, product liability, worker’s compensation or medical malpractice. We all want to improve our patient’s lives and improve our clinical skills.”

My follow up questions was: “What are the most common cases you reviewed?”

He explained that there are several large patient studies classifying medical malpractice cases. Mostly, these cases are the same types of cases we do every day.

“In my opinion, there are two factors that make a patient more likely to have a poor outcome and be more likely to start litigation: 1. Tobacco 2. Antidepressant medications. These two items are significant and can be used to help a doctor appreciate an added risk of patient dissatisfaction.”

When I asked him for advice for someone wanting to be involved in this sort of work, Dr. Merrill suggested that the easiest way to get these cases is to take the continuing medical education courses for worker’s compensation and acknowledge your additional education certificate on your curriculum vitae.

“I think most doctors are not interested in medical-legal case review. Your review services will soon be requested.”

I then posed the question: “Have you ever worked on a case where you were conflicted about your testimony or opinion? If so, how did you handle this situation?”

He responded with:

“Yes, but the answer is simple. Treat others as you would want to be treated. This is not always easy to do, but the basic concept of patient care and safety comes first. I think the idea of ‘conflict’ can also mean empathy or caring for the patient and doctor. The most emotional cases involve harm or damage to the patient even when the standard of care is met. Everything was done correctly but the outcome is not what the patient or doctor expected. Both sides wish the result was different. Bad things can happen to good people.” 

The SpecialtiesThis led me to ask: “Do you have a systematic process when reviewing a case?” 

He simply said: “Yes, I review the case chronologically. I try to follow the patient and doctor as the situation changes and decisions are made over time.”

I closed with this final question: “Has there been a case that you remember having an impact on you or resonating with you?”

He answered with this:

“Yes. Tobacco is a terrible addiction. Nobody stops smoking and the effect on the foot is devastating. Antidepressant medications create a difficult patient-doctor dynamic and can exaggerate any adverse situation. Diabetes is unrelenting and can destroy bone, tendon, nerve, and skin. Diabetic dementia and diabetic denial are real. Diabetic side effects cause patients to be noncompliant.”


by Tiffany Cerda.

School: Barry University School of Podiatric Medicine

The Specialties

Special Edition, Legal, Interview

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