"THIS is a 43-year-old female lawyer who presents with [horizontal ellipsis]" Have you ever heard this kind of presentation opening on rounds? Why do some physicians seem more on guard or wary when a patient is a lawyer, rather than a management consultant, an administrative assistant, a librarian, or a financial planner? Is it because certain viruses target lawyers? Do attorneys have tougher skin to penetrate with a catheter or needle? Are there environmental exposures that afflict attorneys and not others who work in similar office settings? Are lawyers actually a different species from humans?
Although some defendants in malpractice cases may claim that lawyers are a different species, basic taxonomy tells you that they aren't. With the staggering number and cost of malpractice lawsuits in this country, many physicians consciously or unconsciously associate lawyers with malpractice lawsuits and may assume that a lawyer is more likely to sue or know other lawyers who are willing to sue.
WHAT TO DO
Before you automatically assume that an attorney is carefully observing you and finding ways to sue you, remember that, just like physicians, there are a wide variety of personalities and job descriptions among lawyers. In fact "ambulance-chasing" malpractice or personal injury lawyers make up only a small percentage of the total number of lawyers. For their 2006 America's Best Graduate School rankings, U.S. News and World Report ranked 179 U.S. law schools. Think about how many graduates these law schools produce each year. Many specialize in a wide variety of nonmedical-related issues, including patents and trademarks, taxes, the environment, corporations, immigration, entertainment, and employment. A number of lawyers don't even practice law anymore, having entered politics, business, writing, entertainment (for example, Ben Stein from Ferris Beuller's Day Off and Win Ben Stein's Money is a lawyer), and even medicine.
Moreover, the fact is, anyone can bring a lawsuit against you. The person doesn't need to be a lawyer. He can be of any occupation, ethnicity, gender, socioeconomic status, or background. He can even be a physician. You can't predict who will be more or less likely to use legal action. Lawsuits arise from several different situations. In some cases, legitimate negligence occurred. In others, the physician made an honest, human mistake. In still others, bad outcomes occurred despite the fact that everything was done correctly and properly. Sometimes, no bad outcomes or mistakes occurred. The plaintiff may simply have a personal dislike for or vendetta against the physician or be looking to exploit the system to make money. As you can see, these situations can occur with anyone.
Finally, some of the patients who don't reveal their professions may in fact be attorneys. Either no one asked them their occupations or they chose not to reveal it because they were no longer practicing, weren't in a condition to answer, or didn't want to be treated differently. In fact, if they're looking for lawsuits, it's possible that they may want to catch health-care workers off guard by "hiding" as a non-attorney. What's more, patients who aren't attorneys may have spouses, siblings, parents, children, or best friends who are attorneys. The bottom line is that lawyers can be anywhere, they aren't necessarily more likely to sue you, and lawsuits can come from anyone. Therefore, in this case, "occupational profiling" isn't going to help you.
Therefore, there is little attorney-specific advice. The patient's occupation shouldn't determine whether or how you treat the patient. You must be vigilant, conscientious, and careful with every patient. If possible, try to develop a rapport with each patient and communicate well. Carefully document what you do. Act naturally. If you keep thinking that this patient is an attorney, then you may act nervous or uncomfortable, which may unnecessarily worry the patient or make him wonder what you have to hide. Don't treat the patient any differently. Don't do any procedures that you aren't qualified to do or comfortable doing. Recognize situations where supervision or accompaniment by another health-care worker or witness is important, such as during breast or pelvic examinations or anything associated with risk or discomfort.
PREVENTION AND PREPARATION
Properly learn and practice procedures. Sharpen your patient interaction and communication skills. Learn what must be documented and how to document it. Physicians and physicians-in-training should make an effort to understand the medical legal system as well as they can. Nowadays, learning the legal ramifications of what you do may be just as important as knowing histology and pharmacology. Ask experienced physicians about important legal issues and concerns. Understand important medical-legal decisions, cases, and policies. In the end, you're better off paying more attention to the law and what you're doing than whether or not your patient is a lawyer.