What does a physician contribute to a life care plan?

Why do the treatment intervals in a life care plan change?

Every future-care line contains an implicit assumption about how long a result lasts. Radiofrequency ablation is projected at some interval because the nerve regenerates; an injection is projected because the effect wears off. Those intervals are population figures, and this patient is one person.

What shortens them is usually terrain. An untreated inflammatory and metabolic load means a procedural result does not hold as long, which changes the interval and therefore the number. That is why the metabolic workup belongs in a life-care discussion rather than only in the clinical chart — see metabolic dysfunction and injury.

It also cuts the other way, honestly: where the terrain is treated and improves, the projected frequency should come down. A plan that only ever moves in one direction is advocacy.

Do treatments insurance won’t cover belong in a life care plan?

Where an indicated treatment is not funded by any plan, it still belongs in the forecast, priced as an out-of-pocket cost. The clinical indication and the coverage status are two separate facts and should appear separately in the record — see orthobiologics and damages and coverage is not evidence.

This practice is not aligned to a side. Its obligation runs to the patient’s health and safety, which is the same reason it is not beholden to any position that would keep it from seeing what is actually there. We do not offer opinions on liability, we do not accept a referral or a review conditioned on reaching a particular conclusion, and we will say plainly when the evidence does not support the claim — whichever party was hoping otherwise.

Frequently asked questions

Will you sign a life-care plan?

We will provide the clinical foundation and review the medical assumptions in a planner’s draft. We do not author the plan or its costs.

How far out can a prognosis be stated?

Honestly, not far. Stating a range with its basis is better than a single figure with none.

Does a projected treatment have to be one the patient is already receiving?

No, but it has to be indicated for a diagnosis already established. A projection for a treatment aimed at an unidentified generator is not defensible — see diagnostic nerve blocks.

What if the patient improves?

Then the plan should be revised downward. We will say so if asked.

What is a life care plan?

A life care plan is a forecast of the future care an injured person will need, with a cost built on top of it. In a pain claim it is only as good as what is known about that particular body: the diagnosis and pain generator, which treatments are indicated, the interval between them, and how long each result is expected to hold.

What is a life care plan in a lawsuit?

In a lawsuit, the life care plan is the future-care figure. A planner authors it and sets the costs; the physician supplies the clinical foundation underneath — the indication for each treatment, the expected interval and the prognosis with and without treatment — and reviews the medical assumptions in the draft. This practice publishes no prices and does not author the plan.

What does a life care plan look like?

It is a list of future treatments, and each line should state three things: the indication, the interval and the assumption about how long the result will hold. Indicated treatments that no plan funds still appear, priced as out-of-pocket costs, with coverage status recorded separately from the clinical indication. When the patient improves, the plan is revised downward.

Related reading

• Orthobiologics, future care and damages
• Metabolic dysfunction and injury
• A denial is a budgeting decision
• What terrain means
• Records that survive cross