Healthcare Consulting & Life Care Planning – Interview

Interview/LCP: Patricia Hedrick

© 2008 The Medical-Legal News

Patricia Hedrick is founder of Med-Legal Healthcare Consultants, Inc. and resides in the greater Los Angeles area. She is married with two children and enjoys sailing, reading, kickboxing and dancing. She has been certified in life care planning since 1999 and has been a registered nurse for 20-plus years working in a variety of settings. Her company provides case management, life care planning, legal nurse consulting and nurse coaching. She is an international business consultant, speaker, author and is a testifying expert; pattyhedrick@gmail.com.

Healthcare Consultant & Life Care Planner Patricia Hendrick on Legal Nurse Consulting & Life Planning.

Q: How did you begin as a life care planner?
A: Through contacts I had made as a nurse case manager, I received my first referral for a life care plan on a catastrophic case for an insurance company.

Q: What professional titles do you hold?
A: I have my BSN in nursing and a BA in rehabilitation from Seattle University. I am a Certified Registered Rehabilitation Nurse (CRRN), Certified Case Manager (CCM), Certified Life Care Planner (CLCP) and Certified Professional Disability Manager (CPDM).
Currently I am the president for the Los Angeles Chapter of Legal Nurse Consultants (AALNC-LA) and am on the board for Sigma Theta Tau Honor Society of Nursing and Rehabilitation Nurses Society (RNS).

Q: Do you testify as a life care planner?
A: Yes.

Q: As a life care planner do you need to continue to work clinically to qualify as an expert?
A: I continue to work as a catastrophic case manager and legal nurse consultant. I maintain my certification in life care planning by obtaining the required continuing education units and being involved in professional organizations and attending educational events.

Q: How many years have you been in LCP practice?
A: I became a certified life care planner in 1999 but had been assisting with life care plans for a few years prior.

Q: What are your LCP specialty areas?
A: Traumatic brain injury, spinal cord injury, strokes, general rehabilitation, amputations, geriatrics and pediatrics.

Q: How did you become aware of life care planning as a specialty practice?
A: Through case management and rehabilitation nursing journals and some of my associates, who were taking the training program.

Q: Why did you go into life care planning?
A: I wanted to experience working the full continuum of care from being a rehabilitation nurse in the acute setting to developing a life care plan, which is critical to protect a catastrophically injured patient’s future quality of life. Life care plans are a tool for case managers and families to use to help ensure that patients obtain the care, equipment and services they need. LCPs have frequently been referred to as their blueprint for future care.

Q: What was your clinical experience before going into life care planning?
A: I previously worked on a rehabilitation unit alternating between the spinal cord, traumatic brain injury and stroke rehabilitation units. I then worked for a case management company providing field and telephonic case management services before going into management and then my own business.

Q: Describe your transition from clinical practice to LCP practice.
A: Working on the rehabilitation unit, I always wondered about the patients after they left. This is what drew me to case management. The family and patient seemed overwhelmed with how they were going to manage their care once discharged, and often times did not know where to start.
When I worked in the hospital we did not have internal case managers. We had a discharge planner who would sometimes contact an external case manager if it was a complex enough case. Sometime the patients or family would come back to visit and they were overwhelmed with trying to coordinate the patient’s care.
As a case manager, you are the liaison between the patient, the insurance company, family, attorneys, physicians, etc. and help to coordinate the patient’s care and provide resources. I wanted to work as an external case manager or field case manager, which is what I did when I left the hospital.
I came in contact with some life care planners and knew immediately it would be something I would enjoy and fit well with my background. Life care planning combined my rehabilitation nursing, vocational rehabilitation and case management backgrounds. It fit very well with starting my own company and offering me flexibility, which was one of the main reasons I wanted to branch out on my own.

Q: How hard was it for you to start as a life care planner?
A: Change is never easy, but to some degree it was a natural progression from case management. Part of being a case manager is determining what the future care or needs are and being proactive. Life care planners had been contacting me on my case management cases requesting input — and giving recommendations on some of my cases.
With life care planning it is a collaborative process that involves contacting physicians, family, other providers, therapists, vocational counselors, etc., for recommendations. As a case manager, I was part of the collaborative process. Now, I wanted to be the person putting the plan together.

Q: What barriers did you face?
A: Initially it can be a little overwhelming. There is always that fear that you are forgetting something in your plan that will be very important. Also, when I first started it was a fairly new field and there were not a lot of resources. Many physicians, therapists, etc., had never heard of a life care plan and some providers were skeptical about providing any costing resources.

Q: Did you obtain any formal training? If so, where?
A: I received my training from the University of Florida and was very fortunate to have some of the industry leaders as my instructors. I continue to participate in the Life Care Planning Summits, conferences and continuing education classes. I became a Certified Life Care Planner (CLCP) in 1999.

Q: Describe your first case.
A: My first major case involved a nurse who was working in a hospital and was in the hyperbaric chamber with a patient, and ended up as a quadriplegic. She was married with children and had been very active. There were many layers to this case and I worked closely with the team to determine current and future needs.

Q: What is your most memorable case? Why?
A: The first time I went to trial was probably my most memorable case. This was a case about a man in an MVA rollover in which he became both blind and paraplegic. It was my first time at trial, but more important was the man’s incredible attitude and the support system he received from his fiancee. The two worked together to make the best of a bad situation. He never lost his sense of humor or interest in what was happening in the world, even though his world had so radically changed.

Q: What was your most difficult case? Why?
A: My most difficult case involved a young teenager who was traveling with his family and was involved in a rollover accident. He sustained a severe traumatic brain injury and his father and some other people were killed. His two brothers and he all had to move to California to live with their aunt since the mother was not in the picture. This case was challenging because there were many issues dealing with family, guardianship, schools, living arrangements, treatment, etc.

Q: Do you use subcontractors in doing your life care plans? If so, in what capacity?
A: Yes, sometimes for research or the costing of items.

Q: What are the top three things you like most about being an LCP?
A: Collaborative process: I miss working on the rehabilitation unit providing direct care, yet life care planning gives me the opportunity to interact with the multidisciplinary team and family to determine a patient’s current and long-term needs.
Flexibility: I can work on the plan at five o’clock in the morning or at midnight. It allows me to have time for other things during the day if needed.
Life care planning process: Providing a consistent methodology to the plan helps ensure the patient will have a comprehensive plan that addresses both the patient’s current and future needs, and works as a tool for the case manager and family to use to help guide them.

Q: How often do you market?
A: I have been told not often enough. It seems to always end up at the bottom of the to-do list.

Q: What is your biggest marketing challenge?
A: Taking the time to market, and following up afterward.

Q: What marketing tools do you use?
A: Website, expert witness directories and networking.

Q: What do you think is the biggest reason you continue to receive cases?
A: The majority of my cases are referrals from previous clients or colleagues, or from a new attorney who has been referred to me. I receive cases from both plaintiff and defense sides. I try to make sure I have a clear understanding of any deadlines, trials, mediations, etc., so that there is no miscommunication as to when the plan needs to be completed.

Q: Have you written any articles? Any chapters or books? How many and on what topics?
A: Yes, I have a chapter in Nurse Entrepreneurs, Tales of Nurses in Business, published by the National Nurses in Business Association (nnba.net) and an article on life care planning published by California-Legal.

Q: Have you given any presentations?
A: Yes.

Q: Give three areas of interest other than life care planning.
A: Catastrophic case management, legal nurse consulting services including chronologies, attending defense medical exams, expert witness testimony and providing nurse coaching services.

Q: Where do you see yourself in 5 years?
A: I will continue to provide case management, life care planning and legal nurse consulting services. I would like to expand my nurse coaching and give more presentations. Who knows? Maybe I’ll even write a book.

Q: Where do you see the specialty of life care planning going in the next five years?
A: I think life care planning will continue to evolve and be recognized for the added quality of life it can provide. By providing services and being proactive, costly complications can be prevented or reduced.
Also, as Medicare Set Asides become more prevalent, life care plans will continue to be needed to assist with the development for the MSAs.

Q: What recommendations would you make to a new LCP about the challenges of this specialty?
A: Never stop learning. There are a multitude of resources available now including professional organizations, listserves, peer reviewed journals, books and excellent conferences and seminars. The field is rapidly changing and it is important to stay on top of it. Also, I recommend when first starting out that you have a mentor to bounce ideas off of. Actually, I still network with other life care planners and value their input and recommendations.

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