Personal injury mills are becoming very commonplace, especially in densely populated urban areas. These are places where injuries are literally manufactured, or exaggerated, all in the name of profit. These facilities are combined care practices that have bad reputations for creating or perpetuating back pain conditions. Injury mills are a huge problem for the insurance industry, back pain patients and society as a whole.
I had to deal with many of these horrific facilities during my career as a trial preparation investigator in New York and these experiences really opened my eyes to the corruption which is possible inside the hallowed medical establishment.
What is a Personal Injury Mill?
When I use this term, I am describing a dishonest combined care practice that offers many therapeutic treatments for back pain in one location. Usually, the practice is run by a medical doctor who employs other care providers to provide a variety of treatments to patients. Chiropractors, physical therapists, massage therapists and others are all on staff, waiting to work together to treat back pain patients.
The facility usually works with their own radiologist, so that all the diagnostic work can be interpreted to fit a diverse protocol of treatment options. The idea here is to keep all the diagnostics and treatment within the same facility, to avoid any outside influence on the treatment regimen. (and to keep all the profit in-house and prevent a more honest caregiver from interfering in the scam!)
There are plenty of legitimate combined care practices. Good doctors (and other providers) only want the best for their patients. However, many are really just medically licensed thieves who exploit the patient and the insurance system. This is the case with injury mills.
Combined Care vs. Personal Injury Mills
A good combined care practice is not a personal injury mill. A good practice will behave like a collection of independent practitioners, who just happen to work together. The diagnosis will be accurate. The treatment will be what is best for the patient, regardless of whether the care comes from within the practice or outside of it. The doctor will recommend getting a second opinion if the patient has any doubts. The treatment will be conservative and work towards ending the pain condition. A good combined care practice is a convenience and blessing for the patient.
The diagnosis from a bad doctor at an injury mill creates a powerful nocebo effect on the patient. Their symptoms will usually get far worse under the care of a personal injury mill. The patient will be kept under the care of providers who will all work to expand the treatment options for economic motivations alone.
For example, the doctor will recommend chiropractic and physical therapy. The physical therapist will recommend electrotherapy and the chiropractor will recommend acupuncture. The doctor will tell the patient that these treatments all work well together. Drugs will be prescribed without regard to possible addictions or health risk to the patient.
The patient becomes a pawn in the facility. More and more treatments mean more and more focus on the pain. More focus on the pain leads to worse symptoms. Careful and premeditated psychological tactics used by the doctors increases the nocebo effect on the hapless victim. Eventually, the patient either winds up in a lifelong protocol of treatments or in unneeded or premature surgery.
For a thorough look at how doctors keep their charges in care indefinitely, read my article detailing the huge problem of symptomatic back pain treatment.
Any care provider can take full advantage of a patient rather easily. The payment for services is virtually never made by the patient, so most will never complain. These fraudulent practices employ attorneys and insurance experts who steal huge amounts of $$$ from the health insurance companies, workers compensation or through litigation.
Some of these practices even go so far as to actually recruit and pay people to get into accidents! They enroll the victims in a care program that defrauds the insurance companies for vast sums of money. This is the extent that some of these medical professionals will go, all in the name of the almighty dollar.
Ending Personal Injury Mills
Do not get involved with a care provider that fits the description of a personal injury mill. You will suffer. Your health will suffer. Your treatments will be sub-par and unnecessary. You might even wind up in jail.
Insurance investigators are working closely with federal and state law enforcement to end these practices. Unfortunately, the penalties are not great enough to prevent more and more combined care practices from turning into personal injury mills. The lure of huge amounts of easy money is too strong of a temptation for some doctors.
Personally, I would like to see ridiculously strict penalties for insurance fraud committed by doctors and lawyers. Medicine and law are professions that put a person in the top echelon for potential monetary earnings. There is simply no need, and no excuse, to become involved in illegal and immoral activities, just to increase the already tremendous potential to earn.
I would recommend long prison sentences, fines amounting to every dollar that these providers stole, plus the permanent revocation of all rights and privileges to practice any type of medicine or law ever. If we made a strong statement of intolerance for this type of behavior, everyone would benefit:
Less needless litigation.
Less chronic pain due to nocebo effect.
Better quality of treatments.
Unfortunately, doctors and lawyers are human and often succumb to the lure of easy money, regardless of the moral implications. It is a sad but true commentary on the state of our healthcare system and the growing prevalence of personal injury mills.