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Sunday, February 28, 2010

"Incesteous" Relationships Between Lawyers And Doctors.

Law firm, medical clinic accused of trading clients
By Andrew Wolfson

Injured when another car struck hers in June 2008, Sharon Langford of Louisville went to see the law firm of Winters Yonker & Rousselle.

She said the firm told her that her health insurance wouldn't cover injuries suffered in car wrecks and that she should get all medical care at 1st Physician Rehabilitation Inc., a clinic on Crums Lane.

When Langford needed surgery, the firm flew her to another clinic in Florida.

She only discovered later, she said, that both clinics are owned by Gary Kompothecras, a chiropractor who also owns the heavily advertised referral service 1-800-ASK-GARY, which refers clients to Winters & Yonker, as the firm is now known, in Louisville and Florida.

In a suit filed last month against the law firm and Kompothecras' Louisville clinic, Langford said the relationship between the two — and their alleged deception — deprived her of the right to treatment by her doctors and cost her money.

Sam Carl, one of her lawyers, said Winters & Yonker settled her accident case for $200,000, then paid itself $70,000 and the medical providers $64,518, leaving her the smallest share, $62,738. (The balance covered medical expenses before she hired the firm.)

“I felt they weren't honest with me,” Langford, a former state corrections officer, said in an interview.

The law firm and medical clinic call the suit frivolous and say they will prevail.

Marc Yonker, a partner in Tampa-based Winters & Yonker, declined to answer questions about his firm's relationship with Kompothecras' companies, and Kompothecras also had no comment, said Gregory Zitani, one of his lawyers.

Lawyers who defend auto wreck cases say Winters & Yonker isn't the only firm that seems to routinely refer clients to the same medical clinics.

But Langford and her lawyers say the case reveals an interconnected network that is rife with potential conflicts of interest.

Carl said the relationship between Winters & Yonker and the Kompothecras clinics raises “disturbing questions” about whether clients are getting the best medical care.

Other lawyers say the arrangement creates an incentive for the clinics to say injuries are accident-related and to run up medical bills.

And ethics experts say that the reciprocal referrals violate ethics rules in Kentucky and Florida, which bar lawyers from giving anything of value in exchange for referrals.

“A lawyer has the obligation to send the client to the best place, not the place from which the lawyer is getting business,” explained Northwestern University law professor Steven Lubet.

There are no publicly available complaints pending against the firm's lawyers at the Kentucky Bar Association, said Linda Gosnell, chief bar counsel, but the suit has been brought to the bar's attention.
Firm's use of clinic

The Courier-Journal's review of Jefferson Circuit Court records found more than a dozen other auto accident and slip-and-fall cases in which Winters & Yonker clients were treated at 1st Physician, including several in which clients said they were sent there by the law firm.

Louisville trial lawyer Chris Meinhart, who has challenged Winters & Yonker's relationship with another Florida medical clinic, said other personal-injury attorneys occasionally recommend doctors to clients — in part because many family doctors don't want to get involved in the legal system.

But Meinhart said Winters & Yonker “systemically” refers clients to a few providers.

In her lawsuit, Langford said that she was examined at the Crums Lane clinic by Dr. Francisco Gomes, who is licensed in Kentucky but is listed as an “inactive physician” by the Kentucky Board of Medical Licensure.

Gomes, who is licensed in Florida and works in one of Kompothecras' clinics there, said Langford needed surgery, and she was flown to Florida, where in September 2008 he removed a disc from her neck and fused two vertebrae, according to her lawsuit.

Lloyd Vest, general counsel for the Kentucky Medical Licensure Board, said it is investigating Gomes, but he couldn't elaborate.

Gomes didn't respond to calls and e-mails.

Kompothecras' clinics don't accept health insurance, according to their Web sites.

Instead, they first bill their patients' auto-insurance carriers to recover from the personal-injury protection all drivers must carry. The mandatory coverage — which must be at least $10,000 — pays for medical bills and lost wages without suing the at-fault driver.

The clinics also obtain a “letter of protection” from Winters & Yonker, in which the law firm promises to cover medical expenses from any settlement or verdict the patient wins in the legal case.

Langford alleges that neither the law firm nor Kompothecras' clinics disclosed that they give each other business “in consideration for receiving client referrals.”

In the suit, she seeks compensatory and punitive damages, as well as the forfeiture of the law firm's fee, claiming the medical costs deducted from her settlement would have been far less if they had been covered by her Humana policy.

Langford is the only former client who has sued Winters & Yonker, according to Jefferson Circuit Court records. But auto-insurance companies and their lawyers have, in other cases, attempted to alert juries to what they say is a cozy relationship between the firm and medical providers.

For example, after another Winters & Yonker client, Elsia Clay of Louisville, sued over injuries she claimed she suffered in a rear-end accident on Feb. 5, 2008, attorneys for the other driver and Allstate Insurance Co. questioned Dr. Gregory Bronner, the medical director at 1st Physician, where Clay was treated.

Bonner acknowledged that the clinic is paid in part based on how much Winters & Yonker recovers for its clients.

A jury awarded Clay only $10,320 of the $120,000 in damages that lawyers at Winters & Yonker sought for her. That included bills from 1st Physician and from an MRI clinic in Jeffersonville, Ind., that is owned by one of Kompothecras' employees, according to state records.

800 referral line

That link is further demonstrated by the “1-800-ASK-GARY” referral line.

According to its Web site, the line promises to connect auto-accident victims with injury attorneys and doctors “who are uniquely suited to your situation.”

Stephanie Portman of Louisville said that when she called the referral line last month, the operator put an intake specialist from Winters & Yonker on the line, who recommended that she seek treatment at clinics owned by Kompothecras.

Kompothecras owns a chain of 40 clinics in Florida and Minnesota, as well 1st Physician, and has spent as much as $4million a year in advertising and marketing expenses for 1-800-ASK-GARY, according to a suit he filed in Florida a few years ago against some of his competitors.

His company is private and doesn't disclose its profits.

Winters & Yonker clients do see other medical providers, according to court records.

But former employees, including Brian Clear, who worked for the firm for about a year signing up clients, said in interviews that there was an expectation clients would be sent to 1st Physicians Rehab or a few other clinics that referred business to the law firm.

He said the firm kept records on where clients were referred.

In a Jefferson Circuit Court case settled in December, a Tampa-based clinic that has treated Winters & Yonker clients, Laser Spine Institute, was forced to accept only $10,000 of its $124,850 bill after attorneys challenged the clinic's relationship with the law firm.

Debbie Lynch initially hired Winters & Yonker to represent her in her car-accident suit. But after she fired the firm and hired other lawyers, she claimed in court papers that the law firm set up surgery for Lynch at the Florida clinic while she was still being treated by her doctors in Louisville.

One of her new lawyers, Meinhart, said Lynch's accident was a “fender bender,” but the clinic and the law firm allowed her medical bills to escalate so high that “there is no way the case could have been settled or tried to a verdict” in an amount sufficient to pay them.

Meinhart said Lynch was never told about the clinic and firm's “outstanding relationship.”

Winters & Yonker and Lynch declined to discuss the case.

Dotty Bollinger, an attorney for Laser Spine Institute, said that the company has “acknowledged and addressed Lynch's concerns” and that her case was settled “in a fair manner.”



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