When are You Ready to Hire LNC Subcontractors?

Do you feel about LNC subcontractors like this legal nurse consultant?

“I fear the time it may take to find reliable, high quality LNCs who will meet deadlines. I do not have time to train them or do the work at the last-minute if they fail to meet my deadline. Because of this I keep my business small and limit my marketing because I already have enough to too much work.”

This quote from a legal nurse consultant reveals the dilemma many LNCs face when contemplating hiring subcontractors. In this post, I cover some of the common questions I receive about hiring LNC subcontractors.

Risks and Benefits

Sure, there are risks when you rely on subcontractors. The person you hire may spend too many hours working on a case, hours that you know you cannot bill to the client. It is a realistic fear that the subcontractor may turn in work at the last-minute, which does not give you time to proofread and fix any errors.

In rare situations, a subcontractor may go behind your back and market directly to your clients. One subcontractor posed this question to me: “How can we do away with non-competes to make it fair for everyone?” This is easy to answer: The LNC who got the client owns the client.

The LNC should expect LNC subcontractors to adhere to non-compete terms related to any clients the LNC introduced to the subcontractor.

It is NOT fair to the LNC business owner for the subcontractor to poach the client.

Another question I received was, “How long does one reasonably have to wait to be hired directly by a lawyer that you previously sub-contracted with through another company?” The answer to this question should be defined in the written agreement between the LNC and the subcontractor. It is common to require a 1-2-year period. (There may also be state laws that define this term.)

Advantages of Hiring Subcontractors

The quote by the LNC at the beginning of this article sheds light on what can happen if you do not hire subcontractors.

Unless you want to intentionally limit the size of your business (and some LNCs make a conscious decision to do so), your business will not grow without subcontractors. You may feel like a hamster on a wheel – endlessly racing to keep up with the work.

Also, if you are the person who does all the work, what happens to your business if you

• Become sick?
• Want a vacation?
• Want to sell the business?
• Get a case in that you do not have the experience to analyze?

Working with subcontractors provides you with a way to grow your business, to broaden your services, and create something that you can potentially sell.

If you are doing all the cases, you do not have a saleable business.

Subcontractors can

• Do research on standards of care, cost of future care, or medical issues
• Organize medical records
• Complete chronologies and timelines
• Write medical summaries
• Write up observations of independent medical examinations
• Serve as expert witnesses

But be cautious when you are an expert witness: An anesthesiologist once said to me, “I would like to hire you to read depositions for me so that I can watch the baseball game instead of reading all those legal documents.” I declined the work. If you are an expert witness, you should not hire someone to read documents that are instrumental in forming your opinions on standards of care.

Don’t overlook the opportunity to hire physicians as subcontractors. I developed a strong relationship with physicians who screened medical malpractice cases for me. Although I thought I was very capable of screening medical malpractice cases, I discovered my physicians were better.

Disadvantages of Hiring LNC Subcontractors

Hiring subcontractors is not for you if you are hypercritical, don’t like to give up control, are a perfectionist or think no one can do LNC cases as well as you can. If you don’t trust others to do work for you, this model is not right for you.

Effective supervision of LNC subcontractors involves a level of trust. The case may involve a specialty that you do not know well, and you need to be able to trust in the capability of the subcontractor helping you.

You also need a degree of flexibility, the ability to give clear directions, and willingness to go through a learning curve. LNCs who are willing to be subcontractors may be on the inexperienced side, although there are exceptions of LNCs who don’t want to develop a business and prefer to get work from other LNCs. They do this knowing they are giving up a higher rate of billable work.

Hire slowly, fire quickly.

When you hire inexperienced people, be prepared for the time needed to carefully review their work product and to stop using subcontractors who are not meeting your standards, are flustered by technology, or can’t follow instructions.

You are in a buyer’s market – lots of LNCs want the experience you can provide.

Another disadvantage of hiring LNC subcontractors is working with people in your local area. You run the risk of training LNCs who may become your competitors, as I did. You can avoid this issue by hiring subcontractors from other parts of the country.

How to Find Subcontractors

When you focus on finding people interested in being LNC subcontractors you will find a lot of people interested in this role. They answer the phone and get a case without marketing. What could be better?

By being active on LNC listservs and LinkedIn groups, you will find LNCs and physicians who are willing to subcontract. Word of mouth referrals are also great sources for locating subcontractors. When you need a person with particular expertise, it is often possible to locate people who do not think of themselves as medical legal consultants, but as experts in a specific field.

When You Get an Inquiry

LNC subcontractors may approach you asking for work. Review the person’s resume or CV, ask for sample work product and for references. Look for typos, the depth of analysis, and the ability to attractively format a document. While there are no guarantees the person wanting to work with you will do an excellent job, you can eliminate some people based on this type of screening.

In your written agreement with the subcontractor, define

• Hourly rate for the LNC subcontractor (usually 33-50% of your billable rate)
• When you will pay the person
• What happens if you cannot collect all the funds owed to you (I recommend paying the LNC subcontractor a prorated portion.)
• That you will edit the work product, which belongs to you and will have your branding on it. The LNC subcontractor’s name (unless this person is an expert witness) is not going to appear on the final product.
• That the work product must be of a quality that meets industry standards
• That if the LNC subcontractor offers a quality guarantee, and you are not happy, you won’t pay
• The LNC subcontractor carries a medical malpractice insurance policy that specifies it is for medical legal work

How to Shine

Once you’ve embraced the idea of using subcontractors, you can turn this into a competitive advantage for your business. Attorneys worry about their consultants not being available or overloaded. They also know that medicine and nursing are complex and that people with expertise in those areas are in the best position to offer learned opinions and guidance.

Knowing that you use, train and supervise subcontractors should give an attorney some peace of mind.

Through my coaching program at LNCAcademy.com I work with LNCs to help them build strong businesses. One of the options we discuss, as I take people by the hand and lead them every step of the way, is subcontracting. If this sounds like something you are interested in, please check this link for the opportunity to schedule a call with me.

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