Is That Deductible? The Court Encounters

The Court System Involving My Patient

One the elements of family medicine I enjoy the most is the long term continuity of care that I get to enjoy with my patients and their families. It allows me to establish strong relationships that holistically encompass their family circle and the community. By being there for them consistently throughout their healthcare journey, I not only provide medical expertise but also offer comfort, support, and reassurance. The benefits of long-term continuity of care extend beyond just medical treatment, it enables me to gain a deep understanding of my patients' individual needs, preferences, and medical history. This knowledge allows for a more personalized care tailored to to my patient’s specific circumstances.

Involvement in patient’s lives is not always sequestered solely within the space of healthcare—because I practice holistic medicine— sometimes it spills over into the education, business, occupational, and legal systems.

For instance, I recently encountered a matter with a patient whom I hadn't seen in 10 years. This patient happened to be involved in a highly publicized murder case, which I vaguely remembered hearing about on the national news nearly 5 years ago. It wasn't until the past few weeks that the situation entered back into my professional domain. Unfortunately, I received papers from court officials on three separate occasions, summoning me to testify. The kicker was that the court case was located over 1000 miles away from my home! I was surprised to receive this notice, considering I hadn’t provided care for this person for the past decade. Unfortunately, during this time frame, our Electronic Health Record (EHR) had changed, and thus I couldn't even access his records to refresh my memory of the medical care I had provided. As a result, I didn't remember much.

One instance of these legal papers being "served" took place at my clinic, which truly startled staff and patients alike. The sheriff's deputy entering and demanding to interrupt me to fulfill his duty shocked my confused staff who all know me as law-abiding citizen. The other notifications occurred in the evenings at my home, one of which was on Christmas Eve. I must admit, my wife and kids couldn't help but secretly find it amusing that their usually straight-laced dad was "getting served."

With only a few days notice and my clinic schedule packed with 30 patients a day, I was essentially forced to attend these legal events and reschedule my patients. This posed a significant hardship on multiple levels, including the loss of income (as self-employed doctor, I am not on salary), the need to reschedule patients during my busiest time of the year, and, on top of it all—I was leaving for a 3-week CME in Australia-New Zealand in just a few weeks.

I arranged for my first deposition to take place at our local courthouse, conveniently located just a block from the clinic. During the meeting, I learned about my role in the case, which was to verify the accused's past medical history in my medical record system, specifically up until their 14th year of his life. Since I hadn't thought about this patient in nearly 10 years, there wasn't much to say other than confirming the accuracy of the medical documents.

And that is my beef in this entire situation in which I feel helplessly involved. The medical record clearly speaks for itself, and being dragged into lengthy court proceedings just to verify what the medical record already states seems like a poor use of my professional time. This is especially frustrating considering it is so disruptive and unpaid—although they do cover travel, lodging, and per diem expenses. Each day out of my clinic costs me about $2-$3000 in income—and this not recoverable.

I am currently working on finding a workaround with Zoom calls for remaining civil and criminal subpoenas so that I don't have to be away from my clinic for too long. Additionally, we are also working through a moratorium or exemption during my three-week international CME.

It can be quite challenging to juggle mid-winter clinic schedules, especially if you are familiar with rural family medicine. On top of that, the weeks leading up to any time away, as well as the weeks following, are always filled with a high volume of patients and urgent acute issues that hastily need worked in prior to my departure or are pensively stacked up for “doc’s return.” So, the idea of fitting in court appearances during this already busy time frame can be quite stressful and extremely disruptive to patient care.

The Court System & Jury Duty

In the midst of all this, as if I were in a comedic play, I also received a notice from our local courthouse informing me that it was my turn to serve on jury duty for a multi-day felony case involving three accused individuals, each with their own lawyers. Needless to say, it was going to be a complicated and lengthy trial. Unfortunately, there was no way to avoid it, so I had to rearrange patient appointments and staffing once again to accommodate attending the court case.

I had never done jury duty, so as an optimist, I had hoped that I wouldn't be selected for the trial jury, so I only scheduled myself out of the clinic for one day. However, upon arriving and observing the trial's structure, I started to worry that I might indeed be chosen and obligated to serve for several days. Despite feeling helpless, I understood the importance of dutifully serving our county's citizens.

Fortunately, several local attorneys were defending the clients recognized me and inquired about the hardships it would cause for me to be out of my clinic for jury service. As a result, they relieved me of serving on the jury. I was truly grateful to be excused from that obligation!

My CME Trip

As I mentioned earlier, I am about to embark on a three-week CME trip to Australia, New Zealand, and Samoa. My wife and I have been planning this trip for over a year. Not only is the CME aspect important and valuable to me, but it also helps my wife and I to work towards some of our personal retirement goals.

Our retirement travel goals include a visit to all the US national parks and as well as visiting our list of the "Wonders of the World". During this trip, we will be able to visit one of the more remote US National Parks in Samoa, as well as check off the Great Barrier Reef and the Sydney Opera House from our list.

It's going to be a great trip, and I'm excited to share about it to our community later this spring.

My Business Meeting

The busy week concluded with a business meeting at our home. This included meeting with our contractor who is currently reconstructing our garage following a house fire two months ago. Simultaneously, we are diligently working through the insurance claim-which included multiple phone calls today. Our garage served as both my "man-cave" and workout area, and it contained numerous professional mementos, personal and professional pictures, and a bunch of personal and business items. Cataloging all the business-professional items in the garage has been quite a task, in addition to managing the normal personal inventory of garage items. In top of all that, it's currently the middle of winter here, making it nearly impossible to complete the garage re-construction due to weather-related material constraints. Therefore, it will not be completed until spring as my contractor politely shared with me. The silver lining is that I can at least use the garage in the winter for my vehicle (I hate scraping windows)

Fortunately my company owned vehicle was not parked in the garage during the fire and thus was not damaged. But the combination of personal and corporately owned products that were damaged in my “man-cave”-garage all must be managed in unison as the garage is re-constructed to support it all.

On the same day, I conducted a medical visit in my home with a patient who holds a special place in my heart. He has undergone a liver transplant, recently started dialysis, and struggles with ulcerative colitis and gout. The poor guy came in with a gout flare-up, seeking guidance on what could be done. The answer was complex, but it ultimately involved adjusting his chronic daily steroid dosage and providing empathetic support to help him through this difficult time.

Is That Deductible?

The question of whether there was a business purpose that made the expenses deductible is now part of our puzzle for this week. As usual, the answer is… it just depends.

• Court appearances for my past patient- although each day out of my clinic costs me about precious income, there is no way to re-coup this costs—or expense out any of this professional obligation.

• Court appearance for jury duty-same answer as above, just different circumstances.

• CME Trip to New Zealand-Australia-this is a deductible business expense, but not everything on the trip will be deductible since not all the activities are business related.

• Home Business Meeting-this was documented and qualified as a home business meeting meeting by following the Augusta rules and thus created home rental income that was a business expense to my micro-corporation.

If you interested in learning whether a professional micro-corporation could help you retain more of your income through business expenses, I invite you to reach out to me to schedule a $99 business consultation call. This small business expense that costs less than the price of a dinner— and will provide you with an annual SimpliMD membership worth $2500! But most importantly it could unlock a host of small business benefits that you may not know about.

Need some one on one coaching to help you figure all this micro-business stuff—including organizing your business expenses? I invite you to sign up for a SimpliMD coaching 4-pack and let me get into the weeds with you!

Tod