Lawyers look to India for answers

Outsourcing medical advice saves time and money, attorneys say.

By COLLEEN JENKINS, Times Staff Writer
Published October 14, 2007

TAMPA - Dorothy Clay Sims' client had suffered an injury, but the doctor hired by defense attorneys accused the woman of faking.

At that point in the deposition, plenty of plaintiff's attorneys would have floundered, lacking enough medical expertise to dispute the claim.

Not Sims. Informed followup questions flashed on her computer screen, instant-messaged by the doctor in India she had hired to listen to the proceedings via a real-time Internet phone call.

"I didn't even know what I was asking," she recalled, "but I said the words." When she finished, the defense doctor went silent.

Sims' law firm in Ocala is one of an increasing number in Florida and the United States that look to India for cheap and reliable legal services, motivated by desires to keep costs down and maximize time for their most critical tasks.

Last month, following the lead of Los Angeles and New York City, the Florida Bar Association became the first state bar to propose an opinion on offshore legal outsourcing. The verdict: It's ethically okay, as long as attorneys licensed stateside supervise the work and protect client confidentiality.

The professional ethics committee's final vote on the opinion in January is likely to meet resistance from some of the state's lawyers. Several committee members are concerned that the opinion is not stringent enough. In a letter to the Florida Bar News, one lawyer encouraged his colleagues "to rally against this misguided proposal."

But Tampa lawyer Bill Wagner, a principal author of the opinion, said the present rules governing attorneys make it lawful to outsource things like legal research and document preparation pretty much anywhere in the world.

"There really isn't anything ethically different in sending it to India or sending it to Arkansas," he said.

From medical to legal matters

India already provides doctors who read X-rays for American hospitals and accountants who prepare tax returns that get reviewed by this country's IRS. With both countries' legal systems rooted in British common law, the move of legal services overseas seems almost inevitable.

A Dallas law firm took the first step in 1995, opening an office in India. But the recent growth in offshore outsourcing usually takes the form of U.S. firms hiring intermediary companies that employ Indian lawyers for tasks handled by paralegals or young associates: document review, legal research and writing, deposition summaries and preparation of immigration documents.

It's the kind of laborious work Miami lawyer Etan Mark did for $300 an hour as an associate at a large law firm. Now, his year-old company, iDiligence, charges clients $18 an hour for work performed by six attorneys in Bangalore, India.

The 91/2-hour time difference allows his legal team to work on projects while their U.S. counterparts are sleeping, for around-the-clock efficiency.

Mark isn't deterred by members of the legal community who accuse him of taking away American jobs.

"I genuinely feel that this is something that can really benefit the legal profession," he said. "The kind of work we're outsourcing is the work that makes second- and third-year associates not want to be lawyers anymore."

Companies increase security

Legal offshore companies have implemented tight security measures in response to concerns about client confidentiality. Ron Friedmann, who blogs about the industry, recently became the senior vice president for marketing at Integreon, a top-ranked legal services provider in India.

Calling last week from Mumbai, Friedmann said security guards had inspected his bags each time he entered and exited the company's office to make sure he didn't have a camera or any device that could store computer data. Each room had paper shredders, he said. Few had printers.

The proposed Florida Bar opinion suggests that law firms limit the overseas provider's remote access to only the computer files needed to complete work for particular clients. The committee also suggests getting prior consent from those clients.

Sims, the Ocala lawyer, incorporates India into her law practice with a twist on the typical outsourcing model.

After a positive experience with doctors on a trip there, she started MD in a Box. For $90 an hour, the company links lawyers with Indian doctors who screen potential cases, analyze records and perform medical research. The same service with American experts costs between $500 and $800 an hour, Sims said.

The company's most powerful tool is also its most technologically advanced. Lawyers can hire an MD in a Box doctor to be present during depositions using Skype, a software program that allows the doctor to listen to the proceedings in real time.

If the Indian doctors catch a defense expert making a medically suspicious claim, they quickly send literature or rebuttal questions to aid the cross-examination.

Since MD in a Box opened for business last year, a handful of Tampa Bay lawyers have become happy customers.

"It's a way to keep physicians honest," said Nancy L. Cavey, a workers' compensation lawyer in St. Petersburg, who counts the St. Petersburg Times as a client. "It levels the playing field."

Times researcher John Martin contributed to this report. Colleen Jenkins can be reached at cjenkins@sptimes.com or 813 226-3337.

Fast facts

Outsourcing to India

-Revenue from the offshore outsourcing of legal services in India is expected to grow from $146-million in 2006 to $640-million by 2010.

-The offshoring industry employed about 7,500 people in India in 2006 and is on track to reach 32,000 by the end of 2010.

-The number of offshore legal services companies has grown from about 20 to 100 in the past two years.

-Only a handful of bar associations have issued opinions on outsourcing legal services overseas: New York City, Los Angeles and San Diego. The Florida Bar ethics committee will vote on its proposed opinion in January.

Sources: ValueNotes, Prism Legal Consulting