For those without insurance, the appeal of a lien agreement isobvious: they can get treatment that they otherwise wouldn't beable to pay for.

Not all doctors fear plaintiffs attorneys. Some are making bigbucks off personal injury lawsuits.

An increasing number of doctors are offeringpatients who are involved in lawsuits to delay payment until aftertheir suit has concluded. In exchange, the doctors are promised acut of whatever the patient wins in a settlement or judgement.

"Lien" doctors are hardly new, but their numbers have sharplyrisen in a number of big states –– California, Florida, Georgia,Colorado –– due to legal changes.

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The arrangements generally do not run afoul of the law and havenot been condemned by legal or medical groups as unethical.However, civil defense attorneys complain that they lead to higherlitigation costs.

For those without insurance, the appeal of a lienagreement is obvious: they can get treatment that they otherwisewouldn't be able to pay for. Lien doctors may also provide servicesthat would not be covered through insurance.

However, plaintiffs attorneys also have an incentive to directclients to lien doctors, even if the client already has goodinsurance.

The incentive is due to the fact that a big part of whatdetermines personal injury judgments and settlements is the priceof the plaintiff's medical bills. If the plaintiff can present therates charged by the doctor, rather than the typically much-lowerrates negotiated by an insurer, the overall judgement or settlementwill be greater, which results in a larger contingency payment forthe attorney.

"This is totally to enhance the bank accounts of the plaintiffs'lawyers," Anthony Kohrs, a civil defense attorney in Los Angeles,tells the Wall Street Journal.

The arrangement obviously does not end up working out for wellfor patients who do not succeed in their litigation. Whileunsuccessful plaintiffs rarely have to pay their attorneys, whowork on a contingency basis, most lien doctors insist on gettingpaid no matter how the lawsuit is resolved.

In many cases, the Wall Street Journal reports, the patients endup negotiating a reduced payment with their doctors.

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