Brian Manookian (link includes significant background information, achievements, awards, etc).

36 years old

Founding partner at Cummings Manookian, a preeminent Nashville plaintiff’s law firm in the field of healthcare and medical malpractice.



Achieving historic client returns through selectivity and symmetry.



  1. Background

After graduating from one of the nation’s top law schools, and four years into a busy practice at boutique healthcare defense firm, Brian Manookian knew something was missing.  The work itself was great.  He was representing the largest healthcare companies in the world in high profile cases across the country.  It was the model that was the problem.

Top corporate defense firms generate revenue almost exclusively through a billable hours model. [Explain billable hours model].  By definition, attorneys in a billable hours model are paid for their time, not the results they achieve.

The resulting disconnect between outcome and incentive can create a very real asymmetry of interests between lawyers and the clients they serve.  Because the lawyer neither shares in the winnings or contributes to the losses, his or her only financial incentive is to keep the case going.  Often to the detriment of the client.

And the downside to the billable model doesn’t only touch the client.  For ambitious lawyers confident enough to be compensated based on merit, the billable model offers the worst of all worlds.  Income is literally capped by the number of hours in the day.  As Brian quickly recognized, no matter how many cases he won, he could never make more than the sum of his total number of annual hours for sale.

  1. Moving to a Symmetrical, Selective Model

In January 2015, Brian Manookian and his partner left their corporate attorney positions and founded a plaintiff’s medical malpractice firm focused on representing patients injured by the negligence of health care providers.

Rather than being paid by the hour working on scores of cases for huge corporate defendants, Cummings Manookian focused on identifying and accepting a relatively small number of cases taken on a contingency basis.  In other words, Brian and his partner would be paid a percentage of the amount of money they recovered in any given case – but only if they won.  And if they lost, they would be out the expenses they advanced on behalf of their clients in the form of litigation costs – often tens of thousands of dollars per case in complex healthcare actions.

The downside to moving away from the billable hour model was the loss of a consistent and predictable paycheck from long days billing corporate clients.  The upside was the opportunity to share in the financial success of cases – truly working symmetrically and as a partners with their clients.

“Only getting compensated at the end of a case – and only in proportion to what you win for your client – forces you to examine every move and action you take to ensure it’s truly advancing the ball, as opposed to simply going through the motions, or worse, churning a file.” Brian related.

The second thing it forces you to do is become very selective about the cases you accept.  We want to keep the number of cases we’re working on low so that we can devote premium attention to each one.  Likewise, if were to take on borderline cases where we are unable to recover substantial sums for our clients, we risk losing money as a firm for costs and expenses associated with cases we don’t win.  Selectivity is key.

Brian says that the business side of his practice these days is not unlike Shark Tank.  “We get over 200 calls a month from individuals seeking representation in this very specialized field of law. If we took every one of them, we wouldn’t have the capacity or resources to do a great job for any of them. Instead we investigate each potential case the same way you would before investing in a business, and for the ones we accept, we truly partner with the clients in the sense that we our financial stake in the case is 100 percent dependent on us succeeding for the client.”

III. Results

Focusing on selectivity and aligning their financial stake with their clients, the result have been astounding.  In 2017, Brian Manookian and his law partner Brian Cummings on their own recovered over $20,000,000 for clients in medical malpractice cases.

To put that number in perspective, it would take a law firm of over 40 attorneys working on the billable hour model to gross $20,000,000 in a single year ($250/ hour time 2000 hours per attorney).

“When you take only selective projects and do great work for a client, more great work tends to come your way, via referrals, and you will find yourself working fewer hours.”

For Brian and his partner, aligning their interests with their clients has been the best and most lucrative decisions of their careers.