Academy of Chiropractic Personal Injury & Primary Spine Care Program

Quickie Consult 331

From the Desk of Dr. Mark Studin
Academy of Chiropractic
Preamble: Many of the issues I bring to you are very small, yet each issue is just that, an issue. If you take care of the small issues, then you will be able to build and more importantly, focus on the bigger issues...a larger practice and more family time.

"Hard Times for Medical Specialists = Good Times for DCs"

This past week, I presented MRI to over 100 DCs. As the meeting progressed, both a pain management specialist(MD) and not one, but two orthopedic spine surgeons showed up, one being the owner and the other his employee.  This was significant, because in years past, usually just the marketing staff or the office manager or the "rookie surgeon employee" would be forced to attend. Not this past week; we had the best they had to offer.


During the presentation, I discussed the chiropractor as the primary care provider in the trauma world and how the medical specialists fit in. I discussed the malpractice costs of the MD specialist and the fact that they can no longer afford to "screen" for surgical cases. I continued by saying, "Our job is to be the first to see the patient and then refer those that have potential surgical implications to the surgeon who can make the determination."


After the meeting, the surgeon who was the owner came up to me, shook my hand and said, "Finally, someone understands that we can no longer afford to see 50 patients a day for screening purposes where only 2-3 need surgery. We need the chiropractors to act as the primary care providers and screen the cases out that have enough room between the disc and the neurological element, leaving only the potential surgical cases for us to evaluate."


As you see, the spine surgeon paid attention to my presentation and was educated on how the chiropractor differentially diagnoses potential surgical cases and they WANT us to do just that. They want us to evaluate the 50 patients, determine that 5 might be surgical candidates based upon the proximity of the disc to the neurological element and refer only those 5, ensuring 2-3 surgeries. Their goal is to have 10 chiropractors screening the surgical candidates and out of 50 cases they evaluate, conclude that 25-30 need surgery.



PLEASE do not lose sight of the fact that their malpractice coverage is between $250,000-$300,000 annually and they CANNOT AFFORD to screen non-surgical cases. Even at $200 per patient, they are losing money by not being in the operating room for qualified patients. In addition, the spine surgeons are getting compensated at a VERY low rate for managed care disc surgeries as I reported a few months ago. Therefore, they are now focusing on personal injury and need you more than ever.


Once you have created the relationship, this becomes an integral part of the conversation with the lawyers. You can then bring YOUR SURGEON to your meetings with the lawyers to get them to understand that THE SURGEON is YOUR team member and have him/her explain the triage of the patient, where everything goes through you, the primary care provider for everything spine.


It really works that way if you have done your homework, set the foundation and have become that clinically excellent spine specialist where the surgeon can trust you to screen the patients. The surgeon also confirmed what other surgeons have said to me, "If the chiropractor is the typical chiropractor, with little or no knowledge of MRI or disc injuries, then I cannot work with him. I will take their referrals and then be done with them. Those that are clinically excellent will get my referrals in return and I will participate in the medical-legal process in meeting with lawyers."


Ensure you have your CV when communicating with MDs, although they are more interested in your ability to communicate verbally on a clinical level. It always comes down to the fact that the best-of-the-best will win.

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