Academy of Chiropractic Personal Injury & Primary Spine Care Program
Quickie Consult 38 L
"An Honest NO if Often the Best Relationship Builder"
This past week, a lawyer pressured me into doing a "peer review" and writing a report so that his case wouldn't be thrown out of court. His back was "up against the wall" and he needed the type of quality report that we all produce so that he could win the case. Here is my reply.
Ed...I have reviewed the records and MRI images you sent. Unfortunately, the MRI company did not do a complete scan. The missed the T12-L1 disc and they reported "suspected very small disc herniation at T11-T12" is hopeful wishing at the best as they stopped acquiring images 2 levels below on the axial views, which would rule in/out herniation. The lesion appears to be a bulge/degeneration, with a very, very, very remote possibility of a herniation. However the issue is moot and irresponsible to guess without the requisite images.
In addition, her primary complaint was cervical according to Dr. Smith (treating doctor) with thoracic and lumbar issues secondary based upon the history and clinical presentation, yet he choose to accept only a lumbar MRI and the obligatory (and necessary) Head CT to rule out hematomas. In addition, your clients do not follow through with enough care to make enough changes to get better, which is a comment beyond the medical-legal scope and in doing so, will also help your arguments of permanencies (although I am not in the business of making your case as I simply want people to get better).
In light of the evidence in front of me, there is no argument for any level of bodily injury or permanencies. I would have approached this patient differently as there are still diagnostic dilemmas not resolved according to the last treatment note, especially if she persists in symptomatology.
In addition, in the future, you should consider steering your patients to someone who better understands the necessity for integrated care and conclusively diagnosing the patient. I would suggest Dr. Bravar in Mineola or Dr. Dow in Melville as I trained them both in trauma care and these oversights would not have occurred. Should Mrs. Patient continue to have ongoing issues, I would suggest a second opinion from either of these highly trained specialists to render a conclusive diagnosis.
With that being said, based upon the documentation you sent me, I cannot add anything of value to the documentation you already have and do not want to waste your money with nonsense. Consider the hour I spent on this file a gift...Mark
After the lawyer received this, he wrote me a note thanking me as I saved him $1000's in court expenses and significant time. This was a bridge builder and added to my reputation.