Academy of Chiropractic Personal Injury & Primary Spine Care Program
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“What’s Been Happening What’s Coming Why? What Do I need to do?”
“If this is all it takes, why did I procrastinate?” Mark Studin 2018
The past 24 hours have both changed and confirmed my understanding of the future trend of the chiropractic profession’s direction and what you need to do to lead. That leadership comes by example of what your office is accomplishing both in number of patients you treat and is reflected financially. Therein lies the verification as I believe our profession is too full of rhetoric (bullcrap) and not facts; numbers don’t lie.
First, this is so important that I am memorializing this in a quickie consult so that everyone of our future members get to both read and embrace the opportunities of our profession. I want you to understand that the items below should all be numbered 1 as they are all equally important and really are a convergence of facts that happened over the last 24 hours yet have confirmed what I have been seeing over the last six months. In addition, I want to give you the opportunity to go back and reread this long after you deleted this email.
Here’s what’s coming:
1. Physical Therapy versus chiropractic:
A. Over the last year I have posted on the US Chiropractic Directory and have been published in various national trade journals articles on why chiropractic has superior outcomes for spine versus physical therapy. These are not meant to be an indictment against physical therapists who perform outstanding work. It is simply meant to illuminate why physical therapists should not be the first treatment option for spine based upon “literature outcome studies.” If you have not read any of those articles (click here to access one), then after you finish reading this consultation take five minutes and read the one linked herein. Initially, I had thought that the physical therapy versus chiropractic argument was more of a combination of a dogmatic belief (that is still perpetuated by respected institutions like the Mayo and Cleveland clinics) that physical therapy is the best viable first option for spine and chiropractic has no proof of efficacy at any level beyond a few patient’s testimonials. I have held that falsehood to be true for close to four decades until recently.
B. Physical therapy and Medicine: It is no secret that for decades medicine has exclusively referred their mechanical spine cases to physical therapists with concurrent prescriptions for pain management and or injections. The literature is clear that this is a failed paradigm and has clearly contributed to the opiate epidemic in our country and worldwide. There is “scant” evidence in the medical journals sharing the rest of the scientific communities “overwhelming” evidence that chiropractic is far superior for mechanical spine issues (no fracture, tumor or infection) versus physical therapy although there is an abundant amount of research available showing the above.
C. Insurance Companies: Insurance companies have gotten a “free pass all the way to the bank” on biomechanical disabilities. They have pigeonholed their contracts in the narrowest sense to cover pain as a result of an anatomical lesion, while ignoring the disabilities for biomechanical failures. As an analogy, it is like the politician, no matter the level of office who repeats the same lie over and over regardless of any overwhelming evidence with the electorate accepting it as gospel. With the carriers, in part, they too often ignore the fact that spinal related pain is the fifth most prevalent diagnosis in medicine and one of the most prevalent disabilities, yet they discriminate against chiropractic for reimbursement and repeat the lie over an over no different than the “crooked politician” for financial gain. In addition, the carriers in third-party personal injury cases have told lawyers that having the chiropractor and not a physical therapist can lower the value of their cases. Not being a believer in conspiracy theories to say they are “conspiring against us,” the question at hand is why? When you examine the Colossus algorithms you will realize that chiropractic costs the carriers significantly more money than physical therapists by providing significantly more information that satisfies the “value drivers” that the carriers have built in.
D. Lawyers: Over the years I’ve heard many attorneys say, “was a physical therapist involved.” In the past, I believed this to be just part of the dogmatic belief favoring physical therapy and an ignorance on what chiropractic can accomplish. The only one that was ignorant was me. Yesterday, when a highly credentialed medical specialist told me that on the witness stand, a defense lawyer questioned his competence by saying “why do you refer to a chiropractor over physical therapists for spine,” it brought into play all of those previous innumerable instances where that same question has arisen in the medical – legal arena (lawyers). Last month, in Colorado, Dr. Ron Salvaggione implored me to add a section on physical therapy versus chiropractic for spine in my lawyer’s seminar presentation. He shared with me that lawyers in his region have a strong preference for physical therapists. Please understand lawyers could “care less” about their clients getting well, they only care about prevailing at a higher level, and they have been pressured financially to produce documentation of physical therapy treatment for spinal related issues to ensure higher settlements. The insurance carriers have been using plaintiff lawyers as their minions to move the populace away from chiropractic and into the medical – physical therapy arena for spinal related issues. This is purely for financial reasons to limit settlement values in a “profit grabbing scheme.” In truth, it is a brilliant business move from the carriers who play the “long game” financially and historically it has been a windfall for the carriers.
D. What do I need to do: This is so incredibly easy, yet so incredibly hard. You need to read and understand not just the article referenced above, but everything I and others have written on physical therapy versus chiropractic. You also need to understand how the Colossus algorithm works, which I’ve been teaching you in the consultations as well as be able to communicate concisely the literature outcomes. Although I have been published numerous times on this topic, I now realize there needs to be a larger effort to educate the chiropractic profession (you) by giving you the proverbial “talking points” so in a conversation you have the “soundbites” needed to communicate your point. I will be developing that shortly for you.
2. Primary Spine Care is here and be prepared for 600+ new patients per month.
A. Hyperbole or Not: Due to recent political events we as a society have become “jaded” to too much inflammatory rhetoric leaving us questioning the integrity of our claims. Although admittedly, I like to create the vision and then work hard to make it reality, the above statement is factual. It is already being played out in cities around the country and is only limited by the number of hours in a day and qualified doctors to both triage and treat these patients. Over the last few weeks, I shared with you both audio and video verification that this is happening with many more to come. Primary Spine Care is real, it is happening, and you need to ensure that you are prepared.
B. Spine Surgeons: Spine surgeons realize that they are losing money by screening 100 cases for 2 surgeries. They realize the time that it takes for a nonsurgical case to be screened is a financially “upside down” proposition. A neurosurgeon’s malpractice ranges from $363,000-$600,000 a year depending upon the number of malpractice claims against them. This alone makes their overhead impossible to waste time on nonsurgical cases as they derive their personal income in the operating rooms. Mid-levels (physicians assistants and nurse practitioners), as a rule have failed in relieving the burdens of most spine surgeons because of their lack of training. Currently, enlightened spine surgeons have realized that chiropractors who are trained (by the Academy of Chiropractic) is their best solution for eliminating nonsurgical cases. Locally, I have been offered the opportunity to screen approximately 150 patients per week (a three-neurosurgeon practice) and treat the nonsurgical cases chiropractically while forwarding the surgical cases to the surgeons. In St. Louis, Dr. Kyle Longo reported that he had a meeting with a neurosurgeon who was relieved to uncover Dr. Longo’s credentials and said he turned away 10 to 12 personal injury cases EVERY DAY and he wants to shift these to Dr. Longo. The same scenarios are currently happening in Memphis, Tennessee, Provo, Utah, Buffalo, New York and a myriad of other cities.
C. Emergency Rooms: In the past I thought emergency rooms were the “holy grail” of perpetual referrals. Although that is accurate it is also no longer THE source, it is only one source. Recently Dr. Sadowski from Enfield, Connecticut reported that in the first eight days of having a relationship with an emergency room he’s received 23 referrals. Another doctor in North Carolina reported that he walked into the emergency room the next day he started receiving referrals simply based upon his conversation that he is credentialed as a “trauma trained chiropractor.” In Buffalo, New York for almost 2 years now the number of referrals from emergency rooms have been constant and purely limited by time, space and manpower of the doctor. In the past, emergency rooms appeared to be the only source of referrals from the medical community; however, today there are a myriad of choices and emergency rooms, still being a good choice is now only one of many good choices.
D. Wall Street: This is perhaps the biggest “Game-changer” to date and my comments about Wall Street are going to be purposely cryptic, but I hope revealing enough for you to fully understand what is happening in the marketplace. Over time, I will be able to divulge more and more information, however currently we are still developing a program that can forever change the referral pattern for mechanical spine patients in the marketplace. Wall Street sees you and recognizes your credentials as being an integral solution to a huge profit center in an undeveloped financial niche. They recognize that your being part of the trauma team is an integral missing piece of the puzzle in the triage of spine cases and they are betting upwards of $1/2 billion dollars on you. That number is not a typo and will ensure that you will be enriched handsomely as a reward for your hard work. Yesterday, the conversation was “can we as a financial institution ensure that every member of your trauma team will be able to handle triaging mechanical spine issues in large numbers and follow your protocols?” My answer was a resounding “yes,” and if the numbers become overwhelming I personally will work with each doctor to ensure that additional help can be attained. Currently, we have already proven this to work in Utah and are RIGHT NOW developing Phoenix, Seattle and then Tallahassee. Doctors in those regions have already been contacted and they are preparing for what has already happening Utah (please note this is not being beta tested as that has been gone on over the last two years) and now I am preparing to bring it to every region in the nation where we have a trauma team member. What will it take for you to be on that list and stay on that list? Please read the next section.
E. Credentials: It always seems to come back to credentials and Wall Street, surgeons, the courts and primary care medical providers all recognize and more importantly SEE your credentials as being expert and the solution to a significant problem we are having that has perpetuated. The analogy is cardiothoracic surgery; would you want a psychiatrist performing open-heart surgery on you? The answer is simply no although they are licensed to do so as a medical doctor, but not qualified. Would you want an obstetrician doing brain surgery on you? The answer is simply no, although they are licensed to do so as a medical doctor, but not qualified. The same holds true for chiropractic; is every chiropractor licensed to manage and treat trauma cases or many spinal disc and cord issues… yes, however are they qualified based upon advanced training? The answer is a resounding NO! Years ago, the new minimum standard was being co-credentialed between chiropractic and medical academia in MRI spine interpretation. Today, the new minimum standard is being a trauma team member as that is the credential that is being recognized by Wall Street, the courts and many medical specialists. In addition, being hospital qualified and primary spine care qualified are also being considered as an arbiter for a first choice and referral beyond being a trauma team member. Please understand that it has taken me close to 15 years of hard work, political maneuvering, financial support for fundraisers and other positioning tools to secure these levels of credentials for you through both chiropractic and medical academia. Also understand, there are more coming as I see what the future is going to require so do not procrastinate in acquiring as many credentials as you can immediately.
F. New courses: the following are new courses that are being worked on with no timetable for completion.
1. Electrodiagnostic interpretation (my 5th attempt to do this)
2. Evaluation and Management: how to do a complete evaluation
3. Apply Spinal Biomechanical Engineering: this is the work of Dr. Ron Aragona, who wants to memorialize his life’s work in an online continuing education program that includes both analytics and therapeutics and I have agreed to support his endeavor to create this program.
4. Pain: I am creating a whole program around both acute and chronic pain and the neurophysiology surrounding it inclusive of objectifying the ideology of the pain and being able to report it in a demonstrative matter.
AND…There is so much more… As always, we NEVER stay the same!!!!!
Mark Studin DC, FASBE(C), DAAPM, DAAMLP
Adjunct Associate Professor of Chiropractic, University of Bridgeport, College of Chiropractic
Adjunct Post Graduate Faculty, Cleveland University-Kansas City, College of Chiropractic
Adjunct Professor, Division of Clinical Sciences, Texas Chiropractic College
Graduate Medical Educational Presenter, Accreditation Council for Continuing Medical Education Joint Partnership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences
Academy of Chiropractic
US Chiropractic Directory