Academy of Chiropractic Personal Injury & Primary Spine Care Program

Quickie Consult 1029
Infrastructure 227 I

From the Desk of Dr. Mark Studin
Academy of Chiropractic
Preamble: many of these issues are small, yet each issue is just that… an issue. If you take care of the small issues, then the larger issues often take care of themselves and you can focus on the larger issues… a larger, more profitable practice and more family time.

“Writing Testing Orders”

“IF it gets loud around you… get quiet… you will find the answer”   Mark Studin 2018 


According to numerous medical specialists who do testing, they need more information from you to make a more accurate diagnosis. Radiologists and neuro-diagnosticians both ask for more… a lot more. The question is what to send and how to send it.


First, The What: Your last full evaluation (either an initial or last re-evaluation) is a great addition as it will give them everything they need as a road map. That is also why your evaluation reports are critical. Having them complete and typed up in a professional, admissible format is also vital. These are the components that build your reputation.


In conversation with a specialist in reputation building who works exclusively with orthodontists, a significant building block is the doctor’s reports to their primary care providers aka general dentists in his world. Without a proper report that looks the professional that you are, hurt your reputation and “perception drives reality” in marketing. He goes on to say (you can watch an interview with him in the Audio-Video section of the consultations) that beyond the report with specialists, you then have to figure out what they NEED to understand you are different than the rest of the chiropractors in your local region.


When the specialist looks at your report, they must see everything they are used to seeing inclusive of history, past history, height, weight, blood pressure, etc. and then they need to see the clinical evaluation that is thorough. Also, there should be a separate note on a referral type instrument (a referral pad or separate document) that focuses them specifically on what you are looking for. As an example:


“There is a pain in the right upper extremity and motor weakness of 3/5 in the right biceps and sensory deficit in the upper outer arm that has persisted since the MVA 3 weeks ago. An MRI was ordered to rule out a space-occupying lesion in that region. Or… An EMG/NCV was ordered to localize the root(s) involved.


It is this type of 1-2 sentence note that separates you from the pack and lets the specialist know that you are different and clinically excellent.


I had a neuroradiologist a few years ago in the northwest region of the country invite local neurologists, physiatrists, pain management and neurosurgeons to sit with our trauma qualified doctor to teach them the latest reporting and imaging protocols purely based upon the chiropractor’s report. It opens doors that you won’t even see!!!


Second… The How: With every referral send your last evaluation.

With MD’s, you should also send your CV no more than once as you don’t want to appear “high maintenance.” To “separate you from the pack” in our profession, they need verification that you are the “real deal” and not a therapist. I would include both the E&M report and a separate note as suggested above on why you are referring them. Also, I am not opposed to hand-delivering the report by someone who is NOT YOU!!!!


Ensure that it is printed on tan stock with black ink; very conservative and a complete report. If you haven’t done a compliance review, get one to ensure you don’t look the fool!!!


Reputation building is critical to your career and is about perception where you must look the part at every level. Your success is not about any one thing, it is the totality of EVERYTHING YOU DO!






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

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