Academy of Chiropractic’s Lawyers PI Program

Narratives 49

From the Desk of :
Mark Studin DC, FASBE (C), DAAPM, DAAMLP

"MMI: Maximum Medical Improvement"

MAXIMUM MEDICAL IMPROVEMENT

It is the opinion of many in the medical-legal arena that you should never release a patient to MMI or maximal medical improvement. Why? Once you MMI the patient, you have said there is nothing that can be done under your care and will render a level of confusion. It is my goal to release a patient from passive care (doctor) and graduate them to purely active care (one they do themselves). All musculoskeletal patients who have experienced any type of connective tissue damage (which is close to 100% of trauma cases) must engage in exercise on a regular basis for the balance of their lives.

Never lose sight of the goal of the doctor, which is get patients to participate in their own recovery and if you MMI the patient, it says that you do not believe that active home care will be necessary or help the patient and you forgo the right to do follow-up evaluations to monitor how the patient is doing participating in their own recovery.

There is also a CPT code for teaching patients home exercises and provided you document well, you should consider using the code and bill for it (if clinically indicated).

CAVEAT: If you are rendering an impairment rating, then you must MMI the patient. This can be considered contradictory because most patients should be given a whole body impairment, but the rules are the rules...no MMI, no impairment rating. Therefore MMI the patient from passive care, releasing them to stabilization care.