Academy of Chiropractic Personal Injury & Primary Spine Care Program

Quickie Consult 1187
Lawyers and Medical 86 L

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. -Mark Studin 2006

" How to explain to Neurosurgeon you are the solution "

 

Dr Studin: So the question is, how to break into the PI space, gracefully because the neurosurgeon's time is challenging, you've got to examine about a 100 patients to get a 8 surgeries. So what we've done around the country and extremely successfully is we trained doctors like to become a neurosurgeon without the knife, he'll do everything from doing a complete ortho neuro exam with a history, order MRI and thin sliced MRIs in the cervical two mils, no gap, because you don't need it in three mills in the thoracic and lumbar, no gap. we're going to get at least two or three clean slices through the desk without touching the bone and we're going to ensure that the MRI companies angle the slices appropriately. We're going to look at all the canals. We're going to make sure no one's moving. We're going to make sure we have stir views. If there is a GE machine, we'll get addiction series. By the way, I teach MRI spine interpretation at state university of New York and Buffalo school of medicine at the graduate level, I run a clinical rotation on MRI neuroradiology and a state university in New York at Stony Brook school of medicine. And I teach in three chiropractic colleges, but what we do is we position the chiropractor who works independently. So in other words, there is no issues of malpractice. There is no issues of employment and works independently with the neurosurgeons. Now in Utah, in Provo, there's a hospital system, and I'm going to leave that out because we're being recorded. They own five mountain hospitals all surrounding different Provo and they built a spine center in the middle. And on average the ERs 962 cases feeding into the spine center and the Chiro can't get all nine 962, So he recruited five other docs and those docs triage those spine cases. Other things are happening also is for subsequent conversation. But what happens is now those 100 patients, you screen for 8 surgeries, you're going to only have 12 to screen for 8 surgeries because the Chiro who's pretty much fellow train on spinal bond mechanics and trauma on top of being trauma trainees, trauma qualified, so that he could take those patients and we're going to see if the space occupying lesion, whether it be a disc or any other neoplasm or whatever it is, But usually disk, especially if it's trauma, if anything approximates the core of the root, well then the flag goes up. If you have motor loss and approximating the corner of the roof, a compressing, it's an immediate referral. If I've sensory well that's a clinical decision. If we see significant myeloma militia and so off to the neurosurgery. And if we see, second series or that I asked this, this looks really nasty, then it's off to the neurosurgeon. But if you are just have a small central herniation or even a lateral herniation and the roots not being a PAC that it's in the lateral recess, there is no abutment, there's no compression, there's nothing for you to do. The goal is to take you and free you up so that you can have twice as much surgical time and not as much clinic time. Now with respect to personal injury, I teach and Rich has been my student for years I'd lecture to over a quarter of a million attorneys in 36 States and I've been at Tennessee a lot. I've been all over the state, but it's no different in Tennessee than it is in Oklahoma or New York and New Jersey, California. It's the same because we also deal with the same and there are algorithms and I know the insurance company algorithms because I've lectured inside Allstate state farm, Geico, MetLife, Risko, Fireman's USA, and a Partridge in a pear tree. So we work extensively with the medical legal community, and working on the personal injury side so that we can actually let them know that they stand a better chance of prevailing at a higher level, purely based on the clinical excellence of the provider. Now, the provider in this case shouldn't be you as the primary care provider. You shouldn't be the primary spy camp provider. Just like if you have a headache and you're sweating and busy, you don't start at the cardiothoracic surgeon. You start at the it's GP and then you work your way up through testing. So you come in for all of those surgically needed cases. You come in perhaps for a second opinion when there's a tough case and you work carefully with the primary provider. Now Dr. Hancock working with you can now start leveraging medical primary care providers to let them know that for all your accident cases that he is working closely with you and he will also let the legal community. Now we've lectured in Memphis to the lawyers a few times already. So you've got someone, which is Dr. Rich is extremely well trained in triaging and directing the patients to you. Now, if you're on the hospital system, you have an opportunity to take those patients and just refer them out even before you see them. If you'd see if them listen, you treat at atomical issues, fracture, tumor infection, we treat mechanical issues, which is biomechanical failures. We'll look at disk issues, we'll look at sacrum and vertebra rotations and just biomechanical stuff. So we treat the mechanical issues, which is 98% of what the spinal issues are. So if your staff recognizes a mechanical issue, reason on the phone and your shift over, let rich triage them cause that's what's happening, that helps set up that five emergency room feed into one center and it just works really well because I think You could do what I do, but I can't do what you do. You could evaluate the patient just like weekends, but it's a gross waste of your time, energy and talent to spend an extra two full days in the clinic when you should spend those extra two days in the operating room because there's very few of you.

Guest Dr: okay.

 

Dr Studin: So the question is, how to break into the PI space, gracefully because the neurosurgeon's time is challenging, you've got to examine about a 100 patients to get a 8 surgeries. So what we've done around the country and extremely successfully is we trained doctors like to become a neurosurgeon without the knife, he'll do everything from doing a complete ortho neuro exam with a history, order MRI and thin sliced MRIs in the cervical two mils, no gap, because you don't need it in three mills in the thoracic and lumbar, no gap. we're going to get at least two or three clean slices through the desk without touching the bone and we're going to ensure that the MRI companies angle the slices appropriately. We're going to look at all the canals. We're going to make sure no one's moving. We're going to make sure we have stir views. If there is a GE machine, we'll get addiction series. By the way, I teach MRI spine interpretation at state university of New York and Buffalo school of medicine at the graduate level, I run a clinical rotation on MRI neuroradiology and a state university in New York at Stony Brook school of medicine. And I teach in three chiropractic colleges, but what we do is we position the chiropractor who works independently. So in other words, there is no issues of malpractice. There is no issues of employment and works independently with the neurosurgeons. Now in Utah, in Provo, there's a hospital system, and I'm going to leave that out because we're being recorded. They own five mountain hospitals all surrounding different Provo and they built a spine center in the middle. And on average the ERs 962 cases feeding into the spine center and the Chiro can't get all nine 962, So he recruited five other docs and those docs triage those spine cases. Other things are happening also is for subsequent conversation. But what happens is now those 100 patients, you screen for 8 surgeries, you're going to only have 12 to screen for 8 surgeries because the Chiro who's pretty much fellow train on spinal bond mechanics and trauma on top of being trauma trainees, trauma qualified, so that he could take those patients and we're going to see if the space occupying lesion, whether it be a disc or any other neoplasm or whatever it is, But usually disk, especially if it's trauma, if anything approximates the core of the root, well then the flag goes up. If you have motor loss and approximating the corner of the roof, a compressing, it's an immediate referral. If I've sensory well that's a clinical decision. If we see significant myeloma militia and so off to the neurosurgery. And if we see, second series or that I asked this, this looks really nasty, then it's off to the neurosurgeon. But if you are just have a small central herniation or even a lateral herniation and the roots not being a PAC that it's in the lateral recess, there is no abutment, there's no compression, there's nothing for you to do. The goal is to take you and free you up so that you can have twice as much surgical time and not as much clinic time. Now with respect to personal injury, I teach and Rich has been my student for years I'd lecture to over a quarter of a million attorneys in 36 States and I've been at Tennessee a lot. I've been all over the state, but it's no different in Tennessee than it is in Oklahoma or New York and New Jersey, California. It's the same because we also deal with the same and there are algorithms and I know the insurance company algorithms because I've lectured inside Allstate state farm, Geico, MetLife, Risko, Fireman's USA, and a Partridge in a pear tree. So we work extensively with the medical legal community, and working on the personal injury side so that we can actually let them know that they stand a better chance of prevailing at a higher level, purely based on the clinical excellence of the provider. Now, the provider in this case shouldn't be you as the primary care provider. You shouldn't be the primary spy camp provider. Just like if you have a headache and you're sweating and busy, you don't start at the cardiothoracic surgeon. You start at the it's GP and then you work your way up through testing. So you come in for all of those surgically needed cases. You come in perhaps for a second opinion when there's a tough case and you work carefully with the primary provider. Now Dr. Hancock working with you can now start leveraging medical primary care providers to let them know that for all your accident cases that he is working closely with you and he will also let the legal community. Now we've lectured in Memphis to the lawyers a few times already. So you've got someone, which is Dr. Rich is extremely well trained in triaging and directing the patients to you. Now, if you're on the hospital system, you have an opportunity to take those patients and just refer them out even before you see them. If you'd see if them listen, you treat at atomical issues, fracture, tumor infection, we treat mechanical issues, which is biomechanical failures. We'll look at disk issues, we'll look at sacrum and vertebra rotations and just biomechanical stuff. So we treat the mechanical issues, which is 98% of what the spinal issues are. So if your staff recognizes a mechanical issue, reason on the phone and your shift over, let rich triage them cause that's what's happening, that helps set up that five emergency room feed into one center and it just works really well because I think You could do what I do, but I can't do what you do. You could evaluate the patient just like weekends, but it's a gross waste of your time, energy and talent to spend an extra two full days in the clinic when you should spend those extra two days in the operating room because there's very few of you.

Guest Dr: okay.

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