Academy of Chiropractic
Quickie Consult 1252
Marketing 153 G
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
"MD and Lawyer Marketing - SLAM DUNK"
We have just resolved both industry’s BIGGEST CHALLENGES
My fingers often see more than my eyes... Mark Studin 2020
When it comes to getting referrals, the two most significant sources are from the medical and legal industries. We deal both with medical doctors and lawyers who have very different needs professionally with you, the primary spine care provider sitting in the middle and working with both. It has always been my job to give you strategies and tools to help both of those industries understand you are their solutions. It is my perpetual rule to do this from a posture of Clinical Excellence in combining our quest for an accurate diagnosis, prognosis and treatment plan with a business strategy that includes the answers for both lawyers and MD's.
Over the years we have worked on you, your knowledge base, your credentials, your ability to take MRI and x-ray images and add tags to highlight pathology and much more. And with all that there always appears to be one piece of the puzzle that is missing to help both industries understand that you have the solution to their biggest recurring challenges.
For lawyers, it is how to make strain-sprain demonstrable to the point of a jury understanding it as PERMANENT serious bodily injury and NOT TRANSIENT. Historically, strain-sprain has been the primary reason for summary judgment dismissals. For medical doctors its how do I explain non-specific back pain as that has been the only explanation they have had if there is no fracture, tumor, infection or nerve root/cord lesions?
We have resolved with technology both of those issues from a posture of clinical excellence that concurrently resolves your issues of concluding an accurate diagnosis, prognosis and treatment plan. To best understand this and have the requisite credentials, you should take the Spinal Trauma Pathology and the Connective Tissue Pathology courses. These are part of the core reasons they are in the Trauma Qualifications. Everything we do is interconnected.
We also know based upon the literature, ligaments can translate 0.6 mm and angularly deviate 7 degrees and once past that threshold, start to damage. Wound repair ensues by activating dormant fibroblasts with collagen vs. collagen and elastin setting the framework for permanent tissue remodeling. The pathology is detailed in all Primary Spine Care courses, Spinal Trauma Pathology and Connective Tissue Pathology courses. You need to understand the above statement at a visceral level to be truly expert and be able to fully understand the triage needs of your patients. From a marketing perspective, the more you know and are credentialed, the more cases you will get. It is a linear equation.
The piece of the equation that has been with us for decades is the pathological explanation and the AMA Guides explaining impairment levels. Please do not conflate pathology and impairment; they are two separate issues and have to be explained accordingly. What has been missing is a demonstrative avenue that renders a simple, visual and clear explanation to resolve the challenges of your referral sources with you having the ability to manage the solution.
Consider the following sample case:
Status post MVA
Cervical Pain 6/10
Significant loss of ROM acquired visually in all planes
Positive foraminal compression
Muscle testing: Deltoid, Biceps, Brachioradialis all 4/5
Sensory deficit over the C5 dermatome
Static x-rays reveal loss of curve and visualized slight translation at the C4-C5 regions with no visible osteophytes or Modic changes.
MRI of the cervical spine showed a mild bulge at C6-C7, otherwise unremarkable
Based upon the above clinical scenario, x-ray digitizing was performed.
The following screenshot is the solution and the power comes in its simplicity.
The green line above represents the threshold for ligament pathology and represents to the medical community a VERY SPECIFIC answer for what medicine erroneously considers NON-SPECIFIC BACK PAIN.
MEDICINE considers it non-specific because they have no answer, other than drugs to manage patients who are not surgical candidates. We understand that physical therapy is the go-to referral for MDs, but the literature is abundantly clear that physical therapy, although great for extremities, in comparison to chiropractic care renders far poorer outcomes because they do not adjust their patients. Mobilization, exercise and adjunctive therapies do not fix the underlying biomechanical failures replacing the malpositioned plica in the facet space allowing persistent nociceptor, Pacinian corpuscle, and Ruffini corpuscle reactions that feed the central nervous system (brain). To fully understand this you MUST take the Primary Spine Care Series, again everything is interconnected.
When you explain to the MD that you were trained through the State University of New York at Buffalo, Jacobs School of Medicine and Biomedical Sciences on connective tissue and biomechanical pathology, almost every prejudice is removed.
For LAWYERS, the green line represents demonstrable pathology where a jury can visualize the bodily injury secondary to trauma and also starts to represent impairment in a pro-rata equation that is consistent with the literature and the AMA guides. Once you start showing demonstrable pathology at this level, It makes the strain-sprain argument of being transient go away based on the physiology and literature on connective tissue repair. it is now up to you to educate the attorney about connective tissue physiology, pathology and wound repairing so they understand what they're arguing as you have now given them a tool to verify the bodily injuries at this level. Also, You now have a demonstrable avenue to pro-rate impairments, the only placce in the industry. The missing piece for lawyers for strain-sprain issues has been demonstrable evidence showing ligamentous injuries that are literature-based and permanent.
To fully understand the graph, anything beyond the line is both ligament pathology and ratable. Once you get past the red line, you have reached maximum impairment. The further you move beyond the green line, the more pathology exists. Additionally, based upon the literature, once you have ligament pathology repaired ligaments will have characteristically inferior compositional properties compared with normal tissue.
From a business perspective, you lease the software and do this test in-office and it becomes a profit center. For billing purposes, I am told by companies that do this solely as a business, charge $450 per region. They use CPT 76499, which is a by-report code and you must send the report with the billing.
Disclaimer: Myself, our company and affiliates urge you to confirm this with a third party billing company as we never set fees or codes; that is always your decision.
To do this in your office, please go to: https://www.symverta.com/
If you want to learn more about digitizing pro-rate cases, the following link is a 20-minute video.