Academy of Chiropractic

Quickie Consult 1287
Marketing 158 G

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

Where do my credentials fit into a marketing strategy

Dr. Studin: Good morning. Okay, so frame a question for me. So the listening audience will understand exactly what you want to have a conversation about.

Guest: Okay. So I'm interested in painting the future of being a fully credentialed traumatized, or trauma.

Dr. Studin: If you've worked with, maybe you work with me, if you work with me, you'll become traumatized. Go ahead. Just a little bit funny.

Guest: What are the real benefits of being fully a credential? Even though I have a pretty good diversification understanding, but to go to the next level.

Dr. Studin: Okay. So let's just get a piece of groundwork. You're not a kid you're old. Okay.

Guest: No, I'm mature.

Dr. Studin: How old are you?

Guest: I'm 64

Dr. Studin: Now I feel young. I like to talk about, um, well, I'm not going to talk about other doctors at the moment, but the real question is, is what's the benefit of the qualifications? What's the benefit? How is it going to help you? Okay. That's a real issue. And the other part of the equation is, is there's a tremendous amount of time that has to be put in in order to, it's not even in our stage of life. It's no longer the money. That's important. It's the time because we realize, and I'm sure you would concur with me that you can always make more money, but you can't make more time. You got it. So is it a valuable investment in time? And when you're younger, it's all about the money, honestly. And when you get older, it gets more, not all but more about the time. So with that being said, the industry is changing. And my goal for you as with every doctor, but it's more acute with you because you're older is to come up with an exit strategy. Now there are organizations out there, academic organizations, which have diplomates, which is the stupidest designation or regression has ever done because it's based in time 300 hours, you're a diplomat. There was no other health profession on the planet that has diplomates and is a chiropractic created designation. Everyone does fellowships, which is two years, four years. I'm a fellow in orthopedics. Um, you know, um, um, you know, I guess this academic standard, we, we create time-based diplomats, which is absurd, but there are estimates out and other programs, which gives you a degree. It gives you initials AF gain, which really are not important. I've come to learn. Um, and they're wonderful. It makes you feel good. And you know, it makes you parents feel good. If they're going to look at it or your wife or your friends, and it's wonderful, but at the end of the day, does it make you a nickel more? And the answer is too often, no. So you've wasted your time and your money on things that are not Fruitful for Me. When I looked at creating all of this years and years and years ago, I said to myself, I want to create something that is real. It's got teeth, it's important. How does it going to put money in my pocket and the da and the doctors that I work with, if I'm not going to profit from it, what's the purpose at the end of the day, because at the end of the day, I'm going to spend a lot of time and money. And all I'm going to have is a piece of paper with a name on it saying, I've earned this. And it does nothing for me. It's useless.

My journey started years ago with a family member. And I don't know if I've shared this with you with a family member who had cancer. And this was back in 2008. I believe it was diagnosed. We needed to find, I couldn't find the right doctor. I skid I'm in New York, Boston, doctor, I could find in that in Columbia area, in the hospital, um, which is which, which was one of the highest rated institutions on the planet, particular cancer. I found the right doctor and I called to get an appointment. I was excited and, and they gave me an appointment for six months out, six months out, this person could be dead by then. My family member would be a garner. And, and, and I said, Holy crap. So what, what I did was is I, I played the whole game. I'm good at this because I live in healthcare.

So I called a friend of a friend of a friend, and then I called someone else politically. And we spoke to this one in this department and that department, and we worked our way up the political ladder to get to that person. And then finally, after a week or so, I got an appointment for the following week or two weeks after that, you know, but it took a while to get in. It was incredible. And I went to find this person and what I, what made my decision is when I read this person's CV, which I had to pay for, by the way, because there's a rule that no one posts their CVS online. So I had to pay for it. So I found this, this particular guy, he was a researcher. He invented devices along the, you know, to treat these things. He was the guy and we finally got in and this guy was great.

He saved this person's life, you know, literally, and going through the process and, and, and the family member had cancer three times, um, in, in five years and needed to have surgery multiple times. And today my family members perfectly well and healthy and fine, but going through that process for five years, what, what came out of it for me professionally was why aren't our referral sources running after us? Why do we start with Ben pens and names on buses and billboards and flyers and ads and, and, and, and breakfast lunches and dinners. Why do we have to rely on marketing and personality? Why do we have to do those things? Because what makes us so special? And the answer is nothing we have or practice. And then we do taping every, we'll take the course, not denigrating to these you're taping, by the way, I'm just coming up with something innocuous that most of us don't use.

What an easy credit we walk into CE we sit back or we turn on the computer home and let it run while we sleep okay. Or, or watch a ballgame. Um, and we learned nothing and we get it. We don't get a real credential that does anything. In addition, our CVS are horrible resumes that Walmart wouldn't accept for job, because we don't know how to write CVS, because it was never a necessity within chiropractic colleges. So all of these things flew in, you know, uh, floated in my head like a pinball machine. And at the end of the day, I said, I want to create, and I committed myself to dedicated, to creating something that would be meaningful to our referrals and to the public to want to use us. And I embarked on, um, working with not only chiropractic academia, but medical academia. And it took me five years to get the medicals to Prudential.

Chiropractic it was a big uphill battle because they didn't like us. Uh, you know, they just didn't like us. And it was a huge enough bill battles. So we did all of those things and got a credential. Then we created over time, things like the trauma qualification and ENM qualification. So MRI qualifications, and, and then, um, I went to a meeting in New Jersey, the New Jersey trial lawyers association, um, through one of our doctors, um, got me an invitation to present to the doctors. And in this particular meeting, it was one of their smaller meetings. There were about, I think, five or 600 lawyers in the room. And, you know, it was one of their smaller gatherings, but, you know, I spoke and the, the, the president, or soon to be president came up to me and said, Mark, we have a problem. There's a court ruling in New Jersey called Lam, L a M B versus Allstate.

And then that court ruling had said, chiropractors are not qualified to opine on MRIs because the chiropractor two courses from the state organization, there was no testing. They didn't learn pathology beyond this. They mimic the radiologist's report and they went on and on and on and on. And I looked at him and I said, you know what? The judge got it, right. The judge got it right. Because all of those things are true. The key versus this was, was the V it was lamb V Allstate Allstate. And then Allstate brought that, that ruling around the country and started applying that standard all over the place. So what we did was we got the MRI course up. We got it, we got it approved through at that, from the university of Bridgeport, college of chiropractic and SUNY Buffalo medical school, state, university of New York and Buffalo school of medicine.

So we got it approved through there. And then we put the, put a dozen chiropractors in New Jersey in front of courts, working with this attorney. And everyone got approved in a VOD vere hearing approved to be able to opine everyone. So, and then we started doing it around the country. Actually, the first one was in Millersville, Maryland was the first place we tested the water. Uh, dr. Anthony Hardnett was the first doctor in the country. And he went up versus against state farm and halfway through the case when he was on the witness, stand, stay, farm called it the German, um, and then actually call the medical school to see if there was a real course. And his name was on it. That was yessing. Yes, they had no objection. So the plaintiff won the case using dr. Hardnett. And since then he hasn't lost the case yet.

Then we, then we brought it around a Jersey, the exact same thing. So word got out very quickly in New Jersey specifically because it was our first real test that doctors of chiropractic will have this credential are the ones we want to work with. And then we started adding things like biomechanical engineering, and we added orthopedic testing and stroke and concussion and EMG, and the P I bootcamp, which goes towards causality, which is actually formally called triaging, the traumas, et cetera, et cetera, and all around the country. Now lawyers are saying, what are your credentials? Show me your CV. And when you sit with the lawyer, you get to say and avoid ear hearing. These are the things that are going to come up and here are my credentials and they, all lawyers all know what VR is. Now, if you're in Colorado, they call it a Shrek hearing.

Cause Shrek was the case was a litmus test in New York. It's the Frye standard. And other cases, they follow the Dalbert, uh, federal Dalbert standard, which was supposed to be on technology, not the doctor. And they, they, they adapt that to call it a rule seven Oh two hearing, but even someone like you who've testified many, many times before. And you have a track record right now in your state. I know factually that doctors have testified before they're being challenged by the defense, because there's a more, there's a narrower standard than they used to be. And the courts, which means the judge, the courts are actually ruling that doctors have a higher standard. Now that emanated, um, from the New Jersey and everything bad, this country starts in New Jersey in 2013, um, N J S a a eight dash six eight, which was a law or not, not, not a regulatory ruling by a department, um, or even case law.

Um, but a law where the governor enacted and signed with a doctor must have credentials and that discipline, and it's not limited to chiropractic. So, and again, that ruling is spread around the country and it's getting much more difficult for non-credentialed doctors, even who previously been allowed, because that's a challenge, uh, to go there and lawyers know that. So there is a much higher standard. Secondly, let's get away from lawyers, let's go to medical specialists. Um, and my favorite example is Aaron Smith and see the park Texas who was in practice eight years, uh, went in front of an orthopedic surgeon. And the ortho surgeon said, I'm going to give you a fi, went to have a meeting with them in this community. And he also searches. I don't have time to talk to you, but you know what? I'll give you five minutes. I'll squeeze you in between.

Well, the ortho just wanted the Kairos referrals. So it was giving them five minutes to proverbially kisses, ring or kisses , um, and to get his referrals, they spent an hour and a half. And you know what? They talked about. MRI slice thickness, sequence acquisition. That's all they talked about, um, for the first hour and 10 minutes. And then the last 20 minutes, they talked about triage predicated upon the real estate between the space occupied neurological element. Is there, is there a compression, is there an abutment what's there? What are the protocols for referring over for, you know, for surgical consideration? The ortho at the end of the meeting said to this kid kid, I love chiropractic. I always have, but I haven't had a chiropractor smart enough to work with them until you, he walked out with eight referrals that day in his pocket.

That first year he got 150 referrals. He met with the second orthopedist surgeon. He got 250 referrals that following year. So he and Aaron went from struggling in practice to extreme athletes only because of his clinical excellence. That's how Eric, um, in Utah got, got five teaching five emergency rooms. So not only refer to him, but they built a spine center and they leased this to him and they all refer all their cases there. So his whole, any given month is about 900 and change spot cases to pull from that's his pool. And he works with the surgeons and I to go around the country, giving you example, after example, primary cares. If you have relationships with them that the, the, uh, axial pain, musculoskeletal pain is the fifth most prevalent diagnosis in a primary spine care office. They, they don't know what to do with them.

They just want him the hell out. I mean, they're referred to PT, to ortho, you know, which is, which has created the opiate issue. And they know that. So if you educate them that, Hey, I work with dr. Shadi, the neurosurgeon, he's incredible. He has, we screening a lot of his patients. So, um, you know, if you have any of these cases, we'll take them from you. We'll get him evaluated. You know, I've been trained through SUNY Buffalo medical school and I'm trauma qualified, I'm MRI qualified. And that's critical because with medical doctors, the two things they're concerned about is that literature base and who qualified you. So therefore, you know, I work with dr. Shabby. I worked with the neurosurgeon, okay. He's, you know, it's going to be six, eight weeks to get into him. We take your patient. We also work with PTs when necessary.

Now we're not going to refer a case to a PT for spine. I will for extremity, but not for spine. So therefore it only takes two or three good MD primaries to build a huge practice on the chiropractic side. But remember when you're dealing with MD primaries, you're going to get the good, the bad and the ugly. You're going to be billing with Medicare, managed care, Medicaid, managed care, and even worse, managed care than that. And you're going to get some PI cases from when you, when you deal with surgeons and specialists, um, then you're going to get a lot more trauma cases. And then you ratchet yourself up to urgent care, which is an ERs. And it's the same thing. You, you want to treat them and street and you want to get them. Then you want to get them out. There's not much you could do for them in an urgent scenario.

We, we take the burden off of you, reduce the opiate issue and keep that patient from coming back because it's a revolving door and on a repeat visit, an ER makes virtually nothing. And it clogs up their whole system. They want them out. And I have an opportunity to educate and render AMA credits to your ER physicians. And you do that under our umbrella. So the goal, I don't need to talk about patients yet. I mean, even patients when I, I went to a cardiologist, um, a decade ago, um, uh, listen, I, I, you know, I'm, uh, I'm a marathon runner. I've got a, roughly 12 pack in buns of steel, but you know, I've taken, they had parents in the case that they have a history of heart condition. So my grandparents and my uncles, everyone, so I went to a cardiologist, um, and I sat in their office and I looked at the walls and what did I say?

I saw a seat. Now, there were, there were six cardiologists in that practice, there was a sea of diplomas on the wall, not one picture diploma after diploma, after diploma, after diploma, that's all I saw on the wall. And it was like, Holy crap, this I'm in the right place. I mean, what is the last time you went to a doctor's office is so stupid pictures on the wall. Okay. You know, a photograph of a Monet cares who cares doctors like to put impressionists on there? Well, I can't stand it. This was impressive. So what we did was we made the recommendation and you've been in the program long enough to have heard about it, take all your diplomas and put them in your reception, not in your office. You want to look at it yourself, big deal. You know, there's a name for doing things to yourself, but, you know, put these things out in the reception area, line, your holes with them.

Patients look at them and it's impressive, which is why will you take a lot of our, almost every one of our courses. You're not only going to CE certificate, you got a diploma to go along with it. And it's pretty awesome. And you get that frames and you put it on the wall. And we have offices, just like the cardiologists are our chiropractic offices who have nothing but diplomas all up and down their hallways in the reception area. Because patients look at it, they go, Holy crap, I'm in the right place. And they refer a lot of patients into the office, purely based on your credentials, because it renders the perception that you are the best of the best and perception drives reality, that all of that matters. So you've now got my entire vision of why credentials matter from lawyers, medical specialists, medical primaries, urgent cares, emergency rooms, and your patients call in 21 minutes and 45 seconds. And I have been traumatized. No, seriously. That's what I answered your question. Yeah, that was good. Yeah. Well, new to me is that the,Uh, you need to, To be requalified in order to be able to testify and appeals upon the judge. Remember that it depends on the judge and you never know that's right. And some judges are really bad against, let me ask you a question. How are judges placed? Do you know the answer to that politically? Yes. For the most part, yes. Yeah. They're place politically or they're voted in, which is again through the political process.

Yep. Now, You've been around long enough that you're jaded and to, to support judges, um, campaigns, insurance carriers. Yeah. Yeah. I know. And there's, there's actually one particular judge, uh, in our area that is so ensured and slated. It's, it's terrible. And he used to work at a used to work for Altspace. Cause we got a lot of those in New York that I don't know, but a lot of the judges used to work for the insurance companies. And you're going to go in front of this Allstate lawyer who that was a judge who's carrying the Allstate banner because they, they contributed heavily to super pack. And then now they don't want you in the court. So you were approved, you were awarded there previously by a different judge, but now he's going to say, well, I want to delve into your qualifications. Okay. What formal credentials do you have?

Doctor and M R I interpretation. Do you have form of credentials? Yes or no? That's the kind of questions they ask, but what's important too, is you have to have your attorney know to qualify before you get to court so that you have those credentials, um, in the, uh, um, whatever the lawyers do before you go. Because sometimes they forget to put that information and then it's difficult to get it introduced at, uh, at trial every, yeah, you're right. And every, but every state is different. Remember that. And even if it is introduced upfront. Okay. I mean, prior to taking this course you've testified in MRI, correct? Uh, yes. Okay. So you're on the witness stands on your next case. Okay. Doctor, I see you were previously approved to testify in MRI and Smith vs. Allstate, but in this particular case, it's, uh, it's, it's perhaps a different, um, finding on MRI.

And I, I want to know doctor, do you have formal, have you, or do you ever forget any course? You've taken with me. Okay. This is before your relationship with us. Okay. Doctor, do you have any formal training on MRI? Yes or no? No. So doctor, have you interpreted MRIs throughout your career? Yes or no? Yes. So you're relying on your experience, absence of any formal training at all, is that correct? Well, it had like a minimal three hours whenever course, you know, a long time ago, but so doctor, you're saying three hours, three hours of coursework, was it done in a, in an academic institution or a hotel or online in a hotel? Which one? In a hotel. So used to have the three hours in a hotel, which is the some parcel of your formal training in a hotel. My expert is a board certified radiologist who spent six years studying radiology for medical school.

And your honor, I mean, you're saying that the inference of the conclusion here, this is this proceeding as a joke, I, I embarrassingly that. I even have to say that this doctor should be precluded from rendering an opinion. It's an embarrassment just for me to have to say that the court should recognize that and stuff like that. And, um, that's what happens. Yeah, sure. Yeah. The goal is just to make it, which is why, you know, we, our, our MRI course is 25 hours, which is, which is the source. But every time when you do the PI bootcamp, there's two hours MRI. When you do spinal trauma pathology, there's two hours of MRI. When you do every single primary spike, your course, there's two hours of MRI. We're just adding another 27 hours of MRI extremities. We're doing another MRI review course of 20 hours.

Um, every time you do, anytime you do a program with me, there's an hour of MRI here and an hour of MRI there, we always throw them in to build. So at the end of the day, you know, you get to say, even the mini fellowship in MRI, that people sit with dr. Feister, that's 40 hours. Okay. A formal training. So many of our doctors have to say, doctor, how many courses did you take an MRI? I don't know. Dozens of them. How many hours? A hundred, 200 hours was it done through a state organization, a political organization. Now it was done through either Cleveland university, Kansas city, which is a chiropractic institution. It was done through the state university of New York of Buffalo school of medicine. My professors were dr. Robert poster, medical, neuroradiologist trained at Harvard. Now the head of neuroradiology, it started the university, dr. Maggie Shadi and medical neurosurgeon, Terry dr. Terry button, who's a medical physicist. And the last to actually work with Paul [inaudible], who's available Lori to advance that MRI. Um, I've been tested, I've had hundreds of tests on these things. You understand what I'm saying? Right? Yeah. I got it. Yeah. That's cool. But no, you've taken the one course.

And that's the place to start. Yeah, because my goal is to make you Bulletproof, not only on the witness stand, but don't think for one second, and I know you're laser locked on just lawyers. And I get that because your conversation goes back to the lawyers and courts, don't think for one second, that your power lies with lawyers. It doesn't, we've expanded your footprint for referrals to medical specialists, medical primers, or visit emergency rooms. We've expanded that footprint and all of the different pieces of knowledge come into play because as the courses are all meant to be intertwined for the most part, you're going to see a lot of recurring themes in courses. Where are we going to talk about this? Then we talked about ligaments. So we talk about connective tissue. Then we talk about blah, blah, blah, blah. And a lot of things are interconnected.

And then when you start having these conversations with the medical specialists, all of a sudden you're different. It's just different. And when you look at hospitals and having a foothold in there, now you have an opportunity to interface with these doctors at a different level, as a peer, as a peer, because you've been trained in the same type of institution they have. And lawyers are almost a joke. It's just too easy. It's just too easy. So, okay. I take it. I've taken a half an hour of your time. You're good. And it was, it was worth it. Yes. You're welcome. You have a great day. Okay. Bye-bye.


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