Academy of Chiropractic

Quickie Podcast 1295
Office Systems 134 OS

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 Legally Determine Modalities to Use

 

Speaker 1:

[inaudible] this is being recorded with permission. Hi, how are you? Good at it's afternoon. Hey Mark. How are you doing? I am doing well. We're going to talk about today. What modalities to use and whatnot that you sent me an email about, uh, certain, uh, pieces of equipment you had that and is it still appropriate to use? Not appropriate to use. And, um, I have to let you know that through my career. I'm a gadget guy. I'm a tech guy. I love tech. I love gadgets. I love stuff through the years, any new piece of equipment that came out, you know, um, when I was in practice through the nineties and early two thousands, I would buy it. I would use it, I get paid for it. And an interesting thing happened, Carrie, your started pushing back against some of the things that would be used in lawsuits and they were suing people and they were going after them.

Speaker 1:

Not only get the money back that they paid, but threefold in Rico suits for an allegations. And one of the doctors who did this was he was dirty. I mean, he had a multi-discipline crap, this with MDs and DCS. And he was actually, the Cairo was doing injections himself on people, which is illegal. Um, but you know, they were busy, but one of the counts that they got him on for fraud was using a certain device. And it was a se uh, current perception, threshold device, some kind of a really high frequency, tens transcutaneous nerve stimulator TCMs and he called me up and he said, Mark, you had did the original research for it. I needed because I need to defend myself in federal court. Can you send it to me? And I found for him in opinion, letter written by the manufacturer and, and he said, no, no, I need the research.

Speaker 1:

I said, this is the research that we got. And I was young and stupid at the time. And it turns out that it was a manufacturer's opinion and not, and not a piece of scientific literature. We fast forward 20 years, I met with the attorneys, uh, for state farm and Geico. And there's a new piece of technology out that measures the small fibers. You're familiar with that. Yes, yes. Okay. They said that they were really circling the wagons to go after that guy. I guess there's no literature. And I actually spoke to them and I'm not going to say I quelled the investigation. I'm not going to say that I changed anything because I don't have that power, but I can tell you that I educated their attorneys on what it is and the, and the value of it. And I haven't heard anything. I'm not saying you're going to, you're not going to, but the reality is, is there's no real research on that.

Speaker 1:

Even though it's been average, 20 years love the technology. It does wonderful things. It's on some fee schedules. People are getting paid for it. Um, but it's indefensible at the end of the day because there's no literature on it. It's not, you know, it's still investigational. Um, I get calls from people doing, uh, surface EMGs with range of motion, dynamic range of motion. They call it out. Some courts have approved it. A couple of trial courts approved that. Um, but that's about it. It was never gone to the appellate division or the highest court in the state to affirm it into law. That it's, that it's, that it's accepted because there's the, the research is not as equivocal. So my answer to you on any piece of equipment, and this is not fair, I'm telling you it's not fair from where I stand. Having had to defend myself in court on, on, on, on nonsense, on some substantive issues on winning and losing the best place to be in the court for the court suit is not to be in it at all.

Speaker 1:

I'm not looking for a fight. Some people are looking for a fight and relish the fight. I'm not one of them. If you're using a piece of equipment and there is indexed peer reviewed scientific literature. When I go to pub med, I go to Ovid. I go to Google scholar. I can find it. I can look it up. I can read it and there validity behind it. Then I'm going to consider using that device. If there's none of those things, I'm not going to use it. I'm going to let someone else take the hit. It's not going to be made. And it's not fair because some of this stuff is really good, but it's also the, the onus is on the people who are producing this really good stuff to support real research, to validate what it does. Now, if I was in practice today, it's a real simple paradigm.

Speaker 1:

I would examine, examine the patient. I'd adjust them. I do exercise rehab. I do therapies, heat stim, ultrasound, diathermy iontophoresis photophoresis. Um, and, um, I dunno if I said exercise rehab. Yes. Those are the things I would do even laser. I, I I'm sure there's research by now on laser cold laser. If there is, I would consider it. It does great things. If it doesn't, I wouldn't. And if I wanted to make more money, I would just get busier and become more efficient at what I did, because there was a lot of money to be made in what I just said. You're the other, and even manipulation under anesthesia. I mean, that's a good one. Good carriers are going crazy on that right now. They're really showing a lot of people. They just don't want to pay and you don't want to get caught in the cross hairs. So, um, I don't know if that answered your question about what to use, not to use and why. Yes it does. The goal is, is to say, I am, you know, me, I am very liberal. I'm very aggressive, but when it comes to compliance and being sued, I am the most conservative person you will ever meet in your life. And a lot of people disagree with me, but I don't, but you know how, you know how much that bothers me. Yeah.

Speaker 1:

Any questions? Nope. That's, that's spoken clearly. There you go. And by the way, those, those fancy devices I bought 20, 30 years ago, I bought, uh, a carpal tunnel treatment machine, which was not even approved by the FDA, but I got some great literature from the manufacturer of transcutaneous neurostimulator. What I found that people being arrested two in the morning, I ran to my office when I read it, honestly, and I threw them in the dumpster. I was spooked. Um, it was just crazy. Crazy, crazy. So Okie dokie. You got it. I appreciate it later, alligator. Bye. Okay.

 

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