Academy of Chiropractic
Quickie Podcast 1309
Office Systems 136 OS
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
Lawyers want to prematurely finalize a case
Dr. Studin: Good morning, what's going on?
Guest: Yeah. So just yesterday I had an email last night from the attorney who had set us one of our cases, it's a personal injury case and the attorney wants me to go ahead and close out the account.
Dr. Studin: What does that? I mean, this is not like going to the supermarket and saying I'm done shopping, What is closed out the account?
Guest: Well, exactly. And so, you know, going through the consults, at this point, I just have to have a conversation with the, with the lawyer. And obviously the goal is right, is to reevaluate this patient within the next four to eight weeks. Right after they've been out of chiropractic. They're not seeing the orthopedic anymore and kind of do a final evaluation.
Dr. Studin: Let’s back up a little bit. Okay. Here's how we start. I have a patient male, 35 years old, got into an accident on January 2nd. I have X number of visits and here we are now. So give me a little bit of background. Okay.
Guest: Male, I think he's 32 with so I don't even have the chart in front of me but accident was probably two to three months ago.
Dr. Studin: How many visits has he had?
Guest: My guess is probably 20, 24.
Dr. Studin: Can you say with a great degree of medical certainty that you have concluded enough care to determine permanency on an accident two to three months ago?
Guest: Absolutely not.
Dr. Studin: There is your answer, so I mean, that's really what it comes down to because connective tissue pathology, you haven't even gotten into the final repair stage of connective tissue pathology. You don't know where it's going to end up. So, I would let the lawyer know that I appreciate you want to conclude the case, but this patient needs at least two to three more months of rehabilitative care, then I'm going to need to send them back or reintegrate back into his repetitive lifestyle with a home exercise program to see what residuals are there for about four to six weeks. And then I'll do a reevaluate him to determine what permanent residuals there are. It's too premature, two to three months, post trauma. We haven't even gotten into the rehabilitative stage. It's just too premature and you're not going to get what you want because more problems are going to come out over time
Guest: when I stopped treating him, so passive treatment and send them onto his active treatment care, what he does to himself.
Dr. Studin: That's what more of the chronic issues are going to come out, which is going to give you more things potentially to argue if they're there for it just might all go away. I don't know. That's the whole purpose of care too. So yeah, no, I agree. And that's basically the conversation I have to have with a lawyer, right?
Dr. Studin: Yes. And you have to start by saying, I understand what your needs are, but it's too soon because theoretically more issues might come out and it's much too premature for this. We need at least another two or three months of passive care. What I do to the patient before you release them to active care, what they're going to do to themselves without my care. And then theoretically, if there's permanency is more of those issues would be documentable and demonstrable, which will give you what you need. But we don't know until we get there, but I need to get you the monster militias, which it's just too soon.
Guest: Okay. Yep. Totally.
Dr. Studin: That's how it works. Okay. Good question.
Guest: And on the patients, then what happens if we have a patient like, I guess apparently part of the issue, is this patient, apparently you're saying he doesn't have transportation. So how does that plan into the,
Dr. Studin: obviously these are things I have to dock your document, chest, that patient doesn't have appropriate transportation and cannot maintain the level of care they need. You do the best you can. Now the other thing you could do is you could do a telehealth visit when the patient can't get in and help them through exercise rehab and those things and that's appropriate.
Guest: Yeah, that's great. Okay. Perfect Mark. Thanks.
Dr. Studin: You're welcome later, alligator