Academy of Chiropractic Personal Injury & Primary Spine Care Program

Quickie Consult 8

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.
A doctor writes on very common practice issues…
 
My biggest weakness in my practice is not getting new patients, but having a systematic, methodical re-examination protocol to inform patients of their progress at the 4-6 week mark. Consequently, my PVA is lower than it should be, at around 23. I have looked into getting a Myovision SEMG, but am concerned as to how much I will really use it, as far as getting the staff and taking the time to train with it. Do you recommend any RE-Ex protocol?
 
The re-examination protocol I recommend has been set forth by Federal Government. Medicare says, “The doctor shall re-evaluate the patient every 30 days.” My rule is if you make the Feds happy, then everyone is happy. It is also good healthcare to often re-evaluate to ensure that your treatment plan is accurate.
 
You also hit the nail on the head regarding your PVA. 23 is a very difficult place to be, as you will always be dependant upon your next new patient for any stability in your practice. The problem you have is your report of findings and the follow up on a daily basis with your patient. Every visit is a form of report of findings, but your initial one is the most important. Do you have a written report? Do you show an initial video? Do you give health care talks?
 
On the re-evaluation, do you sit with your patient and review their entire case? hese are all critical steps in the success of a practice. If you do the above questions, then your practice should have a PVA that doubles, and therefore your volume will double without getting 1 more new patient.
 
Do you recommend the X-ray digitizing as a tool to evaluate aberrant motor units, as referenced in AMA guides for IME ratings?
 
X-ray digitizing is great. However, I never found a need for it and never found a problem getting an impairment rating for my patients.
 
What is the best way to dodge, or should I say neutralize, the lien issue in cross exam from defense?
 
Tell the truth…Having a Lien is not illegal, nor unethical. If there is something I am missing, tell me, as I have been telling juries for decades that I have a lien against the case. Sometimes lawyers don’t like it, but the truth is the truth.
 
Narratives: How long should final narratives be? Some attorneys like them long and drawn out, others don't.
 
A narrative should be long enough to have all the information in it that I have shared with you in the consultations. I have shown that narrative template to 10,000’s of PI lawyers over the years and they were thrilled. In fact, they wanted that format for every one of their clients.
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