Academy of Chiropractic Personal Injury & Primary Spine Care Program
Quickie Consult 64
"Feel Free to Destroy Your Reputation & Then Blame Everyone Else For Why You Are Not Getting Referrrals"
I have now read and critiqued over 1000 final narratives that doctors nationally have already sent to lawyers, and I am amazed that a lawyer would ever want to work with a chiropractor again. I can only assume that the medical profession’s reports are equally poor (I wanted to say “suck,” but I have already offended my quota of people for the week). I have reviewed only a few hundred medical reports and they are not great, but they are better, as a rule, than chiropractors’.
The biggest difference is accuracy. Over the last few weeks, there has been a recurring theme; diagnosing bodily injury that doesn’t exist. An example would be diagnosing radiculopathy with a negative EMG, or the same diagnosis without either a positive EMG or clinical findings. As far as I am concerned, a doctor should never diagnose radiculopathy without confirming with an EMG.
Remember, as I have said previously, “rule out” diagnoses do not exist and should never be used. If you are concerned that there might be pathology, you articulate that in your evaluation report and state that the reason for the EMG is to rule out radiculopathy. You do not diagnose a condition that does not exist.
In addition, I have been seeing radiculopathy diagnosis with positive NCV’s. Bad, bad, bad; if you do not know the differences, take the PI Bootcamp. The lack of that knowledge will invalidate you as an expert with the legal community and you will never get a referral. More importantly, your patients are entitled to be cared for by the best doctor/chiropractor, not just the best bone mover! Never diagnose anything without a clinical basis.
I shared with a few local lawyers, in a forum that I often use to validate my opinions when I want to be absolutely certain, and 100% of them said that if they saw inconsistencies in the diagnosis and findings, they would go further than not referring to you. They would leverage their current clients who were under your care to go to a doctor who knew what he/she was doing and leave your care. Those are powerful words and actions that can and will destroy your practice. Not just a PI practice, as these are issues that create a reputation for a doctor, and we live in very small communities when it comes to word-of-mouth, no matter the actual physical size; word spreads quickly, good and bad.
The opposite is just as powerful. The #1 reason to work with a chiropractor, or any doctor, is their knowledge and their ability to articulate it in writing. Since the foundation is knowledge, you must ensure that your infrastructure is sound. The place to begin is your knowledge base and you must be expert in spine, disc, neurology and disability/impairment. Over the next day or so, I will be sharing with you a checklist of knowledge and credentials that are necessary.
Here is another non-negotiable issue: NEVER, NEVER, NEVER submit a report that reads, “Dictated, but not read.” This is a sure way to get “roasted” on the witness stand and have your reputation destroyed. You are submitting to the courts a document that a $10 per hour person wrote through interpreting your words. Take the time and read what your name is on, signed or not. I urge you to personally sign everything your name is on.
Before he died, my father-in-law gave me a great lesson in life. He used to say “wise-up.” He was right because as soon as you open your mouth or read what you have written, they will know. It is at that very moment you have the chance to win or lose for the rest of your career. The choice is yours.