Academy of Chiropractic Personal Injury & Primary Spine Care Program
Quickie Consult 242
“We Change or We Die”
With everything from dinosaurs to financial investments, time has shown that if you do not change with the times, you become extinct. Practice is no different as I remember having a conversation with a colleague 10 years ago in which I was sharing how I had to constantly redefine myself to survive in practice. The game was changing in so many ways. There were so many managed care programs, new personal injury/no-fault rulings, workers compensation rulings, lawyers needs and an ever-changing landscape with medical specialists vying for the same referrals as I was.
Lecturing to lawyers nationally, I realize that the ability to change is central to the success principle in personal injury, not only for yesterday, but today, tomorrow and the distant future. In the time-honored principle of the "trickle-down effect," we are located somewhere on the bottom as we are not cause, but effect. We have to respond to the needs of the lawyers, who in turn respond to the needs of the courts, who in turn respond to the rulings in other cases, who in turn are an effect of defense lawyers prevailing on their cases, who in turn seek to create strategies that eventually work their way up to the Court of Appeals in the respective states making it the law of the state and eventually the US Supreme Court, if necessary, making it the law of the nation and effectively avoiding having to get 50 individual states to pass the law. Did you get that? Simply put, a lower state court ruling has some precedent value, but unless it works its way up the appeals process, it is only the law of the case. Once it is appealed and won, it has more value in the Appellate Division of a state. Then the losing party can appeal once again to the highest court in the state for a ruling and only then will it become a law of the state. It is an arduous and expensive process, but one carriers have the time and money to persevere through. As a result, as the rulings come down from the courts, the lawyers, in arguing their cases, have additional needs and those needs on the expert side are fulfilled solely by the doctor...you.
As I write consultations, my focus is not to teach you the law or make you lawyers, but to teach you the process because the more you understand, the better you can serve the truth so that your patients can get what is fair so they can live their lives pain free and with dignity. When I speak to lawyers from New York to Washington to Florida to Southern California and all across the heartland of our country, 99% of the time the story is the same. Don't think for 1 second that because you are in Oklahoma your needs are different than those of the doctor in Times Square in New York; they aren't. The only difference is that the doctor in New York gets paid less than you do in Oklahoma.
If you read the consults from beginning to end, you will see many "subtle" and many "not so subtle" changes in direction. The reason is that the needs of the courts literally change daily and it is my job to keep you current on the needs of the lawyers and the courts in maintaining your ability to be expert in the medical-legal arena. It is your job to make those changes and not be locked into a certain way of doing things.
In chiropractic we have often made the mistake of calling the belief of chiropractic our philosophy. "The word 'philosophy' comes from the Greek φιλοσοφία (philosophia), which literally means 'love of wisdom'" (Wikipedia, 2011,http://en.wikipedia.org/wiki/Philosophy). However, as a lifelong member of the principled division of our profession, we do not practice philosophy as a profession, we practice dogma. "Dogma is the established belief or doctrine held by a religion, or by extension by some other group or organization" (Wikipedia, 2011, http://en.wikipedia.org/wiki/Dogma).
We often maintain our dogma of what we believe chiropractic should be in the subluxation model or in the structural model where, in fact, it should be a combination of both. We don't realize that chiropractic is everything state licensure boards will allow it to be and without it all, we wouldn't have a profession today. If philosophy is the love of wisdom, then we would be studying all wisdom and adapting accordingly.
Personal injury is the consummate forum for philosophy and the guiding principles are those that trickle down from the courts allowing us to compete and win in today's economy. I urge you not to get stuck in the dogma of your beliefs because chiropractic, personal injury or practice is not a religion or organization, it is the forum of which you have been given the right by your state board to care for patients. That right allows you to grow with maintaining your core values as you see them, but if you do not change with the times, you will follow the dinosaurs and the Edsel, never to be found. No, that's not true...You can be found manning the aisles in Walmart.