The rapidly-changing personal injury chiropractic landscape and how it is impacting DCs
You go to work and realize that your personal injury chiropractic volume has shrunk, and you didn’t see it coming. You reach out to all the lawyers you historically have gotten referrals from, and they tell you it has been slow on their side, and worse, they are cutting your fees in settlement by 50-60%. You write a great report that has “Colossus” (computer-calculated settlement value) covered. You have AOMSI (alteration of motion segment integrity) documented, and neither have “moved the referral needle.”
This is the theme I have been hearing nationally for the last few years, and it is getting worse for too many.
Avoid growth dead ends
I can say with certainty that Colossus reporting will not get you new cases. I can also safely say that X-ray digitizing and AOMSI will not get you much either. I can also say that you must understand both and use them as they are each a small piece of the puzzle — and needed. However, as a business strategy for growth, they are dead ends. The two core issues in today’s marketplace for personal injury are demonstrative documentation and credentials.
Whether it is Voir Dire, Daubert, Frye or Shrek (all legal expert hearings and named differently per state), credentials have and will continue to be a central reason for medical-legal relationships. It is also essential for the chiropractor to have dual credentials, chiropractic and medical.
I am not suggesting you need to become an MD. Still, you should consider acquiring chiropractic CE credits and medical CME credits, as the legal community recognizes both and will render the perception that you have a higher level of personal injury chiropractic knowledge as an expert. Also, it goes to your opinions being accepted in a broader sector of health care — a critical component of the expert hearings, and one a lawyer understands before entering into relationships.
Personal injury chiropractic: boost your credentials
The more credentials you acquire, the more knowledge you will have. That is a given provided you research the courses you are taking.
Who are they taught by? Are they recognized by academia or a licensure board? Are there examinations? Are you taught theory or clinical application? These are questions judges in courts are currently asking doctors in expert hearings.
Be prepared and avoid those “fluff” CE courses that do not support your practice goals.
Establishing better documentation
The demonstrability of pain generators from pathology as sequelae to trauma has rapidly moved to the forefront of medical-legal relationships. Although I do not suggest at any level that you treat the case or be concerned about the finances of a case, the results speak volumes as to the success of demonstrability of those pain generators.
In a limited study of the medical-legal marketplace, those chiropractors who have become experts at documenting the lesions have helped their patients realize a 1,546% increase in settlement or verdicts. Again, the goal was to document better, and this was the result.
To document better, you need better credentials and the knowledge that comes with those credentials to make you a true expert. Anything short of being an expert will do the opposite, and you will soon become a “one and done” with the medical-legal community. This level of knowledge does not factor exclusively with lawyers; it determines the depth of the relationship with medical specialists and their willingness to collaborate with and refer to you. There is a lot at stake in becoming a true expert.
When considering referrals, it is about your reputation and making your competition irrelevant. Your competition should not be other chiropractors. It should be about not losing referrals to orthopedists, neurologists, neurosurgeons and physical therapists. The evidence in the literature (a topic for another article) strongly points to chiropractic as the first provider of spinal care and you must be ready for the changes in the marketplace that are currently happening.
Prepare for the changing marketplace
Not being prepared will leave you wondering where all your personal injury chiropractic patients went and blaming everything from payoffs (which rarely occur), to nepotism, the “old boys” system to my “dog ate the homework.”
If this is your reality, or your practice indicators indicate this to be your direction, prepare for the future, which is now the present. Others did and they are flourishing, and so can any willing provider.
MARK STUDIN, DC, is an adjunct associate professor of chiropractic at the University of Bridgeport, College of Chiropractic; adjunct professor at Cleveland University – Kansas City, College of Chiropractic; and adjunct professor of Clinical Sciences at Texas Chiropractic College. He is the president of the Academy of Chiropractic, teaching doctors of chiropractic and interfacing with the medical and legal communities (DoctorsPIprogram.com). He can be reached at [email protected] or at 631-786-4253.