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Explaining CRMA Spinal Ligament Injury Testing to Your Patients

Explaining CRMA Spinal Ligament Injury Testing to Your Patients

by | Apr 1, 2020 | Articles, Back and Neck Injury, Injury Market

Explaining CRMA Spinal Ligament Injury Testing to Your Patients

I want to talk about explaining CRMA results to your patients. CRMA is Computerized Radiographic Mensuration Analysis. It’s a spinal ligament injury test that picks up the imaging biomarker of a ligament injury. An imaging biomarker is something that is detectable on an image that leads to a definitive diagnosis. There are 220 specialized ligaments in the human spine, 23 of which are discs. If we have a disc derangement or disc herniation, that’s an imaging biomarker that is picked up on MRI. We can also have excessive motion, which is the most problematic ligament injury there is. That imaging biomarker is picked up on standard stress radiology. We know that there are normal ranges for the movement of an intervertebral body. We know that there are abnormal movement ranges and we know there are seriously abnormal movement ranges that are consistent with what is left behind with a ligament injury.

You first must explain to the patient why you are doing this testing procedure and what you are looking for in the results. After you have done this, you have positioned yourself as an expert in this area by saying, “Look, this testing is what we do in order to determine the severity and location of a ligament injury. This is the most significant injury that the spine can undergo. So we only use the highest level of professional and competent radiologists that we can find to perform this service.” You are elevating yourself and your status. You’ve already done this with the patient. You’ve already explained why you’re sending out for this procedure. You’ve already explained to the patient that this is unique.

I have also educated doctors to tell their patients in their consultation that the majority of people out there that have chronic pain today have the condition that this test picks up and they’ve just never had it diagnosed. It goes undiagnosed so they are living with chronic pain when they could actually be getting help. Having this conversation with your patients will get you more referrals. It assists you with getting more non-injury referrals because remember, the thing that causes acute pain in an injury state is the same thing that causes chronic pain. It is the same condition.

Now you are at the visit where you need to explain their results. For example, Mark’s test came back and indicates a C4 on C5 nerve problem, or you have C4 on C5 alteration of motion segment integrity at that state for translation findings.

You are explaining, “Mark your test results came back. I’ve got them. It shows that you have severe ligament damage in the middle part of your neck.” I would touch the patient, I would point to it. You don’t have to give them the report, that’s not important. Those are not the important things. “Mark, here’s what is important. It came back, there was significant ligament damage. Now what that does is it doesn’t change our treatment goals. The treatment goals that I said to you in the report of findings are still the treatment goals today. Those goals are to have you pain-free at the end of our care and have you have no chronic pain, no chronic situation at all with this condition. To have it not interfering with any activity of your daily living and do not have it interfere with your ability to earn a living at all. I want you where you feel like you never had the injury in the first place. That’s the goal. Now, what this test tells me though, is that you’re at much higher risk for a thing called long-term residual complaints. Those are conditions that never fully go away. That’s a chronic condition. You’re at high risk for that. Now, here’s the thing that I need to tell you. You are the patient that cannot miss care. You can’t miss visits. You can’t miss anything that we’re telling you to do in treatment. You have to be a stellar patient because I’m not just working on your spine to reduce down your acute pain and the situation today, as a provider, I’m looking at your spine and your spinal health 10, 20, 30, 40 years from now. Seriously, I’m looking at your future when we are doing this treatment program now.”

“It’s my job, as your guide, to get you through treatment and you’ll understand it as we go. So here’s what I’m telling you, as a result of this condition, you’ve got to be really good with treatment. You also have to be really good with communicating to me. If I have you do an in-office rehab procedure, I will have you do an at home exercise program, and any of this seems to bother you at all, I need you to tell me right away. Tell me right away. Okay? This is information that I need to know. Now, I gave you injury recommendations about water, about sleep, about an anti-inflammatory diet.” (Doctors, we have a thing called SmartInjuryRecommendations that are just basic fundamentals that you’re going to give the patient to get healthier in the first place and to reduce their own inflammation.)

“I’ve given you those recommendations. Those are good things to do, right? I need you to know that with this level of ligament damage, it causes instability in the spine. Anything that’s unstable is prone to erratic or unpredictable behavior. Your spine may be good for a while and then you can have a flare-up. Now, that’s going to be important for you to know because we’re going to be talking with you about supportive care toward the end of your care.”

 

Doctors, I am initiating supportive care conversations in week one because it’s the truth. “What that means is that I’m going to be recommending probably, no matter how well you do in care, that we do two to four visits a year for the next two years after you’re done with care just to support the care that we did and then I’ll want you to take a look at doing…” My patients that see me twice a year or four times a year, and they do it for 30 years, are going to be much healthier than my patients that wait 10 years, don’t see me, and now they come in with some sort of situation and now they want me to fix it.

So it’s much easier to take care of a spine a little bit over time than it is to take care of a spine that has been badly neglected for years or decades. But this is a  talk we’re going to have toward the end of care. I just want you to know that we are going to be having that conversation. Doctors, you’re starting to talk about this now just by being in your report to the patient and you’re allowing the patient to ask you now, any questions that you want to ask them. You’re telling that patient, “Look, this is the other thing with this condition is, in treatment, a lot of times everything’s going to go really well, so you’ll spend a month or two and all of a sudden you realize, oh my gosh, I feel like I’m a hundred percent better and I should be done with treatment.”

And then suddenly you watch a football game on a Monday night; You sleep wrong on your neck; It feels like you’re right back at day one. You are not back on day one. Now doctors, if you don’t tell them that they can hit this, here’s what’s going to happen. They’re going to think that your care is not working. So if you tell them that it could happen and it happens, your status goes up. So now you’re basically telling the patient if that happens, you just come in for a visit or two and I’ll have you right back to where you were. That’s the nature of this condition. Now, if you tell them that and they hit it, they will be back in your office.

If you don’t tell them that they may have flare-ups, they might be in their office and complaining that their neck hurts.  Their coworker might say that chiropractic care didn’t work for them and that they went to a physical therapist or other doctors. The next thing you know, your patient is now in that other doctor or physical therapist’s office because you didn’t tell him they could have a flare-up. They will think your treatment didn’t work.

At the end of care when you’re talking to them about supportive care.  That you routinely want to have patients see you either twice or four times a year for the next two years after an injury. Just for some routine supportive care. Remember, you’re releasing a patient who is on consistent care with you. You don’t know how it’s going to be when they’re not with consistent care.

If they opted not to take up that recommendation, then I just reminded them that their injury causes an instability. If two months, three months, six months, a year, two years from now, the pain that they feel now starts to it starts to come back, I don’t for a minute, want you to think our care didn’t work. It worked perfectly. And doctors, if you don’t tell patients this and the pain does come back two, four, five, six months later, they think your care didn’t work. You tell them, “No, it’s not because the care didn’t work. It’s because it needs some supportive care. Come right in, right away, do an adjustment or two and let me get you right back to where you were.” Doctors, that’s what you want to talk about.

Now, the other thing that you want to talk about at that point is the fact that they have injury analysis, always. This is obviously not when you’re talking to the patient about their report. This is more into when you’re talking to the patient at the end of care that you always have a baseline of their injuries and that baseline can always be retested and that’s the beauty of a CRMA test. But doctors, what you want to do in that report is, you want to explain the fact that you want to increase their compliance and you also want to explain, “Look, this is the number one situation that most people don’t have diagnosed and when they get injured they need to have this diagnosis.”

So you want to position yourself as that doctor for their friends, their family, their coworkers, the people that they know that have chronic pain, that are in injuries, that are getting bad care because they’re working with doctors that don’t even know how to determine the severity and location of the injuries that they have. This is what makes SmartInjuryDoctors smart. This is what makes SmartInjuryDoctors competent. So it’s important to go over those things when you’re going over that CRMA report.

For more information on Spinal Ligament Injuries please check us out at www.smartinjurydoctor.com or check out our SmartInjuryDoctors® Podcasts on Apple Podcasts, Spotify, Google Play or Stitcher.

For information on spinal ligament testing by board-certified medical radiologists go to www.thespinalkinetics.com

Want to learn more about Smartinjurydoctor's Program?

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Clearwater Florida 33755

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A Chiropractic Subluxation is a Spinal Instability

A Chiropractic Subluxation is a Spinal Instability

by | Apr 1, 2020 | Articles, Back and Neck Injury, Back Injuries

A Chiropractic Subluxation is a Spinal Instability

I want to talk about the term subluxation and spinal instability. I am a doctor of chiropractic. I have been a licensed Doctor of Chiropractic for close to 30 years or maybe even slightly more. In my profession there is a term called spinal subluxation. Very important because it’s what happens in injuries to the spine. A spinal subluxation is a probably one of the most misunderstood terms in my profession. It’s a very simple term.

The term subluxation, or a spinal subluxation in chiropractic, has gotten a bad rap. It’s gotten a bad name. A lot of doctors don’t even like to use it anymore. In my experience, they don’t like to use it because they don’t understand what it is, and they don’t understand how to evaluate it, how to find it, how to remove it. They don’t understand any of that. I didn’t either as an early practitioner, so my education did not provide me with an understanding of what it was, how to locate it, and how to remove it. Even though I went to one of the finest chiropractic colleges in the world.

So I’m sure a lot of you are in the same position and if you’re a young provider, it’s even worse because the more as time went on, the more confused the market became about the term. A  spinal subluxation is nothing more than a misalignment of the vertebra or a vertebra that is an abnormal motion that causes nerve interference. And the nerve interference might be motor sensory or pain problems. Now we could say visceral as well, but that’s a little less explored and a little less understood.

We are just going to stay with motor sensory or pain. So if you have an abnormal position or abnormal motion in the spine and it causes a motor sensory or pain problem, you have a spinal subluxation. Now, my colleagues have confused that term with what’s called a medical subluxation. And a medical subluxation is defined as less than a full dislocation and you see it on x-ray. If you see a misalignment on x-ray medically, that can be called a subluxation, but that’s not what the profession of chiropractic called it. Professional chiropractic calls that a misalignment. If you have a misalignment that’s not causing a motor sensory or pain problem, then it’s just a misalignment. But when it bridges over or it clinically starts to express itself in a motor problem, a sensory problem or a pain problem, then you have an act of subluxation.

Now there’s another term medically that means the same thing and it’s very important in the injury market because the condition that I’m about to share with you is the condition that causes the most amount of chronic pain and disability in the world today. And it’s called a spinal instability, medically. A spinal instability exists in a motion unit when they abnormally move or excessively move, and it causes a motor sensory or pain problem. It’s called a spinal instability. Now, a spinal instability in medicine is exactly the same thing that a spinal subluxation is in chiropractic. They’re identical.

Most chiropractors don’t fully understand what the term spinal subluxation means. They don’t understand a spinal subluxation, that if you have an abnormal motion pattern or an abnormal alignment pattern and it causes a motor sensory or pain problem, you have an active subluxation. Now, you also have an active spinal instability and like both terms, it requires x-ray findings plus a motor sensory or pain clinical correlation. The examinations are very, very easy to do. They’re not standardly being done in my profession of chiropractic or in medicine. A spinal instability examination is not standardly being done. It should be, it should be a standard practice in every chiropractic college.

Now, if you remove the motor sensory or the pain problem that’s associated with the misalignment or mis-movement pattern in the vertebral bodies itself, you have removed the spinal subluxation and you have removed the spinal instability. Even though the excessive motion is still there or the misalignment is still there. If you remove the clinical aspect of what you’re seeing on imaging, you have removed the subluxation or you’ve reduced the spinal instability. It’s just that simple. Now it’s very, very simple to show you what I’m talking about. If I take a pinwheel and I run a pinwheel on the upper part of my outside lateral part of my arm, it’s the C5 dermatome. Means the C5 nerve is somehow affected. Now I can go to the C5 nerve, which I know comes out of the C4-C5 motion unit and I can look and say, is that misaligned or is there abnormal motion there? And if I have this sensory problem, I’m going to see a misalignment or abnormal motion at that unit. And that’s what a spinal instability is, and that’s what an active chiropractic subluxation is.

Now I can address this nerve condition by addressing and bringing into better alignment and restoring the neuromuscular control of the motion unit through spinal adjusting. And I can reduce this sensory problem. Remember I said motor sensory or pain problem, if I reduce it, I’ve reduced the spinal subluxation. I’ve reduced the spinal instability, but routinely understanding every level where it comes out is the job of my profession, the profession of chiropractic, and it should be routinely being done and routinely reported, especially in injury work. Because in injury work, the ligaments and damage to the ligaments are the most debilitating condition that you can have. So being able to perform simple evaluations should be very, very easy for most Doctor of Chiropractic.

And I’m sure there may be in controversy in what I’m saying, because understanding this is the road to standardizing the workups. One of the biggest problems in my profession is that there are no standard workups and there must be standard workups. Imagine if you had the profession of dentistry and all dentists were looking for cavities, but they were all doing it in a different way. There was all kinds of different techniques to try to locate those cavities. It would lead to a pretty confusing profession. In the injury market, especially, if you’re a doctor of chiropractic right now, we need to standardize our examination procedures. And understanding these key two terms is one step toward aligning and standardizing our procedures.

For more information on Spinal Ligament Injuries please check us out at www.smartinjurydoctor.com or check out our SmartInjuryDoctors® Podcasts on Apple Podcasts, Spotify, Google Play or Stitcher.

For information on spinal ligament testing by board certified medical radiologists go to www.thespinalkinetics.com

Want to learn more about Smartinjurydoctor's Program?

Learn more about dr. cronk

Reach Us

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246 Tierney Drive, Suite 1,
New Richmond, WI 54017

1-800-940-6513, ext 700

[email protected]

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701 Richards Ave
Clearwater Florida 33755

[email protected]
Call Lee Ann at 1-800-940-6513, ext 700

CONNECT WITH US

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Who Are You Really Treating With A Spinal Injury Patient?

Who Are You Really Treating With A Spinal Injury Patient?

by | Apr 1, 2020 | Articles, Back and Neck Injury

Who are you really treating when you’re treating a patient?

I know that sounds a little bit funny, but what I want to talk about is giving you an idea of thoughts that you should have with each new patient.

First of all, each person is uniquely different.  When your receptionist answers the phone, that person that they’re talking to could be a source of 100 referrals for you for the next year. They could be a source of 200 injury referrals in their lifetime. They can be a source of so many different things. You have no idea who you’re talking to and unless your clinic, or whoever is answering the phone, treats that person that way, you’re making an error.

You never know who somebody is attached to. You never know that the person that is calling is the wife of a hospital administrator that can get you more injury referrals through the emergency room than you ever dreamed of. You don’t know if it’s the wife, the child, a  friend, or the girlfriend of an attorney that may be able to get you as many referrals as possible. You don’t know if it’s the husband of an attorney that may be able to get you as many referrals. You don’t know if it’s the husband of a Congresswoman.

You don’t know who these people are and you make a mistake every single time. I know I’ve made a mistake every time I’ve ever minimized somebody. Every time I’ve looked at somebody and thought, okay, it was always short term thinking on my part because you’ve got to remember people are attached to a lot of other people, and so when you’re treating that person, you’re treating the whole tribe that comes with that person.

You’re treating all of their connections. If you don’t get great results with that patient, if you don’t handle that patient well, that communication goes out like a ripple out to their whole network. Say the person calls in and they have auto injury and they have headaches and migraine headaches. They are a mother of two children. The two children are 8 and 13 and they have been happily married for 15 years. Okay, well, guess what? When you’re treating that patient who has migraine headaches, you’re also treating their family. You’re treating the husband and the kids, and if you don’t get that condition resolved, think about what it does to that person’s life. If they have migraine headaches for the rest of their life, think about what that does to their marital relation. Think about what that does to their relationship with their kids.

Now, everyone wants to have great relationships, great relationships with your kids, great relationships with your spouse. But if you are in pain all the time, it can really be challenging. Here’s the husband, who does everything for the wife, and who would do anything and everything for her, and now she’s injured, she’s hurting, she’s complaining, and he doesn’t know what to do.  Here’s the kids who love their mommy. They’re going through their various stages and instead of those stages really being acknowledged, they are not. With a child, you go through these various stages. First, newborns and they’re not interacting all that much. Then all of a sudden they start interacting and you’re like, “Oh my God.” And then they become little kids and then they start talking and asking all the questions and they start going to school.

And every single one of these stages is an amazing stage. And if a person is robbed off of that because they’re in pain it’s not a good thing. And the other thing is, is that you’re participating in that person’s life and you’re participating therefore in the lives of everyone that they’re attached to. And I need you to start thinking about that. How are you training your receptionist to handle that call? Are you basically letting them know, hey, if this was the most important, take a famous actor, but if this was Tom Cruise that called in, how would your staff handle him? If this was the head of a country, how would your staff handle him? If this was the governor of the state, how would your staff handle him? If this was Bill Gates, how would your staff handle him? If this was, Taylor Swift, how would your staff handle her?

 

They may handle them different, but that’s not really where you want to be at the highest level because you never know who they are connected to. And it’s those connections and those interrelationships that can make all the difference in the world, in your center, and in your centers of growth. And people like to be acknowledged. Do you think about any experience, any customer service experience that you’ve ever had when somebody made you feel important? You felt good and remembered them. Now, why? Because it doesn’t happen very often. It doesn’t happen often enough, right? The patients that are coming in are your lifeblood in your clinic. They’re your lifeblood.

An injury patient should be treated as if that patient is going to be your patient for the rest of their lives. When they come into you for chiropractic services, whether it’s injury services or non-injury services, the attitude needs to be that this patient is going to be our patient for the rest of their lives until I retire or until they expire. They’ll be my patient until they fire me and they decide that I’m not, but up unto that point for the rest of their life, that’s how I treated them. What’s the importance of good healthcare? What’s the importance? Chiropractic is great on the injury side, it’s fantastic. Best there is for an injury side.

Now when I say best there is, I mean highly trained doctors that can get great results. I don’t mean the average mediocre doctor, that’s not what I’m talking about. There’s average mediocre doctors in every profession. No injury patients should be a part of those doctors. They should not be going to those doctors. Too high risk for long-term residual complaints. As a great doctor, when that injury patient sometimes will have the idea that this is all over when the injury over, but it’s not. Just like dentistry, your teeth have to be maintained. And so you’ll have a dentist your whole life. If you are into optimal health, your body does very well with long-term maintenance of the spine as an organ itself. That’s irrefutable, right?

So when I look at that injury patient when they came into my clinic, I looked at them and said, “Hey, they’re going to be my patient for the rest of their life.” So it’s my responsibility to do a great job for them. It’s my responsibility to set them up for having the best opportunity to have the best health that they can for the rest of their lives. So that attitude has got to permeate into the people that you train to handle these patients. It has to permeate, right? And you set the tone for that in your own center, doctors, you are the ones that set the tone. You’re the ones that train your staff and training your staff on this is really, really important. And making your staff feel important in the process is also important.

So that first contact, when somebody calls you, is that you have the ability to get their information. You take their information, you get their phone number, you’re able to text them. If I get a cell phone number and now my staff is texting them and saying, “Hey, we just want to make sure that you’re on your way and that everything’s okay.” Now it’s better if I could email and text instructions on icing. Instructions on what to do about their injury so that they can start to treat the condition themselves. Very few clinics that I’m aware of do that and they are clinics that I personally have trained.

If you do that, you’re starting to set the tone for the relationship. You’re starting to exchange with that patient before the patient’s ever done any exchange with you. You’re already starting to give to that relationship. There is a law of reciprocity that says if I give you something that you will feel obliged to give me something back. That giving me something back is to show up for the appointment. So all of these things are really, really important and they’re things that should be trained. But that initial contact with the patient, it really has to be understood. Everyone in your clinic has to understand how important these people are. The more important you make all of your patients and the more important you make them feel and the more you acknowledge them.

When is the last time you have a patient that’s been a patient of yours for two, three, four years and they come in every three months or four months or whatever it is. We acknowledged them and said, “You know what, I really appreciate you. I appreciate the fact that you make your appointments, you keep your appointments, and that you take this seriously and that you long-term maintained this.” That’s my whole mission. My whole goal. Or the patient is actually it’s an injury patient and they’re maintaining their schedule. “Hey Mary, I just want to acknowledge you that you’re keeping up with your schedule you’re doing your job and I want you to know that I appreciate that.” Acknowledge people. In my clinic, we used to have an acknowledgement day, sometimes once a month, sometimes every two weeks, where we just picked out things and we just acknowledged patients. We would just pick something out that we noticed about the person that we could admire about them.

When you start to admire people, watch what happens. Take a day, take with your staff and just have a patient admiration day. Pick out something. “Oh my gosh, your hair looks fantastic today.”  “Oh, I really like what you’re wearing today. That’s a really nice color on you. Really matches your eyes.” “I really appreciate the fact that you’re so good with your schedule at the front desk.”  “Gosh Mary, you’re so easy to schedule. We really, really appreciate that. Thank you so much for being so easy to schedule.” Just admire something about them and watch what happens. If you do that for one day, and you do it and all your staff for one day, it’ll change the way you look at things forever and you will understand more of what I just said on this podcast. So make that first contact, understand how important it is and understand how interconnected the people are and understand that you’re treating all of them. So take it with that point of view and see what happens.

 

For more information on Spinal Ligament Injuries please check us out at www.smartinjurydoctor.com or check out our SmartInjuryDoctors® Podcasts on Apple Podcasts, Spotify, Google Play or Stitcher.

For information on spinal ligament testing by board certified medical radiologists go to www.thespinalkinetics.com

 

Want to learn more about Smartinjurydoctor's Program?

Learn more about dr. cronk

Reach Us

Want to know more? We are happy to receive a message from you.

246 Tierney Drive, Suite 1,
New Richmond, WI 54017

1-800-940-6513, ext 700

[email protected]

Leave A Message

CONTACT US

Smart Injury Doctors
701 Richards Ave
Clearwater Florida 33755

[email protected]
Call Lee Ann at 1-800-940-6513, ext 700

CONNECT WITH US

SEARCH THIS SITE

© 2019 Biocybernetics Inc.

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Practices That Train Together Gain Together

Practices That Train Together Gain Together

by | Apr 1, 2020 | Articles, Back and Neck Injury, Back Injuries, Injury Market

A basic concept in injury practices and in the injury practices that I consult is teams that train together, gain together.

One of the biggest errors I think that doctors make is they don’t realize how valuable their staff is.

But beyond that  they don’t realize how valuable their staff is in being able to get better injury results and being able to get better compliance and being able to get better referrals and being able to get better collections and being able to get everything.

When you take the time to train your staff on the things that really matter, the purpose and the goal of  your injury clinic can be achieved quickly and efficiently 

Your trained staff will help you to take patients that are injured, especially ligament injuries and have the patient come through care two months, three months, six months with the best possible results.

How long it takes is not the issue.

Your goal is for your patients to come through care and  have no pain, no problems at work, no problems in their life as a result of the injuries.

That is the mission.

That is the mission that each and every injury clinic should be  trying to achieve.

Now the team that trains together, gains together.

Doing that will lead to getting great injury results, getting great injury referrals, getting your compensation.

Training your team will lead to reducing your insurance problems or attorney problems because it is a team activity. It’s not a single activity.

If you want to learn alone and you want to train alone, you’ll succeed alone.

Being a solo act, you will have a much, much harder time with staff turnover and a lot of different things.

One of the biggest things that you can do in your injury practice is  train your people.

 “Okay, what am I training them in?”

Well, what are you trying to get from the patient in a consultation?

When you’re doing an examination?
Your staff should know exactly what you are trying to assess for.

They should know it completely.

I don’t care if they are in your billing department, your front desk, assist you with notes, or your office manager.

They should know every aspect of what you are doing.

When you do stress radiology, why are you doing stress radiology? What are you trying to find with it? What do the results mean?

Your staff should be trained on all of those components.

When they come in that first day, the first thing that any patient is going to interact with, is your staff, right?

Your patients should get the idea from the first person to the last they speak with, that this is the place where everyone is interested in me and knowledgeable about my care plan.

The more competent your staff is, the more confident in your clinic the patient is.

The more competent they are, the more helpful they are.

It is not just learning new systems.  “Hey, I’ve got this new scheduling system,” and learning how to schedule or, “I’ve got this new billing system,” and here’s how you’re going to bill. “I’ve got this new EMR system.”

It is actually training them about why you’re doing what you’re doing and what you’re trying to find with each and every thing you’re doing.

When you do a reexamination, every single member of your staff should know exactly what you’re doing and they should know exactly what that patient’s going through.

If that patient just came out of an exam and they have questions on something, and you left the room, or they are walking out and they have three or four questions, who are they going to get those questions answered from?

Your staff.

If your staff is trained, then your whole clinical operation is like a well-tuned machine.

It’s very organized and it’s very in rhythm, in sync.

People feel that.

They really do. And they experience that.

When they experience that, the experience is much better for them in your office.

So you need to train your staff.

The SmartInjuryDoctors® Program that I developed,  has as one the component of  training your staff. It is a major component.

We have checklists that go through each and every significant event that the patient is going to experience.

When you are talking to the patient about an MRI finding or you are talking to the patient about an excessive motion finding, how you express yourself matters to the patient.

How your team expresses themselves matters just as much when they’re getting asked questions about, “Why did you do this test,” or “Why did you do that test?”

It matters.

The tighter your group is and the tighter the communication is, the better the patient feels that they are in the right place.

Because when they feel that way, they get an experience that is far superior than if they are in a clinic that doesn’t.

That is what makes people refer.

That is what makes people remember.

When you’re looking at these little details and you are training your staff on these details, it makes all the difference in the world.

I know from my own personal practice of 17 years that that made a huge different for me and my clinic.

I trained my staff.  I always let them know why we were doing what we were doing.

You want to get to the point where your people can answer the questions that the patients are going to have because who are the patients spending time with?

Your staff.

Do you know what makes your clinic unique?

Does your staff know what makes your clinic unique?

If you know what makes your clinic unique, but you’re not teaching it to your staff, why are you withholding that?

Because you want to develop a clinic that is unique.

You want to start to differentiate yourself.

Then you want to train your staff on how you are different because that difference is what they will be proud of.

It is what they will be promoting.  You don’t want to withhold that.

You want to actually express it.

I cannot tell you how many times I have said, “Look, if you want this program to work you’ve got to train your staff, because it’s that impactful to your clinic, your clinic results, and your clinic growth.”

That is why in SmartInjuryDoctors®’s training program, I emphasize it so much.

Not training, on how to schedule or those things that I assume that you’re doing just fine but on the aspects of injury care and why you’re doing what you’re doing.

Your staff has to know about that.

When your staff is really good at answering the questions, you will see better results.

You will see better compliance.

You will see less problems with insurance.

And you will see more internal referrals.

Don’t underestimate the return on investment.

The return on investment is through the roof when you train your staff.

Staff training is very, very important.

In the SmartInjuryDoctors® program, it is stressed. And stressed

Thank you for your time

For more information on Spinal Ligament Injuries please check us out at www.smartinjurydoctor.com or check out our SmartInjuryDoctors® Podcasts on Apple Podcasts, Spotify, Google Play or Stitcher.

For information on spinal ligament testing by board-certified medical radiologists go to www.thespinalkinetics.com

Want to learn more about Smartinjurydoctor's Program?

Learn more about dr. cronk

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New Richmond, WI 54017

1-800-940-6513, ext 700

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Clearwater Florida 33755

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Where Should Doctors Spend Their Money

Where Should Doctors Spend Their Money

by | Feb 26, 2020 | Articles, Back and Neck Injury, Back Injuries, Injury Market, Marketing, Medical Radiologists, Podcast, Smart Injury Lawyer, Spinal Injury, Spinal Ligament

My friend Grant Cardone taught me the three basics of money.

The first basic is get your money right.

That means, get your house in order, don’t overspend, don’t spend more than what you make.

The second basic is to learn to make a lot more money.

You learn to make a lot more money by getting highly competent at whatever it is that you’re going to do.

You want to become a professional in your area, not an amateur, an actual professional, and you want to get extremely good at it.

An extreme professional in injury work means that your diagnostic acumen is second to none.

You know how to diagnose and determine the severity and location of spinal injuries.

You know how to get great results and you do get great results

You know how to document in a very simple manner so that it is easy for everybody to understand exactly what the patient’s condition is so the patient has access to any benefits that he may be entitled to.

That’s being a highly competent injury doctor.

So my friend Grant Cardone says, “Get your money right. Learn how to make more money and then put your money in a place where you can’t lose it, where the money can make you more money.”

Those are the three things with money.

Now, where should you be putting your money right now?

Doctors that I’ve consulted with will conserve, save, always try to save their money.

The biggest place that you want to put your money while you’re getting your money right and while you’re learning how to make money is on your own education.

You have to invest money in yourself.

That is the place that is the highest return on investment for any doctor.

Think about it doctors, when you invest outside of your own practice, outside of yourself and your education and your enhancement, a lot of times these investments don’t pan out.

You’re always looking to make money here, make money there.

These attempts to make money are on things that are outside of your control instead of enhancing what is in your control.

One of the biggest things that you want to be spending money on is on your own education, your own enhancement.

You should be looking for things that can cut your learning curve.

In the injury market, look for somebody that has been in the injury market with huge success.

Someone that you’re going to work with, that you’re going to get behind, that you’re going to a seriously study what they have to offer.

Someone who spent years sorting it all out and offers to share that information with you to help you to be a professional success.

That is my Smart Injury Doctor Program.

I want you to join this group.  I have knowledge to share and I want you to have it. 

But I want those doctors that want to commit to seriously study this program.

And be willing to study it until he is an expert

You can get through the doctor part of the course easily in a day, but the information in it will change your career.

But I want the best of the best in the program. The doctor who goes through the course and then begins applying it.  The one who might want to go over it five, six, seven times, to re-educate, reapply, realize, “Oh wow,  I didn’t get all of it’s application the first time I read it,” and then apply more and more and more.

Someone who is doing this course as a professional.

When you  hire and work with a consultant, you apply their knowledge and techniques until it becomes a part of you and your practice. They are an expert and now you are too.

You need to be spending your money on education.

Choose an educator that can shorten your learning curve.

Stick with the professional who can change your career and make you the best in your area.

There are so many programs, so may doctors going from one program to the next to the next because  those programs don’t have all that is needed to change the way they practice. 

Education for themselves, their staff, marketing tools and mentorship. 

They come out of a program they dabble from one thing to the next thing, to the next thing, never becoming a pro in their area because if you become a pro in that area, then like my friend Grant Cardone says, “Get your money right, make more money,” when you become a pro in your area, it’s almost impossible not to make really good money.

If you’re in the top 2% of your profession for skill and ability, it’s impossible to not make a lot of money.

Is that worth investing in?

Are you worth investing in?

Yes.

Instead of being an amateur and saying, “Hey, the grass is…”  Go Pro  

Make your grass the greenest grass there is by tending to you and your pasture.

Make it so that others are jumping into your pasture going, “Wow, that’s a green pasture. I’m going to give up my pasture to get in your pasture.”

Make it so that people want to come to work with you because your pasture is so green.

Get to the point where not only your pasture is green, but everyone that’s around you has a green pasture because yours is greener and greener and greener.

You will be creating a lot of money for yourself, your staff, your family.

Another thing that you will experience is you will also begin to create a lot more time for yourself.

First you have to expend money into your own education.

It’s really, really critical.

You the doctor are the best ROI.

You know your strengths and your weaknesses.  Strengthening what you are good at already, investing in that. That is where your power lies.

When you’re buying a service, you want to go to somebody that is at the top of their area.

For me, my strength is spinal ligament injuries, spinal ligament injury diagnostics.

It is working with radiologists, setting up systems.

Knowing how to determine the severity and location of a ligament injury.

Knowing the simple examination procedures that you clinically correlate with a ligament injury.

Knowing what all the guidelines are.

When I say all the guidelines, not every guideline written in the history of guidelines, just guidelines that are pertinent to spinal ligament injuries.

Knowing what the guidelines are for frequency and duration of treatment.

Knowing what the guidelines are for best practices and delivery of services for spinal ligament injuries.

I am a professional and I have made it my business to know and understand about Personal Injury Work 

That is why I am so confident that you can become a Smart Injury Doctor. I have done all the research and I am willing to share it with you.

I don’t spend my time on a person who read a book and now is explaining to me about how something works. You shouldn’t either

I go to the author of that book.

I want to get to the originator of these ideas, no matter what I’m working in.

For example, if I’m looking at marketing, I want to work with a top marketer. That is why I work with Grant Cardone.

Grant Cardone is one of the top marketers in the world. He’s one of the top salespeople in the world. He is the best of the best in his particular area. That is why I want to work with him.  

Another example is I’m building an AI with a group that I consider to be a really top of the line group.

If I’m going to build something or I’m going to promote something, or I’m going to get involved with something, I’m looking for the top of the top.

To educate myself, to take out my learning curve. I don’t have time to waste and neither do you!

One of the key things I want to impart to you is that it’s okay to put yourself in a position to enhance yourself.

To spend the money on your own enhancement, to spend your money getting involved with people that are more advanced than you are. That’s where you want to be.  It is OK to do that.

 

Join our elite group. Become a Smart Injury Doctor today.

For more information on Spinal Ligament Injuries please check us out at http://www.smartinjurydoctor.comor check out our SmartInjuryDoctors® Podcasts on Apple Podcasts, Spotify, Google Play or Stitcher.

For information on spinal ligament testing by board certified medical radiologists go to www.thespinalkinetics.com.

Want to learn more about Smartinjurydoctor's Program?

Learn more about dr. cronk

Reach Us

Want to know more? We are happy to receive a message from you.

246 Tierney Drive, Suite 1,
New Richmond, WI 54017

1-800-940-6513, ext 700

[email protected]

Leave A Message

CONTACT US

Smart Injury Doctors
701 Richards Ave
Clearwater Florida 33755

[email protected]
Call Lee Ann at 1-800-940-6513, ext 700

CONNECT WITH US

SEARCH THIS SITE

© 2019 Biocybernetics Inc.

Terms | Privacy
Competency Leads to Patient Prediction

Competency Leads to Patient Prediction

by | Feb 8, 2020 | Articles, Back and Neck Injury, Back Injuries, Injury Market, Jeffrey Cronk, Marketing, Medical Radiologists, Podcast, Smart Injury Lawyer, Spinal Injury

Competency Leads to Patient Compliance

Competency is the ability to meet all the requirements that are needed to handle something perfectly. That’s competency.

Where does it come from? It comes from Latin, and it’s to strive for the attainment of something. When somebody is highly competent at what they do, it means that they are excellent at what they do. They can meet the demands of the situation.

Let us bring that into patient care and personal injury.

In the personal injury market today, one of the biggest competencies that must improve is the competency of the doctor understanding exactly how badly injured his patient is.

Competency comes from knowledge. It comes from knowing. It doesn’t come from being blind to something. It comes from knowing it and understanding it.

Spinal ligament injuries are the number one cause of pain and disability in the world today because in general, the market is highly incompetent in understanding how to diagnose this condition. We cannot get a good result with patients unless we understand how to diagnose the condition.

The idea out there today that MRI is the best way to diagnose a ligament injury is absolutely ludicrous. I mean, ligament injuries have two imaging biomarkers. There are 220 specialized ligaments. 23 of those are discs.

Yes, you are going to pick up a disk herniation on MRI, but that’s 10% of the disc structure for the most part.

The other imaging biomarker that’s so important is excessive motion. When ligaments are damaged in the spine, it causes excessive motion.

We can see this on CRMA imaging. Therefore, we can determine how badly damaged these ligaments are by how much excessive motion there is. Of course, we can also have a combination.

We could have both excessive motion and disc herniation at the same segment if a disc is involved if it is in a segment where there is a disc involved.

Remember, in the cranial cervical junction, we have no discs. The only thing we are going to see there is excessive motion.

How does competency in this lead to patient prediction?

It is really simple. The more that you understand your patient’s injuries, the more that you understand the path that the patient is going to take.

Let me give you an example. With spinal ligament injuries, patients will start to receive conservative care. The doctor that understands what that patient is going to go through has the ability to predict what they will go through because they understand it.

In other words, if I’ve been down this path a lot of times before, I have the ability to predict what will happen.

If I’m a Sherpa and I look at someone and I say, “Wow, they’re out of shape,” I’m going to predict that they’re going to get altitude sickness, so I’m going to take precautions. I’m going to have more oxygen for them.  That’s what a good guide does.

Doctors in rehabilitative care today are guides. They are guiding the patient through their recovery.

This knowledge makes one more confident. The more that you know, the more you can understand and predict what your patient will run into along the way.

Every patient is different. A patient that is 45 years old, out of shape, obese, has high blood pressure, is on two or three different medications for health conditions, is not going to rehab the same as a 25-year-old who has 6% body fat, is in the gym four times a week and is a vegan and completely hydrates their body. These people will rehab differently.

But when you have spinal ligament injuries and you know spinal ligament injuries, then you can predict.

One of the biggest predictors, when you get backtest results that show how badly damaged a person is and you’re explaining it to the actual patient at that point, it’s very easy to say, “Look, most people will find that they will start to gain improvement in recovery quite nicely. However, ligament injuries cause instability. Anything that’s unstable is prone to erratic or unpredictable behavior”.

Inform the patient about what can happen. For example, “You can feel that you’re doing great, you’re moving along just great, and all of a sudden you have a setback. You slept on the couch wrong, you slept in a funny position wrong, you slept with somebody’s pillow that was different than your own pillow, you fell asleep at work in the chair and your neck was in a funny position, and it feels like you’re right back at day one with care. You’re not. You need treatment or two”.Especially if a chiropractor is a treating doctor, they need an adjustment or two, and usually, they’re right back to normal.

Now, if you don’t tell them, “Hey, one month, two months, three months into care, you can experience this,” and they experience it, then they think that your care did not work. They think that your care is not good. They think that it’s failing simply because you weren’t competent in the route, you weren’t competent in guiding the patient.

Because if worked with ligament injuries enough to predict what may happen, you can explain that to the patient. And when you explain that to the patient, if a patient now hits that, if they now hit, “Oh my gosh, I woke up… I was watching the Green Bay Packers get beat by the San Francisco 49ers and I fell asleep, and, oh my god, it feels like, my neck, right like it was after the car accident three months ago. And I’ve been in treatment for three months. Oh my god, this isn’t working.”  If you communicated beforehand, they will know you are competent

Now, here’s another example. When a patient has a serious ligament injury to the spine, because it causes instability, they may need lifetime care. As a Doctor of Chiropractic,  a licensed Doctor of Chiropractic for 30 or 31 years, I have been adjusted ever since I was born. My uncle was a chiropractor. I have very little spinal issues. Matter of fact, I’ve never had a problem with my back. I’ve never had a problem with my neck. Have I been in car accidents? Yes, I have. Have I been in rugby accidents, have I had rugby injuries? Yes, I have. Have I had sports-related injuries? Yes, I have. I broke my arm in two places. I broke my leg once. I broke my collar bone twice. I broke my scapula, my shoulder, in five places. So yes, I have had injuries. But do I suffer from any kind of ongoing chronic pain in my spine as a result of any of these injuries? No, I do not.

Why? Because I routinely take care of my spine. I routinely practice maintenance of my own spine. Now, a lot of patients don’t understand that concept. When you have a ligament injury it can cause the patient to need more care. As the doctor in charge of the patient’s care,  you predict where this comes in.

Week one tell them about the severity and location of a ligament injury and also explain that this can mean that they need some ongoing care, two visits, three visits, four visits a year just to help maintain their spine, much like you would go to the dentist twice a year just to help maintain your teeth. They may need that.  Begin talking about supportive care in week one, not when it comes up three months, four months, five months later. I’m talking about it right away because it’s a fact of life.

If at the end of care, the patient is feeling perfect. They don’t have any problems, they don’t have any pain, and now they’re having a hard time understanding why should they come back and see me four times a year for the next year or two just to make sure that this all stays stable. They don’t understand that, so they don’t opt for it.  I’m explaining because I have the ability to predict. I’m competent in this field.

Just for example sake, a patient’s name is Mark. “Mark, do you remember what I told you about these ligament injuries? I said that they cause instability. And anything that’s unstable is prone to erratic or unpredictable behavior. Well, the reason why I’m saying that is because you can start to have a symptom come back because of that instability. It does not mean that our care failed. 

I noticed you’re not opting to see me on a regular basis for the next two visits a year or four visits a year. You don’t want to schedule that. That’s fine. I understand that. But here’s what I want you to also understand. Two things. One, if the pain starts to come back, I do not want you to think for one second that our care didn’t work. It worked perfectly. It just means that the instability has now gone active and you need to come back in for an adjustment or two, a treatment or two, and you’ll be right back to where you were.”

If you tell them that and you basically tell him, “Hey, look, you can hit this,” and they hit it, your credibility goes up, not down. If you don’t tell them about it, so if you don’t give them their future prediction of what they can hit, and you don’t tell them about it and they hit it, they think your care failed.

This inability to communicate will cost you a lot in referrals. It’ll cost you a lot in goodwill. It’ll cost you a lot of patients who think, “Oh my gosh, I just went through three months, six months’ worth of care, and now this thing is starting to go chronic. This didn’t work.”

This occurs simply because most doctors don’t understand ligament injuries enough to understand what to communicate to the patient. If they do communicate with prediction, their patient understands more about their condition.  They are more compliant.  They get better results.  And you get better referrals.

It is very, very simple.

You have the ability to predict. I have the ability to predict. If I have a patient who’s somewhat unhealthy coming into these injuries, then it’s going to take longer. I have the ability to predict that it’s going to be slower.

I have the ability to predict, if they’re not compliant with their treatment program, that it’s going to be more problematic.

I have the ability to predict, if they’re super dehydrated, that their risk for long-term chronic pain is higher.

I have the ability to predict, if they’re obese, that same thing, their long-term risks for chronic pain is much higher.

I have the ability to predict a lot of things.

The providers that we train to do as well.

When you have a spinal ligament injury, you have to find somebody who understands this injury. It is the most common cause of chronic pain and disability in the world today and it’s the most expensive injury in the market today.

There are too few doctors whose primary focus is this condition, whose primary focus is leading their competency in this area to be extremely high.

I have a program called the Smart Injury Doctors Program. We’re creating some of the most competent doctors in the market today for spinal ligament injuries.

That is what these programs are about.

They are short, sweet, and to the point.

What I’d ask you to do is, if you have difficulties in the personal-injury market right now, you have difficulties in the work comp market, you have difficulties in the injury market, tell me what they are.

These are some of the easiest injuries in the market to work with once you’re competent with the condition. Really.

These are not hard injuries to work with. It’s just that there are so few doctors that even understand how to at first just confidently diagnose it and really be competent with it. I mean really certain with it.

For more information on Spinal Ligament Injuries please check us out at http://www.smartinjurydoctor.comor check out our SmartInjuryDoctors® Podcasts on Apple Podcasts, Spotify, Google Play or Stitcher.

For information on spinal ligament testing by board-certified medical radiologists go to www.thespinalkinetics.com

Want to learn more about Smartinjurydoctor's Program?

Learn more about dr. cronk

Reach Us

Want to know more? We are happy to receive a message from you.

246 Tierney Drive, Suite 1,
New Richmond, WI 54017

1-800-940-6513, ext 700

[email protected]

Leave A Message

CONTACT US

Smart Injury Doctors
701 Richards Ave
Clearwater Florida 33755

[email protected]
Call Lee Ann at 1-800-940-6513, ext 700

CONNECT WITH US

SEARCH THIS SITE

© 2019 Biocybernetics Inc.

Terms | Privacy