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The Don’ts and Do’s of Building a Successful Personal Injury Practice through Lawyer Referrals
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Written by Dr. Mark Studin DC, FASBE, DAAPM, DAAMLP   
Wednesday, 22 September 2010 15:47

The Don’ts and Do’s of Building a Successful Personal Injury Practice through Lawyer Referrals

by Dr. Mark Studin DC, FASBE, DAAPM, DAAMLP

 

After a lawyer refused to accept my referral of a patient to him, I got my ego out of the way and started asking very difficult questions.

 
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Written by TAC Staff   
Wednesday, 22 September 2010 15:46

The Secret to Nutritional Counseling & Building a Chiropractic Practice through Wellness….

Weight Loss, Anti-Aging, Pain Management, Disease Management & Prevention—With or Without Diet Products.


Dear Colleagues:

As a practicing chiropractor for 17 years, I have seen a number of fad nutritional products and programs which provided short-term results, and did not focus on a patient’s lifestyle and eating habits. Most programs concentrate on meal replacement shakes, nutritional supplements or general diet booklets. In the past, I had nothing that spelled out exactly what food my patients need to eat specifically for their food preferences and nutritional goals. I used to give them a list of foods to omit or eat, or wrote out a few pointers. Most of the time, it was general information they already knew and they resented omitting foods they loved. I was not seeing much change in my patients’ eating habits and I thought they were not receptive to changing. Furthermore, the typical American diet is inflammatory and most of the problems I treat are due to inflammation and oxidation. I am now providing nutritional programs to most of my pain management patients.

Now, in a few minutes, my CA’s tailor a specific clinical meal plan based on body composition, metabolic rate, the number and size of meals, desired goal weight, exercise routine and the lifestyle and foods that my patients desire, using the Lifestyle Nutrition software we provide—any type of meal plan, including Atkins, Zone, Food Combining, American Heart Association, Diabetic, Pain Management, Sports Nutrition, Blood Type, Chronic Fatigue, etc. My CA’s are providing meal plans for weight loss, gain and, most importantly, weight maintenance after weight loss!

 

By having a wellness program that focuses on food and lifestyle, which markets well in today’s economic climate, I am generating a significant amount of chiropractic referrals into my practice.

 

I have learned, through the Lifestyle Nutrition webinars they provided our staff, that the Lifestyle Nutrition Metabolic Analyzer accurately provides a sliding scale of carbohydrates, fats and protein in the meal plan, based on the sex, height, weight, age, lean muscle mass and activity level of the patient. For example, if I am presented with a muscular active athletic patient, he will receive more low glycemic carbohydrates than a 45-year-old peri-menopausal insulin resistant secretary who sits all day. The Licensed Nutritionists at Lifestyle taught us that customized blood sugar management is more important for overall health than counting calories. By providing a balance of the macronutrients, my patients have more energy, a higher metabolic rate, more lean mass and less hunger, cravings and fatigue.

One of the main features of the software is the ability to incorporate any of my nutritional supplements or meal replacements or nutritional bars directly into the customized meal plan. This has increased our nutritional product sales; they are asking us questions about the nutritional products we offer because they are incorporated into a program tailored for them. For some of my conservative patients, I include a multiple vitamin at breakfast and dinner; others may receive a bar or shake as a lunch or PM snack. I heard from Christopher Fuzy, MS, RD, LD, a licensed clinical nutritionist and the founder of Lifestyle Nutrition, they can add any nutritional supplement to the meal plan, just by our staff entering the nutritional information about the product into the software. Many doctors who use network-marketing products are using his equipment and software to elevate their nutritional counseling programs to help incorporate the products they offer into a meal plan. We "focus on our patients’ lifestyle—not your products."

Lifestyle Nutrition provided me with exactly the information I needed to introduce nutrition counseling to my practice and patients with posters, custom brochures and a surveys. I am now also using their health risk assessments, to provide corporate wellness programs to my patients’ employers. They provide sample TV commercials and proven sample news ads. By having a wellness program that focuses on food and lifestyle, which markets well in today’s economic climate, I am generating a significant amount of chiropractic referrals into my practice. This program sets me apart from other chiropractors.

The average cost for a commercial weight loss program is between $960 to $1200, and is not physician supervised. Our program costs 30-40 percent of the cost of most weight loss programs in the US. We set up nutritional packages ranging from $250 up to $1,095, depending upon the patient’s need. Our average patient spends $495 for a six-week program. The initial session is with me and then the subsequent sessions are with my CA’s. Some PPO’s are reimbursing for preventative medicine and fitness testing.

Most of my patients’ New Year’s resolutions will be to eat healthier and the Lifestyle Nutrition program allows me to help them achieve their New Year’s Resolutions!

By promoting long-term lifestyle changes using real food and customizing a nutrition and exercise program individually for your patients, they are more receptive and the counseling is a positive and effective experience. The training and support has allowed us to incorporate the program into our practice, especially this time of the year: January through March is weight loss and wellness season!

Sincerely,

A Happy and Successful Chiropractor

John A., D.C., C.C.N.

Des Moine, IA

Christopher Fuzy, M.S., R.D., L.D., has a Masters degree in Clinical & Sports Nutrition and undergraduate degrees in Nutrition and Chemistry, and has trained over 700 physicians nationwide with the Lifestyle Nutrition program in the past 19 years. For more information or a practice consultation, go to www.PhysicianWellnessProgram.com or call 1-800-699-8106.

 
Neck Pain Aggravated by Foot Imbalance
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Written by John J. Danchik, D.C.   
Wednesday, 22 September 2010 14:33

Neck Pain Aggravated by Foot Imbalance

by Dr. John J. Danchik, D.C.

 

History and Presenting Symptoms

The patient is a 32-year-old mother of three active young children, who presents with chronic neck pain and fatigue. She reports a motor vehicle collision four months ago, during which she received a hyperflexion/hyperextension "whiplash" injury. While her acute neck stiffness has improved, she describes persistent aching in her lower neck, varying from 4.0–7.5/10. She also has frequent occipital headaches requiring the use of pain relievers, and she has not been sleeping well, awakening frequently. These ongoing symptoms have resulted in a progressive tiredness that makes caring for her family difficult.

 

Exam Findings

Vitals. This active woman weighs 136 lbs, which at 5’6’’ results in a BMI of 22—her weight is healthy. Her blood pressure and pulse rate are both at the lower end of normal range. She drinks a few glasses of wine each week, usually with meals. She reports that she has not smoked tobacco in about ten years. Posture and gait. Standing postural evaluation finds generally good alignment, with intact spinal curves, except for generalized cervical hypolordosis and anterior head translation. There is also a slight lateral tilt of her pelvis to the right, accompanied by right calcaneal eversion and a lower right medial arch. Dynamic treadmill gait evaluation finds hyperpronation of the right foot and ankle, with asymmetrical pelvic movements when walking at various speeds. Chiropractic evaluation. There is loss of regional cervical range of motion in all planes, but particularly in flexion, extension and right rotation. Motion palpation identifies several lower and upper cervical joint restrictions, with moderate tenderness and loss of end range mobility. Several compensatory fixations are noted in the lumbopelvic region. Neurological tests are negative, including sensory and reflex testing of the upper and lower extremities. Additional findings. Palpation of the right foot finds localized tenderness of the second, third and fourth metatarsal heads, with callus formation underneath. All foot and ankle joint ranges of motion are full and pain-free, bilaterally.

 

Imaging

A cervical X-ray series confirms the clinically-suspected hypolordosis with an anterior cervical gravity line. No contraindications to cervical manipulation are identified.

 

Clinical Impression

Chronic postural strain syndrome of the cervical spine, complicated by previous whiplash injury and asymmetrical pedal support. The right foot demonstrates loss of both the medial and anterior arches, with calcaneal eversion and hyperpronation during function. The asymmetry of the lower extremities affects her lumbopelvic region, adding to the postural strain.

 

Treatment Plan

Adjustments. Specific, corrective adjustments for the cervical and lumbopelvic regions were provided as needed. The right metatarsal heads were mobilized into an arched position, and the calcaneus and navicular bones were also adjusted. Support. A cervical support pillow was supplied, with instructions to spend as much time as possible in the supine position before (at least 30 minutes) and during sleep. This pillow was custom-fitted, based on four body measurements and a description of her mattress type. In addition, custom-made, flexible stabilizing orthotics designed to provide support for the calcaneus and the arches of the foot were provided. Rehabilitation. She was immediately started on a daily cervical posture corrective exercise – posterior translation against dynamic resistance. Marble pick-up and towel-scrunching exercises were also begun in an attempt to strengthen the intrinsic foot muscles.

 

Response to Care

She responded well to the spinal and foot adjustments, and reported a rapid decrease in her neck pain and headache symptoms. Once she received the cervical pillow and orthotic stabilizers, she reported feeling more energy and being much better rested. After five weeks of adjustments (10 visits), daily home exercises and using the cervical pillow and wearing the orthotics, she successfully completed her re-examination and was released to a self-directed maintenance program.

 

Discussion

While many cases of neck pain and headache respond well to a local approach consisting of cervical adjustments and use of a cervical support pillow, some are more complex. This patient showed a commonly seen combination of a forward head posture with increased anterior foot stress and loss of the metatarsal and medial arches. In her case, this was primarily unilateral, resulting in a lower extremity asymmetry with lumbopelvic consequences.

 

Dr. John J. DanchikDr. John J. Danchik, the seventh inductee to the ACA Sports Hall of Fame, is a clinical professor at Tufts University Medical School and formerly chaired the U.S. Olympic Committee’s Chiropractic Selection Program. Dr. Danchik lectures on current trends in sports chiropractic and rehabilitation. He can be reached at This e-mail address is being protected from spambots. You need JavaScript enabled to view it

 
Generate Healthier Patients with Laser Therapy
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Written by Dr. Phil Harrington, D.C.   
Wednesday, 22 September 2010 14:26

Generate Healthier Patients with Laser Therapy

by Dr. Phil Harrington, D.C.

 

AncillariesLaser therapy is a progressive service that will en-hance clinical outcomes, increase patient satisfaction and expand your market share. This article will outline six reasons why you should implement laser therapy in your practice.

1. Treat More Conditions

Laser therapy’s primary mechanism of action is biostimulatory. By enhancing cellular output of adenosine triphosphate1,2 (ATP), injured tissues heal more rapidly and with better quality.3 As Dr. Rick Harris of Mabank, Texas, says, "Laser therapy lets me treat more conditions on so many more people. Soft tissue injuries are now a much larger part of my practice."

Therapy lasers accelerate tissue repair and growth,4,5
improve nerve function,6 and
reduce inflammation7 and
scar tissue formation.8

 

2. Treat More Patients

Approximately 10% of the population currently visits a chiropractor. Patients who are "chiro-phobic" react favorably to laser therapy, because you are simply shining light on them. Once they are in your clinic, you can tell them the Chiropractic Story. And, even if they choose not to get adjusted, at least you have helped them, and not someone else down the street. "I have more patients presenting with a much wider range of conditions for laser treatment," says Dr. Ben Acree of Fort Dodge, Iowa.

3. Increased Clinical Results

Laser therapy is an excellent adjunct to all chiropractic services. When used in combination with adjustment, decompression, or soft tissue work, many chiropractors have witnessed improved clinical results. Therapy lasers accelerate tissue repair and growth,4,5 improve nerve function,6 and reduce inflammation7 and scar tissue formation.8 Dr. Harris adds, "I’m getting results with laser therapy that I couldn’t even dream of with any of the other modalities I’ve utilized." And Dr. J. R. Kille of Springfield, Missouri, adds, "I have had dramatic results with post knee replacement therapy in as little as three laser treatments."

4. Added Revenue Stream

You can incorporate laser therapy into your practice by having the doctor perform the treatment, having a trained chiropractic assistant administer the laser prior to the patient’s seeing the doctor, or to have a "stand-alone" laser therapy center—a clinic within a clinic. Laser therapy is a new stream of revenue in your clinic that adds new patient visits and value to existing patient visits. "A laser is an expensive piece of equipment for sure. But it started covering the cost of the system after only one month of use, so it is definitely a worthwhile investment," says Dr. Kille.

5. Increased Patient Compliance

Patients being treated with laser therapy will usually improve faster than without and, if they can feel a difference quickly, they will be more likely to return for care, as well as refer family and friends. Dr. Kille says, "My newspaper ads bring in new patients because laser is the latest technology, but they keep coming in because it works."

6. Stay on the Cutting Edge and Avoid Burnout

Since they have been cleared for use in the US for less than ten years, therapy lasers are cutting edge technology. Progressive chiropractors appeal to educated patients. Through increased patient flow and improved clinical outcomes, adding laser therapy to your practice can also help you avoid burnout. Dr. Harris says, "I think that the best part of laser therapy is the ability to get results on my chronic and difficult patients. It is so much more fun at work now." Another chiropractor added, "The laser has given me an excitement about helping people that I haven’t felt since discovering chiropractic itself!"

We can complain about how the world is treating us, or we can change the way we treat the world. Adding laser therapy to your practice can give numerous benefits to you and your patients. "The single most beneficial move I have ever made for my patients in 24 years of practice was implementing laser therapy," says Dr. Dan Knapp of Sarasota, Florida.

Dr.-Phil-Harrington-BDr. Phil Harrington is a 1996 Palmer Graduate with ten years clinical experience. He is currently Senior Vice-President of K-LaserUSA, and can be reached at 1-866-595-7749, ext 104, or at
This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

 

References

  1. Mochizuki ON, Kataoka Y, Cui Y, et al. Effects of near-infrared laser irradiation on adenosine triphosphate and adenosine diphosphate contents of rat brain tissue. Neuroscience Letters. 2002; 323(3):207-210.
  2. Sato K, Kaseano S, Takigawa C, et al. A double blind assessment of low power laser therapy in the treatment of postherpetic neuralgia.

 
Ask the Advisors Q&A
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Written by Larry Goodman, D.C.   
Wednesday, 22 September 2010 14:22

Ask the Advisors Q&A

with Lisa Goldberg and Larry Goodman, D.C.

 

Q: How can I cut my overhead without cutting service and efficiency?

A: There are a lot of programs out there that will actually increase efficiency and cut overhead. For example, one of the things that we recommend is an automated phone service that will actually confirm appointments for you. This alone will cut your administrative staff by 20 hours a week. This is also the time to look around your office and track your expenses so that you can try to save some money. Something that might seem very simple, like changing a malpractice carrier, can actually save you up to 25% to 30% alone.


Q: I am frustrated in my office because I am having a hard time with my collections and my colleagues have suggested that I search for a billing company. What are some of the things to look for in a billing company; they all seem so much alike?

A: First of all, the one question that everyone asks a billing company is what the percentage that they keep is. The percentage is important; but do not get fooled by a low percentage. Low percentage could mean low service. You want to know what the percentage is and, if they collect, you have to make sure that they not only bill but they also collect. When you interview billing companies, find out what their appeals process is and if you are able to access that information at any time. Also, ask if they give you anything free. Some billing companies will throw in an EMR system at no cost.


Dr. Larry Goodman is a chiropractor who has been doing consulting and practice management for 15 years.

Lisa Goldberg is the executive director of Physicians Choice Concierge (PCC), a company specializing in revenue enhancement. If you have a question you’d like Lisa and Larry to answer in an upcoming issue, email This e-mail address is being protected from spambots. You need JavaScript enabled to view it or call 1-888-369-2224.

 
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