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Why Don’t Chiropractic Colleges Teach Standard Injury Workup?

Why Don’t Chiropractic Colleges Teach Standard Injury Workup?

by | Feb 3, 2020 | Articles, Back and Neck Injury, Back Injuries, Injury Market, Jeffrey Cronk, Marketing, Medical Radiologists, Podcast, Smart Injury Lawyer, Spinal Injury, Spinal Ligament

Why Don’t Chiropractic Colleges Teach Standard Injury Workup?

My question is why don’t chiropractic schools in this country actually teach their students how to do a standard spinal injury evaluation?  This topic may seem a little bit controversial, but it needs to be addressed.

It not just chiropractic colleges who are remiss, it is also missing in osteopathic colleges and medical colleges. But since chiropractors are the spine specialists and trauma to the spine is the number one cause of chronic pain and disability, the market needs experts in this particular area. So why in the world would the chiropractic colleges not teach standard spinal injury assessments?

Doctors of Chiropractic are not taught how to determine the severity and location of a simple ligament injury.  They are not being taught about the fact that there are two ways to image a ligament injury, depending on what ligament is damaged.

If you have a disc herniation, you’re going to use obviously an MRI. But the fact is, there are 220 specialized ligaments that hold the spine together.

If you have damage to the supporting ligaments around the disc, shear force injuries, they cause excessive motion in the spine. That excessive motion of the spine is how you determine the severity and location of the actual ligament injuries.

If you have a C4/C5 motion unit and you have severe excessive 3.9 millimeters of translation back and forth movement, due to the supporting ligaments now being damaged due to the trauma. And at four and five we know that the fifth cervical nerve exits, we know that that would cause a possible motor problem. We would have possibly a deltoid muscle weakness. We would have the lateral side of the arm, either hyper or hypo sensitive. We want to check that dermatome so we know where the C5 dermatome is. If we knew what muscles are involved and we can test for the particular level.

For an examination procedure, we have a hypersensitivity or a hypo sensitivity at the C5 dermatome and we have a C5 muscle that’s testing weak, then we should immediately want to know, what’s the C4/C5 motion unit like? That’s the main motion unit. Could be the one above or the one below that as well. But is that damaged?

If it’s damaged, the ligaments are damaged and you’re going to see excessive motion. If there’s excessive motion, how much excessive motion is there? Is it mild, moderate or severe?

Because if we have excessive motion that causes a motor sensory or pain problem, we have in the old terms clinically a chiropractic subluxation, which means misalignment or misalignment pattern. The mismotion pattern that causes a nerve condition.

It’s also called a spinal instability in medicine, meaning excessive motion that now causes a motor sensory or pain problem.


And it’s the easiest thing in the world to do a workup on. It’s the easiest thing to image and it’s the easiest thing to standardize in injury practices across the country. But it’s not being done.

The fact is that 90% of the patients out there are in chronic pain, do not have a pathoanatomic cause.

We have experts like William Maurice, the head of the Ohio State Biodynamics Laboratory who is a leading researcher in spinal biomechanics and spinal pressures in the world. His book is called The Working Back System where he’s trying to help solve the problem of low back lumbar spine.  This is the number one cause of disability, lumbar injuries, cervical injuries are the number four and cervical injuries also lead to the number six leading cause of chronic pain and disability, which are headaches.

He cites eight out of nine, or 90% of the patients who have a low back disability, do not have an exact path though anatomic caused identified by doctors that basically are treating the patient, creating a huge expense for employers and Workers Comp., for example

One of the things that is needed in the market itself is the simple understanding of how to determine the severity and location of these ligament injuries that are so expensive to the employers. Employers should be demanding it.  

If I’m going to use a Doctor of Chiropractic, they need to know how to do a standard examination for these types of injuries.

If I’m going to use a medical doctor, or an osteopath, then they need to be able to understand, and standardly work up these injuries, because it’s the misdiagnosis or the the lack of diagnosis, that creates an environment of substandard.  

Remember, if you’re going to change something, you must get down to the cause of what it is before you’re going to get great results in changing it.

If you don’t know what the injuries are and you were not taught to standardly workup an injury, you were not taught how to determine the severity and location of a simple ligament injury.

It is not and never has been just writing a cervical sprain down on a diagnosis code.

For somebody today to say, “Well, this patient has a cervical or lumbar sprain and that’s their diagnosis.” That’s like somebody having a leg injury and having the doctor say they have a lower extremity sprain.

The first thing anybody should be asking is, “Well, where is the sprain? Where is the ligament injury? How bad is it and where is it?”

If have you had a leg sprain, you’d say, “Well, where in the leg?”

In the knee, how bad is it? Well, it’s a grade three sprain. It’s a grade three ligament problem.

This is how I identified it. This is how we imaged it. This is what we’re doing to treat it.

It is the first step to great injury results. I don’t care if you’re an employer,  a patient, or a doctor,  the first thing that has to occur in order for you to get good results is you have to identify the severity and location of the injuries.

And we have to be able to do that standardly.

Right now there are 60,000, 80,000, 90,000 chiropractors out there, my colleagues, none were trained in a one year, six month program and how to determine the severity and location of a simple ligament injury. That injury that causes the most amount of problems in the market today. So if you’re a student today at a chiropractic college, you should be asking your educators why they’re not teaching you that.

That would be like dentists coming out and not knowing how to locate the severity and location of dental decay. Of course when you go to dental school, you’re going to be able to determine the severity and location of, of dental decay of tooth decay. So why in the world would you be in a health market, in a health care educational program today, and not know how to determine the severity location of a spinal ligament injury?


It just blows my mind that that’s occurring. It occurred for me, I graduated from Palmer College one of the oldest colleges in chiropractic in the country. I graduated in 1988 and I was never trained how to do it.

 I know to this day when I asked students that are coming out of all of the chiropractic colleges and just say, “Okay, simply tell me how to determine if a ligament is damaged in the spine.” Remember the spine is the main thing that Doctors of Chiropractic deal with.

If ligament damage is the number one cause of pain and disability in the world today, how do you determine the severity and location of a patient that’s just injured their ligaments? How do you know where it is and how bad it is?

If you don’t know where and how bad, how are you going to get successful results with it? If you’re getting some successful results with it, think about how much more successful you could be if you knew the severity and location of the condition.

If all doctors were trained in it, that would change the environment in the United States.

Chiropractic, my profession is very small. When groups do research, the research of the markets about a $14 to $15 billion market. It’s a very small market. It’s like a third of 1% of the total healthcare dollars spent are spent in the profession of chiropractic.

It is very, very small. It represents less than a third of 1% of the total healthcare dollars spent. That is 14-15 billion in medicine, back problems, low back problems in 2010 we approximately $253 billion.

Medical doctors in the market today, weren’t trained either on how to determine the severity and location of a simple ligament injury. It is not occurring in the medical market either. And it needs to be occurring with every doctor.

Because the more that you understand, you will be able to accurately and swiftly know the diagnosis. Leading to the use of conservative care procedures that are highly successful for this type condition. Lessening or eliminating patients suffering from long term chronic problems that could have been prevented.


Chronic pain and problems are devastating to injury patients emotionally and financially.

It hinders their ability to work, it hinders their ability to be successful in their family, and to participate in normal activities of daily living.  

It doesn’t have to be that way. We have to get much better. We have to become Smart Injury Doctors and use accurate and objective testing for ligament injuries and diagnosis and treat quickly and with confidence.


Remember, you can’t misalign a spine. You cannot have a hyperlordotic cervical spine or reverse cervical curve, a PLRC5, without ligament damage. Therefore, you must understand about ligament damage

If you’re going to be trading in these things, particularly in the injury market, if you haven’t learned how to determine the severity and location of a simple ligament injury, that is what the Smart Injury Doctors program is for. You go to www.Smartinjurydoctor.com and you become a specialist.

We’re creating a group of doctors, chiropractic doctors, medical doctors, and osteopaths, that fully understand the urgent need for accurate objective testing and swift and accurate diagnosis.

Come in and learn about ligament injuries. We are the leading group of injury specialist.  It is where we are training doctors to have that level of understanding.

You should have been educated in this deep understanding in your basic training, so should’ve I, but unfortunately,  it’s not there.

We must get it outside of our formal education.

Become a Smart Injury Doctor and lead the way into the future of injury care.

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The Three Skill Sets You Must Have to Build a Successful PI Practice Today

The Three Skill Sets You Must Have to Build a Successful PI Practice Today

by | Jan 16, 2020 | Articles, Back and Neck Injury, Back Injuries, Spinal Injury

What are the three things as an injury practice business owner do you need to do exceptionally well in order to truly expand in the injury market and do it so that it’s easy? So that it’s not so stressful?

There are three basic skill sets that you must have. I’m going to lay those skill sets out today. They’re very simple.

The first skill set is that you, as a clinician, must be extremely good at what you do. You must be able to do a few things well.

  • You must be able to diagnose all of the injuries that the patient has. And you can’t miss injuries and simple ligament injuries. You must understand that there is a disc herniation and then there is excessive motion. You must understand picking up both findings so that you can determine easily the severity and location of any ligament injury that the patient has. You must be able to diagnose these things incredibly well.
  • Then you must be able to treat them incredibly well.  The first thing to treatment and treatment results is really having a sound understanding \ of what the underlying condition is that you are treating. The better you understand the underlying condition, the better your treatment results are going to be. You must be able to diagnose well, and you have to be able to treat well.

And today in the injury market, you’re in a medico-legal situation. You must document well.

  • Your documentation determines the benefits that the patient is going to be able to have access to and potentially get.
  • Your documentation determines whether the plaintiff attorney has a hard time or not.
  • Your documentation determines whether the defense attorney has a hard time or not.
  • Your documentation depends whether the insurer has a hard time or not.

You must be able to express yourself simply when in a deposition or a court trial setting.

  • You, as a doctor, must be able to diagnose all the injuries the patient has.
  • You must be able to get great treatment results with these conditions on a regular basis. And I mean great treatment results.

If a patient that goes through your treatment program, no matter how long it takes, they should not have chronic pain, any activities of daily living disorders, duties under duress, or loss of enjoyment of life factors.

If you can do this with a high degree of confidence and a high degree of predictability and routinely with patients, that’s step number one in your business because you are the person that produces the product and results of an injury clinic.

The second biggest thing that you must have is a well-trained team. Your team is super, super important and training your team is one of the highest returns on investment activities that you can actually do.

Everyone trains their staff, everyone trains the front desk staff how to answer the phone, the billing person how to code for bills, how to send out and make phone calls to insurance adjusters, and to follow up on denials. Everyone trains their staff to help your patient fill out the paperwork correctly ,how to route the patient to the room correctly, or how to schedule the patient correctly. Those are all routine things. That’s not what I’m talking about here. What I’m talking about now is the ability to train your staff to answer questions about the injury work that you do, as good or better than you do. When I say better, sometimes the staff are better because they’re simpler and they put things in layman’s terms much.

  • Your staff needs to understand what a patient is going through. They need to understand the reality of the patient, whether it’s day one, which is one of your most important visits.
  • What is that patient going through?
  • When they first get into your clinic, what is the experience that they’re going to go through? What’s the experience with the first phone call?
  • Routing them in, filling out your paperwork, gathering their insurance information,
  • Introducing you, the doctor in their first visit.
  • Your consultation, examination procedures,
  • Imaging procedures of you do them internally.
  • Treatment procedures.
  • Information that you provide them with to take home.
  • How they are rescheduled.

Every person in your staff needs to understand the high points of what needs to get communicated in each one of the visits.

  • If you or your staff do not understand, or  you don’t have a team around, you’re seriously cutting the number of referrals you can get;
  • you’re seriously cutting the amount of the reduction of problems that you would have with reimbursement;
  • You’re seriously cutting down the results that you can get with the patients as far as their physical results;
  • You are cutting down a lot of things that simply don’t need to be cut down.

Training your staff is one of the most important things you can do but training them specifically in what makes you unique as an injury provider is even more important. When patients leave the room and walk down the hall and suddenly have more questions, if they can’t go to anybody in your clinic and ask and get a great answer to the question, you’re seriously losing money, results, and causing yourself a lot unnecessary of stress. That’s simply because you haven’t trained your staff.

The doctor also must be able to market. Marketing is nothing more than determining how you want to be perceived in the market.

  • You must ask yourself how you want to be perceived in the market? You want to be perceived as the best doctor a patient can go to.
  • And what does that mean? It means that you are fast, effective, you don’t miss things, make the rehabilitation very easy and simple to understand, and you get great results.
  • You document so that anyone that the patient is involved with, from a plaintiff attorney, defense attorney, their insurance carriers, to their state work comp carriers, has a lot easier time with it.

That’s how you want to be perceived. I want to be perceived as somebody who doesn’t miss injuries. If I’m going out to attorneys, I want to be perceived as somebody who documents so incredibly well that it makes their life super, super easy. If I want to be looked at by insurers, I want to be looked at somebody that’s honest, ethical, and highly professional. That’s how I want to be looked at. That is called a marketing strategy. Deciding how you want to appear to your market.

A marketing plan is deciding how you want to get that perception out to your community. Advertising is where you put that message on paid or unpaid communication lines. A paid communication line might be a radio commercial or a TV commercial, or you might do some sort of a newspaper ad. You might be doing all kinds of social media posts. You might be sending newsletters out to your patients, past and present. You need to communicate to your patient base on a regular basis. That’s called marketing.

When you accomplish these three things, it becomes very easy to expand. It’s easy to put associates in behind you. It’s easy to bring in new, well trained staff and retrain staff. If you understand how you want to be perceived and you’re putting that perception in the market, you’ve got it made in the injury market. And the injury market, in my personal and my professional experience, is the most fun market to be involved in because it’s a very high purpose game.

Patients that are injured have a 50/50 chance of never fully recovering, so they need the best doctors to be treating them. And that’s what made that game super, super fun for me because I wanted to be that doctor.

I run a program called the SmartInjuryDoctors programs and that’s why doctors are attracted to the program because that’s what they want to be. Marketing does one really neat thing; it repels what you don’t want, and it attracts what you do want.

You must decide professionally what you want to be in, how you want to be perceived. Because once you make that decision and once you start going down to that path, you will attract what you want to attract. Right now, if you’re getting things that you don’t like, you need to look at how you’re being perceived and what you’re putting out because that’s what you’re attracting. I like to always work with high level people. That’s what I like to work with, and I think you will too.

The three components of your business are you, your staff, and marketing. They are key things to being able to grow your injury practice now and for the next decade or decades to come.

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

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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

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What is a true expert?

What is a true expert?

by | Jul 31, 2019 | Articles

What is a true expert?

What is an expert, and particularly, what is an expert in the spinal soft tissue injury market or the spinal ligament injury market?

What is an expert? What actually is an expert? I want doctors to start to be able to identify experts, so when they have questions, when they’re looking for advice, they’re looking for education, that they are, indeed, searching out experts.

So, what is an expert? An expert is somebody who has specialized knowledge due to experience. The only way you gain that specialized knowledge is through experience. Today, there are so many so-called experts in the spinal soft tissue injury market. And here’s a fact that I’m going to point out. Spinal ligament injuries are the number one cause of chronic pain and disability.

All our experts, all of our expertise of the past has led to this condition being the number one cause of chronic pain and disability in the market today. We’ve got to find better experts, but before we do, we must define what is an expert. So, again, an expert is somebody who has specialized knowledge through experience, and through the application of that knowledge.

I’m going to give you an example. We can have an engineer, and engineers are the ones that design and build bridges. Professors of engineering teach our students today. They can be an expert at bridge building, so that professor could be described as an intellectual expert at bridge design, bridge building, and every aspect of putting a bridge together. But yet, they’ve never built a bridge, so they don’t have any experience in the thing that they are an expert in. To me, that’s not a real expert. That’s a paper expert. That’s an educational expert. That’s an ivory tower expert.

Let’s take the student, who goes out and builds six tremendously large impressive bridges that help us all. That expert has specialized knowledge. Let me tell you what happens with that expert. That expert went through the same education that every engineer did, right? So, just because you have an engineering degree, you could say, “Hey, I read a ton of books on bridge building”, and today, you could be a highly renowned expert. As a matter of fact, you could have a lot of titles behind your name showing that you’re an expert, but you have never built a bridge.

So, here’s the difference. The person that has built a bridge knows what information is important and what information is not. The key to an expert is that they can differentiate what is important and what is not, whereas the non-expert thinks everything is important.

When you are new to a subject, one of the biggest issues that you have with the subject is that everything seems so important. You’re not sure what is important and what is not. So, today, we need to start relying on experts. That expert, that expert that’s built a bridge, can come in and say, “You know what? 90 percent of what this professor is teaching actually does not apply and is not really necessary to understand in order to build that bridge.” That’s the difference between a true expert. A true expert can tell you what is important and what is not important.

In the area of spinal ligament injuries, we have a lot of so-called experts, but we don’t have a lot of experts when it comes down to determining the severity and location of a ligament injury, using excessive motion testing, and using MRI with excessive motion testing.

What is excessive motion testing?

Excessive motion testing is designed to pick up the imaging biomarker of a ligament injury. A ligament injury leaves two imaging bio-markers behind. An imaging biomarker is a specialized feature that determines the diagnosis of a condition. An imaging biomarker for a fracture is a separated bone on x-ray.

An imaging bio-marker for ligament damage is two-fold. Excessive motion is picked up and measured. When you’re in the injury market, it should be measured independent of the provider. Providers should not make these measurements themselves simply because they are going to use that information for determining a treatment plan, determining impairment, determining if they need a consult with a spinal fusion surgery consultant, a spinal fusion surgeon. They’re going to use that to make return to play parameters decisions for contact sports. They’re going to use this information, and the information is significant, so it should be done independent, unbiased.

You have excessive motion testing, and you have MRI. Today, there’s been such an over-utilization of MRI for spinal ligament injuries, and MRI is not even one of the better tests. It’s a good test for a disc. Remember, you have 23 discs and over 220 specialized ligaments. MRI is great for a disc study, but it’s not great to pick up excessive motion.

MRI was never designed to do this, and excessive motion is one of the most damaging aspects of a spinal ligament injury. It’s picked up with stress radiology and accurate measurements, but again, doctors, smart doctors, SmartInjuryDoctors, know that those results should be done independent. Results from an MRI should not be read by the treating provider. Disc herniation should be determined outside of the treating provider, and the treating provider can use that to make better treatment decisions.

Excessive motion testing should be done outside of the treating provider. Now, why do I say that? Well, because as far as somebody in the market that has utilized … What I said is an expert is somebody that has experience. I have as much or more experience in the market utilizing these procedures as anyone. So, I have direct experience with it, so I’m coming from complete experience, and there are not enough doctors in this market that have experience with excessive motion testing.

  • How does it combine with MRI testing?
  • How do you use it then to get better treatment results?
  • How do you use it to focus on and enhance and change your treatment plan?
  • How do you use it to manage your patient get better results?
  • How do you use this information to make sure that your patient doesn’t have chronic pain at the end of your care?
  • How do you use this information to make sure that your patient is seriously reducing their risk for long term residual complaints?
  • How do you use this information to make sure that you’re doing everything that you can to make sure that the person is not disabled or debilitated from these types of injuries?
  • How do you use this information to align with other factors of care that you can use in order to get better results?

That’s what an expert can do. When we look at excessive motion testing, I think if a provider has maybe 500 studies under their belt, they’re getting some really good expertise in this area, maybe 200. But, how many providers in the market today have actually sent out 200 plus injury patients and then monitored to the results of the test, clinically correlated it for the spinal instability level, accurately treated it, and then sufficiently documented it, so it makes everyone’s life easier? How many experts in the market are there that have done that? It’s very few, and they’re very rare. That’s what we’re producing with SmartInjuryDoctors for back and neck injuries. That’s what makes these doctors incredibly unique.

What I wanted to talk about was an expert. When you find an expert that has 10, 20, 30 years of experience, and you want to know about that subject, you want to get with that expert, and you want to have that expert take 20, 30 years of what they’ve experienced in the market and get that information in a week.

That will hyper-escalate the evolution of the science. So, that bridge builder that’s built 10 bridges can tell you a lot of things, and if new education programs and new information is based off of that information, then you’re going to have a serious expansion in the science of bridge building or a serious expansion in the science of spinal ligament injuries or a serious enhancement of the science of the treatment of spinal ligament injuries.

Now, spinal ligament injuries, remember, they’re not sexy. You’re never going to see a St. Elsewhere or House, where the provider actually went, “Oh my gosh, why are they having debilitating headaches? Oh my gosh, why are they having debilitating neck pain?” And only to find out 50 minutes later through all of this testing and weaves in and out of the story, that it was a simple spinal ligament injury, and that it was only due to the sheer acumen of the doctor’s, House, in this case, brilliance that he actually picked it up.

That’s not what you’re going to see with this, but the doctors that are really good with this condition should be the most significant doctors in the market today because this market causes … This condition causes the most chronic pain and the most disability.

I am always hit by, “Well, this expert or this person said this.” And my question is always, “Okay, well how much excessive motion testing have they done?” I don’t mean how much have they said they’ve done. How many studies have they sent out? How many times? How much have they taken that information and relied on it clinically? It’s almost always none. So, they’re relying on an expert that has little or no experience in the subject that they’re asking the expert to give their experience on or their education on.

Get with the providers. Get with the experts that really do have expertise, and they are not just talking about it. They are not just reading about it. They haven’t read everything there is to know about it. They actually have applied their knowledge to get a very specific result.

That’s what you’re looking for. That’s what we’re creating in the SmartInjuryDoctors’ programs. We’re creating doctors that are relying on the expertise in very, very small niche subjects, and the most important subjects there is in the spinal ligament injury market.

Don’t get caught following an expert who’s really not an expert. Search for really good experts. Glean what you can, and then take their information and take it to the next level because that’s what we need in our injury markets today. We need the top doctors in our injury markets, and those top doctors should have access to all the injury patients as far as I’m concerned. The best doctors in the injury market should have the most injury patients, and our whole work, employers, insurers, should be directing those injured patients to those doctors.

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
What the Back and Neck Injury Market Needs Is Better Doctors

What the Back and Neck Injury Market Needs Is Better Doctors

by | Jul 19, 2019 | Articles, Back and Neck Injury, Injury Market

What the Back and Neck Injury Market Needs Is Better Doctors

What I want to talk about in this article is what the injury market really needs. It needs better doctors. And it’s very, obvious that this is true by looking at the statistics in the injury market.

The statistics in the injury market are horrific.

I’ve been in this injury market for a long time, I’ve worked with a lot of different doctors. One of the things that’s so interesting to me, and it’s something that needs to change, is doctors are so proud of … Like if you take these, for example, in the back and neck injury area, doctors will proudly actually show statistics. I wrote a video called “Whiplash Statistics Don’t Lie.” And it’s on Spinal kinetics You Tube channel, and it goes through 41 studies that show the horrific results of anybody that suffers a spinal ligament injury in the fact that they have a significant risk to never, ever get out of the pain that they actually have as a result of these injuries. I don’t think anybody in the market disagrees with the fact that we need to have doctors who are a lot better at treating patients and getting results. We don’t need more doctors. We need smarter doctors.

We need doctors that can get results and we need that to be the primary focus …

The market for 2019 is starting to change and the market for 2020, 2021, 22, and beyond is going to be about results. Not about the money that doctors can make. Any doctor that can get great results in the injury market won’t have a problem earning money. Money’s not an issue. Anytime that you’re really good at what you do, and in the Smart Injury Doctors Program I say the smart injury doctors are doctors that are striving to be in the top 20 percent of their profession, so they are really good at what they do. Those doctors do not have a money issue. Those doctors aren’t the ones talking about the money that they make or the money that they can make. They’re talking about the results that they get. They’re constantly striving to look for better diagnostic procedures, better patient management procedures, and better treatment procedures that yield better results. They also can document in a way that allows everybody in the market to have a much easier time, because when you’re in the injury market, you’re in the medical-legal environment where documentation means everything. But if you look at the statistics today, the National Safety Council says that for every medically attended injury in the Workers’ Comp market today is a 42-thousand-dollar bill to the employer. So, injury care … all care, for that matter, but injury care which is a huge portion of the health care market, must start to focus on getting better results.

We want doctors to go out of business.

Now, when I say that, the great doctors will never go out of business. But bad doctors will. The injury market has allowed bad doctors to survive. Doctors that are just more interested in the patient as a dollar sign instead of the patient as someone that they get great results with. You can tell those doctors in the market, you can tell those consultants, you can tell those experts, because that’s what they’re talking about. They’re never talking about the results they get with the patient. They’re talking about:
  • how much they billed
  • how much they made
  • how much their attorney made
But they don’t ever talk about the devastation of the life. When an attorney and a doctor make a huge amount of money in injury care, it’s because the patient didn’t do well under care. It’s because the results of the patient were not good. Now some of them, in catastrophic injuries, everyone agrees, those are very difficult to deal with. Those are very difficult to deal with. In the back and neck injury market, not so much. So, there are too many doctors in the market today that are proud of the fact that they make attorneys money. Well, how do you make attorneys money? You make attorneys money by not getting good results with the patients. A doctor’s job in the injury market is to diagnose properly what the patient has. Full, accurately, completely, as well as you can. Treat the condition to a great result in a highly effective and efficient manner, and document in a such a way that everyone has a very easy time understanding exactly what you did. But results. The future market in the injury market is a results-based market. It’s a market that’s going to sane out, it’s going to start to call out bad doctors, bad procedures, bad equipment. And it’s going to start to go after good results. Anything that produces good results today in the injury market will thrive, especially in the new injury market that’s coming.

So, what we need today in the injury market is really simple:

We need great doctors; we need great injury doctors. SmartInjuryDoctors that can get great results with the patients. Those are the doctors that have high-purpose practices. Those are the doctors that look forward to getting up every morning and going to practice. I know when I was in private practice, we were very good at patient results. And I very much so looked forward to getting involved and getting in with the patients. Nothing else mattered. When I say it didn’t matter, yes, I was running a business, and yes I had to deal with staff and contracts and healthcare contracts and contracts for PPOs and HMOs and Medicare changes, and all the various things that you have to do in a private practice today to thrive and survive. My point is that I just absolutely love… The point that got me up in the morning, was working with the patients and getting the great results that changed lives.

Remember, as an injury doctor, when you have an injured person come in, they come in with a family.

Let’s say it’s a mother of four children and married, husband. Right? Big family. Well, when you are treating that patient, you’re also treating all the dynamic that goes with that patient. When you improve that, and you know you’re improving that, it’s an amazing practice. Injury practice is the most purpose-driven practice that you can have. It’s the most beautiful practice that you can have because of the effect that you have on the injured person’s lives. The biggest thing that’s needed in the market today are doctors that are highly effective at getting great injury results in a very cost-efficient, cost-effective, very shortened time manner. The better we can get at getting great end results, the better the doctors are. And that’s what we call Smart Injury Doctors. I also just want to remind all doctors in this program today, that a doctor’s job is to reduce patient benefit needs. Now this gets so confused in the market today, because I know as a person who has trained doctors and trained attorneys for a very long time, one of the worst questions that I would ever be asked by a doctor was:
  • ‘How do I show, or do I make patients’ attorneys’ money?’
  • ‘How do I increase settlements?’
I hated that question, just hated it. Still to this day, I do. Because good doctors don’t do that. Good doctors know, just like I knew, when I was in private practice, I knew that when you get great injury results, you are aligned with everyone in the market, which is exactly where you want to be.

You want to be aligned with everyone in the market.

What does the patient want? That’s exactly what the patient wants. What does the patient’s insurer want? That’s exactly what the patient’s insurer wants, they want great results in a short and cost-effective manner, as short as possible. What does the patient’s attorney want? They want the same thing. What do the defense attorneys for the insurance industry want? They want the same thing. So, when you are good at what you do with injury work, you are what everyone in the market needs, and you have a much easier time in private practice. Injury recovery results. I don’t mean monetary recovery. I mean physical recovery. Injury physical recovery results, and doctors that can get these results fast, efficient, and cost-effective, are the most sought-after doctors in the market. And doctors, I just wanted to say to those of you in the injury space, that’s what we’re all working towards, that’s what the Smart Injury Doctors program works towards, but I just wanted to do a simple program on that to remind everybody in the market that that’s truly what we’re after. 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

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Why an MRI Is Not the Best Ligament Injury Imaging Test

Why an MRI Is Not the Best Ligament Injury Imaging Test

by | Jul 17, 2019 | Articles, Spinal Ligament

Why an MRI Is Not the Best Ligament Injury Imaging Test

In this article we want to discuss an article that was published in the American Family Physicians Journal. This article brings up a topic that I’ve been talking about for years. And it’s only gotten worse. This article claims that 90% of today’s injured patients who’ve suffered a back or neck injury are working with doctors who do not have a clear understanding of their injuries. Wait, it gets even worse.

There’s A Familiar Lack of Understanding Present in This Article

These same doctors are unable to find the underlying physical conditions of these injuries at a time when these back and neck injuries have never been easier to diagnose. We’ve gone over this before and I am not going to go into depth in this article abut the role that an MRI and stress radiological studies play in picking up the two key bio imaging markers for these injured patients. These injuries account for:
  • #1 Cause of disability and chronic pain: Lumbar Spine Injury
  • #4 Cause of disability and chronic pain: Neck Injuries
  • #6 Cause of disability and chronic pain: Headaches associated with an injury to the ligament of the cranio-cervical junction or the cervical spine itself
I want to go over this with you in detail. I’ll put a link to the article here which appears on the American Family Physician website. The article we’re going to break down is the one called “Non-Specific Low Back Pain in Returning to Work” You can open it up and follow along with me.

I’m going to point out some things that are very prevalent in the market today and this is exactly what needs to change.

It says that as many as 90% of persons with occupational non-specific low back pain are able to return to work in a relatively short period of time. Now, I’m going to contest this point and quite a few other things in this article. You see, this position paper is a telltale sign of today’s market and it’s pushing the agenda that if there are no red flags with a patient, we as doctors can get them back to work quickly.

What are these red flags, you ask?

  • Infections
  • Fractures
  • Cauda Equina Syndrome
If one of these isn’t present a patient should be encouraged to remain as active as possible. We should minimize bed rest. It states that we should advocate the use of hot and cold compresses to minimize swelling and tell patients to take anti-inflammatory medications as desired.

What this article is telling doctors to do…

These patients need to take part in home exercises and be returned to work as soon as possible. Medical and surgical interventions should be minimized when abnormalities are not found in physical examinations. Patients who are having difficulty returning to work after four to six weeks should be examined and studied for possible personal and occupational psychosocial factors. A multidisciplinary program should be strongly considered to prevent a delayed recovery in those patients struggling to return to normal baseline activities and pain levels. One of the biggest problems I see with delayed recovery is that it is often the result of a delay of an accurate diagnosis of what the problem is in the first place. This article rightly points out that these medical doctors openly admit that they do not know what the underlying pathology is as you’ll see here. So, it goes on to say that patient advocacy should include unnecessary and ineffective medical and surgical interventions, work loss, joblessness, and chronic disabilities. The next thing the article states is that the management of low back pain and determining a patient’s safe return to work are common issues encountered by family physicians today.

Challenges include unfamiliarity with:

  • A patient’s individual job demands and requirements
  • Complex Workers’ Compensation systems
  • The vast array of diagnostic and therapeutic interventions of questionable effectiveness and value
The medical doctors in this article are actually openly admitting that most of the diagnostic and therapeutic interventions they order have questionable effectiveness and value when it comes to treating and diagnosing these injured patients.

Clearly, the object of this article is to encourage a plan of conservative care.

What is conservative care?
  • Physical Therapy
  • Chiropractic
  • Massage
  • Acupuncture
This is what most family doctors follow when they talk about following a conservative care path for their injured patients with occupational low back pain. This article throws around a lot of terms, so let’s take a moment and define one of them. Occupational nonspecific low back pain is pain that occurs predominantly in the lower back without neurological involvement or serious pathology. Let’s be real here, okay?

What they are basically promoting in this article is an early return to work for injured patients. And that right there is a huge part of the problem.

It says that according to the United States Bureau of Labor Statistics that there were 4.2 million non-fatal occupational injuries or illnesses reported by private industry. Sprains and strains accounted for approximately 42% of the injuries. So, as doctors they need to understand that when we look at the number of injuries, those involving the back is number one. It’s the number one cause of chronic pain and disability in the world today. And if you remember as I stated earlier the next is number four. That’s a huge number of our injured workers. So, sprains and to the back and neck are going to require doctors in the market who understand what a bio imaging marker looks like in an injured patient with neck or back complaints. Meaning, you will no longer have patients walking around with an incorrect diagnosis of nonspecific mechanical low back pain.

The Role of Risk Factors in Diagnosing These Injuries

This article goes on to attribute the cause of this nonspecific low back pain to certain risk factors. That’s because these doctors will openly tell you that they have no way of accurately diagnosing these patients. In general, medical doctors cannot clearly identify the cause of this pain in 90% of the patients they see. Now, when I say medical doctor, I’m talking about general practitioners. Now, it goes on to say that some physical demands including manual lifting, bending, twisting, and whole-body vibration are associated with an increased likelihood of low back pain. Please note: Association is not equivalent to causation. It should also be noted that personal and occupational psychosocial variables play a more important role in spinal pathology than just the physical demands of the job.

And that’s where it can get kind of tricky…

They openly admit they don’t know the cause of this low back pain, yet in a sentence or two later they are saying there’s strong evidence that personal or occupational psychosocial variables play a more important role in these injuries than the spinal pathology itself. Now, that my fellow doctors… Could not be further from the truth.

Let’s look at what they list as psychosocial risk factors:

  • Depression: Well I would argue that anybody who suffers from chronic pain and cannot get help from the medical community might exhibit signs of depression. Especially in an active person who cannot find relief or understanding from a doctor who understands their condition.
  • Education Level: This is an understanding and belief that those with lower education levels are more prone to chronic disabilities. Again, what does someone’s education level have to do with an injury. Isn’t more likely the case that a doctor who cannot solve a problem with an accurate diagnosis is likely to blame a patient’s lack of education as the basis for the patient himself not understanding their own injury?
  • Excessive Pain: Well, if you are in constant pain and the medical community is not offering relief, over time this can build up. Is there anyone who wouldn’t say that this amount of chronic pain would be classified as excessive?
  • Fear Avoidance: If you are suffering and unable to find anyone to help you, it’s fair to say that you would fear returning to the same position that caused you pain. That’s a totally legitimate concern. That’s not something I would classify as fear avoidance or job dissatisfaction.
  • Somatization disorder: That is when you are putting too much attention on a condition. Si, again if the doctor cannot figure out what the problem is, if they cannot get to the underlying problem that is going to cause you some obvious distress. It would be hard to imagine a condition like this not dominating your life. So, this talk of “putting too much attention” on this condition seems to be unfair from the patient’s point of view.
  • Unemployment Compensation: What does this have to do with a medical condition? If you’re unemployed and trying to get money to live on from an employer whose job caused your injury, I do not see how that causes pain. I would say it’s the same thing with workers’ compensation claims. It’s not fair to say that legitimately injured patients are trying to distort their injuries just to receive some compensation.
All these issues are problematic when you consider what is really going on.

There is no standardized method of diagnosing these injuries.

Even my own profession of chiropractic is problematic. They have not and are unlikely to standardize the workup of these injuries. The major chiropractic schools don’t even teach bio imaging markers that are consistent with soft-tissue injury to the spine. So then, this becomes the problem that all professions have: physical therapy, chiropractic, Medical doctors, medical specialists. They all have the same problem. No knowledge of what is going on with these types of injuries and no way to consistently diagnose them. This is why SmartInjuryDoctors are so important in the market today. I hope that what I just laid out for you is something that you enjoyed because 90% of the patients suffering from back and neck injury should not be working with any doctor who is incapable of diagnosing the underlying condition. Most of these doctors, no matter what their specialty are just making the same mistakes over and over. They end up relying on articles like this one to justify their rush to return patients to the work force. Patients who are still injured and still in pain.

That is what I am trying so hard to change.

With these articles, my podcasts, my videos…I’m trying to reach doctors wherever they are and show them a better way of doing things. That’s what the SmartInjuryDoctors Program is all about. We need the injury market to change because the patients deserve to work with doctors who not only care, but doctors who can get real results. 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.

Terms | Privacy