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A Little Bit About DMX, Digital Motion X-Rays

A Little Bit About DMX, Digital Motion X-Rays

A Little Bit About DMX, Digital Motion X-Rays

In this article I want to talk a little bit about Digital motion x-rays or DMX. There’s a lot of information out in the market regarding DMX, most of it coming from the providers who have DMX units in their practices.

So, let’s talk about what DMX is.

First, DMX is not a primary imaging tool, it is a secondary x-ray imaging tool.

It is a tool that is usually used by chiropractors and is often used only in the neck. This is because the output of a DMX machine is not strong enough to image the lumbar spine region. This means that DMX can’t really do anything for a patient suffering from chronic low back pain. And as we continually reference, ligament injuries to the lumbar spine are the number one cause of chronic pain and disability in the world today.

Since these injuries cannot be assessed by a DMX machine, DMX does nothing to solve one the the biggest problems in the spinal injury market. The DMX is limited to being a cervical spine injury tool.

To my knowledge there’s only around 200 DMX units in the United States.

Even with this low relative number of machines the providers who use them can be quite vocal about their efficacy. I read and hear them talk a lot about the fact that they’re so much better or more significant than regular x-ray.

I must take issue with this unwarranted criticism of x-ray.

X-ray is the number one primary imaging tool in America for ligament injuries. It is by far the best primary imaging tool in the country. When used properly, it picks up better than 95% of what is needed to make a good spinal ligament injury diagnosis.

I don’t really have an issue with the idea of DMX itself. My only real problem is the providers that use it run down x-ray and that to me is problematic and causes confusion in the market, potentially causing harm the millions of patients that suffer from these injuryies every year.

X-ray is cost effective and uses a lower dose of radiation. Since DMX is a secondary Imaging modality to be used 4-6 weeks after that injury, the treating provider cannot get key information about ligament assessment right away with the DMX. With x-ray you don’t have to wait. It’s not a secondary imaging tool. It’s a primary tool and most findings that you will see on a DMX are found on general digital x-rays.

I don’t care if you use DMX. DMX is what it is. If you want to expand the science of DMX, I have no problem with that. Just don’t run down digital x-rays, because they are highly effective and everyone in the country has access to them.

What you’re going to find on the DMX you’re often going to find in a general x-ray study.

X-ray is the best tool in America for ligament assessments. So, SmartInjuryDoctors® know that with basic ligament testing, basic x-ray, and a really accurate intersegmental motion study, you’re going to pick up the majority of severe ligament damage and injuries that most patients in the injury market are suffering.

That’s why I’m a huge proponent of x-ray. I’m not antagonistic or against DMX by any means. Again, I’m only against providers who use DMX as an opportunity or platform to run down regular digital x-ray and say that somehow these x-rays are so deficient. They also tend to say that one of the things that comes up in DMX is that there’s bad movement patterns that occur mid-movement in the patients range of motion. This is something that tends to be promoted a lot but is very difficult to see.

As a doctor who’s been doing ligament testing for a long time. Probably more years than anyone else currently active in the injury market today. I have probably been involved with the measurements of more studies than anyone in the country today and I’m going to tell you that that I’ve never seen these phenomena of mid-motion translation patterns that do not show up on end range motion.

This is a common thing that DMX providers like to talk about, in order to sell the idea that it is superior to digital x-rays. They openly will say that they’ve done hundreds or that they’ve seen thousands of these of mid motion problems that do not show up at the end range of motion with general x-ray. Yet I’m in the market, and I’ve asked for some examples, show me 10 or 20 of them out of these hundreds or thousands that are out there, and I never get any help finding them.

We have even asked to independently measure these images, which have inherent difficulties to compare the digital x-rays because of the differences in the output of the image formats of each.

I have never been able to get my hands on images that show this and again I have done a lot of them and have never seen this phenomenon so it cannot be common.

So, we’ve simply not seen it. In fact, I’ve ran a two national spinal ligament testing companies for a lot of years and I’ve never seen it in a DMX study. Ever. It can’t be common, that’s all I’m saying. I am also not saying that it is not there, I am just saying it is not common.

What I’d like you to understand is that in many ways digital x-rays are by far superior in my experience.

All digital x-rays are in a format called DICOM. It’s an easy to use format and virtually every radiologist in the world is familiar with it and can read these x-rays.

DMX on the other hand is not in standard DICOM format. Which means that most radiologists cannot work with it, so it does not scale as a broad based solution to the epidemic of spinal ligament assessments needed to meet today’s market need.

This makes x-ray a far more accessible tool than DMX in my experience.

With x-rays being a DICOM images, they’re also much easier to accurately measure spacial relationships such as excessive motion. You can calibrate a DICOM image and make incredibly accurate measurements from them. With DMX this is much more difficult since it is not in the DICOM format.

Now the thing I want you to walk away with today is that SmartInjuryDoctors® know they can use good x-ray studies to do 99% of all ligament injury assessments. This is not the standard in today’s injury market. Too few doctors are able to do a standard spinal instability work-up.

Sometimes we do need a secondary imaging procedure.

Secondary imaging procedures that I like best are the MRI.

If you are not picking up an injury on a standard x-ray then to me, the next logical step is an MRI. If you’re a DMX user who has a really good understanding of DMX and you’ve already tested everything with a standard x-ray and you believe that you have missed something with a standard x-ray and you document clearly what you believe was missed and what you are now trying to rule in or rule out, then I am a huge fan.

I’m all for this type of use of a DMX image, to supplement standard x-rays when the doctors feels and clearly states what he or she is trying to accomplish with the imaging.

But don’t tell someone like me, who’s been doing x-ray studies successfully for years that the x-ray is deficient and missing so much, as that has not been my experience at all. That’s what I don’t like about the trend around DMX. It tends to run down x-rays, and the experts in the field who’ve been using x-rays to make credible, accurate ligament injury diagnoses for years. These doctors get incredible results for their patients and should not be run down this way.

That does not sit right with me and that is what I protest in the the small niche called DMX. Please remember that DMX studies probably in any given year represent 0.00006% of the x-ray studies performed in the us. I took liberty to show a very small percentage as a guess just to show the reader that this is a very small niche.

I’ve written other articles and talked on my podcast about ICA best practices for x-ray. The standard digital x-ray is still the number one primary imaging tool available for ligament injury assessments. We do not need other modalities like MRI, DMX, and CT being used to run down the x-ray when the x-ray has so much data in it.

We just need doctors who can mine the data in x-rays properly and then clinically correlate it. That is what will help to eradicate the epidemic of chronic pain resulting from these injuries. That is what we are doing in the SmartInjuryDoctors programs.

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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Is X-Ray Important Today?

Is X-Ray Important Today?

Is X-Ray Important Today?

My journey into the spinal injury market came from frustrations I experienced as a practicing chiropractor. So, I have a real passion and dedication to chiropractors who wish to become masters of spinal ligament injuries.

Recently I’ve noticed a disturbing trend, the movement away from routine use of x-rays. From my viewpoint and experience as an injury provider and an injury trainer, I believe this is a big mistake.

The number one cause of chronic pain and disability in the world today is a ligament injury.

These ligament injuries cause spinal instability. The only way you can effectively and objectively evaluate spinal instability is through stress radiography. Let me remind you that a spinal instability is simply the inability of the spine to maintain alignment under load. To evaluate it, you must load the spine to see if it is able to maintain proper alignment.

Now, when it misaligns under stress, this misalignment causes excessive translation and angular patterns that can be picked up on the spine. This makes it extremely easy to determine the severity and location of a ligament injury.

It’s quite easy to identify clinically through motor testing, sensor testing, or a pain evaluation correlation if that excessive motion is causing the problem. If we determine that it’s that level that is causing the motor, sensory, or pain problem we know that we have a spinal instability.

Just like we talk about all the time, this is crucial. Spinal instabilities are the number one cause of chronic pain. The number one cause. Let that sink in for a moment and you will begin to realize the severity and potential of the injury market for those that understand what is going on.

Spinal instabilities are the leading physical cause of low back problems. The fourth leading physical cause of neck problems and the sixth leading cause of chronic headaches.

I was taught a long time ago, to not see is to not know.

You must be able to see the spine to know what is going on with the spine. It’s virtually impossible to evaluate the integrity of the spine and know what you’re dealing with unless you can see. For doctors to say that x-ray evaluation is not important is problematic.

Most people who show up at a chiropractor’s office are coming in because of pain. The x-ray is the best diagnostic tool we have available. By no means are we talking about the overuse of x-ray. We do not want to order x-rays for the heck of it or because we do not know what else to do.

This misguided movement away from x-rays has led to such confusion in the United States, that today top researchers and guidelines openly admit that 9 out of 10 chronic pain patients and injury patients do not have a specific anatomical derangement pattern identified.

In today’s injury market the number one diagnosis for lower back issues is labeled as non-specific mechanical low back pain.

This means that doctors understand that something mechanical is causing the pain but are unable to identify what that “something” is. That’s no good for anyone in today’s injury market, to not know what the cause of something is. These non-specific diagnoses are the number one diagnosis for not just the lower back, but also the neck. Without being specific these diagnoses do not contribute to effective, systematic treatment plans.

If you wan to arrive at a specific diagnosis, then you are going to need to get into x-ray evaluations. As a doctor, I personally do not see any way to determine which misalignment or how badly the spin is misaligning without the use of x-ray. X-ray properly used is the number one tool for understanding injuries and understanding what could be triggering their chronic pain.

With ligament injuries, time is everything.

If you’re an injury patient or you treat patients with a spinal injury time is critical because of how the body reacts to the injury. It doesn’t matter how the injury happened; these patients could’ve been injured:

·        at work;

·        in an auto accident;

·        playing a sport;

·        or simply from a misstep at home.

No matter the cause, these injured patients need to get to a qualified provider as soon as possible.

Think about someone injured on the job. The longer that patient goes without seeking care and receiving effective treatment, the longer they are out of action and the higher the claim costs. This delay also leads to a higher risk of long-term residual complaints, that’s why patients with ligament conditions need doctors who understand how to assess these conditions.

Today, we need more doctors who understand how to great x-ray evaluations.

There is a specific type of x-ray that is showing a lot of promise to making these evaluations even easier. Digital motion x-ray or DMX is a more advanced form of x-ray. The only problem with it is that there is minimal access to them. In the entire United States, there are only 200 units, maybe 300, up and running.

So, we need great doctors who can make an evaluation based on conventional x-ray. Virtually anybody can get access to these x-rays.

We need to be able to actually have an injured patient go to the doctor, get those x-rays, and then have an excessive motion test. This helps a qualified doctor understand how much excessive motion the patient has. Now the doctor can clinically correlate either a motor, a sensory, or a pain problem at that level. When this occurs, we have a doctor that knows what the underlying problem is that is causing the problem.

An orthopedist may shut off the pain right away using a nerve block.

Now to take it a step further, most patients get to the doctor. If the doctor understands the underlying condition, they often can treat it conservatively just fine. We have a tool available known as the nerve block. When a patient needs to have pain shut off right away, they may end up under an orthopedist’s care who performs a nerve block to give relief.

The interesting thing for us, is that nerve block positively identifies which nerve is causing the problem. When an orthopedist or pain management goes in and anesthetizes a nerve and the pain goes away, that’s the ultimate objective diagnosis of where the problem is coming from.

Excessive motion can irritate the nerves and cause the motor, sensory, or pain problem. Now, if it’s a spinal instability causing this excessive motion a patient still needs a provider who really understands how to treat the condition even after the pain is shut off with an injection.

Often the pain will return, so we need a doctor who can deal with the long-term well-being of the patient. That’s what the whole SmartInjury® Program is about, producing doctors who understand the problem’s cause and can effectively treat injured patients.

X-ray is still the most important tool for back and neck conditions.

We should always remember that the x-ray is still the best diagnostic tool we have available.

Why?

Because, it’s not okay for everyone to walk around in today’s injury market with all this chronic pain and be working with doctors who cannot tell you what exactly is causing it.

The SmartInjury® Doctor can perform an evaluation of spinal instability routinely using universally available x-rays and an excessive motion study. These are the doctors that employers, insurers, attorneys, and injured patients should be dealing with. That’s what I am creating today with our program, a supply of providers who can shift the injury market from misunderstanding and ineffective treatment to effective diagnoses and care that gives patients relief from debilitating chronic pain.

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?

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

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CONTACT US

Smart Injury Doctors
701 Richards Ave
Clearwater Florida 33755

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

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© 2019 Biocybernetics Inc.

What Is A Smart Injury Lawyer?

What Is A Smart Injury Lawyer?

What Is A Smart Injury Lawyer?

Welcome to today’s program. Today what we’re going to be talking about is what is a smart injury lawyer? Well, every day in America, every seven seconds, there’s a work-related injury. Every seven seconds in America, there’s an auto-related injury. And every day, every two seconds in America, there’s a home-related injury. So, injuries are the number one cause of chronic pain in the country and in the world today. Oftentimes, an injury patient or a patient that’s been injured may require the services of a lawyer in order to assist them with the adjudication process of their claim.

What we call a smart injury lawyer is one of the most sought-after lawyers in the market.

 There’s a reason why they’re the most sought after lawyers in the market, is because they’re unusual in the fact that they understand the injuries that they represent. Now they don’t have a doctorate. They’re not medical doctors. They’re not chiropractors. They’re not osteopaths. They’re not medical professionals. They’re not healthcare professionals, but they know about the injuries that they represent. That’s what makes them so sought after. Sought after from the patient’s point-of-view, or the client’s point-of-view. Sought after from doctor referrals point-of-view, because doctors want to work with attorneys that understand the injuries.

I have been a doctor in the injury market for the last 30 years.

 I’ve been a licensed doctor of chiropractic for the last 30 years. I’ve had a law degree since 2013 with special emphasis in personal injury work. Now I’m going to tell you that the majority of doctors in the spinal injury market, the biggest frustration that they have as doctors is that they’re oftentimes working with a client, with a patient, in their case a patient, that is working with an attorney that does not understand their injuries at all. In the area of spinal injuries, this is rampant in the legal community. Most attorneys in my experience do not know anything about the injuries that they represent when it comes to spinal injuries. Things like spinal ligament injuries, they have very little information on. A smart injury lawyer knows to the “T” what these injuries are all about, not because they have a medical degree in it, but because they have basic training and basic understanding of what these … just how significant these injuries are.

Today, they’re the number one cause of chronic pain and disability.

If you read the American Pain Association’s 2007 low back guidelines, an injury to the lower back, just the medical management of that condition is $9,000 to $19,000 per year. Work comp, if we go to worker’s comp, average cost of an average medically documented injury, according to the National Safety Council, is $42,000 per injury. The majority of these injuries are spinal injuries. So, what a smart injury lawyer in the market today is, is it’s a lawyer that actually understands the injuries that their client has. A smart injury lawyer that knows back and neck injuries knows that MRI is not necessarily the greatest test for ligament damage, not because MRI is not a great test. MRI is a great test. There are 23 discs that are specialized ligaments in the spine. MRI is a great imaging test for those 23 ligaments, however there’s over 220 specialized ligaments that hold the spine together.

One of the most major findings in a ligament injury was never designed to be picked up on MRI.

That’s excessive motion. Excessive motion, so anytime that you injure a joint, and the ligaments hold a joint together, anytime you damage the ligaments to the joint, the joint bones in their movement patterns will show excessive motion on stress testing. It’s a specialized form of radiographic testing that tests to see in different positions if the joint is slipping in and out of alignment. So, a smart injury lawyer knows that MRI of the spine was never designed to pick up excessive motion. So, it’s not a bad test. It’s just not a great test when it comes to ligament assessments. Smart injury lawyers know that the primary imaging procedure used is a set of great digital X-rays. A great digital X-ray study will tell you a lot about the ligament status of the, in this case, client.

Now, a smart injury lawyer will also know that if you have an excessive motion in the spine, so a smart injury lawyer knows that whenever you damage a body part, you must derange it. There’s no way to damage a human body part without deranging it. If a person’s bitten by a dog, there’s a very unique dog bite, which is a lesion or a derangement pattern that’s left behind. If a person is burned, it doesn’t look like a dog bite. The derangement pattern looks different. If a person is shot with a gun, and they have a gunshot wound, the derangement pattern is different.

Different types of injuries leave different types of derangement patterns behind.

In the spine, we have shear and compressive force. Whether the person’s in an auto accident, they slip and fall at home, they slip and fall at work, they lift something that’s too heavy for them at work, there’s shear force and compressive force to the spine. Now if the spine gets damaged, the ligaments get damaged. It causes excessive motion. The excessive motion is how a smart injury lawyer for back and neck injuries knows that’s the best way to assess the amount of ligament damage that you have. They also know that in the AMA impairment guides, which are basically injury guidelines, that there are three specific findings for spinal damage. One is picked up on a CTR X-ray, it’s called a fracture. One is a ligament finding picked up on X-ray, and accurately measured intersegmental motion study called a CRMA, or a computerized radiographic mensuration analysis. And then the other ligament finding, if the disc is involved, is an MRI.

We have to remember, if we go up to the top of the neck, there are no discs involved up there. So, your X-ray study is still your best study. So, what is a smart injury lawyer? A smart injury lawyer is a lawyer that understands the injuries. They don’t just turn cases. They actually take the time to learn about the injuries that they’re representing. That’s what makes them very sought after. That’s why doctors want to refer to them and that’s why patients seek them out. All I wanted to do today was just to explain, that’s what a smart injury lawyer is.

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

1-800-940-6513, ext 700

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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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© 2019 Biocybernetics Inc.

What the Back and Neck Injury Market Needs Is Better Doctors

What the Back and Neck Injury Market Needs Is Better Doctors

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

Want to learn more about Smartinjurydoctor's Program?

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

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

SEARCH THIS SITE

© 2019 Biocybernetics Inc.

Why an MRI Is Not the Best Ligament Injury Imaging Test

Why an MRI Is Not the Best Ligament Injury Imaging Test

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

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What Is Marketing for Doctors in the Injury Market?

What Is Marketing for Doctors in the Injury Market?

What Is Marketing for Doctors in the Injury Market?

Doctors in the injury market, lawyers in the injury market, specialists in the injury market, all want to market to get more injury patients, and there’s a commonality in the injury market that it’s very difficult to market for injury patients.

I totally disagree with that. First of all, one of the things that we create in the SmartInjuryDoctors® Program, for some the best injury doctors in the country, is the ability for these doctors to get a message out so that patients know that they’re there. I believe that the best doctors in the injury market are those that can get great results. That’s what we want to produce. That’s why we’re producing the SmartInjuryDoctors® Program. Doctors that can take back and neck injuries and get great results. They can get fast, effective, efficient, and very cost-effective results with these patients.

We Have This Idea of Marketing and That Marketing for Injury Patients Is Very Difficult

Well, it’s not difficult if you understand what marketing is. There’s a lot of books written on marketing, there’s a lot of things that could be said about marketing, for this segment I’m going to make it very, very short, and I’m going to define some terms. I’m going to make it easy to understand what marketing is.

Marketing is how you are perceived in your market. A marketing strategy then, is how you go about influencing how you want to be perceived in the market. Most marketing starts with a survey. You survey the public to find out what they want, and then you supply that want. That’s your marketing message, that you can supply what they want, and people will buy. That’s marketing.

Everything You Do Impacts Your Marketing

So, if marketing is how you’re perceived in the market, everything that you do with injury work is marketing. From the time that your front desk takes that first call, you’re marketing. Everybody that handles a patient in your clinic is marketing to a degree because they’re providing a perception. It’s how you and your clinic are being perceived by the injury patient. That’s marketing.

Your documentation is marketing. Your documentation that goes to the insurer is marketing. Good or bad. Your documentation that goes to a lawyer is marketing. Good or bad. So, if everything you do is marketing, you have to decide your marketing strategy and how you want to be perceived?

Before I move onto the next step, let’s just quickly define one other thing, that a lot of doctors don’t understand. That’s what is the difference between marketing and advertising. If marketing is how you want to be perceived in your market. Advertising is what you do to deliver that message to the public so that they know you’re there.

The Difference Between Marketing and Advertising

Advertising can be free or paid. For example, all the social networks are free. However, advertising can also cost you a lot of money. Advertising is taking your message and putting it on communication lines so that people can perceive you, whether it’s newspaper ads, TV commercials, radio commercials, social network posts, videos on YouTube, that’s all advertising. The message that you’re relaying, is your marketing.

On the injury side of things, one of the things you want to market today is fast, effective results. Remember, when you look at marketing, each market has a different need. If you look at patients, what do patients want? Well, they want fast, efficient, and very inexpensive care. That’s what they want, in general, right? So, if I’m marketing, or you’re marketing to injury patients, you want to focus on fast, effective results because that’s what they want.

Marketing to Attorneys

If you’re marketing to attorneys, what do attorneys want? Well, they want excellent documentation. So, one of the ways that you might market to an attorney is by focusing on the fact that we don’t waste your time with poor documentation. Our SmartInjuryDoctors® are the best doctors in the country as far as documentation goes, because they understand the simplicity of what everyone in the market needs, so it becomes very, very easy. If I’m with attorneys, it’s very easy to market and say, “Well, look we don’t waste your time with bad documentation.” And trust me, most documentation in the injury market is pretty bad.

Most of the time in the spinal ligament injury market, ligament injuries aren’t even documented, so the severity of the injury is not documented, and that starts a problem. It causes problems for attorneys, insurers, and adjudicators, it starts a problem all down the line. So, if I’m a SmartInjuryDoctor® who is marketing to an attorney, one of the things that we’re going to say is that we don’t waste your time with bad documentation, like the majority of doctors that you probably work with.

Marketing to Medical Doctors

If I’m marketing to medical doctors, or other providers seeking referrals, I might choose something like: “We don’t submit patients to any form of excessive care. All the care that we give is the care that the patient needs, and no more.” That’s what we provide. We provide only care that’s necessary to get that condition stabilized fast, effectively, and then we release the patient. That’s what I’m going to be talking about if I’m talking to medical doctors.

Three Things You Must Do Well

All I wanted to do in this short post, is just explain, what is marketing? It’s how you are perceived in the market. There are three things that you want to do excessively well in this market:

  1. You want to be able to diagnose the injuries, the extent of those injuries, and you don’t want to miss injuries. If you’re a doctor of chiropractic, I’m going to tell you one of the things that I recommend that the doctors market is that when they’re assessing injuries they communicate to the market that they only use top medical specialists to interpret their imaging, to get an accurate diagnosis.
  2. You want to be exceptionally good at treating those injuries.
  3. You want to be exceptionally good at documenting in such a simple way that everyone in the market knows exactly what’s going on. That reduces problems for the patient. It reduces problems for the patient’s attorney. It reduces problems for the insurer. It reduces problems for everyone in the market.

When you’re providing everyone with what they need in the market, you’re marketing, and that will actually cause you to bring in a lot more injury patients. If you’re the top doctor in your area, you should be seeing as many of the injury patients in your local area as you possibly can, because those patients as we talked about in other additions of this program, are at super high risk for long term residual complaints.

Send Your Market the Right Message

You want to intentionally decide what message you are sending to the public in your area. Once you choose your message, you want to advertise and promote, so that people become very aware that you’re here. Our key thing today about marketing is how you’re perceived. A marketing strategy is deciding how you want the market to perceive you, and understanding your market is important because then you can put forth what the market wants. They will perceive that you have what they want, and that’s the simplicity of marketing. That’s all marketing is.

I hope that clarifies things. Like I said, I want to keep it very, very quick and to the point, on a particular topic. All I wanted to address here was what marketing is, and that it does not have to be difficult for injury patients. It really does not. Our SmartInjuryDoctors® know that, and they know that they have a message that they’re readily putting out., It’s very, very easy to do, and that doctors, is marketing.

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?

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

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

SEARCH THIS SITE

© 2019 Biocybernetics Inc.