Short North Accident Injury Care

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Whiplash Accidents Injuries Treated, Liability & Labor Disability Injuries Treated, Short North Columbus, Ohio

Call 614 299 9797 to make an appointment.
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Mark van Hemert, DC, DACS

The design of this article is to give the chiropractic profession an introduction into the value and usefulness of clinical outcome assessment procedures. Using outcome assessment methods of case management gives the chiropractic profession an effective way to document the need for care.

This results in receiving the compensation for services they rendered.
In today’s environment of manage care, the attending clinician’s care is constantly being reviewed and challenged.

The chief areas of concern for the third-party payers is over-utilization and costs. Over-utilization is a problem in chiropractic, whether it be real or only perceived by outside reviewers.

This perception can only be overcome on a case by case basis by objectively proving that care provided was reasonable and necessary. Á Due to the acceptance of the Mercy guidelines

(Guidelines for Chiropractic Quality Assurance and Practice Parameters) by the insurance industry, the document is the authoritative reference to counter the insurance industry’s attempt to limit quality and the quantity of care.

The primary reason the Mercy guidelines carry a high level of acceptance and credibility by the insurance industry, is because its ratings are based on scientific evidence.

A synopsis of today’s situation reveals that the care rendered by the attending clinician is constantly being challenged by the third-party carriers. IME opinions of excessive care or no permanent impairment are detrimental to the patient’s medical/legal case.

Cases that involve acute injury with associated liability frequently require the intervention of the court system or workers’ compensation system to resolve the case.

This inherent intervention leaves the door wide open for the probing eyes and opinions of the IME. Due to a lack of knowledge and documentation by the attending physician, patients receive inadequate medical care and inferior documentation of their injury, rational for therapeutic care, determination of maximum improvement, and final impairment.

Third-party carriers are aggressive in their review of care to determine the point of maximum improvement. Many clinicians feel that if patient care is within the guideline numbers, their fees will be paid.

However, the therapeutic necessity of care is frequently being challenged. A lack of knowledge of the practice guidelines does not substantiate the patient’s contractual right to receive care to the maximum ability of the injury to respond to active care and improved function.

power… the 1980s witnessed a shift in power from the providers of health care to the payers of it … and those practitioners whose services are labeled worthless could face financial ruin … chiropractors are especially vulnerable.”

Whiplash Accidents Injuries Treated, Liability & Labor Disability Injuries Treated, Short North Columbus, Ohio

Call 614 299 9797 to make an appointment.

Liability & Labor Disability Injuries Treated, Short North Columbus, Ohio
Call 614 299 9797 to make an appointment.

Even when all aspects of case are well managed, problems for reimbursement can ensue. If the liability for the automobile accident is disputed, the settlement will often be different when compared to an undisputed case.

For example, if the treated patient is found to be 20 percent comparatively negligent for not wearing his seat belt, the final award of $10,000 would now total $8,000.

This final award now reflects the 20 percent comparative negligence. In our opinion, it is not fair for the doctor to reduce his bill by any amount to compensate the patient for his negligence.

Labor Disability

There are times, most often in severe traumas, when a labor disabling status will be afforded to the patient.

To justify this status and the accompanying reimbursement for lost wages, the doctor must document what specific occupational activities are prohibited by the injury. Failure to document the need for temporary disability will cause the patient to lose financial compensation for his loss of earning.

Documentation

This is a broad classification which encompasses all written words concerning this accident. We are of the opinion that “travel cards” and “fill in the blank exam forms” are no longer sufficient in the current medical/legal system.

They tell what was done but not the reason. The literature is very clear as to how to properly document each of the patient’s office visits. The SOAP acronym is most often used:
“S” refers to the patient’s subjective complaints,
“O” refers to the objective evidence for care seen on each office visit,
“A” stands for the doctor’s assessment of the patient’s condition, and the
“P” pertains to the treatment plan of that visit.

This type of documentation is not only taught in the chiropractic schools, but is also recommended by most malpractice insurance carriers as the proper way to document each of the dates of service.

It should be mentioned that even the best attorneys can not adequately represent their clients interests without proper documentation from the doctor.

We hope this discussion has enlightened and provided a reasonable source of reference for both sides of these issues.

The doctor has a heavy burden. He must not only adequately treat the patient, but also assume the responsibility placed upon him by the legal system. The financial and personal rewards for his efforts will be more than adequate for the effort expended.

Liability & Labor Disability Injuries Treated, Short North Columbus, Ohio
Call 614 299 9797 to make an appointment.

Chronic Pain & Injuries Treated, Short North Columbus, Ohio

Call 614 299 9797 to make an appointment.

Chronic pain is defined as pain that persists longer than 90 days beyond the course of the natural expected healing time. As a chiropractor in Columbus, Ohio, I get calls from both new and established patients on a regular basis who complain of back pain, neck pain, etc.

One of the factors that comes into play when planning a chiropractic treatment program is the duration of the patients pain. In general, the longer that a patient suffers with a painful condition, the longer / more intense the treatment is needed in order to fix it. Acute or recent episodes of pain respond much quicker than do chronic conditions.

Pain is very difficult to quantify by any practitioner. Pain is subjective in nature and completely defined by the person experiencing the symptoms, the fact that chronic pain can exist without an obvious cause makes it much more difficult to treat.

I see the difficulties that my chronic pain patients have with their conditions on a daily basis. Aside from the actual pain that they experience, those who suffer with chronic pain often limit their activities for fear of exacerbating their conditions. They also have a much harder time focussing on mental tasks as the pain is a constant source of distraction. The more severe the pain, the more difficulties these people have with attention demanding tasks.

While we strive to avoid pain, pain is a wonderful tool of the nervous system. Pain lets us know of actual or potential tissue damage with an unpleasant sensation that directs our attention to the affected area so that we can either immediately take action to stop the process or focus on healing the injured body parts. Chronic pain sensations are a bit more insideous.

Chronic pain often involves a decrease in the sensativity of the nerve fibers that send messages of pain from the damaged area. With a decreased sensativity (threshold), the nerve is much more likely to transmit painful sensations to the brain then a healthy nerve / tissue combination. This activity within the nervous system is know as a wind up phenomenon and it is very difficult to stop once it has been established. In some other cases, nerve fibers that normally don’t carry painful sensations not only begin to transmit pain signals but it is thought that they may actually generate the signals themselves.

In my office, chronic pain is often the result of untreated sprain / strain type injuries of the joints. In untreated or under-treated sprain / strain injuries, the joint or the muscles that move the joint are laden with scar tisuue that acts to either limit or alter motion of that joint. With time, the awkward, unnatural biomechanics of the scar tissue laden joint results in irritation, inflammation and finally pain and spasm.

While chiropractic care is often successful at re-establishing “clean” biomechanics of a joint, it is always better to get the care in the beginning of an injury versus waiting for that injury to become chronic, with a requiring more care with a decreasing chance of complete recovery.

Because of the possibility of an acute painful condition becoming a chronic one, I always encourage my patients to take care of themselves immediately when they first start to experience pain. I have practiced chiropractic care for almost two decades now and I can say that chronic painful conditions of the spine are devastating.

Not only do they make you experience pain, but in most instances they limit your physical activities creating a situation that can easily degrade from inactivity secondary to pain, to deconditioning and eventually to obesity and ill health in general leading to a dissatisying lifestyle.

The bottom line on chronic pain is this – avoid it if you can. Don’t ignore your pain. Painful acute conditions that are left untreated can easily spiral into a chronic condition that has the potential to alter your lifestyle in a negative way.

Chronic Pain Injuries Treated, Short North Columbus, Ohio

Call 614 299 9797 to make an appointment.