From: Dr. Margolies .. 2-13-09 www.chirosmart.net www.chirosmart.net/shop http://boards.chirosmart.net Note: Standard Process Nutrition Meeting in my office is on Thursday, February 26th at 10:30 am. Posting this week: For sale Summit X-ray machine in excellent condition .. DC is looking for an excellent quality patient educational DVD and projector screen .. For sale Quick Notes Chiropractic Note Software System .. For sale VAX-D table in Atlanta, Ga E-mail message this week .. Continuity I attended a great seminar this past weekend. Dr. Pete Fernandez capped his personal injury seminar with a mock trial. He brought to Atlanta a defense and plaintiff attorney as well as a judge from Okalahoma to review a doctors case file and prepare for an actual trial, similar to what we see on court TV. Of interest, was the discussion before and after the trial. The weakness of the case was presented by the plaintiff attorney, the patient's lawyer, after reviewing his client doctor's file and mentioned a strong phrase and often overlooked problem, the doctor's file had "too much noise." There was too much fluff, too many questionnaires with conflicting answers that added fuel to the defense side, the insurance company attorney, and created nightmares for the patient's attorney. The defense attorney during his cross-examination ripped the chiropractor's testimony to pieces and with ease based solely on the records in hand. He described how easy we doctors make their case and agreed with the other attorneys assessment. Doctor, how often do you review every line and every checked box on your case history forms whether for general wellness or specific accident review? I realize that I've been sloppy and my records have way to much noise. What is noise, well, if an attorney is ready for trial, they usually request your records, this is called discovery. During their review, they look for inconsistencies, such as you writing one thing and the patient writes another. Your case history and your narrative mentions the patient looking to their passenger or reaching for something in their vehicle prior to the collision leaving the perception that they were negligent and part and parcel for the collision, your exam notes cervical flexion at 25 degrees while a flexion x-ray, taken the same day, is more than normal, your SOAP notes are too sudsy with little supporting your continued or therapeutic treatment and I can go on. For a sharp attorney this is a gold mine, a file screaming with contradictions and reasons to drill the doctor if there was a trial. What's a good doctor to do? Leave out the fluff, it doesn't create a better case for you or the patient and is less than objective as it is "hearsay," or what the patient describes rather than your objective observations and findings regardless of the mechanics presented to you. We can have a healthy debate of the message above, whether there is fluff or noise but for sure, every doctor reading this needs to review their record keeping, case management, proper review of all records and be as able and diligent as the continuity professional on the TV series 24. This is one day in the life of Jack Bauer, over a 24 hour, multi week period. What any member of the series looks or wears from hour one needs to be the same at hour 24. Look at the credits of a movie or TV series and you'll find someone dedicated to be watchful and mindful that every detail is accounted for. Is there such a person in your office, someone able to scan the case history forms, be assured that every office procedure was provided the patient, referrals were asked and generated, public relations and marketing was on going and nothing is left behind. Now that's a full time job and a huge task but be assured if implemented, the results would be incredible Find the continuity and you'll continue with success Have a Great Day Dr. M Postings: Dr. Joel E. Margolies or www.chirosmart.net have no responsibility for anything posted or purchased either on the website, message board or within his weekly e-mail. Responsibility is strictly between the parties deciding to either post or purchase For sale Summit X-ray machine in excellent condition: Reply to: glshaw@juno.com DC is looking for an excellent quality patient educational DVD and projector screen: Reply to: waldhorn@comcast.net For sale Quick Notes Chiropractic Note Software System: $1900, new system sells for $2700. Price includes transfer fees, installation support, training, 6 months of customer support, and all updates. Also includes: two wall charts, credit card-sized wand, patient labels, charger, and all cables. Reply to: falite@bellsouth.net For sale VAX-D table in Atlanta, Ga: Immaculate, low usage with belts, harness and supplies. Value price at $25,000. Bid via e-bay at: http://cgi.ebay.com/ws/eBayISAPI.dll?ViewItem&item=180327921672&ssPageName=A DME:B:EF:US:1123 Current bid is $12,998. Auction ends Friday 2/20/2009.