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Hi, I am Dr. Mark Studin, and today with ChiroSecure, we’re gonna bring you some kind of generational information about our profession and it’s about chiropractic’s, reputation. Honestly I’ve been in the game for 44 years and I’ve seen a lot. Perhaps more than most, probably because I’m older than most, or been in the game more than most.
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But I also, I consult doctors in 49 states and I’ve lectured to over 400,000 attorneys in 40 states. And I speak to attorneys inside insurance companies and claims reps. And I am I teach at three chiropractic colleges at various levels. I teach at a medical school. I’ve been published in the NIH 56 times with 10 more papers ready to that’s in peer review right now.
And I speak to a lot of people and I listen. I listen actually more than I speak, which is the exact opposite of these presentations, but it’s about the next generation and securing the next generation. And at the same time, can you secure tomorrow in your office by also securing the next generation?
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Now, here’s the truth, and I’m into truth. The truth is chiropractors are considered. To be below a physical therapist and above a massage therapist, and I’m not talking about your patients. Listen, I just had a patient last month regain their hearing. It’s my third patient in my career. God, I felt like Dd Palmer and Harvey Lola, but she regained her hearing.
I’ve had patients regain their breathing when they were asthmatic and eczema’s go away, and the count was literally countless of low back cases and neck pains and a whole bunch of other systemic issues. I’ve watched the miracles of chiropractic and our patients think we can walk on water.
They think we’re incredible. They love us, we’ve given them their lives back. But again, we’re still mired in a percentage of utilization and I’ve seen published reports say, oh, it’s a, we’re 12, 14% utilization. I don’t see evidence of that. We’ve been in a, we’ve been in a cycle between seven and 10% utilization for decades, and part of it is because our reputation is mired and things that really don’t support the profession is growing.
Now, someone once said to me that medicine is going to be the ones that’ll validate chiropractic, and I never understood it. I do now really well because for the past 10, 15 years we’ve been working with the State University of New York at Buffalo School of Medicine in a department of the Office of Continuing Education or the Department of Medicine, department of Family Medicine.
And I’ve been working intensely and getting chiropractors accredited through medical academia in the same courses because it’s a co-sponsorship with Cleveland University college of Chiropractic in Kansas City. I’ve been working with Dr. Cleveland and his staff to get, courses approved, but, and then working with the SUNY State University of New York, SUNY Buffalo Medical School to get courses co-sponsored.
It’s the same level of academics, but when I walk into a physician, a medical physician’s office, a family practitioner, ortho, neuro neurosurgeon, I start talking to them about slice thicknesses of MRI and extrusions that are commune versus, fragmented and I talk about doing a T two fat saturation.
They go, you’re only a chiropractor. Where were you trained? And I tell them through the State University of New York at Buffalo School of Medicine. Really? I just went from a lowly chiropractor below that of a PT to a peer. But it’s a lot more than that. And I’ll get back to that in a minute when we do our reports.
And I created a new EHR system because I just couldn’t stand the ones in our industry anymore. They were hurting us at every level. They look horrible. They don’t, there’s no guardrails for compliance. And you have a profession of doctors, too many of whom cut corners and the corner cutters are hurting us.
Simple things such as vitals, height, weight, blood pressure, pulses. First of all, your license mandates that you do a whole bunch of those things. Actually, all of them in virtually every state. If your patient has a stroke and you didn’t take their blood pressure and they went to the ER and their blood pressure was two 40 over one 90, be prepared to kiss your license.
Goodbye. But we should be doing that as proforma. And you don’t even have to do it. Your staff can do it with one of those automatic cuffs you can get from the drug store at the corner that costs 40 bucks. And then because there’s no decision making, it’s all automated and it goes in your report. And it should, for every single evalue, doing every reval to ensure your patient has a level of stability.
Because when a co-treating doctor gets your report and they get it, how do they get it? They get it usually in personal injury or workers’ comp cases when the lawyer gets your records and shares them, or you have a licensure issue and they don’t see those things, or patients come in and you don’t do those things and they expect that in a real doctor’s office, it’s actually a responsible thing to do.
It protects the public, but when you don’t do it and people don’t see it. Gimme a break. You’re not a real doctor. That’s what real doctor is doing. You know what? I agree with that statement because if someone, chiropractors don’t cause strokes, we don’t cause dissecting aneurysms. But you know what we do?
If a patient’s in the middle of undergoing a stroke incident, we don’t, we’re not able to determine that. We don’t understand what that looks like. And by the word sudden. Is what it looks like. Sudden headache, sudden diplopia, sudden ataxia, sudden ringing of the ears, sudden in conjunction with, or independent of trauma.
So that word sudden is a key. And if you have out of control, high blood pressure, listen, you can adjust ’em until the cows come home. They’re set up for a stroke or a heart attack. That’s what they’re set up for. They might need some immediate urgent care. You could put ’em on a diet to lose 50 pounds and it’ll work six months from now, four months from now.
But what’s happening between now and then? And you give ’em a rah session and they go back out and they’re eating their McRibs, for breakfast and their McGriddles for lunch and their, their 63 pounders for dinner with 14 gallons of coke in the middle. You could adjust them all you want, but they’re going back to their old habits.
And the reality is some people do change tremendously, but if they’re in an urgent scenario and they have a heart attack or they have a stroke and they take a history, which doctor have you been saying? I saw my chiropractor. Did he take your blood pressure? No, he told me to lose weight. Did he take your blood pressure, your pulse?
No. I had a patient die in my arms. From a dissecting aneurysm in the 1980s in my parking lot, I got a call the next day from the medical examiner looking to arrest me and that for wrongful death, and I was told that they knew the patient didn’t come in the office. They that I just wanted to confirm that with me.
I met him in the parking lot. I actually spoke to them first and told ’em to go to the emergency room if I didn’t do that. Then he said the next step was to look at your records if you didn’t take their blood pressure. Then I would’ve arrested you for wrongful death. But thankfully we didn’t get that far.
But this stuff is real. And when they see you don’t do those things. You know what? You’re not a real doctor. What about review of systems first? Even if you bill a 9, 9, 2 0 2, you need to do a focused one. Past family social history. This is what in every specialist report. You want to be considered a specialist.
You want to be considered even a family chiropractor, a family practitioner. I don’t want, I don’t want to be a neurosurgeon. I don’t want you to be a neurosurgeon. I don’t want that. I love chiropractic. It does wonderful things Surgeons can’t do, no desire to give drugs and cut people open. Zero zip, not as zilch.
But when you look at a neurosurgeon’s report, you’ll see vitals, past family, social history, review of systems with virtually every single report. Every one, and that’s the standard that we’re judged by. The neurosurgical reporting standard, which just happens to be the many code standard for what you need in a report.
Even with timed using time versus elements in what your licensure board needs to see and listen, bad things happen to good people. Eventually, if you’re in the game long enough, patient’s gonna have a heart attack, have a stroke something. Your reports are gonna go perhaps to a licensure board. I’m defending a doctor right now in Minnesota for licensure issues, and it’s no different than the doctor in New York, New Jersey, California, Texas, Georgia, Florida, Oklahoma, that I did in the past, and it’s the same thing.
Your notes didn’t meet the standard of your code, the notes didn’t meet the standard of your diagnoses. The basics of ensuring the patient’s safety was not performed. I’ve seen that time and time again. Oh, they’re after me. They’re after car. No, they’re not After. They’re not after you. You have a standard of license, but all of that leads to chiropractic’s reputation.
One of the things I’ve done and I’ve become a professor, an adjunct professor at the State University of suny SUNYs, UNY, SUNY Buffalo Medical School, department of Family Medicine. I am a co-author and or a peer reviewer in the National Institute of Health, national Institutes of Health, NIH. And we’re putting case histories right now up and we published 56 this past year.
And we have Ted Moore on the hopper, the peer reviews to go in and it’s all on pro chiropractic literature. All pro chiropractic case reports, who reads, those medical residents have to go through those in their training. And the NIH has a huge reach. It’s through Research Gate and they get millions and millions of hits every single year.
We’re being seen on a regular basis. I get notes from them and emails. You’re being read, you’re being read. I pub, I post that on the US Chiropractic directory and the research portal. By the way, this is free for the world to look at. And as of this morning, I had 43,988 views of those research articles around the globe.
The US Chiropractic directory has gotten 23 million hits on other pro chiropractic research, but which are really white papers that I authored, a co-authored quoting research. But now we’ve got the power of the NIH behind us and medical academia validating chiropractic by co-sponsoring and posting these articles.
And they’re wonderful. They’re all with imaging showing what we do. So this is how we bolster chiropractic’s reputation. Look at the courses you take and the postdoctoral courses you take. Look at the courses. Is it philosophy, is it always the same Kinesio tape And year after year, do you sit in the classes and bring your phone and play, Wordle or whatever you play?
Or do you take substantive courses, which will give you real credentials? We’ve gone and created real credentials. We’ve created at the very top, the fellowship. It’s a two year program, which is about 370 hours of academic training with live mini fellowships embedded within that in MRI Spine and MSK extremities.
We’ve also created qualifications, medications recognized through Cleveland University, Kansas City Chiropractic and Health Sciences with all courses co credentialed through SUNY Buffalo Medical School. In trauma care in MRI, spine, interpretation in evaluation and management in primary spine care and primary spine care just means you’re the first referral option for spine.
That’s all it means. But now on your cv, which is your new business card, it says Medical school. Medical school. Medical school. Medical school. Now say you are on one main street in Colorado Springs. I open an office across the street from you on two main street in Colorado Springs, and a referral source comes and says, Dr.
Smith, the guy across the street, tell me about you and why I should refer my patients to you on the local orthopedic surgeon. And you say I’ve been a chiropractor for 25 years. I’m really good at what I do. My patients get well. I use the most advanced techniques. I’m very involved in the Colorado Chiropractic Association.
I. I’m involved in my church, my synagogue. I volunteer for Little League. I do a lot of charity work, but really my patients love what I do. Oh, great, doc. Thank you so much. And then they come to me and they say, doctor, Studin, tell me why we should refer to you. I’ve been in practice for 25 years and I’ve practiced the latest techniques.
I’m involved in the chiropractic, the Colorado Chiropractic Association. I’m involved in my church synagogue and I do a lot of charity work. The thing that I’m the most proud of is I’ve been published in the National Institute of Health for Spine four times this year and three times last year.
I’m trauma qualified with courses recognized in the State University of New York, Buffalo School of Medicine. I’ve also got a mini fellowship in MRI spine through the same medical institution. And I’m continuing my, my, my academics right now towards my full fellowship in primary spine care, which is perhaps one of the highest academic honors we can achieve in our industry, in really the most in invalidating that I’m credentialed in the most cutting edge techniques in our industry.
Who’s gonna get the referrals? The guy across the street of me. It’s easy. I am, I just made that person irrelevant. But who am I talking to? I’m not talking to my mom. I’m talking to a lawyer who’s got personal injury cases, who wants to put me up on the witness stand, at least in his mind, even though we both know we’re never gonna get there, he needs credentials.
We’re talking to the family medical doctor around the corner. I. Who’s gonna say, oh, you’ve been published in the NIH. You’ve been trained in medical academia. I’m going to you the ortho neuro neurosurgeon. You might have a follow up question and say, Dr. Studin, what slice thicknesses do you think, and I’ve gotten this so many times, it sounds ridiculous.
It might not be in your world, but it’s in their world, especially the ortho spine surgeons and the neurosurgeons. What slice thicknesses do you recommend in the cervical spine? And I’m gonna say it’s easy. The American College of Radiology allows three millimeters. I want two millimeter slices, but I want ’em cleaned through the disc.
I don’t want to touch the end plates, so it’ll overshadow any pathology. In addition, I want a T one, I want a T two. I want a stir or a T two fat set. That’s really important and I want the axials corresponding to that. And with that, if there’s any neurological deficit. A compression or abutment on the court of the roof.
I’m gonna send ’em to you for consideration of collaboration to see if anything else should be done while I treat them conservative, conservatively, if it’s still indicated. However, if there is any abrupt motor laws, I’m not gonna touch ’em until I collaborate with you First. They go, are you, this is what we get.
Are you sure you are a chiropractor? I said, yeah. Where were you trained? I went to New York Chiropractic College, graduated in 1981. But the reality is I got the bulk of my training through the State University of New York at Buffalo School of Medicine and my fellowship training program, and this is what we do.
I have a neurosurgeon in the community that I’m very close with, and he said to, I said, why don’t you refer more to chiropractors? He said, because they’re not you. No one knows anything. I talk to them. I feel like I’m talking to idiots. I’d rather refer to a physical therapist. They’re really good at what they do when they stay in their lane.
If you were in practice, you would get 100 of my patient, 100% of my patients that are spine to screen before I see them. And I have doctors around the country who are doing that with neurosurgeons fellows in our program, people who are highly trained, who are screening all the patients for the neurosurgeons.
This changes our reputation. When you look at your EHR system, are you still referring to a patient by their first name? It’s a joke. I saw Jane yesterday and she complained up. Jane, only US demented chiropractors do that. It’s absurd. You do you have relations with Jane when you’re done? Do you smoke a cigarette?
Look her in the eye and batch your eyelashes? Gimme a break. I saw Mrs. Jones yesterday. It’s a formal report. Don’t put the patient’s first familiar name. It renders an error of prejudice. And you’ll get nailed if you’re doing personal injury on that. But you’ll be the joke actually you’ll be the joke at the next physicians or medical doctor meeting.
They’re gonna pass. Oh, look at this chiro. Hes doing Jane and even said so on the report. He’s all over. Jane. Jane. But think about that. It fir, it perpetually denigrates our profession. It denigrates your office. Some people, I have people getting 70, 80 referrals a month selectively choosing who they’re taking, whether it’s personal injury, whether it’s managed care, and a lot of doc.
And those doctors are no longer taking those horrible managed care programs that we have in our industry that’s destroying the fabric of our of our profession. Most of those doctors won’t take them. You shouldn’t either. Because they all have middlemen that have DC after the names that are raping you financially.
When you get 20, 30, 35, or even 40 bucks a visit in one of those managed care companies, there’s middlemen usually that are chiropractors that are taking money from you each visit for just creating a network. So I would really consider long and hard before you work with that. That hurts our profession.
But you are hurting our profession also by cutting corners. No vitals, no review of systems, cranial nerves, just simple stuff. A full neurological and orthopedic examination. The average chiropractor, including documentation is about 45 minutes into a patient. You should be doing a report a reevaluation every 30 days.
Not every 12 visits, not every 33 months, every 30 days. It’s usual and customary. I do this with licensure boards. I defend doctors and RICO cases. I have relationships with the attorneys who go after them. So if you wanna know why our profession is being denigrated, because you’re corner cutting, it’s just as easy to do it right as it is to do wrong.
I work very hard to create EMR Chiro, which is an EHR system. And it’s built on the Advanced MD platform, and there was no chiropractic provisions in there. I rewrote the whole thing. It took me 14 months at 60 hours a week and learn four computer programs to create this and put guardrails in. So if you don’t have the EHR chiro system, which you should go to your system and put your own guardrails in, ensure you do things like stroke screening, that’s critical.
That needs to be there. That protects the public. Oh, I’m gonna, I’m gonna, I’m gonna palpate, do a range of motion, see if muscles are spastic. Now I’m gonna treat them. I see that time and time again. Be careful. Be careful. You’re hurting your reputation, you’re setting yourself, you’re exposing yourself, you’re setting your set up to be sued to lose your license.
You potentially can hurt your patients, which is the most important thing. You’re not following what you’re supposed to do and playing by the rules. And more importantly, you’re hurting our profession. So if you ever want to gimme a jingle, I’m more than happy to chat with you about this. My phone number is (631) 786-4253.
That’s 6 3 1. 7 8 6 4 2 5 3 or just Google my name. It’s all over the place. So again, I want to thank ChiroSecure from the bottom of my heart for giving me the opportunity to be able to share and help perhaps raise the perception of chiropractic through the actions of each individual chiropractor.
Again, have a wonderful day and we’ll see you next month.
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