UNSTUCK

R.J. Hammett, DC

The old axiom is true; if you’re digging a hole in the wrong direction, stop digging!! Having practiced from 1980 to present, I’ve seen at least two financial/economic recessions. Both had similar psychological effects on the public and in Chiropractors’ practices. First, the sky was falling. Second, what do I do now?

In a minimal study of both national and state associations, chiropractors’ incomes and patient volumes are down 25% to 35% across the country. Fortunately, not everyone has decided to participate in this down turn. It’s all about your focus and where your head is at and not what’s going on outside. Don’t get me wrong, the economy does affect your practice and life, but your job is to adapt to the environment, much like an adjustment allows the body to adapt to its environment. It’s curious that I have friends who practice in the worst depressed cities in the country helping 60 to 80 new patients a month. I have friends who are laying off staff, working longer hours, and seeing 5 to 6 new patients a month in relatively sound economic cities. The difference is their perception of what and who is their focus.

Today, right now, look at your attitude, your staff’s. What are you focused on? Old Dr. Gonstead used to say, “I have one patient that’s before me right now, not the one hundred plus waiting in the reception room.” That’s exactly where your head must be at. What can I do for this patient, right now, right here?

Here’s your exercise for 2010:

1. Only focus on what you can fix, not what you can’t.

2. Look to your patients for answers to growth in your practice. It is your hours? Your fees? Your staff? Your attitude? Your treatment? Whatever they tell you to do, do it.

3. Forget yesterday, last year, or anything from your past…you can’t go forward until you let go of the past.

4. Clean up your home, your clinic. Clean up anything you are not using. Get simple, get free.

5. Do something you’ve never done before, especially something you are afraid of.

6. Write down your goals and get pictures of them. Look at them daily.

7. Get rid of negative friends, peers, or anyone who doesn’t add to the quality of your life.

8. Be grateful that people trust in your ability to help them become healthy. It is, after all, a privilege to help others, no an obligation.

9. Get real with people. Tell them the truth of chiropractic. Quit being a pseudo-medical wimp. Quit buying and using practice gimmicks.

10. Have fun, laugh more, and live more. Remember, you can’t get out of life alive, so act like it.

11. Fear nothing.

Till Next Time…

Pre-Existing Injuries and Why They Increase the Value of an Injury Claim!

Matthew D. Powell,
Board Certified Civil Trial Attorney - Florida
Matthew Powell is a board certified civil trial lawyer in Tampa, Florida, who started his career representing over 20 insurance companies. After learning the defense side, he quickly found he could not represent insurance companies and started out on his own to represent injured victims. He is a frequent speaker and instructor, teaching lawyers and chiropractors how to sharpen their skills in trying low-speed rear-end car collision cases. He has had the honor of obtaining $1,000,000 verdicts for his clients. He can be reached at matt@EPTInjuryLaw.com.

INTRODUCTION
An all too common problem is the patient with pre-existing conditions or injuries who comes to you for care after a car crash. You may ask, how should this be handled? Very often I hear lawyers and doctors try to ignore, forget, or bury the prior injury or condition. This is a recipe for disaster. By down-playing the pre-existing condition, it will destroy the patient’s credibility with a jury and the insurance adjuster. Omitting or down-playing the pre-existing condition also makes the doctor look really bad on the stand and results in a win for the defense team. The defense will know about every prior insurance claim thanks to Insurance Office Service, Inc., which for $25.00 will provide a full report of any and all insurance claims in their massive data base. The good news is that the law is generally quite helpful for the patient who suffers from a pre-existing condition.

The law basically says:
“If the patient’s injury (from the new car crash) resulted from an aggravation of an existing injury or disease (such as degenerative changes), the jury should attempt to determine what portion of the patient’s condition was caused by the car crash. If the jury cannot determine what new damages were caused by the crash, then the jury is told to award damages for the entire condition.”

So the good news is that a pre-existing condition does not hurt the patient’s claim. In my opinion, it makes it easier to explain to a jury why it does not take as much trauma to injure my client considering they were already suffering from the pre-existing disease or condition. So this really helps with the causation issue in a low speed crash. Juries get it that the recent car crash is really the straw that broke the camel’s back.

Once the jury understands that the crash caused the bigger problem, they have a hard job separating the new injuries from the old ones. If they can’t clearly separate the old injuries from the new ones, then they should award damages for everything.

As a practical matter, you have to really educate your patients about why a pre-existing condition can help their case. If they understand the implications of the pre-existing condition to the value of their injury case, they will give you a better history. They won’t be tempted to forget about their old problems in hopes it will help their case.

At trial, when my client has pre-existing injuries, I always bring this out early so that everyone knows we are not trying to down-play them. When I call my client to the witness stand, I will ask them a line of questions about how did they feel five minutes before the crash? Was their old neck injury bothering them at that time? How about one hour before? How about one day before the crash? When did it last bother you before this crash? “Oh, I was doing very well for about ____ months. Then I will ask, how did it feel after the crash? “Oh, it was terrible, it was like 3 times worse than it had ever been before.”

Then, when I call my doctor to the stand, we talk about how my client was damaged goods before this crash due to the pre-existing conditions, and why they have been hurt more easily by the crash and why the injury is more serious than someone who did not have these pre-existing conditions.

If we are lucky enough to have digital motion X-rays taken before the car crash, then I request a second digital motion X-ray taken after the crash to compare the studies. With the PostureRay’s (from PostureCo www.postureco.com) help, we can make great objective comparisons between the two studies. The PostureRay allows us to accurately show how much more the pre-existing condition has been made worse due to the crash.

SUMMARY
Don’t be shy about pre-existing conditions. Embrace them for what they are, often times, you can ethically use them to increase the value of your patient’s legal claim, not reduce it.

Chiropractic BioPhysics, Instability Ligament Laxity, PostureRay, whiplash, x-ray digitization software, Digital Motion X-Ray DMX