Re: I am really pissed off! (pardon the language)

[Guest guest]

,

As I understand it, deconditioning is a phrase to define people who are flabby, out of shape and in general poor health due to 'lack of condition'. That's what I've considered it to be when I've heard the term. I do think, honestly, that people can have chronic pain due to lack of regular exercise program. The key here is that they must have this pain prior to the MVA in order to exclude treatment or call treatment unreasonable. Otherwise, how do they suddenly have pain form lack of condition? I would be able to argue the point that given two patients of the same age and sex, One a flabby, out of shape person with no pain; the second a person in good physical condition who is also in no pain; (hang in there for my long run on sentence!) both in an MVA of equal intensity. OK with me? The in shape one will recover sooner and have a reduced potential for chronic pain. I can also argue that a person in great shape who's in an accident and loses the ability to keep up with their exercise plan will lose some conditioning. Thus deconditioning. I personally believe it's that patient's right to be treated until they reach their pre-accident condition. They should be allowed to recover from 'deconditioning' caused by the accident. I see this often and am very willing to argue that point with any claims rep.

Minga Guerrero DC

Portland OR

In a message dated 1/7/2003 6:47:15 PM Pacific Standard Time, drmfreeman@... writes:

Docs,

I am truly steamed. I am reviewing a Defense Medical Exam from Medical

Consultants Network, Inc. that is part of a file that I have been asked to

review by the defense. The two doctors who examined the plaintiff were a

Lynn Bell MD (a neurologist who ALWAYS finds against the patient) and a

chiropractor with a similar reputation who I believe is a member of this

listserve, and thus I will not name him, per our rules below. The man was

significantly hurt in the crash, which was a substantial rear-impact/frontal

impact, and had about 9 months of chiropractic treatment prior to the DME,

which was performed in September of 2001. At the time of the exam the man

was still significantly symptomatic (although the DME docs did everything

they could to minimize his complaints), and according to records that I have

subsequent to the DME he sought treatment from MDs and PTs and a DMD for TMJ

pain, among other problems.

Regardless of the continued symptoms and objective findings of injury, no

review of imaging or suggestion for the further diagnostic workup, the

perpetrators of this sham evaluation concluded that "the initial injuries

would be attributed to the motor vehicle accident (sic). The continued

complaints of pain would probably be an issue of deconditioning as opposed

to any traumatic injury."

I have a question for you honest docs out there - what's the ICD-9 code for

"deconditioning." How does deconditioning cause neck pain, TMJ pain, and low

back pain? What is deconditioning? How do you grade it? What is the evidence

of it? What tests did these or any other sell-out doc ever do to test the

condition of a patient diagnosed with chronic pain resulting from

deconditioning?

This is just another reason for ODOC to join with the CAO in supporting a

bill in the upcoming legislature to regulate DMEs.

Until that time how about this suggestion; why can't the OBCE form a

peer-review committee for the single purpose of judging the professional

conduct of docs who do DMEs? I will volunteer to be the first member. Anyone

else with me on this one?

D Freeman

Mailing address: 2480 Liberty Street NE, Suite 180

Salem, Oregon 97303

ph 503 763-3528

fax 503 763-3530

cell 503 871-0715

[Guest guest]

,

Re:

> Regardless of the continued symptoms and objective findings of injury, no

> review of imaging or suggestion for the further diagnostic workup,

I think it is considered a violation of OBCE Rules to fail to request and

evaluate existing imaging while perpetrating (I mean performing) a DME or

any other exam.

It may also constitute a violation to ignore objective findings in reaching

a diagnosis. On the other hand, if peers review objective findings and reach

a completely different conclusion, it may constitute failure to dx. due to

incompetence. Of course there are plenty of defense attorneys who will

defend a doctor's right to be incompetent.

If Jack is involved, I suppose I'll have to be involved. SOMEONE has to show

up to interpret for the country boys. (That thar set of objectionable

findin's aint akin to a pair o' skunk chaps on a wort hog's behind. That

thar's my fanal answer!)

Seriously though, I hope you all realize that Jack is considered one of the

finer minds in chiropractic. He fairly, honestly, and competently, sorted

through forensic evidence for Peer Review which would make a bank auditor

blanche.

--

E. Abrahamson, D.C.

Chiropractic physician

Lake Oswego Chiropractic Clinic

601 First Street

Lake Oswego, OR 97034

503-635-6246

> From: " Dr. Freeman " <drmfreeman@...>

> Date: Tue, 7 Jan 2003 18:45:06 -0800

> " Oregon DCs \(E-mail\) " < >

> Subject: I am really pissed off! (pardon the language)

>

> Docs,

> I am truly steamed. I am reviewing a Defense Medical Exam from Medical

> Consultants Network, Inc. that is part of a file that I have been asked to

> review by the defense. The two doctors who examined the plaintiff were a

> Lynn Bell MD (a neurologist who ALWAYS finds against the patient) and a

> chiropractor with a similar reputation who I believe is a member of this

> listserve, and thus I will not name him, per our rules below. The man was

> significantly hurt in the crash, which was a substantial rear-impact/frontal

> impact, and had about 9 months of chiropractic treatment prior to the DME,

> which was performed in September of 2001. At the time of the exam the man

> was still significantly symptomatic (although the DME docs did everything

> they could to minimize his complaints), and according to records that I have

> subsequent to the DME he sought treatment from MDs and PTs and a DMD for TMJ

> pain, among other problems.

> Regardless of the continued symptoms and objective findings of injury, no

> review of imaging or suggestion for the further diagnostic workup, the

> perpetrators of this sham evaluation concluded that " the initial injuries

> would be attributed to the motor vehicle accident (sic). The continued

> complaints of pain would probably be an issue of deconditioning as opposed

> to any traumatic injury. "

> I have a question for you honest docs out there - what's the ICD-9 code for

> " deconditioning. " How does deconditioning cause neck pain, TMJ pain, and low

> back pain? What is deconditioning? How do you grade it? What is the evidence

> of it? What tests did these or any other sell-out doc ever do to test the

> condition of a patient diagnosed with chronic pain resulting from

> deconditioning?

> This is just another reason for ODOC to join with the CAO in supporting a

> bill in the upcoming legislature to regulate DMEs.

> Until that time how about this suggestion; why can't the OBCE form a

> peer-review committee for the single purpose of judging the professional

> conduct of docs who do DMEs? I will volunteer to be the first member. Anyone

> else with me on this one?

>

>

> D Freeman

> Mailing address: 2480 Liberty Street NE, Suite 180

> Salem, Oregon 97303

> ph 503 763-3528

> fax 503 763-3530

> cell 503 871-0715

>

>

>

> OregonDCs rules:

> 1. Keep correspondence professional; the purpose of the listserve is to foster

> communication and collegiality. No personal attacks on listserve members will

> be tolerated.

> 2. Always sign your e-mails with your first and last name.

> 3. The listserve is not secure; your e-mail could end up anywhere. However, it

> is against the rules of the listserve to copy, print, forward, or otherwise

> distribute correspondence written by another member without his or her

> consent, unless all personal identifiers have been removed.

>

>

[Guest guest]

729.89 postural fatigue possibly supported ala Farfan?

Deconditioning is as rampant as obesity.

Deconditioning is very likely the single most common source of chronic axial

pain. Any chronic pain patient that is not engaged in a muscular

strengthening and aerobic conditioning program is not likely to overcome

this deficiency. The only way a patient will " recover " while deconditioned

is to progressively do less and less. Ultimately everyday tasks may become a

source to feed the cycle of strain and chronic pain. Sad but true. Again

this demonstrates that subluxation is not the primary cause of pain but the

multifactorial result of abnormal structure and function; just as DD Palmer

said: " . . . too much or not enough tone " .

Willard

I am really pissed off! (pardon the language)

Docs,

I am truly steamed. I am reviewing a Defense Medical Exam from Medical

Consultants Network, Inc. that is part of a file that I have been asked to

review by the defense. The two doctors who examined the plaintiff were a

Lynn Bell MD (a neurologist who ALWAYS finds against the patient) and a

chiropractor with a similar reputation who I believe is a member of this

listserve, and thus I will not name him, per our rules below. The man was

significantly hurt in the crash, which was a substantial rear-impact/frontal

impact, and had about 9 months of chiropractic treatment prior to the DME,

which was performed in September of 2001. At the time of the exam the man

was still significantly symptomatic (although the DME docs did everything

they could to minimize his complaints), and according to records that I have

subsequent to the DME he sought treatment from MDs and PTs and a DMD for TMJ

pain, among other problems.

Regardless of the continued symptoms and objective findings of injury, no

review of imaging or suggestion for the further diagnostic workup, the

perpetrators of this sham evaluation concluded that " the initial injuries

would be attributed to the motor vehicle accident (sic). The continued

complaints of pain would probably be an issue of deconditioning as opposed

to any traumatic injury. "

I have a question for you honest docs out there - what's the ICD-9 code for

" deconditioning. " How does deconditioning cause neck pain, TMJ pain, and low

back pain? What is deconditioning? How do you grade it? What is the evidence

of it? What tests did these or any other sell-out doc ever do to test the

condition of a patient diagnosed with chronic pain resulting from

deconditioning?

This is just another reason for ODOC to join with the CAO in supporting a

bill in the upcoming legislature to regulate DMEs.

Until that time how about this suggestion; why can't the OBCE form a

peer-review committee for the single purpose of judging the professional

conduct of docs who do DMEs? I will volunteer to be the first member. Anyone

else with me on this one?

D Freeman

Mailing address: 2480 Liberty Street NE, Suite 180

Salem, Oregon 97303

ph 503 763-3528

fax 503 763-3530

cell 503 871-0715

OregonDCs rules:

1. Keep correspondence professional; the purpose of the listserve is to

foster communication and collegiality. No personal attacks on listserve

members will be tolerated.

2. Always sign your e-mails with your first and last name.

3. The listserve is not secure; your e-mail could end up anywhere. However,

it is against the rules of the listserve to copy, print, forward, or

otherwise distribute correspondence written by another member without his or

her consent, unless all personal identifiers have been removed.

[Guest guest]

Courtroom mistake # 1 - expecting justice to be served inside a courtroom.

Examples:

The Stella's are named after 81-year-old Stella Liebeck who spilled coffee on

herself and successfully sued Mcs. That case inspired the Stella Awards

for the most " uniquely successful " lawsuits in the United States for last

year.

Brought to you by the good old US Justice System, the following are this

year's candidates:

- Kathleen on of Austin, Texas, was awarded $780,000 by a jury of her

peers after breaking her ankle tripping over a toddler who was running inside

a furniture store. The owners of the store were understandably surprised at

the verdict, considering the misbehaving little toddler was Ms.on’s

son.

- A 19-year-old Carl Truman of Los Angeles won $74,000 and medical expenses

when his neighbor ran over his hand with a Honda Accord. Mr. Truman

apparently didn't notice there was someone at the wheel of the car when he

was trying to steal his neighbor's hub caps.

- Terrence Dickson of Bristol, Pennsylvania, was leaving a house he had just

finished robbing by way of the garage. He was not able to get the garage door

to go up since the automatic door opener was malfunctioning. He couldn't

re-enter the house because the door connecting the house and garage locked

when he pulled it shut. The family was on vacation, and Mr. Dickson found

himself locked in the garage for eight days. He subsisted on a case of Pepsi

he found, and a large bag of dry dog food. He sued the owner's insurance

claiming the situation caused him undue mental anguish. The jury agreed to

the tune of $500,000.

- Jerry of Little Rock, Arkansas, was awarded $14,500 and medical

expenses after being bitten on the buttocks by his next-door neighbor's

beagle. The beagle was on a chain in its owner's fenced yard. The award was

less than sought because the jury felt the dog might have been just a little

provoked at the time by Mr. who was shooting it repeatedly with a

pellet gun.

- A Philadelphia restaurant was ordered to pay Amber Carson of Lancaster,

Pennsylvania, $113,500 after she slipped on a soft drink and broke her coccyx

(tailbone). The beverage was on the floor because Ms. Carson had thrown it at

her boyfriend 30 seconds earlier during an argument.

- Kara Walton of Claymont, Delaware, successfully sued the owner of a night

club in a neighboring city when she fell from the bathroom window to the

floor and knocked out her two front teeth. This occurred while Ms Walton was

trying to sneak through the window in the ladies room to avoid paying the

$3.50 cover charge. She was awarded $12,000 and dental expenses.

- This year's favorite could easily be Mr. Merv Grazinski of Oklahoma City,

Oklahoma. Mr. Grazinski purchased a brand new 32-foot Winnebago motor home.

On his first trip home, having driven onto the freeway, he set the cruise

control at 70 mph and calmly left the drivers seat to go into the back and

make himself a cup of coffee. Not surprisingly, the R.V. left the freeway,

crashed and overturned. Mr. Grazinski sued Winnebago for not advising him in

the owner's manual that he couldn't actually do this. The jury awarded him

$1,750,000 plus a new motor home. The company actually changed their manuals

on the basis of this suit, just in case there were any other complete morons

buying their recreation vehicles.

[Guest guest]

Well ya but....

Ok so deconditioning and obesity kinda' (spelling such as this is for the J.

Pedersens of the world!) go hand in hand or tend to co-exist. Obesity has

been associated for years with symptoms such as adverse fat distrubution and

multiple secondary disorders, including of course low back pain (or at least

we always assumed such).

Obesity is defined as being 30% over ideal weight, which influences normal

body mechanics as well as recovery from musculoskeletal injury.

Facet joints have been described as contributing to a significant proportion

of patients suffering with persistent or chronic recurrent lower back pain.

Since an obese patient is at a higher risk (or are they) of disability

compared to a patient with normal weight, obesity has been described as a

confounding variable in recalcitrant low back pain.

Last year a study was published in the journal " Pain Physician " somewhat

conflicting with what Willard suggests and what you and I have always

believed.

This study of 100 folks, 50 in " Group I " which were of normal weight and 50

in " Group II " who were considered obese, by random allocation was used.

Facet joints were investigated with diagnostic blocks using 1% lidocaine

initially, followed by 0.25% bupivacaine.

The results showed that the prevalence rate of facet joint pain in chronic

low back pain in Group I (normal weight folk) was 36%, in the obese (Group

II) folks the prevalence was 40%, with no significant differences among the

two groups.

The studies conclusion:

" It is concluded that the prevalence of lumbar facet joint mediated pain of

40% in obese patients and 36% in patients with normal weight with a

false-postiive rate of 33% in obese patients and 44% in nonobese patients is

similar to the results of multiple previous studies concluding that facet

joint mediated pain is a common occurrence in obese patients; however, the

incidence of facet joint mediated pain is similar in obese patients and

nonobese patients.

Evaluation of Role of Facet Joints in Persistent Low Back Pain in Obesity:

A Controlled, Prospective, Comparitve Evaluation. ML, Pain Physician,

4(3)266-272, 2001

Hope this helps!

Vern Saboe, DC

Albany

I am really pissed off! (pardon the language)

>

> Docs,

> I am truly steamed. I am reviewing a Defense Medical Exam from Medical

> Consultants Network, Inc. that is part of a file that I have been asked to

> review by the defense. The two doctors who examined the plaintiff were a

> Lynn Bell MD (a neurologist who ALWAYS finds against the patient) and a

> chiropractor with a similar reputation who I believe is a member of this

> listserve, and thus I will not name him, per our rules below. The man was

> significantly hurt in the crash, which was a substantial

rear-impact/frontal

> impact, and had about 9 months of chiropractic treatment prior to the DME,

> which was performed in September of 2001. At the time of the exam the man

> was still significantly symptomatic (although the DME docs did everything

> they could to minimize his complaints), and according to records that I

have

> subsequent to the DME he sought treatment from MDs and PTs and a DMD for

TMJ

> pain, among other problems.

> Regardless of the continued symptoms and objective findings of injury, no

> review of imaging or suggestion for the further diagnostic workup, the

> perpetrators of this sham evaluation concluded that " the initial injuries

> would be attributed to the motor vehicle accident (sic). The continued

> complaints of pain would probably be an issue of deconditioning as opposed

> to any traumatic injury. "

> I have a question for you honest docs out there - what's the ICD-9 code

for

> " deconditioning. " How does deconditioning cause neck pain, TMJ pain, and

low

> back pain? What is deconditioning? How do you grade it? What is the

evidence

> of it? What tests did these or any other sell-out doc ever do to test the

> condition of a patient diagnosed with chronic pain resulting from

> deconditioning?

> This is just another reason for ODOC to join with the CAO in supporting a

> bill in the upcoming legislature to regulate DMEs.

> Until that time how about this suggestion; why can't the OBCE form a

> peer-review committee for the single purpose of judging the professional

> conduct of docs who do DMEs? I will volunteer to be the first member.

Anyone

> else with me on this one?

>

>

> D Freeman

> Mailing address: 2480 Liberty Street NE, Suite 180

> Salem, Oregon 97303

> ph 503 763-3528

> fax 503 763-3530

> cell 503 871-0715

>

>

>

> OregonDCs rules:

> 1. Keep correspondence professional; the purpose of the listserve is to

> foster communication and collegiality. No personal attacks on listserve

> members will be tolerated.

> 2. Always sign your e-mails with your first and last name.

> 3. The listserve is not secure; your e-mail could end up anywhere.

However,

> it is against the rules of the listserve to copy, print, forward, or

> otherwise distribute correspondence written by another member without his

or

> her consent, unless all personal identifiers have been removed.

>

>

[Guest guest]

<PRE>Legislative remedies are in the works with an IME bill all ready to go

before

the Oregon congress this next session. Please join us a the Chiropractors at

the Capitol Day on Jan 23 for full details. Sunny Kierstyn, Member, Board of

Directors, CAO.

[Guest guest]

Sorry , but these " cases " are mostly hoaxes, and the " Stella " award is a

PR dream from the insurance industry.

D Freeman PhD DC MPH

Forensic Trauma Epidemiologist

Department of Public Health and Preventive Medicine

Oregon Health and Science University School of Medicine

Mailing address: 2480 Liberty Street NE, Suite 180

Salem, Oregon 97303

ph 503 763-3528

fax 503 763-3530

cell 503 871-0715

Re: I am really pissed off! (pardon the language)

Courtroom mistake # 1 - expecting justice to be served inside a courtroom.

Examples:

The Stella's are named after 81-year-old Stella Liebeck who spilled coffee on

herself and successfully sued Mcs. That case inspired the Stella Awards

for the most " uniquely successful " lawsuits in the United States for last

year.

Brought to you by the good old US Justice System, the following are this

year's candidates:

- Kathleen on of Austin, Texas, was awarded $780,000 by a jury of her

peers after breaking her ankle tripping over a toddler who was running inside

a furniture store. The owners of the store were understandably surprised at

the verdict, considering the misbehaving little toddler was Ms.on’s

son.

- A 19-year-old Carl Truman of Los Angeles won $74,000 and medical expenses

when his neighbor ran over his hand with a Honda Accord. Mr. Truman

apparently didn't notice there was someone at the wheel of the car when he

was trying to steal his neighbor's hub caps.

- Terrence Dickson of Bristol, Pennsylvania, was leaving a house he had just

finished robbing by way of the garage. He was not able to get the garage door

to go up since the automatic door opener was malfunctioning. He couldn't

re-enter the house because the door connecting the house and garage locked

when he pulled it shut. The family was on vacation, and Mr. Dickson found

himself locked in the garage for eight days. He subsisted on a case of Pepsi

he found, and a large bag of dry dog food. He sued the owner's insurance

claiming the situation caused him undue mental anguish. The jury agreed to

the tune of $500,000.

- Jerry of Little Rock, Arkansas, was awarded $14,500 and medical

expenses after being bitten on the buttocks by his next-door neighbor's

beagle. The beagle was on a chain in its owner's fenced yard. The award was

less than sought because the jury felt the dog might have been just a little

provoked at the time by Mr. who was shooting it repeatedly with a

pellet gun.

- A Philadelphia restaurant was ordered to pay Amber Carson of Lancaster,

Pennsylvania, $113,500 after she slipped on a soft drink and broke her coccyx

(tailbone). The beverage was on the floor because Ms. Carson had thrown it at

her boyfriend 30 seconds earlier during an argument.

- Kara Walton of Claymont, Delaware, successfully sued the owner of a night

club in a neighboring city when she fell from the bathroom window to the

floor and knocked out her two front teeth. This occurred while Ms Walton was

trying to sneak through the window in the ladies room to avoid paying the

$3.50 cover charge. She was awarded $12,000 and dental expenses.

- This year's favorite could easily be Mr. Merv Grazinski of Oklahoma City,

Oklahoma. Mr. Grazinski purchased a brand new 32-foot Winnebago motor home.

On his first trip home, having driven onto the freeway, he set the cruise

control at 70 mph and calmly left the drivers seat to go into the back and

make himself a cup of coffee. Not surprisingly, the R.V. left the freeway,

crashed and overturned. Mr. Grazinski sued Winnebago for not advising him in

the owner's manual that he couldn't actually do this. The jury awarded him

$1,750,000 plus a new motor home. The company actually changed their manuals

on the basis of this suit, just in case there were any other complete morons

buying their recreation vehicles.

OregonDCs rules:

1. Keep correspondence professional; the purpose of the listserve is to foster

communication and collegiality. No personal attacks on listserve members will be

tolerated.

2. Always sign your e-mails with your first and last name.

3. The listserve is not secure; your e-mail could end up anywhere. However, it

is against the rules of the listserve to copy, print, forward, or otherwise

distribute correspondence written by another member without his or her consent,

unless all personal identifiers have been removed.

[Guest guest]

" Deconditioning is very likely the single most common source of chronic

axial

pain. "

Sorry Willard, I don't buy it, and I have never seen a shred of proof to

support it. Decondition may exacerbate a condition, but in and of itself it

is far too prevalent in asymptomatic people for me to accept it as a cause

of pain.

D Freeman PhD DC MPH

Forensic Trauma Epidemiologist

Department of Public Health and Preventive Medicine

Oregon Health and Science University School of Medicine

Mailing address: 2480 Liberty Street NE, Suite 180

Salem, Oregon 97303

ph 503 763-3528

fax 503 763-3530

cell 503 871-0715

I am really pissed off! (pardon the language)

Docs,

I am truly steamed. I am reviewing a Defense Medical Exam from Medical

Consultants Network, Inc. that is part of a file that I have been asked to

review by the defense. The two doctors who examined the plaintiff were a

Lynn Bell MD (a neurologist who ALWAYS finds against the patient) and a

chiropractor with a similar reputation who I believe is a member of this

listserve, and thus I will not name him, per our rules below. The man was

significantly hurt in the crash, which was a substantial rear-impact/frontal

impact, and had about 9 months of chiropractic treatment prior to the DME,

which was performed in September of 2001. At the time of the exam the man

was still significantly symptomatic (although the DME docs did everything

they could to minimize his complaints), and according to records that I have

subsequent to the DME he sought treatment from MDs and PTs and a DMD for TMJ

pain, among other problems.

Regardless of the continued symptoms and objective findings of injury, no

review of imaging or suggestion for the further diagnostic workup, the

perpetrators of this sham evaluation concluded that " the initial injuries

would be attributed to the motor vehicle accident (sic). The continued

complaints of pain would probably be an issue of deconditioning as opposed

to any traumatic injury. "

I have a question for you honest docs out there - what's the ICD-9 code for

" deconditioning. " How does deconditioning cause neck pain, TMJ pain, and low

back pain? What is deconditioning? How do you grade it? What is the evidence

of it? What tests did these or any other sell-out doc ever do to test the

condition of a patient diagnosed with chronic pain resulting from

deconditioning?

This is just another reason for ODOC to join with the CAO in supporting a

bill in the upcoming legislature to regulate DMEs.

Until that time how about this suggestion; why can't the OBCE form a

peer-review committee for the single purpose of judging the professional

conduct of docs who do DMEs? I will volunteer to be the first member. Anyone

else with me on this one?

D Freeman

Mailing address: 2480 Liberty Street NE, Suite 180

Salem, Oregon 97303

ph 503 763-3528

fax 503 763-3530

cell 503 871-0715

OregonDCs rules:

1. Keep correspondence professional; the purpose of the listserve is to

foster communication and collegiality. No personal attacks on listserve

members will be tolerated.

2. Always sign your e-mails with your first and last name.

3. The listserve is not secure; your e-mail could end up anywhere. However,

it is against the rules of the listserve to copy, print, forward, or

otherwise distribute correspondence written by another member without his or

her consent, unless all personal identifiers have been removed.

[Guest guest]

this has been a huge issue in Washington for several years. In fact our

licensing board has taken steps to regulate DME's through law. The efforts

are somewhat heavy handed, and attempt to impart liability to the examining

doctors for future damages due to claims of problems caused by

non-treatment. Field doctors understandably do not like having their cases

cut off arbitrarily. My concern from the other side of the fence is that we

must give the insurance industry a way to accurately review claims, or they

will invent a nasty way of doing it without our consent or input (see

Colossus). One effective plaintiff strategy is to obtain several DME's from

the same frequent fliers, showing the same impressions regardless of the

findings. Judges and juries are not favorably impressed by this type of

pandering.

If you're interested in legislative remedies, let me know, and I will follow

up with our board.

Roy

--

Roy Steinberg DC DABCO

Steinberg Consulting Services Inc.

14136 NE 32nd Place

Bellevue WA 98007

425-883-8783: voice

425-556-0616: fax

> From: " Dr. Freeman " <drmfreeman@...>

> Date: Tue, 7 Jan 2003 18:45:06 -0800

> " Oregon DCs \(E-mail\) " < >

> Subject: I am really pissed off! (pardon the language)

>

> Docs,

> I am truly steamed. I am reviewing a Defense Medical Exam from Medical

> Consultants Network, Inc. that is part of a file that I have been asked to

> review by the defense. The two doctors who examined the plaintiff were a

> Lynn Bell MD (a neurologist who ALWAYS finds against the patient) and a

> chiropractor with a similar reputation who I believe is a member of this

> listserve, and thus I will not name him, per our rules below. The man was

> significantly hurt in the crash, which was a substantial rear-impact/frontal

> impact, and had about 9 months of chiropractic treatment prior to the DME,

> which was performed in September of 2001. At the time of the exam the man

> was still significantly symptomatic (although the DME docs did everything

> they could to minimize his complaints), and according to records that I have

> subsequent to the DME he sought treatment from MDs and PTs and a DMD for TMJ

> pain, among other problems.

> Regardless of the continued symptoms and objective findings of injury, no

> review of imaging or suggestion for the further diagnostic workup, the

> perpetrators of this sham evaluation concluded that " the initial injuries

> would be attributed to the motor vehicle accident (sic). The continued

> complaints of pain would probably be an issue of deconditioning as opposed

> to any traumatic injury. "

> I have a question for you honest docs out there - what's the ICD-9 code for

> " deconditioning. " How does deconditioning cause neck pain, TMJ pain, and low

> back pain? What is deconditioning? How do you grade it? What is the evidence

> of it? What tests did these or any other sell-out doc ever do to test the

> condition of a patient diagnosed with chronic pain resulting from

> deconditioning?

> This is just another reason for ODOC to join with the CAO in supporting a

> bill in the upcoming legislature to regulate DMEs.

> Until that time how about this suggestion; why can't the OBCE form a

> peer-review committee for the single purpose of judging the professional

> conduct of docs who do DMEs? I will volunteer to be the first member. Anyone

> else with me on this one?

>

>

> D Freeman

> Mailing address: 2480 Liberty Street NE, Suite 180

> Salem, Oregon 97303

> ph 503 763-3528

> fax 503 763-3530

> cell 503 871-0715

>

>

>

> OregonDCs rules:

> 1. Keep correspondence professional; the purpose of the listserve is to foster

> communication and collegiality. No personal attacks on listserve members will

> be tolerated.

> 2. Always sign your e-mails with your first and last name.

> 3. The listserve is not secure; your e-mail could end up anywhere. However, it

> is against the rules of the listserve to copy, print, forward, or otherwise

> distribute correspondence written by another member without his or her

> consent, unless all personal identifiers have been removed.

>

>

[Guest guest]

Just to be totally fair , sometimes the jury if not allowed to know

the other circumstances as the trial is exclusively about liability of the

injury. Weird but true...and maybe just.

--

E. Abrahamson, D.C.

Chiropractic physician

Lake Oswego Chiropractic Clinic

601 First Street

Lake Oswego, OR 97034

503-635-6246

> From: ang320@...

> Date: Wed, 8 Jan 2003 09:09:22 EST

>

> Subject: Re: I am really pissed off! (pardon the language)

>

> Courtroom mistake # 1 - expecting justice to be served inside a courtroom.

> Examples:

>

> The Stella's are named after 81-year-old Stella Liebeck who spilled coffee on

> herself and successfully sued Mcs. That case inspired the Stella Awards

> for the most " uniquely successful " lawsuits in the United States for last

> year.

>

> Brought to you by the good old US Justice System, the following are this

> year's candidates:

>

> - Kathleen on of Austin, Texas, was awarded $780,000 by a jury of her

> peers after breaking her ankle tripping over a toddler who was running inside

> a furniture store. The owners of the store were understandably surprised at

> the verdict, considering the misbehaving little toddler was Ms.on¹s

> son.

>

>

>

> - A 19-year-old Carl Truman of Los Angeles won $74,000 and medical expenses

> when his neighbor ran over his hand with a Honda Accord. Mr. Truman

> apparently didn't notice there was someone at the wheel of the car when he

> was trying to steal his neighbor's hub caps.

>

>

>

> - Terrence Dickson of Bristol, Pennsylvania, was leaving a house he had just

> finished robbing by way of the garage. He was not able to get the garage door

> to go up since the automatic door opener was malfunctioning. He couldn't

> re-enter the house because the door connecting the house and garage locked

> when he pulled it shut. The family was on vacation, and Mr. Dickson found

> himself locked in the garage for eight days. He subsisted on a case of Pepsi

> he found, and a large bag of dry dog food. He sued the owner's insurance

> claiming the situation caused him undue mental anguish. The jury agreed to

> the tune of $500,000.

>

>

>

> - Jerry of Little Rock, Arkansas, was awarded $14,500 and medical

> expenses after being bitten on the buttocks by his next-door neighbor's

> beagle. The beagle was on a chain in its owner's fenced yard. The award was

> less than sought because the jury felt the dog might have been just a little

> provoked at the time by Mr. who was shooting it repeatedly with a

> pellet gun.

>

>

>

> - A Philadelphia restaurant was ordered to pay Amber Carson of Lancaster,

> Pennsylvania, $113,500 after she slipped on a soft drink and broke her coccyx

> (tailbone). The beverage was on the floor because Ms. Carson had thrown it at

> her boyfriend 30 seconds earlier during an argument.

>

>

>

> - Kara Walton of Claymont, Delaware, successfully sued the owner of a night

> club in a neighboring city when she fell from the bathroom window to the

> floor and knocked out her two front teeth. This occurred while Ms Walton was

> trying to sneak through the window in the ladies room to avoid paying the

> $3.50 cover charge. She was awarded $12,000 and dental expenses.

>

>

>

> - This year's favorite could easily be Mr. Merv Grazinski of Oklahoma City,

> Oklahoma. Mr. Grazinski purchased a brand new 32-foot Winnebago motor home.

> On his first trip home, having driven onto the freeway, he set the cruise

> control at 70 mph and calmly left the drivers seat to go into the back and

> make himself a cup of coffee. Not surprisingly, the R.V. left the freeway,

> crashed and overturned. Mr. Grazinski sued Winnebago for not advising him in

> the owner's manual that he couldn't actually do this. The jury awarded him

> $1,750,000 plus a new motor home. The company actually changed their manuals

> on the basis of this suit, just in case there were any other complete morons

> buying their recreation vehicles.

>

>

> OregonDCs rules:

> 1. Keep correspondence professional; the purpose of the listserve is to foster

> communication and collegiality. No personal attacks on listserve members will

> be tolerated.

> 2. Always sign your e-mails with your first and last name.

> 3. The listserve is not secure; your e-mail could end up anywhere. However, it

> is against the rules of the listserve to copy, print, forward, or otherwise

> distribute correspondence written by another member without his or her

> consent, unless all personal identifiers have been removed.

>

>

[Guest guest]

Thanks, Roy. I am really not sure what to do; I am not in the middle of the

legislative or political arena at this point in time, but I know that the

CAO is promoting legislation to make the DME system safer for consumers.

D Freeman

Mailing address: 2480 Liberty Street NE, Suite 180

Salem, Oregon 97303

ph 503 763-3528

fax 503 763-3530

cell 503 871-0715

I am really pissed off! (pardon the language)

>

> Docs,

> I am truly steamed. I am reviewing a Defense Medical Exam from Medical

> Consultants Network, Inc. that is part of a file that I have been asked to

> review by the defense. The two doctors who examined the plaintiff were a

> Lynn Bell MD (a neurologist who ALWAYS finds against the patient) and a

> chiropractor with a similar reputation who I believe is a member of this

> listserve, and thus I will not name him, per our rules below. The man was

> significantly hurt in the crash, which was a substantial

rear-impact/frontal

> impact, and had about 9 months of chiropractic treatment prior to the DME,

> which was performed in September of 2001. At the time of the exam the man

> was still significantly symptomatic (although the DME docs did everything

> they could to minimize his complaints), and according to records that I

have

> subsequent to the DME he sought treatment from MDs and PTs and a DMD for

TMJ

> pain, among other problems.

> Regardless of the continued symptoms and objective findings of injury, no

> review of imaging or suggestion for the further diagnostic workup, the

> perpetrators of this sham evaluation concluded that " the initial injuries

> would be attributed to the motor vehicle accident (sic). The continued

> complaints of pain would probably be an issue of deconditioning as opposed

> to any traumatic injury. "

> I have a question for you honest docs out there - what's the ICD-9 code

for

> " deconditioning. " How does deconditioning cause neck pain, TMJ pain, and

low

> back pain? What is deconditioning? How do you grade it? What is the

evidence

> of it? What tests did these or any other sell-out doc ever do to test the

> condition of a patient diagnosed with chronic pain resulting from

> deconditioning?

> This is just another reason for ODOC to join with the CAO in supporting a

> bill in the upcoming legislature to regulate DMEs.

> Until that time how about this suggestion; why can't the OBCE form a

> peer-review committee for the single purpose of judging the professional

> conduct of docs who do DMEs? I will volunteer to be the first member.

Anyone

> else with me on this one?

>

>

> D Freeman

> Mailing address: 2480 Liberty Street NE, Suite 180

> Salem, Oregon 97303

> ph 503 763-3528

> fax 503 763-3530

> cell 503 871-0715

>

>

>

> OregonDCs rules:

> 1. Keep correspondence professional; the purpose of the listserve is to

foster

> communication and collegiality. No personal attacks on listserve members

will

> be tolerated.

> 2. Always sign your e-mails with your first and last name.

> 3. The listserve is not secure; your e-mail could end up anywhere.

However, it

> is against the rules of the listserve to copy, print, forward, or

otherwise

> distribute correspondence written by another member without his or her

> consent, unless all personal identifiers have been removed.

>

>

[Guest guest]

I truly believe that a patient has the right to be returned to 100%

pre-accident condition. That means no pain, full ADLs, etc...with no

exceptions (assuming that was their condition pre-accident). Based upon this

notion I have no qualms fighting " tooth and nail " for my patients. The only

way I know how to fight is to push myself to stay current and educated. PIP

cases are where our patients get burned, so LOSRIC and accident

reconstruction and junk science is where I am turning most of my attention

now. I encourage all of you who are tired of the BS to FIGHT! If not for

your profession, then for your patients. Study your literature, know your

references and don't be intimidated by anyone (except for maybe Mr. T). " I

pity the foo who won't fight for their patients "

Terreri, DC

I am really pissed off! (pardon the language)

> Docs,

> I am truly steamed. I am reviewing a Defense Medical Exam from Medical

> Consultants Network, Inc. that is part of a file that I have been asked to

> review by the defense. The two doctors who examined the plaintiff were a

> Lynn Bell MD (a neurologist who ALWAYS finds against the patient) and a

> chiropractor with a similar reputation who I believe is a member of this

> listserve, and thus I will not name him, per our rules below. The man was

> significantly hurt in the crash, which was a substantial

rear-impact/frontal

> impact, and had about 9 months of chiropractic treatment prior to the DME,

> which was performed in September of 2001. At the time of the exam the man

> was still significantly symptomatic (although the DME docs did everything

> they could to minimize his complaints), and according to records that I

have

> subsequent to the DME he sought treatment from MDs and PTs and a DMD for

TMJ

> pain, among other problems.

> Regardless of the continued symptoms and objective findings of injury, no

> review of imaging or suggestion for the further diagnostic workup, the

> perpetrators of this sham evaluation concluded that " the initial injuries

> would be attributed to the motor vehicle accident (sic). The continued

> complaints of pain would probably be an issue of deconditioning as opposed

> to any traumatic injury. "

> I have a question for you honest docs out there - what's the ICD-9 code

for

> " deconditioning. " How does deconditioning cause neck pain, TMJ pain, and

low

> back pain? What is deconditioning? How do you grade it? What is the

evidence

> of it? What tests did these or any other sell-out doc ever do to test the

> condition of a patient diagnosed with chronic pain resulting from

> deconditioning?

> This is just another reason for ODOC to join with the CAO in supporting a

> bill in the upcoming legislature to regulate DMEs.

> Until that time how about this suggestion; why can't the OBCE form a

> peer-review committee for the single purpose of judging the professional

> conduct of docs who do DMEs? I will volunteer to be the first member.

Anyone

> else with me on this one?

>

>

> D Freeman

> Mailing address: 2480 Liberty Street NE, Suite 180

> Salem, Oregon 97303

> ph 503 763-3528

> fax 503 763-3530

> cell 503 871-0715

>

>

>

> OregonDCs rules:

> 1. Keep correspondence professional; the purpose of the listserve is to

foster communication and collegiality. No personal attacks on listserve

members will be tolerated.

> 2. Always sign your e-mails with your first and last name.

> 3. The listserve is not secure; your e-mail could end up anywhere.

However, it is against the rules of the listserve to copy, print, forward,

or otherwise distribute correspondence written by another member without his

or her consent, unless all personal identifiers have been removed.

>

>