Re: Articles, re pre-existing

[Guest guest]

Hi Charlie:Not sure if I can point you to literature that helps but there is something else that I feel is improtant.But, I think it is important to state the fact that in many, if not most of the adult patients we see as chiros, patients have so-called co-existing/co-morbid/confounding  conditions. This is now the norm in our rather unhealthy society. If there is a short-term onset (such as a singular trauma and/or an unknown, albeit rapid onset of acute or highly increased sx) then it is fair and logical and appropriate to assume that the primary causative factor is the singular event and that other co-existing or pre-existing conditions are not " causes " but rather  confounders or complicators that may mitigate or slow the healing/recovery process for the patient.

In most cases that we chiros see, it would not be fair to say that the pre-existing/co-existing condition is the primary cause. Medical example: When an elderly person in a nursing home falls and breaks there hip, you don't see the insurance company denying hip surgery due to pre-existing osteoporosis. It is assumed that the osteoporosis did NOT " cause " the fall or the fracture. The fall was the cause of the fracture and the fracture may have been facilitated, or made more likely, due to osteoporosis, but the fall was the primary or " preponderant " cause and the osteoporosis is the confounder/complicator of healing.

Starting about 7-8 years ago, at my office, all new patients have the following in the chart:-symptoms (that are diagnoses)-causative factors (icd code)-confounders/pre-existing conditions (icd code)

-other diagnoses that may be pertinentand finally:  A brief written statement about " the primary mechanism(s) of injury and/or causative factor(s) " I personally believe that our various work comp and PIP cases have almost never had a problem with IMEs or adjutors calling the co-existing/pre-existing conditions the " primary cause " and this probably has  a lot to do with that initial wording in the case.

Anyhow, good luck.-- J. This email and any files transmitted with it are confidential and intended solely for the use of the individual or entity to whom they are addressed. If you have received this email in error please notify the sender.

[Guest guest]

, What you 'add' is considered standard information in any new-patient workup ...... should be part of our opening data on every new patient. That way, whoever looks at the chart next, knows you know what was going on with the patient and are including that background in your current and on-going assessments. Good content. SunnySunny Kierstyn, RN DC Fibromyalgia Care Center of Oregon 2677 Willakenzie Road, 7CEugene, Oregon, 97401541- 654-0850; Fx; 541- 654-0834www.drsunnykierstyn.com To: caughlindrc@...; oregondcs From: johncollinsdc@...Date: Mon, 30 Jul 2012 13:07:17 -0700Subject: Re: Articles, re pre-existing

Hi Charlie:Not sure if I can point you to literature that helps but there is something else that I feel is improtant.But, I think it is important to state the fact that in many, if not most of the adult patients we see as chiros, patients have so-called co-existing/co-morbid/confounding conditions. This is now the norm in our rather unhealthy society. If there is a short-term onset (such as a singular trauma and/or an unknown, albeit rapid onset of acute or highly increased sx) then it is fair and logical and appropriate to assume that the primary causative factor is the singular event and that other co-existing or pre-existing conditions are not "causes" but rather confounders or complicators that may mitigate or slow the healing/recovery process for the patient.

In most cases that we chiros see, it would not be fair to say that the pre-existing/co-existing condition is the primary cause. Medical example: When an elderly person in a nursing home falls and breaks there hip, you don't see the insurance company denying hip surgery due to pre-existing osteoporosis. It is assumed that the osteoporosis did NOT "cause" the fall or the fracture. The fall was the cause of the fracture and the fracture may have been facilitated, or made more likely, due to osteoporosis, but the fall was the primary or "preponderant" cause and the osteoporosis is the confounder/complicator of healing.

Starting about 7-8 years ago, at my office, all new patients have the following in the chart:-symptoms (that are diagnoses)-causative factors (icd code)-confounders/pre-existing conditions (icd code)

-other diagnoses that may be pertinentand finally: A brief written statement about "the primary mechanism(s) of injury and/or causative factor(s)"I personally believe that our various work comp and PIP cases have almost never had a problem with IMEs or adjutors calling the co-existing/pre-existing conditions the "primary cause" and this probably has a lot to do with that initial wording in the case.

Anyhow, good luck.-- J. This email and any files transmitted with it are confidential and intended solely for the use of the individual or entity to whom they are addressed. If you have received this email in error please notify the sender.