Re: ****SPAM**** Re: requesting IME-legal please chime in

[Guest guest]

We as a profession must be honest with our assessments. If we, as an individual

practitioner, feel the patient does not need care, is malingering or otherwise,

we must report our findings in our notes. Do not treat this patient under the

auto insurance if your findings do not support such care. There may always be

chiropractors that turn the other cheek in order to make a buck, and

unfortunately those are the ones that give the rest of the profession a bad

name. If you choose not to see them based upon your evaluation, send that

information with your exam bill to the insurance adjuster. They will likely use

that information later to close the case, if it is well documented.

Requesting an IME does not need to go through the insurance company though. You

may request a second opinion from another chiropractor asking them specifically

if there are injuries from this crash that need ongoing treatment. Hopefully

you choose someone honest and ethical and they will give an appropriate

response.

But most importantly, do not treat someone you do not feel needs it.

dan miller dc

> I recently voiced my concerns about a similar patient so called his adjuster

and requested an IME. I was laughed at. I was very careful with what I said

about the patient, but basically that the subjective info did not correlate with

the objective findings and that I did not feel further care was necessary.

Luckily, I had plenty of documentaion to support this. Turns out he found

another DC who was happy to continue months and months of additional treatment.

But, I washed my hands of him.

>

> Am curious as to how others handle these situations.

>

> Best of luck,

> Barrett

>

> Sent from my Verizon Wireless BlackBerry

>

> Sender: oregondcs

> Date: Wed, 20 Jun 2012 00:04:37 -0000

> To: <oregondcs >

> Subject: requesting IME-legal please chime in

>

>

> dear listserve,

>

> I just got a new MVA pt who has been seen from 2 other practioners. Pt's

symptoms do not correlate with physical exam findings and there is generally an

appearance of malingering- pt dislikes her job, there is marital dichord and the

pt is deconditioned- Pt's accident was almost 4 months ago, " bump " in the

parking lot kind of thing-with resulting severe neuro deficits, exaggarated

muscle weakness,etc.... Xrays were ordered from another practioner, all were

negative.

>

> Question-can I quietly hint or request an IME? this is a new one for me-

personally, I do not want to treat for more than a couple of visits

>

> Legally, what are my responsibilities regarding putting an end to this and

what might the repercussions be?

>

> Thanks

>

> Babbbitt, Forest Grove Health and Fitness

>

>

>

[Guest guest]

I too had a suspicious patient who I had doubts about recently.  I referred patient to Dr. Saboe and  the situation was handled quite professionally .  I would agree with Dr. 's sound advice-and send this suspicious patient to a trustworthy DC who can do an IME.  I would highly recommend Dr. Saboe.

Schneider DCPDX

We as a profession must be honest with our assessments.  If we, as an individual practitioner, feel the patient does not need care, is malingering or otherwise, we must report our findings in our notes.  Do not treat this patient under the auto insurance if your findings do not support such care.  There may always be chiropractors that turn the other cheek in order to make a buck, and unfortunately those are the ones that give the rest of the profession a bad name.  If you choose not to see them based upon your evaluation, send that information with your exam bill to the insurance adjuster.  They will likely use that information later to close the case, if it is well documented.

Requesting an IME does not need to go through the insurance company though.  You may request a second opinion from another chiropractor asking them specifically if there are injuries from this crash that need ongoing treatment.  Hopefully you choose someone honest and ethical and they will give an appropriate response.

But most importantly, do not treat someone you do not feel needs it.

dan miller dc

> I recently voiced my concerns about a similar patient so called his adjuster and requested an IME. I was laughed at. I was very careful with what I said about the patient, but basically that the subjective info did not correlate with the objective findings and that I did not feel further care was necessary. Luckily, I had plenty of documentaion to support this. Turns out he found another DC who was happy to continue months and months of additional treatment. But, I washed my hands of him.

>

> Am curious as to how others handle these situations.

>

> Best of luck,

> Barrett

>

> Sent from my Verizon Wireless BlackBerry

>

> Sender: oregondcs

> Date: Wed, 20 Jun 2012 00:04:37 -0000

> To: <oregondcs >

> Subject: requesting IME-legal please chime in

>

>

> dear listserve,

>

> I just got a new MVA pt who has been seen from 2 other practioners. Pt's symptoms do not correlate with physical exam findings and there is generally an appearance of malingering- pt dislikes her job, there is marital dichord and the pt is deconditioned- Pt's accident was almost 4 months ago, " bump " in the parking lot kind of thing-with resulting severe neuro deficits, exaggarated muscle weakness,etc.... Xrays were ordered from another practioner, all were negative.

>

> Question-can I quietly hint or request an IME? this is a new one for me- personally, I do not want to treat for more than a couple of visits

>

> Legally, what are my responsibilities regarding putting an end to this and what might the repercussions be?

>

> Thanks

>

> Babbbitt, Forest Grove Health and Fitness

>

>

>

------------------------------------

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Tell a colleague about OregonDCs! (must be licensed Oregon DC)

[Guest guest]

USE OF THE VARIOUS MALINGERING TESTS AS WELL AS PRESSURE SENSITIVE QUANTIATIVE TESTING OF THE AREAS OF COMPLAINT. (REPEAT TWICE AND COMPARE THE NUMBERS) bOB W. Pfeiffer, D.C., D.A.B.C.O.Lee Pfeiffer, R.N., B.S.46 N.E. Mt. Hebron Dr. (no USPS mail)P.O. Box 606 Pendleton, OR 97801drbob@...leernbs@... All people smile in the same language From: oregondcs [mailto:oregondcs ] On Behalf Of SchneiderSent: Tuesday, June 19, 2012 8:55 PMTo: Cc: kellybpdx@...; dr.babbitt; oregondcs Subject: Re: ****SPAM**** Re: requesting IME-legal please chime in I too had a suspicious patient who I had doubts about recently. I referred patient to Dr. Saboe and the situation was handled quite professionally . I would agree with Dr. 's sound advice-and send this suspicious patient to a trustworthy DC who can do an IME. I would highly recommend Dr. Saboe. Schneider DCPDXWe as a profession must be honest with our assessments. If we, as an individual practitioner, feel the patient does not need care, is malingering or otherwise, we must report our findings in our notes. Do not treat this patient under the auto insurance if your findings do not support such care. There may always be chiropractors that turn the other cheek in order to make a buck, and unfortunately those are the ones that give the rest of the profession a bad name. If you choose not to see them based upon your evaluation, send that information with your exam bill to the insurance adjuster. They will likely use that information later to close the case, if it is well documented.Requesting an IME does not need to go through the insurance company though. You may request a second opinion from another chiropractor asking them specifically if there are injuries from this crash that need ongoing treatment. Hopefully you choose someone honest and ethical and they will give an appropriate response.But most importantly, do not treat someone you do not feel needs it.dan miller dc> I recently voiced my concerns about a similar patient so called his adjuster and requested an IME. I was laughed at. I was very careful with what I said about the patient, but basically that the subjective info did not correlate with the objective findings and that I did not feel further care was necessary. Luckily, I had plenty of documentaion to support this. Turns out he found another DC who was happy to continue months and months of additional treatment. But, I washed my hands of him.>> Am curious as to how others handle these situations.>> Best of luck,> Barrett>> Sent from my Verizon Wireless BlackBerry> > Sender: oregondcs > Date: Wed, 20 Jun 2012 00:04:37 -0000> To: <oregondcs >> Subject: requesting IME-legal please chime in>>> dear listserve,>> I just got a new MVA pt who has been seen from 2 other practioners. Pt's symptoms do not correlate with physical exam findings and there is generally an appearance of malingering- pt dislikes her job, there is marital dichord and the pt is deconditioned- Pt's accident was almost 4 months ago, " bump " in the parking lot kind of thing-with resulting severe neuro deficits, exaggarated muscle weakness,etc.... Xrays were ordered from another practioner, all were negative.>> Question-can I quietly hint or request an IME? this is a new one for me- personally, I do not want to treat for more than a couple of visits>> Legally, what are my responsibilities regarding putting an end to this and what might the repercussions be?>> Thanks>> Babbbitt, Forest Grove Health and Fitness>>>------------------------------------All posts must adhere to OregonDCs rules located on homepage at: http://groups.yahoo.com/group/oregondcs/Tell a colleague about OregonDCs! (must be licensed Oregon DC)