The Five Steps to Great Spinal Injury DocumentationThere is a lot of confusion about injury documentation. There are five general steps to injury documentation, and it is currently being made much more complicated than it needs to be. All injury documentation has...
What is a true expert?
What is an expert, and particularly, what is an expert in the spinal soft tissue injury market or the spinal ligament injury market?
What is an expert? What actually is an expert? I want doctors to start to be able to identify experts, so when they have questions, when they’re looking for advice, they’re looking for education, that they are, indeed, searching out experts.
So, what is an expert? An expert is somebody who has specialized knowledge due to experience. The only way you gain that specialized knowledge is through experience. Today, there are so many so-called experts in the spinal soft tissue injury market. And here’s a fact that I’m going to point out. Spinal ligament injuries are the number one cause of chronic pain and disability.
All our experts, all of our expertise of the past has led to this condition being the number one cause of chronic pain and disability in the market today. We’ve got to find better experts, but before we do, we must define what is an expert. So, again, an expert is somebody who has specialized knowledge through experience, and through the application of that knowledge.
I’m going to give you an example. We can have an engineer, and engineers are the ones that design and build bridges. Professors of engineering teach our students today. They can be an expert at bridge building, so that professor could be described as an intellectual expert at bridge design, bridge building, and every aspect of putting a bridge together. But yet, they’ve never built a bridge, so they don’t have any experience in the thing that they are an expert in. To me, that’s not a real expert. That’s a paper expert. That’s an educational expert. That’s an ivory tower expert.
Let’s take the student, who goes out and builds six tremendously large impressive bridges that help us all. That expert has specialized knowledge. Let me tell you what happens with that expert. That expert went through the same education that every engineer did, right? So, just because you have an engineering degree, you could say, “Hey, I read a ton of books on bridge building”, and today, you could be a highly renowned expert. As a matter of fact, you could have a lot of titles behind your name showing that you’re an expert, but you have never built a bridge.
So, here’s the difference. The person that has built a bridge knows what information is important and what information is not. The key to an expert is that they can differentiate what is important and what is not, whereas the non-expert thinks everything is important.
When you are new to a subject, one of the biggest issues that you have with the subject is that everything seems so important. You’re not sure what is important and what is not. So, today, we need to start relying on experts. That expert, that expert that’s built a bridge, can come in and say, “You know what? 90 percent of what this professor is teaching actually does not apply and is not really necessary to understand in order to build that bridge.” That’s the difference between a true expert. A true expert can tell you what is important and what is not important.
In the area of spinal ligament injuries, we have a lot of so-called experts, but we don’t have a lot of experts when it comes down to determining the severity and location of a ligament injury, using excessive motion testing, and using MRI with excessive motion testing.
What is excessive motion testing?
Excessive motion testing is designed to pick up the imaging biomarker of a ligament injury. A ligament injury leaves two imaging bio-markers behind. An imaging biomarker is a specialized feature that determines the diagnosis of a condition. An imaging biomarker for a fracture is a separated bone on x-ray.
An imaging bio-marker for ligament damage is two-fold. Excessive motion is picked up and measured. When you’re in the injury market, it should be measured independent of the provider. Providers should not make these measurements themselves simply because they are going to use that information for determining a treatment plan, determining impairment, determining if they need a consult with a spinal fusion surgery consultant, a spinal fusion surgeon. They’re going to use that to make return to play parameters decisions for contact sports. They’re going to use this information, and the information is significant, so it should be done independent, unbiased.
You have excessive motion testing, and you have MRI. Today, there’s been such an over-utilization of MRI for spinal ligament injuries, and MRI is not even one of the better tests. It’s a good test for a disc. Remember, you have 23 discs and over 220 specialized ligaments. MRI is great for a disc study, but it’s not great to pick up excessive motion.
MRI was never designed to do this, and excessive motion is one of the most damaging aspects of a spinal ligament injury. It’s picked up with stress radiology and accurate measurements, but again, doctors, smart doctors, SmartInjuryDoctors, know that those results should be done independent. Results from an MRI should not be read by the treating provider. Disc herniation should be determined outside of the treating provider, and the treating provider can use that to make better treatment decisions.
Excessive motion testing should be done outside of the treating provider. Now, why do I say that? Well, because as far as somebody in the market that has utilized … What I said is an expert is somebody that has experience. I have as much or more experience in the market utilizing these procedures as anyone. So, I have direct experience with it, so I’m coming from complete experience, and there are not enough doctors in this market that have experience with excessive motion testing.
- How does it combine with MRI testing?
- How do you use it then to get better treatment results?
- How do you use it to focus on and enhance and change your treatment plan?
- How do you use it to manage your patient get better results?
- How do you use this information to make sure that your patient doesn’t have chronic pain at the end of your care?
- How do you use this information to make sure that your patient is seriously reducing their risk for long term residual complaints?
- How do you use this information to make sure that you’re doing everything that you can to make sure that the person is not disabled or debilitated from these types of injuries?
- How do you use this information to align with other factors of care that you can use in order to get better results?
That’s what an expert can do. When we look at excessive motion testing, I think if a provider has maybe 500 studies under their belt, they’re getting some really good expertise in this area, maybe 200. But, how many providers in the market today have actually sent out 200 plus injury patients and then monitored to the results of the test, clinically correlated it for the spinal instability level, accurately treated it, and then sufficiently documented it, so it makes everyone’s life easier? How many experts in the market are there that have done that? It’s very few, and they’re very rare. That’s what we’re producing with SmartInjuryDoctors for back and neck injuries. That’s what makes these doctors incredibly unique.
What I wanted to talk about was an expert. When you find an expert that has 10, 20, 30 years of experience, and you want to know about that subject, you want to get with that expert, and you want to have that expert take 20, 30 years of what they’ve experienced in the market and get that information in a week.
That will hyper-escalate the evolution of the science. So, that bridge builder that’s built 10 bridges can tell you a lot of things, and if new education programs and new information is based off of that information, then you’re going to have a serious expansion in the science of bridge building or a serious expansion in the science of spinal ligament injuries or a serious enhancement of the science of the treatment of spinal ligament injuries.
Now, spinal ligament injuries, remember, they’re not sexy. You’re never going to see a St. Elsewhere or House, where the provider actually went, “Oh my gosh, why are they having debilitating headaches? Oh my gosh, why are they having debilitating neck pain?” And only to find out 50 minutes later through all of this testing and weaves in and out of the story, that it was a simple spinal ligament injury, and that it was only due to the sheer acumen of the doctor’s, House, in this case, brilliance that he actually picked it up.
That’s not what you’re going to see with this, but the doctors that are really good with this condition should be the most significant doctors in the market today because this market causes … This condition causes the most chronic pain and the most disability.
I am always hit by, “Well, this expert or this person said this.” And my question is always, “Okay, well how much excessive motion testing have they done?” I don’t mean how much have they said they’ve done. How many studies have they sent out? How many times? How much have they taken that information and relied on it clinically? It’s almost always none. So, they’re relying on an expert that has little or no experience in the subject that they’re asking the expert to give their experience on or their education on.
Get with the providers. Get with the experts that really do have expertise, and they are not just talking about it. They are not just reading about it. They haven’t read everything there is to know about it. They actually have applied their knowledge to get a very specific result.
That’s what you’re looking for. That’s what we’re creating in the SmartInjuryDoctors’ programs. We’re creating doctors that are relying on the expertise in very, very small niche subjects, and the most important subjects there is in the spinal ligament injury market.
Don’t get caught following an expert who’s really not an expert. Search for really good experts. Glean what you can, and then take their information and take it to the next level because that’s what we need in our injury markets today. We need the top doctors in our injury markets, and those top doctors should have access to all the injury patients as far as I’m concerned. The best doctors in the injury market should have the most injury patients, and our whole work, employers, insurers, should be directing those injured patients to those doctors.
For more information on Spinal Ligament Injuries please check us out at http://www.smartinjurydoctor.comor check out our SmartInjuryDoctors® Podcasts on Apple Podcasts, Spotify, Google Play or Stitcher.
For information on spinal ligament testing by board certified medical radiologists go to www.thespinalkinetics.com
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