I am a 2nd generation chiropractor and have been practicing in Scottsdale/Phoenix, Arizona, since 1987.
For a number of years, chiropractors all over the country got reimbursed quite well for the services we performed. Back in the day, most people had health insurance, with the average deductible being $200 and the insurance company paying 80% of our bills. There were no limits on the dollar amount or number of visits. Back then, our documentation didn't seem to matter!
But then reimbursements starting getting lower, deductibles and co-pays were higher and even our PI cases were getting crushed.
The typical examination I performed at the time really didn't show much in the way of abnormal findings. Every report of findings I tried felt like I was trying to sell the patient treatment, which just didn't feel right to me. I wasn't trained to be a salesman - I was trained to be a doctor.
In the late '90s, I decided to learn everything I could about documentation and reimbursement. I quickly realized that our reimbursement is in direct proportion to the quality of our documentation. I studied the Mercy Guidelines, which weren't nearly as bad as we were all led to believe. I studied the AMA Guides to the Evaluation of Permanent Impairment. I studied research regarding pain and injury. I became certified by the American Board of Independent Medical Examiners.
I discovered that what we think we need to document is quite different than what we actually need to document.
The good news is that there are really only 3 things we need to document - our initial exams, our daily visits and our re-exams!
And so began my mission: to learn how to perform a thorough and well-documented examination that tells me what I need to know clinically AND allows me to determine if my patient needs my care or not. Once I figured that out, my mission became how to effectively document my cases, including cash patients and personal injury patients and everyone in between, on a day to day basis.
Once I solved the exam, daily note and re-exam problem, the challenge was how to satisfy - make that EXCEED the documentation requirements, IN AS LITTLE TIME AS POSSIBLE.
I found that by examining my patients in a particular way, they were understanding what I was talking about.
I never had to sell chiropractic to them - chiropractic just seemed to sell itself. Well, I got pretty good at it. In fact, I go so good at it that I was asked to teach other chiropractors how to do it. I started teaching seminars to chiropractors in 2001, hoping to help elevate our profession and help doctors to succeed. I found that I love speaking and teaching doctors, so I've been traveling all over the country ever since.
I'm also always on the hunt for companies and products that can help us to have exquisite documentation in as little time as possible, with the least amount of effort and the least amount of cost.
