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Friday, September 16, 2016

How to Properly Manage a Personal Injury Patient

Proper management of an injury patient is an important part of patient care that should not be overlooked.  When a new patient comes into my office, I always make sure that the patient has a clear understanding of the process.

The procedure involves detailed documentation of the patient's history, which includes finding out about prior injuries, car accidents, prior medical treatment for any body part, even if the treated body part was not accident related.  The reason behind this, is that all parties involved will want to know whether the patient's new injury overlaps with any prior medically treated areas of the patient's body.

Moreover, included in the history are any other medical conditions, as well as family history, and prescriptions currently being taken.  From this, you can learn a lot.  For example, a patient recently told me that she has a family history of aneurysm resulting in death to her sister and father. Chiropractors should never overlook this history, and blatantly do cervical adjustments on these types of patients.

At the end of the initial visit, there should be an initial report written and each subsequent visit with the doctor should be documented in standard SOAP form.  The patient always signs the chart note for the visit.  No signature and no visit ever happened.

I almost always make sure the patient is quickly referred to an orthopedic specialist or his medical doctor who could also diagnose emergency medical condition if necessary.  Emergency medical condition or EMC, is specific to Florida, and is required if the patient has a more serious injury, and its purpose is that it frees up the patient's full insurance benefit, if extensive treatment is necessary.  The insurance company is counting on the fact that the patient will not have an EMC and will only be responsible for 25% of the claim.  Without it, the insurance company takes away 75% of the patents insurance benefit.

Soft tissue injuries are better diagnosed with objective tests, like MRI.  Sometimes, X-rays are ordered if fracture or dislocation is suspected.  Most of the time however, x-rays do not turn up injury in patients that have injuries that are soft tissue in nature.  Over the years, I have seen some broken ribs, sternums, and bones in the hands and feet, but this is rare.  X-rays have shown dislocations, over the years,

Depending on the frequency of the visit, the course of treatment can vary between a couple months and upward of 6 months or more.

Any other referrals will be made if necessary, including orthopedic doctors, neurologists, podiatrists, mental health doctors, etc.

Finally, a report is generated when the patient is released from standard care, at maximum medical improvement, MMI.  If there is a request for an impairment rating, I will provide the rating in the report, and forward the report to the attorney who is helping to resolve any claims.

During this whole process, COMMUNICATION is key so that everyone is on the same page, and nothing is missed.

I have been seeing mainly personal injury type patients for 20+ years.  If you have been involved in a car accident, don't hesitate.  Please call my office to schedule your first visit.  If you are a lawyer and have a client who you think could benefit from an experienced doctor in regard to accident care, I will love to see that person.  It is NOT my goal to provide GOOD care to my patients;  it IS my goal to provide EXCELLENT care to my patients.

Alan Himmel, DC PA.

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