IME’s and Peer Reviews
Houston Chiropractor Comments: Independent Medical Examinations (IME’s) and Peer Reviews have become common in the modern health care system. As a chiropractic orthopedist in Houston, Tx that performs both of these, I am aware that most patients do not know what they are.
An Independent Medical Examination (IME) is similar to getting a 2nd opinion. At my office we perform IME’s for both Texas Department of Insurance Division of Workers’ Compensation (TDI-DWC), as a designated doctor, and for insurance companies. The actual IME is an examination performed by a doctor on a patient who was not previously involved in the treatment of that patient, to evaluate the patient’s course of prior treatment and current condition.
The purpose of the IME can vary depending on who orders the examination. The examination can be ordered by an insurance company, the patient, or an attorney representing the patient. Typical questions asked are, is the patient at maximum medical improvement (MMI), is there an impairment ratine (IR), what is the extent of the injury, and can they safely return to work (RTW). Currently only 250 MD’s, DO’s, and DC’s have passed the requirements of the TDI-DWC to perform these designated doctor examinations. The rigid requirements to perform these exams are carried over to the insurance IME that is typically performed as part of an accident claim.
A peer review is the evaluation of work of another doctor in the same field of care. Typically the review will make sure that the minimum documentation standards are being met and that the treatment rendered is supported in the medical records. It functions as a form of self-regulation by qualified members of a profession within the relevant field. The review will show if any of the documentation requirements noted in the Texas Administrative Code (TAC) are absent and if any of the treatment exceeds the accepted treatment guidelines. This also helps the reviewed doctor to improve the medical records for future patients.
I have performed 100’s of peer reviews and IMEs over the last 30+ years. I am currently on the Medical Quality Review Panel (MQRP) for the TDI-DWC and I am a Standards of Care Reviewer (SCR) for the Texas Board of Chiropractic Examiners (TBCE).
Dr. Ward Beecher practices at Beecher Chiropractic Clinic at 1001 Pineloch, Ste 700 Houston, TX 77062. You can schedule an appointment at www.BeecherChiropractic.com or by calling (281) 286-1300. If you have any questions regarding this blog, please comment below!
Is Chiropractic Safe After Neck or Back Surgery?
Clear Lake Chiropractor Comments: Periodically I will be talking to the spouse or parent of a patient and they will state “I wish that I could get chiropractic care, but I had neck or back surgery in the past”. Having surgery in the past does not prevent you from receiving chiropractic care in the future.
The most important thing to determine is what surgery was actually performed. Most patients that I talk to do not know exactly what surgery was performed or even what specific level of their spine was operated on.
There is a big difference between a patient that had a single level foraminotomy or discectomy vs a multi-level fusion with hardware. The foraminotomy and discectomy are minimally invasive surgeries that typically only require about 4-6 weeks for the surgical wound to heal before a patient can resume or begin chiropractic care. A spinal fusion will typically require about 6-9 months for the fusion to heal. The area that was fused cannot be adjusted, but the areas above and below the fusion can become problematic and require chiropractic care.
After a person has had spinal surgery, chiropractic care is actually very beneficial. After you have been operated on, you will begin to develop scar tissue. Chiropractors are very good at minimizing the amount of scar tissue development and keeping the spinal joints moving as much as possible. This will help to slow the arthritic changes that commonly occur after neck and back surgery.
In summary, don’t assume that you cannot enjoy the benefit of chiropractic care after surgery. Talk to your doctor of chiropractic and get the facts first. Then you can experience the pleasure of health.
Dr. Ward Beecher practices at Beecher Chiropractic Clinic at 1001 Pineloch, Ste 700 Houston, TX 77062. You can schedule an appointment at www.BeecherChiropractic.com or by calling (281) 286-1300. If you have any questions regarding this blog, please comment below!
I Can’t Believe That My Doctor Referred Me Here
Houston Chiropractor Comments: Some of my patients are still surprised that another doctor referred them to our office. They still think that most doctors don’t send patients to chiropractors.
In my 34 years of being a doctor of chiropractic (DC), I have seen a great change in the attitude of most doctors. In the late 1980’s there were still some older doctors that didn’t understand how chiropractic worked, so they spoke poorly about my profession. As the years have gone by and more patients and doctors have seen or received the excellent benefit of chiropractic care, the acceptance of chiropractic has risen.
During my time in practice, I have worked to treat the conditions that I get the best results on and refer the patients who would benefit from another doctor. As a result, we have an excellent reputation with the medical profession in our area. We get referrals from family doctors, ortho and neurosurgeons, podiatrists, dentists and physical therapists.
I have found that most doctors are happy to refer you to our office if you are not responding to your treatment or therapy with them. The key thing is for them to know what is working and realizing when someone might provide better care.
Don’t be surprised that you have been referred here, instead be thankful that your doctor referred you somewhere that you could get better results. You might even be surprised when you see him or her here getting treatment. 😉
Dr. Ward Beecher practices at Beecher Chiropractic Clinic at 1001 Pineloch, Ste 700 Houston, TX 77062. You can schedule an appointment at www.BeecherChiropractic.com or by calling (281) 286-1300. If you have any questions regarding this blog, please comment below!
Goals and Expectations
Houston Chiropractor Comments: January is the time of the year that people set their fitness goals. Some people have the goal of losing weight. For some it is becoming stronger. Others wish to become more flexible. Still others wish to train for a specific event like a 5K fun run or hiking trails. These goals are all excellent, but for some people the expectation of when they see results should be realistic.
As people get older, it takes longer to get the results that we expect. We remember how much weight we use to lift at the gym. We recall how fast we use to run or how far. Some people have not ever really exercised before, but have read an article or saw an exercise video and think that those results should be easily obtainable.
This time of the year we see too many patients who have various sprain and strain injuries or even muscle tears. Remember that slow and steady wins the race. Lift a little less than you think. Run a little slower than you want. Aim for losing 1-2 pounds a week instead of 4-5. Do your program once correctly instead of having to constantly restart after you hurt yourself or binge eat.
This also leads to having realistic goals on your recovery. Patients tend to think that since their injury came on quickly, they should recover immediately. Unfortunately having your complaint resolve in 1 visit doesn’t happen always. Just because you had a low back injury resolve in 2 weeks 20 years ago doesn’t mean that you will respond the same this time.
After we examine you, we will be able to set realistic goals for improvement and recovery and what your expectation should be for relief should be. Do your therapy correctly the first time and we won’t have to work around any exacerbations or aggravations.
Dr. Ward Beecher practices at Beecher Chiropractic Clinic at 1001 Pineloch, Ste 700 Houston, TX 77062. You can schedule an appointment at www.BeecherChiropractic.com or by calling (281) 286-1300. If you have any questions regarding this blog, please comment below!
When Not To See A Chiropractor
Houston Chiropractor Comments: Most of the time patients will tell their friends about all of the different conditions that chiropractors treat and what wonderful results they received. As a chiropractor with over 33 years of experience treating patients, I have also found a few conditions that you should not see a chiropractor for. These are actual conditions that patients have come in to my Houston, TX office complaining about.
One condition is called cauda equina syndrome. This can occur in people who have a history of a herniated disc in their low back. They make a sudden motion or lift something up and the herniated disc becomes worse and puts pressure on the spinal cord. A symptom is sudden loss of bowel or bladder control. This is a surgical condition and not one that will respond to chiropractic care.
Another condition is called ankylosing spondylitis. This is an inflammatory arthritis that causes the spine to fuse together. Since this condition leads to stiffness, it is common for people to seek out chiropractic care to help with flexibility. The problem comes with people thinking that you can adjust a fused joint and make it no longer fused. Instead, it is a matter of using other therapies and exercises to allow the most flexibility without aggravating the inflammatory condition.
The final condition that you should not see a chiropractor for is pain that is getting worse with rest. This is a hard one for younger doctors to understand because they see so many conditions that are helped with chiropractic that they want to help everyone. If a condition is getting worse even after resting it and being in the proper relaxing position, you would probably benefit from medication first. If rest helps, but gets worse with movement, chiropractic can probably help.
Dr. Ward Beecher practices at Beecher Chiropractic Clinic at 1001 Pineloch, Ste 700 Houston, TX 77062. You can schedule an appointment at www.BeecherChiropractic.com or by calling (281) 286-1300. If you have any questions regarding this blog, please comment below!
3 Signs That You Need To See A Chiropractor
Houston Chiropractor Comments: Are you wondering if you need to be seen by Dr. Ward Beecher at Beecher Chiropractic Clinic? Some people think that the only time they need to see a chiropractor is after an auto accident or an injury of some sort. Below are 3 signs that you need to be seen by Dr. Beecher in his Houston clinic.
- Chronic pain in your neck, back, or shoulders.
If you wake up in pain or are regularly suffering from pain in your neck, back, or shoulders, it may be time to be examined by a chiropractor. The chiropractic doctor can determine if the pain is due to a misalignment of the spine, poor posture, tight muscles or bad work/sleep positions.
- Do you regularly suffer from headaches?
A doctor of chiropractic can help determine the cause of most headaches. Most headaches are caused by tension in the neck and shoulder muscles. Sometimes this leads to the neck leaning forward and the shoulders rounding. These conditions respond well to chiropractic care. If the headache does not appear to be musculoskeletal, the doctor of chiropractic can order the appropriate tests and make the correct referrals.
- Does your back or neck “go out” at random times?
Patients will mention during their history and examination that their neck and/or back does great for a long period of time and then “just goes out”. They notice that it is usually doing the same activities, such as weeding their garden, lifting a cooler or driving long distances. A chiropractor can help determine why a specific spinal area is the “weak link” and fix it. Your doctor of chiropractic will also demonstrate the correct way to bend and lift as well as showing you ways to make modifications in your activities. Strengthening the muscles around that area will help to reduce the repeat problems.
As a chiropractor with over 33 years of experience, I try to determine what I can do, what you can do yourself, and what you need to avoid to help correct the cause of your pain.Dr. Ward Beecher practices at Beecher Chiropractic Clinic at 1001 Pineloch, Ste 700 Houston, TX 77062. You can schedule an appointment at www.BeecherChiropractic.com or by calling (281) 286-1300. If you have any questions regarding this blog, please comment below!
Common Questions About Chiropractic
Houston Chiropractor Comments: I was talking to my staff today and one of them mentioned that when she talks about chiropractic to people out of the office, they often have questions or concerns. Some of these concerns are based on lack of knowledge about chiropractic and some are based on “fake news”.
The most common concern that she mentioned was that people think that they will get paralyzed or have a stroke if they get their neck adjusted. This is not true. This is why chiropractors pay the lowest amount for their malpractice insurance compared to other doctors. Chiropractic adjustments do not paralyze you or cause a stroke. A review of medical literature showed that in the rare case of a patient suffering a stroke, the artery was already dissecting when they arrived at the office complaining of neck or head pain. This also occurs in medical doctors’ offices. In both cases it needs to be quickly diagnosed and referred to a hospital for prompt treatment.
The second most common concern is that if they start chiropractic care they will have to keep coming in for the rest of their lives. This is also not true. In our office the goal is to get you out of pain and then give you the tools, via stretching and exercises, to keep you pain free without any spinal complaints. Some people choose to be seen periodically on a maintenance basis because they enjoy feeling good and operating at their maximum potential, but it is their choice. Several patients have stated thru the years that by getting periodic “tune-ups” they have been able to decrease their medication and the need to see other medical doctors.
The final concern that some people have is hearing the “popping” noise when they get adjusted. They think that the noise is bones being ground together when in fact it is just gas inside the joint. It is similar to the sound that occurs when you open up a bottle of Coke. It is gas quickly changing pressure. If you tried to adjust the joint again, just like opening the bottle of Coke again, it would not make the noise. If hearing the noise still bothers you, there are ways to adjust the spine without making any noise. 😊
Dr. Ward Beecher practices at Beecher Chiropractic Clinic at 1001 Pineloch, Ste 700 Houston, TX 77062. You can schedule an appointment at www.BeecherChiropractic.com or by calling (281) 286-1300. If you have any questions regarding this blog, please comment below!
What is the Difference Between a Chiropractic Orthopedist and an Orthopedic Surgeon?
Clear Lake Chiropractor Comments: As a board certified Chiropractic Orthopedist, I have people ask me this question. Most patients do not know that a chiropractor can go for additional post-graduate education that leads to a couple different board certifications. Doctors of Chiropractic can be board certified in areas of study such as neurology, radiology and orthopedics.
There are several similarities between a Chiropractic orthopedist and an orthopedic surgeon. Both doctors complete a 4-year undergraduate degree which is followed by a 4-year medical or chiropractic degree and internship. After this point, the two doctors engage in different paths. The medical doctor then begins a 4-year residency program studying the basics of orthopedic surgery followed possibly by a 1-year fellowship in a sub-specialty. The Chiropractic orthopedist will then enter a 4-year orthopedic program while treating patients non-surgically, with a variety of complaints.
To achieve my board certification in Chiropractic Orthopedics, I took additional classes for 3 ½ years, followed by a written and oral examination. Some of the additional training included orthopedic and neurological testing, whiplash treatment, management of extremity complaints, advanced imaging and medical legal report writing.
In summary, orthopedic surgeons are trained to treat problems with medication or surgery. Chiropractic orthopedists use non-surgical treatments to help patients restore their proper function through treatment of the bones, joints , tendons, ligaments, and muscles. Both help their patients get well…just differently.
Dr. Ward Beecher practices at Beecher Chiropractic Clinic at 1001 Pineloch, Ste 700 Houston, TX 77062. You can schedule an appointment at www.BeecherChiropractic.com or by calling (281) 286-1300. If you have any questions regarding this blog, please comment below!
What To Expect On Your First Chiropractic Visit
Clear Lake Chiropractor Comments: Most patients have no idea what to expect on their first visit to a chiropractor. If they are lucky, they have a basic idea of what will happen from the person or doctor that referred them, but they are not sure exactly what will occur. Some patients have just heard good things about chiropractic and want to try it no matter what the visit entails. Other people have no idea what will go on, they just know that the traditional medical approach isn’t giving them the permanent relief that they want.
The first visit at my office is very similar to any orthopedic doctor’s office. After the new patient paperwork is filled out you are brought to an exam room. At the start of the visit, I will ask if you have any questions that I can answer before I start asking you about your complaint. Most people don’t have any questions, but it is easier to answer their inquiries at the beginning so that they don’t forget what it is that they want to ask me.
The next part of the visit is taking a history of what is bothering you. Finding out what caused your problem, if anything makes it better / worse, and any treatments you have already tried. This will help me to determine what type of examination I need to perform.
The next part of the visit is the examination. This involves several nerve and orthopedic tests to determine what is actually causing the pain or problem. At this point I will be able to determine if this is a case that I can help so that that I can begin treating, do I need to take an x-ray / order an MRI, do I need to refer you to a different type of doctor, or can you resolve the problem on your own with proper stretches and exercises.
If we can treat you, we will go over the various options. This may involve spinal adjustments, physical modalities such as ice/heat, muscle stimulation, traction, or ultrasound or various exercises and stretches. If we cannot treat you, we will tell you what you can do and / or refer you to the appropriate doctor.
In summary, your first visit here is just like any other doctor’s office. We are just trying to find out if we can get you well without the need for drugs and / or surgery. Most people are relieved to find out that they can get relief on their first visit.
Dr. Ward Beecher practices at Beecher Chiropractic Clinic at 1001 Pineloch, Ste 700 Houston, TX 77062. You can schedule an appointment at www.BeecherChiropractic.com or by calling (281) 286-1300. If you have any questions regarding this blog, please comment below!
Do Auto Accidents Cause Permanent Injuries?
Houston Chiropractor Comments: Frequently patients will say that they had an auto accident at some time in the past and that it caused all of their current complaints. They will say this even if they only have the pain every couple of years and the rest of the time, they are active and pain free. They will believe it to be true even thought their x-rays do not show any degenerative changes from the accident. They are convinced that it is true because some doctor told them in the past that they are permanently impaired from the accident, even if it was minor.
These people will limit their activities and exercises because they have been told something that usually isn’t true.
While some accidents cause permanent injuries, they are the exception instead of the rule. Most auto accidents only cause minor discomfort or no pain at all. If the pain resolves in 2-3 days while using ice and OTC medication, you are fine.
If the pain persists after 72 hours, it is best to be examined by a doctor that treats musculoskeletal injuries on a daily basis. In my 33 years of being a doctor of chiropractic (DC), I have found that chiropractors are best suited to diagnose what is wrong with you and to determine what is the best treatment. Most general practice MD’s do not treat muscular pain regularly and therefore typically only prescribe medication for pain, inflammation and muscle spasms. Orthopedic and neurosurgeons are looking for problems to operate on. Most problems will resolve with chiropractic care and physical therapy. If the problem is surgical in nature the chiropractor will make the appropriate referral to a surgeon.
In addition, it is also important what treatment is performed. Some patients will only go to a physical therapist who only treats the muscular complaint and does not check to see if the patient has any joint misalignments. This is similar to having your car hit a curb and not realigning the tire. Eventually it will wear unevenly. The chiropractor can gently adjust the bone back to where it should be.
In my 33 years of being a chiropractor, I have found that most people who have pain as a result of an accident can be pain free in 2 – 8 weeks of therapy. It is important that you do the proper treatment, therapy, and exercises in the correct order. The patient is then shown home-based exercises and stretches to maintain their gains. This is similar to a dentist fixing your teeth and then showing you the correct way to brush and floss.
Treat your injuries correctly after an accident and you will be able to live your life fully without fear of future problems.
Dr. Ward Beecher practices at Beecher Chiropractic Clinic at 1001 Pineloch, Ste 700 Houston, TX 77062. You can schedule an appointment at www.BeecherChiropractic.com or by calling (281) 286-1300. If you have any questions regarding this blog, please comment below!
