A few months ago I received a phone call from one of my former associates, Tao (first name). Tao had worked in my clinic in Pleasanton, California for more than a year prior to establishing his own successful practice in Phoenix, Arizona. The main purpose for the call was a consultation regarding the management of an infant who had been injured in a motor vehicle collision. Specifically, the insurance adjuster's attitude toward the claim was: "our chiropractic consultant informs us that it is unlikely that an infant can be injured in a motor vehicle collision, and therefore treatment of an infant after a motor vehicle collision is not likely to be reasonable or necessary."
Chiropractors who treat motor vehicle collision injuries, including those to children, are probably all too familiar with this attitude. Several years ago, I had the opportunity to testify in a case in which a seven-year-old child and a 22-month-old toddler were injured in a motor vehicle collision. The children were treated successfully by a chiropractor; the mother of the children was adamant that the chiropractic care for her children was necessary for the improvement of their condition caused by the motor vehicle collision. Yet the case went to trial because of the attitude by the insurance company and their chiropractic paper reviewer. They claimed that the children did not need the amount of care they received, and that the treating chiropractor's records could not justify the care he gave to the children.
One of the consequences of this trial was my generation of a chapter in a new book, Pediatric Chiropractic, edited by Anrig and Plaugher, Williams and Wilkins, 1998. From my initial literature search, I selected approximately 200 articles that I felt to be most relevant for chiropractors. In the process I learned a great deal, including the following:
Many of the concepts that pertain to adults in motor vehicle collisions also apply to children, including the basic principles of inertial acceleration/deceleration injuries, preparedness prior to impact, and rotation of the head or trunk prior to impact. Overall, studies indicate that the pattern of injury among children involved in motor vehicle collisions is similar to that of the general population.
However, these injuries to children can be unique because of the following factors:
Motor vehicle collsion injuries are the leading cause for death in children older than one year of age, the leading cause of children's doctor visits, and the most common reason for admittance to hospital emergency departments. Motor vehicle accidents are the most frequent cause for injuries to children and young adults. Some examples:
Pediatric Chiropractic. Ed: Anrig C, Plaugher G. Williams and Wilkins, 1998.
Daniel J. Murphy, DC, DABCO
Many relevant diagnostic signs are not performed deliberately by the examiner or by the patient at the examiner’s direction. They are observed as the patient reacts to their condition. Fortin’s finger sign, Minor’s sign, and Vanzetti’s sign are three examples of this principle.
Spearheaded by burgeoning scientific and clinical research literature, psychedelics have reached a level of media coverage and popular interest that has not been seen for over half a century. By “psychedelics,” we are referring to the unique class of substances that includes psilocybin (the active compound found in so-called “magic mushrooms”), LSD, dimethyltryptamine (DMT), ayahuasca, 5-MeO-DMT, and mescaline – each of which occurs in the natural world (except for LSD, which is a semi-synthetic compound).
While working at the Lovelace Medical Center in Albuquerque, N.M., one of the primary care physicians stated that imaging every patient prior to receiving chiropractic was not medically necessary. It was at that point I reconsidered the need for the imaging of every patient to avoid malpractice.
