The Shoulder Exam
The Shoulder Exam
The normal Range of Motion (ROM) for the shoulder joint is:
| MOTION | |
| FLEXION | |
| EXTENSION | |
| ABDUCTION | |
| ADDUCTION | |
| INT. ROTATION | |
| EXT. ROTATION |
Details Of The Chief Complaint
Details Of The Chief Complaint
SOURCE: A Chiro.Org Editorial
By Paul D. Mullin, D.C.
Before we examine any new patient, we need to gather a detailed history, particularly of the current complaint(s). I want to thank Paul D. Mullin, D.C. of Palmer College for suggesting these 18 questions, to help DCs in gathering the information they need to clearly understand a patient’s issues.
These questions are a good example of the interviewing skills required of any doctor: (more…)
What is Medical Necessity?
What is Medical Necessity?
SOURCE: A Chiro.Org Editorial
“Medical Necessity” is the slippery slope, according to the Physician’s News Digest
“There are almost as many definitions of medical necessity as there are payors, laws and courts to interpret them. Generally speaking, though, most definitions incorporate the principle of providing services which are “reasonable and necessary” or “appropriate” in light of clinical standards of practice. The lack of objectivity inherent in these terms often leads to widely varying interpretations by physicians and payors, which, in turn, can result in the care provided not meeting the definition.”
Medicare defines “medical necessity” as services or items reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member.
From an Insurers standpoint, this is why documentation of the patient encounter is so important. The standard note taking format for every patient encounter is the SOAP note. Medical (chiropractic) necessity is defined by your own notes. Let’s review what actually defines reasonable and necessary in the SOAP note:
There are more articles like this @:
The new SOAP Notes Page and our
Do You Use Outcome Assessment Questionnaires?
Do You Use Outcome Assessment Questionnaires?
If you haven’t noticed lately, every provider in each discipline is being held accountable for the care they provide to a patient. Why? Because evidence–based treatment approaches are becoming an expected “standard” for proving the effectiveness of care over time, and because tracking outcomes is a means by which insurers decide if the care provided has been necessary.
The Outcome Assessment Page contains, or links to, most of the best-supported OA questionnaires. It also has a collection of articles about the use of OA in the field.
You may find the Outcome Assessment Guidelines Section of interest.
That page is one of many of the useful tools found in the
Clinical Documentation Section.
Cervical Spine Trauma
Cervical Spine Trauma
The cervical spine provides structural stability and support for the cranium, and a flexible and protective column for movement and balance adaptation, along with housing of the spinal cord and vertebral arteries. It also allows for directional orientation of the eyes and ears. Nowhere in the spine is the relationship between the osseous structures and the surrounding neurologic and vascular beds as intimate or subject to disturbance as it is in the cervical region. Whether induced by trauma or not, cervical subluxation syndromes may be reflected in total body habitus. (more…)
Antibiotic Abuse
Editorial Commentary:
The CDC (Centers for Disease Control) has been begging conventional medicine to stop overprescribing antibiotics for decades. Even so, a recent study in the Journal of Hospital Infections found that 37% of 600 antibiotic prescriptions were considered unnecessary and another 45% were considered to be inadequate.
Considering that antibiotic use in infants has been associated with doubling the incidence of asthma, and other studies have revealed that 76% of adults who visit a primary care physician because of a sore throat are given an antibiotic, even though viruses (that are not affected by antibiotics) are the primary cause for upper-respiratory-tract infections. (more…)