Crash Course on Personal Injury Practice Success
Interview with Personal Injury Practitioner Dr. Tom Arnold
Dr. Tom Arnold is a december 1989 graduate of Texas Chiropractic College and moved to Albuquerque, New Mexico, and began practicing in early 1990.
In an interview with The American Chiropractor (TAC), Dr. Arnold explains what it is like to be a doctor with approximately 95 percent of his patients being
Personal Injury.
TAC: What inspired you to become a chiropractor? Do you have a specific story?
Arnold: Frankly, as a kid I started giving myself adjustments. It started with popping my knuckles, then my knees and then neck and back. I was always athletic and it helped me get through my sports, so I had a firsthand experience of the benefit it provided even though it was not administered by a chiropractor. As an adult, I started going to a chiropractor just to stay tuned up for sports and it made an enormous difference. After several years in the financial world as a stockbroker, I was burned out. And I quit. During the next year, I discovered a special God given gift in my hands and, with the encouragement of friends and family, I pursued that gift through chiropractic.
TAC: What type of patients do you generally treat or attract?
Arnold: Approximately 95 percent of my practice is Personal Injury. I concentrate on automobile collision injury cases and I enjoy caring for the injured. It offers me a challenge to use more of my clinical skills in ways that aren’t necessary when treating chronic pain patients. I can empathize with auto collision victims.
TAC: What was it about Personal Injury that led you to develop a clinic almost exclusively treating that condition?
Arnold: My interest in automobile injury cases developed in my last year of chiropractic school. During that time I married a young lady who had been injured in an automobile collision three years before we met. She was hit from behind and continued to deal with severe headaches, neck and upper back pain. She is a registered nurse and, at the time of the accident, she didn’t know anything about chiropractic and therefore pursued the medical model of treatment which was prescription medications and physical therapy. As she said, “It really didn’t help.” When we met, she was living on handfuls of ibuprofen just to get through the week. As I cared for her, her condition greatly improved. The sad news is that her problems never completely resolved and developed into a long-term chronic condition. I can say without reservation that her situation and experience deeply influenced me. I have made a life-long commitment to develop my clinical skills through post-doctoral training as much as I can to provide my patients a recovery experience intended to prevent or at least improve the chances that they will not suffer like my family has. I say “family” because, when one person suffers, it affects the whole family.
TAC: What did you do specifically that changed your practice in building a PI patient base?
Arnold: I started looking at the legal community in a completely different manner than I used to. I used to think of them as a “necessary evil” of the Personal Injury world and they looked at me as a “necessary evil” when they represented my patients, because my documentation was horrible. I have since come to realize that, in order to help my personal injury patients as much as I can, I must think outside of the box of just treating their injuries. I had to learn to objectively and effectively communicate my patient’s situation to his or her attorney. This now gives the attorney an articulate explanation to allow the truth to be the deciding factor in a trial or settlement. Since then, my relationships have flourished as I am now looked upon as an expert by the medical-legal community.
TAC: Are you required to testify, or do depositions frequently?
Arnold: Yes, I am asked to testify several times per year.
TAC: How important is your clinical knowledge when doing Personal Injury cases?
Arnold: This is the most important question you can ask. Your clinical knowledge is the most important component and that has little to do with your knowledge of adjusting the spine. If it wasn’t for my post-doctor training in spinal related subjects like disc pathology, neuropathology and crash dynamics, I wouldn’t be able to articulate or testify about my patients’ injuries from a factual base. That is especially true when being cross examined in a trial or deposition, because lawyers will come at you and the only way for the truth of case to prevail is to be clinically excellent.
TAC: What type of knowledge base and CE Courses do you feel are necessary to succeed in a PI Practice?
Arnold: Prior to my commitment to personal injury, I only took continuing education courses to keep current with my adjusting skills. Since making the decision to be the best of the best in the Personal Injury arena, I have taken courses in advanced imaging, neuro-diagnostics, crash dynamics and documentation, to be able to apply a broader understanding of the legal challenges that face the plaintiff attorneys who represent my patients. Clearly, establishing high-quality working relationships with the plaintiff attorney community is vital. To do so, I have to demonstrate that I speak their language by providing them a quality product in the form of reports and documentation on their clients’ conditions, especially if there are residual disabilities.
TAC: How is what you do now, after having practiced this way for a while, differ from when you started?
Arnold: Back then, I didn’t know that I didn’t know. But now I’m committed to keep growing in my knowledge to expand my practice. I realize it is a life-long journey.
TAC: Have your credentials affected your ability to work with the legal community and, if so, how?
Arnold: I have to admit that, for a long time, I was clueless about the importance of credentials. There’s no way to calculate what that has cost me in lost opportunities. Now that I have “seen the light,” so to speak, my curriculum vitae reflects the efforts that I have made over the years to elevate my standing in the Personal Injury arena, through my credentials vs. through rhetoric. As a result, I’m working with attorneys who otherwise would not have given me the time of day.
TAC: What kind of notes system do you use, and is there a reason?
Arnold: My daily patient progress notes are taken in a standard S.O.A.P. format. This format covers the requirements for proper documentation. The last thing I or any other doctor needs is an insurance audit that reveals substandard and inadequate documentation that leads to a demand for a refund to the insurance company. I can live without that nightmare.
TAC: What were the biggest mistakes you made that affected your PI practice?
Arnold: I don’t know that this was a mistake…more like a blessing in disguise; but, a few years ago, I was one of the early adopters in the field of nonsurgical spinal decompression. For over a year, I stopped taking PI cases and concentrated just on decompression. I began to miss the automobile injury cases and finally returned to my roots. In retrospect, it was good for me to get away from Personal Injury cases for awhile, because now I believe I have renewed energy and empathy for this unique segment of the patient market.
TAC: What type(s) of diagnostic testing procedures do you use and why?
Arnold: For functional diagnostic testing like computerized ranges of motion and computerized muscle strength tests, I am equipped to do them in my office. However, when the patient needs electro-diagnostic procedures like an Electromyography/Nerve Conduction Velocity study (EMG/NCV), Somatosensory Evoked Potential test (SSEP), brainstem auditory evoked response (BAER), Video Electronystagmography test (VENG) or visual evoked potential (VEP), I refer them to the appropriate specialist and treat in a team environment.
For structural diagnostic procedures, I have plain film X-ray in my office and refer out for magnetic resonance imaging (MRI), computed axial tomography (CT) scans and bone scans.
The short answer to why is simply to arrive at the most accurate diagnosis possible.
TAC: What has really impacted your growth as a chiropractor and that of your practice?
Arnold: I would have to give a well deserved round of applause to Dr. Mark Studin for sharing with me his vast wealth of knowledge and experience in dealing with the legal community and for encouraging me to strive to be, as he says, “the best of the best.” One of the not so obvious secrets I picked up from him was the importance of developing a strong “infrastructure” composed of the curriculum vitae, effective narrative report format, and medical-legal educational and communication system.
TAC: With your practice being Personal Injury, can you give our readers your advice about setting up and maintaining such a practice in today’s healthcare system?
Arnold: If you don’t have a strong empathy for the automobile collision victim, then don’t bother. I like this niche and I’m sure it is much different than a family practice. I like the specialization and the unique challenges of providing admissible documentary evidence and testimony to the legal community. Keeping up with the medical literature is a bit of a challenge because there is a constant flow of new research that validates these injuries and supports what we do to treat automobile injury patients.
TAC: What general advice would you give an established chiropractor whose PI practice might be struggling?
Arnold: It’s probably struggling because he or she has not established a solid infra-structure of credentials, narrative reports, and medical-legal educational and communication systems that lets the legal community know that he or she is the real deal. Like I did, there are programs in the chiropractic community that can guide you through the process so you do not have to “re-invent the wheel” and which will shorten the learning curve.
One thing I learned, simply advertising or marketing will not get you the Personal Injury practice you want; that will only be achieved by becoming the best at what you do through your knowledge and a solid infrastructure.
TAC: Any final words for our readers?
Arnold: Through this whole process of working effectively in the Personal Injury world, the biggest winners are more than just my patients. The legal community in my area now has a “new-found respect” for chiropractic because they realize that chiropractors have the same knowledge base as their medical counterparts. The end result is that chiropractic wins and that makes me proud!
You may contact Dr. Arnold at [email protected].
Editor’s Note: Do you know an Amazing Chiropractor that you’d like TAC to highlight in our The Amazing Chiropractor series? Contact TAC’s editor Jaclyn Busch Touzard, by phone/fax at 1-305-716-9212 or email [email protected]. We want your inspiring story! Contact us today!