#3 EMR, Macros and Reporting to the Medical Community 

#5 “Clinical Compliance, Reporting and the Primary Care MD Referral”

You can be the smartest doctor in the world, have the best diagnostic capabilities in the country and your staff can be the most jovial in the universe, but it really makes little difference if no one knows.  That is why practices are using social media, print ads in local newspapers, patient email blasts and public speaking engagements.  Chiropractic, as a profession, continues to miss the opportunity to educate and promote our expertise to the medical community.  NO ONE DOES WHAT WE DO.  Therefore, there is no competition.  I reviewed a research article on the clinical competency related to the  musculoskeletal  system.  When it comes to promoting to the medical community, we have to start with the musculoskeletal system because it has the most research and is the easiest for MDs to understand.  The interesting thing is MDs are NOT taught in medical school to refer to PTs for musculoskeletal problems.  Therefore, it is a learned behavior.  In the research paper that I will share with you in a minute, medical professionals had some of the lowest scores on the Basic Competency Examination [BCE] for musculoskeletal conditions.  It is not hard to understand why MDs don’t really understand HOW to refer for diagnosis and treatment of these conditions.  Here are the results of the study by Humphreys, Sulkowski, McIntyre, Kasiban, and Patrick (2007). 

The following results were published in this paper for the Basic Competency Examination and various professions that are in the front line of the diagnosis and treatment of musculoskeletal conditions.  In Table 2 on page 47, the following results were shown when the passing score was established at 73% or greater:


Recent medical graduates (18%), medical students, residents, and staff physicians (20.7%), osteopathic students (29.6%) physical therapy  (MSc level, 21%), physical therapy (doctorate level, 26%), chiropractic students (51.5%). 

In Table 2 on page 47, the following results were show when the passing score was established at 70% or greater. 

Recent medical graduates (22%), medical students, residents, and staff physicians (NA), osteopathic students (33%) physical therapy  (MSc level, NA), physical therapy (doctorate level, NA), chiropractic students (64.7%).

Let’s break this down a little bit and hopefully, this will give you the education that you need to really succeed at this program.  Until you really understand why the parts of this program are set up the way they are, you will continue to doubt the program and will go into it half-heartedly. The authors reported, “In the United States, approximately 10% to 25% of all visits to primary care medical doctors are for MSK [musculoskeletal] complaints, making it one of the most common reasons for consulting a physician” (Humphreys et al., 2007, p. 44)”  That is a ton of patients.  Take into consideration that a busy primary care office will have about 120 unique patients per MD per week.  If we look at 25% coming due to MSK, that means, on average, a single primary care physician will see 30 MSK patients per week.  Guys, am I making sense here?  This is where you start your marketing and your relationship.  Understand that the MD is ignoring many of these issues that will turn into chronic pain because they don’t understand the musculoskeletal system.  EDUCATE them and they WILL REFER.  Educate them on why chiropractic is the best choice and then stay in front of them. 



Humphreys, B. K., Sulkowski, A., McIntyre, K., Kasiban, M., & Patrick, A. N. (2007). An examination of musculoskeletal cognitive competency in chiropractic interns. Journal of Manipulative and Physiological Therapeutics, 30(1), 44-49.{jcomments on}

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