My last article raised the question of the expertise of medical experts. Having a surgeon performing an IME to evaluate the need for surgery is valid. Having that same surgeon evaluate injuries that occurred two years before is at best questionable as that doctor’s opinion is rarely supported by their training or experience.
Ironically, while chiropractors are held in lower esteem by the automobile insurance industry it is medical research that makes it clear that chiropractors are far more qualified to evaluate musculoskeletal conditions.
In a recent zoom meeting with Christopher Brigham, MD, the chief editor of musculoskeletal chapters of Fifth and Sixth Editions of the AMA Guides to the Evaluation of Permantent Impairment, he mentioned a study that found 82% of MDs who had chosen to specialize in orthopedics, failed a basic 25 question musculoskeletal test. As one of the world’s leading experts on musculoskeletal problems he seemed especially confused by this study.
I pointed out that this is only the first of a series of studies involving the same musculoskeletal test. Given the high failure rate on the next round, the passing grade was lowered to 70%. Even so 78% of the MDs still failed this test. This was the basis of the AMA Resolution #310 in 2003 that stated, “It is therefore reasonable to conclude that medical school preparation in musculoskeletal medicine is inadequate.”
A third round of the test in 2005, was given to medical students, residents, and staff physicians. This time 79% of them failed to demonstrate any basic understanding of musculoskeletal issues. Of the 21% who did pass this time around 58% them were orthopedist or staff physicians in hospitals.
A fourth round in 2006 aimed to determine if osteopaths were better prepared to address musculoskeletal issues. Once again, 70.4% of the osteopath and 82% of the MDs failed. In a repeated round they lowered the passing grade from 73 to 70%. This time 67% of the DO’s and 78% of the MDs still failed.
In 2009 the test was administered to medical school students and 95% of them failed. Two years before the test was administered to chiropractic students, all seniors at Canadian Memorial Chiropractic College. This time the chiropractic students had an average score of 80.8%.
So here is the thing. If 82% of MDs going into orthopedics failed and almost 81% of chiropractic students passed there should be little question as to who is best equipped to address musculoskeletal issues. The catch is that in personal injury it is not healthcare. It is injury care.
There are several programs that teach chiropractors how to better diagnose and manage a personal injury case. The one offered by the American Academy of Motor Vehicle Injuries includes 150 hours of instruction, far more than the others. It also has a certification test administered by the National Board of Chiropractic Examiners.
For your clients seeking care for their injuries sustained in a motor vehicle collision they would be well served to be treated by a chiropractor who understands neuro-musculoskeletal systems, rather than by a family doctor whose best course of treatment is medication to cover up the symptoms.
For you as an attorney the value of a chiropractor who has been trained on how to diagnose, document, and manage all of the injuries should facilitate getting a fair settlement offer.
Stay tuned for my next article. Things are about to change.
