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IMPORTANT:  Under Construction.  Many links may be broken.

Table of Contents

• Needed Items
• Needed Forms
• Treatment Thought Process
• CAIR Principle
• Key to success!
• Important reminder!
• Resource Links

 

 

 

 

 

 

 

Needed Items

1. Highly specialized equipment
One of the advantages of carving out a niche is it allows you to focus your budget toward specialized equipment. You must have things no one else does and let everyone know!  This specialized equipment is going to vary depending on your niche.

2. Highly specialized supplies
Same as above.

3. Highly specialized products for purchase
Open up another revenue channel and increase the perceived value of your services by offering your patients products they need and want ...at the convenience of your own office.

4. Treatment Table
Make sure to get a nice treatment table with a face-opening in your main exam room.

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Needed Forms

1. Flow Sheet
This forms is critical for success. It must allow you to sequence the treatments you wish to render as well as allow description for each procedure or modality setting.

2. Daily Notes
Your daily note is for longer narratives, however, most of your info on the flow sheet will suffice, generally.  Make sure to have a two-column daily note. It's much more functional, easy to read and reference, as well as to add communication notes.

3. Exercise Logs
Have separate logs for each joint and list the ones prescribed most often and leave blank spaces for custom entries.

4. Re-evaluation Form
Your progress reports should give a before and after picture of the patients condition. Not only will it help your patients see the value of your service (when improvement was made) but your referral sources are more likely to read it. Add a segment at the bottom which allows the referring MD to check the "I concur with the above treatment plan" box and fax back to you for the instances where you require an extension of the patients script.

5. Discharge Form.
You can use the "Re-evaluation Form" form above. Include an option where discharge is decided should they meet your discharge criteria.

Recommended discharge criteria:

• Subjective complaint is managed at a 2 or less (on a 10 point scale) during ADL's
• Objective measurement(s) are 80% of normal
• Functional impairment is 80% of normal
• Independence with self care and home exercises

6. Quick Status Note
Sometimes you will not perform a complete Re-evaluation and only want to communicate a quick status note. Make it simple including only the pertinent pieces of information you want to communicate.
 

Don't try and re-invent the wheel.  Use our forms and documents.

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Treatment Thought Process

1, Teamwork
You cannot do it alone. You can't try and schedule the appointment, collect copays, answer phones, clean treatment rooms, get the ice, do the ultrasounds, etc. Not only does it lower the perceived value of your services, you are wasting money.  You have to view yourself as an employee of a business entity. Yes, you own that entity but you are also an employee of that entity (whether you are formally on payroll or not).  If you are trying to do all the tasks mentioned above, it's the same as paying someone $30-40 per hour to do an $8 hour job.  Even worse, the $40 an hour tasks such as developing your newsletter, making "contact" with your patients (to grow your word-of-mouth advertising) is not being done because you are too busy doing the $8 an hour things.

2. Comparable Sign
You must show the patient regularly they are improving by measurable means or else they will not see the true improvement. It's just someone trying to lose weight. From day to day it's hard to realize the changes but most usually they are making progress.

3. Attainment of Goals
It's important to have your discharge criteria in mind at all times in order to have truly great outcomes.

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CAIR Principle - Steps to a sound treatment plan

C ontrol destructive forces

The first stage of healing and restoration begins with the controlling of forces from the injured or effected area.  This is why the patient's role stage is so important in the evaluation process.  They should learn things NOT to do such as, in the case of a herniated disc patient, they should not hold their breath when bearing down or lifting. Fluid dynamics can also be considered in this phase since it reduces inflammation and pressure in the area.

A pply safe and appropriate forces

You cannot move to this phase until the first one is accomplished. Once the area is calmed down and destructive forces removed then and only then can the healing begin, that is when you want to impose safe and appropriate forces to stimulate proper healing of connective tissue, etc.  Examples would be gentle stretching, isometrics, oscillations, etc.

I nitiate challenging forces

Now is the time to progress and impose forces that are more challenging such as resistance, proprioceptive, dynamic stabilization exercises.

R estore high level functional forces

Only now can you begin to push the structures and go to extreme end-ranges and plyometric type movements. Exercises geared to mimic their functional activities.  Make them better than they were even before their injury!

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Key to Success

Perform only the skilled procedures and treatments and hire an assistant, aide or technician to handle everything else.

 

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Important Reminder

Make sure every patient leaves knowing something they didn't before they came.

 

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Resource Links

• If you have any trouble with this section (most do) than consult with James Ko at 1.800.801.4511 ext. 701 or jamesko@indefree.com 

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