Personal Injury & Philosophical Chiropractic. Is It Possible?

Hello, this is Dr. Joe Esposito. We're excited for this edition of align your practice podcast. I have a special guest and a dear friend of mine, Dr. Renny. Edelson. How are you?

Great. Great to be here. Thanks for having me today.

Yeah, so ready, I wanted to just start by letting the listeners know, a lot of people listening probably know you. You're becoming an icon and a professional, I think you're, I think you're there 39 years in practice. And I just want to frame out some of your background that that some of it I didn't even know. So people can know who they're listening to. But you actually me being part, you and I be part of a national franchise allied life, you were actually one of the founding members of the first group that created a franchise many years ago called chiropractic, USA, and trudge through the pathway for all of us behind you to actually start building this franchise network that's available in the profession. So I want to thank you for that right off the bat. But you're also one of the first doctors who got hospital privileges, which is a big deal. When we were shunned by medicine for so long to actually break through that is amazing. You're also a chiropractor for the Miami Dolphins chiropractor for the Panthers. And you're you were actually friends with some of my mentors, I didn't have the close relationship, but people like siga Foose people like in grasim. I know you were a part of CJ merchandise movement many years ago. So it's interesting. Today we're gonna be talking about personal injury. And I want Dr. Adelson to kind of explain his journey because I know Dr. Adelson, as a principal subluxation high philosophy practitioner, and when he said he was doing work in personal injury, I was kinda like, I didn't understand it. So why don't you talk a little bit about just a few moments about the journey that I just framed out for you. And then how you got from there to become literally an expert in managing personal injury.

So It'd be my pleasure to do so. So, and it's probably a longer story than we have time for today. So I'll just kind of hit some broad strokes. At the very beginning of my practice, in the early years. One of the things that you mentioned was the hospital staff privileges, we were doing work with Post Traumatic Stress Disorder people. And these are people that for a multitude of reasons, either whether they served the country, or they actually were some sort of job where they got injured on the job, and they were being drugged after death, and never were rehabbed properly, they wound up having all kinds of problems. And so we've kind of found this niche where, hey, who's better to run that wing in the hospital than a chiropractor, you know, they have people like pts and stuff like that. And we wound up really filling the beds in the hospital, and really getting them rehabbed and started introducing chiropractic. And this was in a charter, private charter group hospitals in Miami. And it was really, really awesome. But my practice, my personal practice grew so big that I had to make a choice, you know, which way am I going to go? Am I going to take the big check from the hospital? Or am I going to so to me, I went into chiropractic because I wanted to save the planet. So that wasn't my goal wasn't that I just wanted to crack that nut and, and be able to get into the hospital. And that was pretty cool. You know, to be able to say check, I did that. along that journey, also becoming and getting really close with people like Shula and the people, his really their friends, where I got to be the preferred chiropractor for the Miami Dolphins. And then after three years, I was with the Florida panther Hockey Association. And, you know, I learned a lot from these guys. I mean, they were all really run by the orthopedic groups, and the PTS, and there really wasn't a lot of room for me to be able to make leadership decisions or like have the conversations that I would have in my, in my regular practice with the players. But what quickly happened, as most of the listeners are going to appreciate is that chiropractors tend to become part of your family. You know, and so we have we're relationship building people, you know, medical doctors, not so much right? So next thing you know, I'm friends with all of these players. And, and so I get to participate in a field Good Friday moment, where you know, they're all lined up and say, Hey, Doc, can you do this hip and knee thing that you did a man that really helped me I was running like Fire after that, and I go, Yeah, I'm gonna, I'm gonna save your life first, and then I'll go ahead and look at that dip thing, okay. And then there'll be like, okay, all right, cool, you know. And so like I constantly was just embedding a little philosophy, and then they wanted more. So but what I found that quickly through that process was that, really what they were trying to do is, and I know everybody's familiar with this, just get them back in the game. They have the biggest investment in these players, and anything that they need they get anything that they need they can get. The problem is, is that they use them up until they can't any longer. Then they've done what kind of sounds like a mechanistic approach that we know, philosophically in chiropractic, doesn't go tinker with the body tinker with the body tinker with the body, so you can't tinker with it anymore?

Yeah, yeah, just get what you can out of it. Right. Let's move into you know, this the concept of personal injury let frame it out, because there are some students on here, let's get really one on one here. And let's get into this conversation a little, what is Personal Injury just as an entity, for those that know nothing about?

I mean, my definition is different than than what most people would think it's, you know, when you when you're analyzing a practice, and you're, and you're, and you're looking at the metrics of attraction into your office, right, we're looking at what's the mechanism of injury, like was one of the first questions that you're asking, and I loved framing this after students, because they're so close to, you know, the diagnosis and all the things that you have to learn that you that you have to learn to forget, in order to run a successful business. But but they're closer to that entity. And it's easy to have this conversation with somebody that's young coming out of school. So, you know, you have to have clinical excellence, you have to be able to go into an examine, yes, understand orthopedic neurological testing, you got to understand when you're reading X rays, but the definition of it, of it of a personal injury to me is somebody that was involved in an injury, the mechanism of injury was probably more motor vehicle oriented. And now, that could be on a bicycle, it could be on a golf cart, it could be a slip and fall. But that would be categorically a personal

automobile accidents is the highest prevalence of someone who comes in in a case of personal injury. But if I tripped on the curb, and fell and hurt my back, is that a personal injury?

I mean, I would think so.

Yeah. So there are anything where there's actually a causative action, some type of trauma where you are injured by something. And but the most common one is, is these car accidents, right? People are getting hit, they're getting injured. So the there has always been, and I told you this before we got on, I honestly wouldn't see a personal injury patient because I was under the assumption that they were not true. It was a real there was like a scam or some kind of issue with it. And I felt kind of silly. But that's what I remember in school. That was the kind of feeling I was given. But I felt kind of silly, because I had a personal injury case coming toward a college can't louver neck, but accident four days ago, the amount of edema around T one and T three was insane. The amount of swelling coming up, I gotta cook the eggs, the posterior aspect of the cervical spine, I was shocked at the amount of trauma, and she was giving drugs and drugs and drugs, and then a neck brace. And she came in a week later. And I was sitting there like, I'm not accepting personal injury cases why this person was suffering. And I know what they needed more than anything, was chiropractic care. So it opened my eyes to like learn really about the essence, why is there a negative? Has there been a following negative stigma? And you've been a subluxation based chiropractor. And just real quickly, how did you bring such integrity? Because I visited your practice, I was blown away to the management of these cases versus what you hear as a stereotype.

So not not different than yourself. Dr. Joe, I did not get into this personal injury type service until way later in practice. Now I dabbled with it for a lot of years. But I didn't really fully dive in until almost 30 years into practice. If you think about that, it's because and what I took prepared five years of credentialing at 25 years in practice, to get myself to the point where I was I felt like I understood like an S Expert, certain things that that I can easily communicate and be the expert. So I'm gonna, I'm gonna reel backwards because listen, you asked me a question. Yeah, the question kind of would be answered properly in two different ways. Some people want to chiropractic world want to be more philosophically based, and there, they don't want to deal with personal injury because they don't want to deal with the paperwork. Other people don't want to be philosophically based, they don't care to educate the world, and save the planet one spine at a time. And, and, and retain relationships and have poor lay have entire families, that neighborhoods, you know, for that matter to come into the practice, they want to just be able to render care and make a lot of money. They don't care about the paperwork. So So there's those two different kinds of philosophies. I think, in chiropractic as some people just say, Look, I don't want to go ahead and do these long orientations or any of these type of things, I just want to go ahead and see personal injury, when I'm done with them, and 30 to 60 days, I'm done. And I get to start fresh again, I don't have to build any relationships.

So that's interesting. So you broke it down, if we were to look at the positive and negative. So in personal injury, you have to document you have to objectively test, there is some work to be done, that you could be this philosophical Cairo that is doing great work, if you add objectivity. And it's not changed your practice at objectivity measured correctly, you can offer care to these people that are suffering. On the other side of the coin, you said, some people don't want to build relationships, there may be introverted, they may not be good at marketing, or building relationships, and personal injury, these are people that are hurt, they're referred to take care of them. And it's and it works for them. The stigma part of it, I think it's because there was feelings over the years, because there are doctors or attorneys that are into, you know, whether it's cases that are real, or they're they're not there out of integrity, basically, I don't like that, that skews the whole essence of taking care of personal injury cases. But there is some of that stigma. Because there's a lot of revenue to be generated from managing and taking care of these people. Is that why there's that stigma? Is some of the negativity people that are out of integrity and managing these cases.

I would think so at some level, for sure. But I, you know, I, you know, I have a kind of a different outlook on it. And it's, you know, I love chiropractors, they're, you know, my life is, chiropractic is my life, chiropractors, you know, when I die, I'm going to be able to say, hey, all of the people that I'm that I'm closest with are either my practice members, their families, their or chiropractors, right, I surround myself with, you know, with that, but there's still chiropractors that love loves to be the hero in the story, you know, and if you're going to be a philosophically sound, then you're going to give more praise, to have the innate intelligence that's inside the body that has way more wisdom than any of the education that you can pick up from any mentor or book. And it already knows that cup is already full from birth, from the first from the womb to the tomb, you know, and so to me, healing is again, above, inside out, above, down, Inside Out job, it's not an outside in thing and the chiropractor's well could be some of the chiropractors love to be the hero in the story, you know, you come to me, I'll take care of you. A I did this, you know, good job, Pat, on the back. I'm your hero, and I'm like, You're not the hero. They're the healer, you're a great mechanic, pull the car around back and don't talk to me. You know, I love to because as you know, I've had 40 Associates in my career so far, you know, I find that there's those two types of people but to me, you know, again, when you want to be a philosophically based chiropractor, you know, you have to understand that the philosophy of chiropractic is sound, you know, subluxation interferes with innate intelligence in the body. It's as simple as that healing is an inside out job. Principle number six, you know, there's no process that doesn't require time. When someone's involved in an injury. These people really injured and you can say, I'm like, I don't know if it isn't a scam, or what is it? And I'm like, You know what, when someone comes in, and I think that they're a malingerer, I can smell it a mile away and I don't accept the case. Okay, I kick them out. But what chiropractor? Have you ever met Dr. Joe in their lives that in their career that put X rays up and you did not find subluxation?

That's too often

never, it's never happened. So

yeah, so So you're saying you can tell the difference, they need care. But you can tell because of your experience those that had a true accident now, now you go ahead and you want to take care of this individual that had a true serious trauma. But there's some complexities that I don't know about scared me, but confused me. When I was dealing, I'd like to spend the rest of this time. And we're going to follow up with another podcast talking about management of patients. But the complexity for me is I didn't really know how to manage it. It was an attorney in my town that I met. And he asked if I would see people that have had injury, I said, Sure. So he would refer as an attorney to me, and he would kind of like dictate, and then he wants my records, that he's kind of like trying to tell me how to guide this care. And I was just really confused. So you have an attorney, you have a hospital, you have an MD, I'm the chiropractor, you got a patient that's in pain. Give me some ideas on how you manage the complexities of that. So I just be the chiropractor and do my job? Or do I have to build relationships with people and I don't want to make anyone mad. And I want to make sure I do the right job for the patient. So give me some scoop on that. All right,

wow. That's a lot. I'm going to I'm going to go a little bit back in my career and say, you know, when I was doing personal injury on the early years, earlier years, when I didn't know as much as I know, now not as much of an expert, I wasn't as good with the vernacular and being able to explain it. They brought me to court, almost every case. So I probably been to trial, like 50 times. And this is this now, they would never ever, ever invite me to invite me to the courthouse because they know they're going to lose their butt. Okay. But here's the reason why. So practice member comes into your practice, right? And I'm thinking, what am I great at, I can sit in front of an audience healthcare class for half an hour to help better results, faster workshop, and I can light that room up, right? I have an audience, just like a jury. Right? A jury of the of my peers that don't know what I know. And if they knew what I knew they do what I do, right. So um, so I tell the practice person that walks in day one discovery, and they're coming in and telling me all of the parts of their body that hurt. And I'm like, Look, before we go ahead and get started, let's just come to agreement on a couple of things. Your attorney is salivating and only wants to know about what injury is a new causally related to this injury. The auto insurance adjusters want to blame everything on something that was pre existing. Okay? And then they go, okay, and I go, here, you and I sit. It's both. But they don't care. But

that's so big. So you're saying the attorney is salivating because he's building a case and the case helps the patient get paid for the suffering, the damage to the car, the loss of work, so he attorney is supporting the client, but the attorney is salivating the fact that this client had numerous injuries that he could, with law, substantiate, he got hurt from this incident. And that's his job, and he's salivating on this. And then you're saying the insurance company's job is to say all this new stuff, doesn't matter. It wasn't bad, you're fine. Look at how you've been in trauma. You had arthritis, you had accidents before. This is all that's their job. So they're saving the stockholders of the insurance company money, that's their job. And then you're sitting with this person, and you're telling them, it's both it's all the old stuff, and it's all the new stuff. And you're the only one putting both of these together and looking that person in the eye and said, Yeah, it's both that's that's I mean, let me

let me let me let me layer in real quick because now I'm sitting in front of the jury right and I tell us that the practice member, the potential practice member, right, we're day one and I go if I sat in front of a jury and I said look, you take an old twig and go like this and twist it real quick. And you go ahead and take a brand new branch and go ahead and twist it real quick. Which one's going to be damaged more the elbow there's your answer. And that's the reason why they won't bring me to court.

So if you have pre existing injury and damage to your spine and you have a trauma accidents just got to get worse. It's gonna

get so you So you started off talking about scam you see, I don't think of it that way. And that's why just kind of put a you know, to put a lid on that it's not At a scam that people have as much as five miles an hour causes three G's of force into the body. All of those areas where there was subluxation. And degeneration and what I call adaptation over its over years of time, literally are aggravated. And that's what we see as the inflammation and the pain and the dis. You with me?

Yeah. And I never I never saw, I think maybe one Mullingar. But when I was in school, that was a context I got, I may read it wrong. I misunderstood it. But I didn't accept personal injury cases. And I felt when I first started seeing them, I was like, What am I doing? These people need care. So. So I agree with you. This is like such a powerful component of what chiropractic can help because we can get in there immediately. You know, these people are needing surgery, they need care right away. And chiropractic should be helping these injured people that are having an auto accident. So to finish up this particular episode, we are going to follow up getting a little bit more detailed about how to manage a case, just the complexity of the relationship that you just explained, which was very interesting. You have the car insurance provider, you have the attorney you have the patient, you have yourself, you seem to have mastered this relationship. I was a little nervous that the attorney was trying to tell me what to do and how to do I enjoy getting these referrals. I didn't want to hurt that relationship. But my job is to honor the patient. Just in finishing up this session. How do you navigate the respect of that and still honor my patient? Like,

I'm a little two faced when it comes to that. You know, like, what was that guy? The the villain in Batman, you know, because I have my relationship with, you know, with a particular law firm, and what's the second largest law firm in the country. And I do, I do work almost exclusively with them just because of the integrity that's wrapped around the particular person who runs and owns that, that that law firm. So I have a, you know, a really, really special place and a relationship with these type of people in that way. And philosophically, it feels good to me because philanthropic, Lee, as a result of the profits that we are doing by helping sick people get well and people that are injured, get well, we go ahead and touch the lives of a lot of people. However, we all know, and I'm not shy to tell this to the potential practice member, as they're sitting in my room to let them know that the attorneys love to play doctor. They just love to play doctor, they'll say I need MRIs, I need this, I need that. And I'm like, what degree do you have to go ahead into that make a determination as to what this person needs. So when you said before and not to, you know, to stand you corrected, but on the person who's the expert, I'm the wellness person, and I'm the person who's building the case, the attorney doesn't build the case, the attorney is not a doctor. And I'm very, very, you know, very firm on that. And literally just two days ago, I had that I had to have a conversation with one of the attorneys, there's 78 of them in this firm, by the way. Wow. And and and I would say my other job is to teach continuing legal education. Okay, to those attorneys, when they want to know more, because they don't understand, they work on a very antiquated, philosophical, you know, legal foundation that says, hey, you know, I need all these positive tests, and they don't really care about the providers and who's going to eat one at the other end, at the end of the day, their job is to negotiate a settlement. I'm the person who creates the impairment, I'm the person who's layering up every diagnosis that I have, by getting an orthopedic or a neurosurgeon by making sure that I have all of these other people so so I'm really really sound on, you know, that I am the expert in the case, they are not sometimes I have to have a conversation with the lawyer to make sure that they understand, hey, listen, I appreciate the referral and whatnot. But I'm the doctor on the case you're not so let me go ahead and do my job and I will prepare the story. My job is my other job is to be the author of the story. And to present that the information to the lawyer so that they can put it demand and to the insurance company which I want nothing to do with. So as

we substantiate that you're the leader, in that case, you're going to do what you need to do to serve that client and you put the attorney into his place in position that converse of that is a chiropractor that doesn't take good notes. They don't do any They're testing, you got ridiculous pain down the leg for three, four months, they're like, let me just adjust, you adjust you there's no other diagnostics. That is not the way to handle the case. So although the attorney is maybe pushing, it is our job to for the patient for their health and for their case, right to substantiate that there is damage. And you have to quantify that on behalf of the patient, because there indicates they are trying to substantiate the damage they achieved, they achieved. So even though you may not think you need this one test for that particular service, that test may give you some more clinical data. But it also may substantiate the case for that patient that really got injured and has some impairment. Right. I mean, there's another side of the Cairo's that do not do any of the case management, right? I mean, speak to that for a moment.

Well, there's there's minimally 25 value drivers that 95% of the chiropractors are going to miss. And that's scary. And the reason why is because as we get into into practice, we ought to get lazy, or, you know, we take one of these weekend seminars, and we think that we're an expert. And you know, and we start following this path. And we don't really substantiate the injuries. We know as chiropractors, we're experts in subluxation. If you do flexion extension views, just for example, I don't want to unpack the whole clinical thing. We could do that in another episode. But you know, you do a flexion of force flexion of forced extension, you're going to see aberrant motion and ligament laxity. Does that does that matter? Kyra practically, you bet. You know, the spine is nothing more than the armor protecting the central nervous system, the brain, brainstem and spinal cord. If you have any type of injury or any type of problem there, it's going to show up on MRI and all of these other things. So clinical excellence is really important. I wanted to know and I learned from the laureate assistant to the person who invented MRI, which was called NMR, up in Stony Brook and I got a five year program under my belt to read MRI, why I don't want to be an expert, and go to court and start discuss, I just want to know how to read an MRI and know what it is I'm looking at. Yeah.

Okay, so So you see that side too is that we we as as leaders in the profession and chiropractors to help our doctors be able to substantiate objectivity and clarify that case for for the patient as well, which is, I think, a gap in the profession. Well, we're gonna we're gonna end it here that was really, that was really massive ready that my biggest takeaway is what you said two things. And I just want to close up on this, the two things that I took away was I didn't really have that clarity that the insurance company said, everything's old attorney said, Everything's new. And you're in the middle, totally authentic, tell the patient, it's both. That was one. The second one is, is the stick what a great analogy of like, new injuries are worse when you have old injuries. That's a fact too. So I love those two statements. So hopefully all you listening or watching got some juice out of that, we're going to have ready come back in the next episode. And we're going to break down a case and actually give you some guidance. Now you're not going to be an expert like Dr. Adelson after a couple of podcasts. But if you are interested in learning more, Dr. Adelson is a senior doctor the Allied life organization, and we're looking at really bringing in some more principled cons concepts and, and procedures that Rennie recommends that we do to take care of personal injury cases. So any closing thoughts or any?

No, I mean, I just think Listen, when people walk through the door, you know, we're in the job of saving lives. Right? And, and when people walk through the door, you know, doesn't matter if they fell off the ladder in the garage, or they were involved in an accident, or they were just lifting the laundry basket, you know, and pulled their back and said it just started yesterday. You know, it doesn't really matter. To me, personal injury can be extremely lucrative, but it needs to be done. Right. And to me, if you're only doing that, and you're doing that exclusive, then, you know, at some at a large level, which is my lifelong work, is I believe that every The world needs chiropractors, the world needs chiropractic. The world doesn't need more chiropractors to see personal injury patients. Yeah, they just you know, the world needs more chiropractic, and in the next episode, I'd like to maybe unpack a little bit more of, you know, how does this blend with your expertise, Joe? Because we were having a discussion outside of the rooms here that were just so phenomenal about metabolic problems. And how do you how do you how do you bridge those to things, and I'd love to unpack some of that, especially for the students that are going to be like just eager to want to know some more of this.

Well, even even the practitioner that's out there for 20 years understanding metabolic derangement, and trauma, and what we're doing in some of the icon, clinics, revolutionary clinics like yours, where you're bringing a metabolic function, you look at physical, you're looking at muscle, the management of repair subluxation, and what you're doing, and you're centers that are actually making massive changes to people and getting people the personal injury industry to see you're getting outcome. Because what I didn't realize is I didn't think the Attorney cared about anything. I thought it was just money, but they want their clients better. And they're proud when they send it to the chiropractor that gets results gets the outcome. Of course, they want to see a settlement. But you're making people better and they're bragging, they're bragging that their attorney said go see that guy. And that's where we want the profession to be raised. In that we are serving what we do, like you said, these are just two injured people. And we're just taking the best care home possible. And they can't stop bragging about chiropractic, right?

One Yeah, and one more thing, if new patients are coming through the door, you know, we as chiropractors, we have an intention to be that person's chiropractor for the rest of their existence on the planet, right? And their and their whole families. But we have to earn that right. But when you have personal injury, you got tons of new patient opportunities that people are really injured people that you are going to substantiate clinically that need future care, how easy is it to go ahead and to parlay them into, you know, a wellness or a maintenance plan after you're done with the initial corrective intensive care.