The Importance of Giving Back

The Importance of Giving Back

As most of my avid blog readers out there already know, I am a Baltimore Chiropractor whose clinic spends the majority of its time treating Baltimore car accident injury patients. Of course we see patients who have not been involved in Baltimore auto accident injuries, and we spend a fair amount of time treating headaches, neck pain, mid back pain, lower back pain, and sciatica as well.

I opened the clinic about 4 years ago. My goal was simple: to become the premier destination for chiropractic/rehab services for Baltimore City while catering to the Hispanic demographic located in Southeast Baltimore. We’ve seen approximately 2000 new patients in that time frame. A lot of my chiropractor friends ask how I got to see that many new patients so quickly. And the answer is “I give.” I wake up early to see the early risers, I work through lunch to see patients who only have a short period of time on their lunch breaks for care, and I stay late to see those working far away who only want to come here. I worked every Saturday for the first two years. I give and I give and then I give some more. There’s a saying in business networking that “giver’s gain.” Starting with one new patient, helping them to the best of my abilities, the referrals started to snowball. Online reviews grew and the practice grew. It continues to grow to the tune of 75-80 new patients a month. I am beyond pleased with the success of the practice and my ability to help the citizens of Baltimore live healthier, happier, pain-free lives. There have been bumps in the road as we have hired (and then fired) staff members whose commitment to patients was not in line with what I was looking for. But I suppose that is to be expected with any (relatively) new business.

Anyone who has ever started a business or ran a business knows that there is usually a cost to business and financial success. Typically that is decreased health (due to stress and meals on the go) and decreased “relationship” health, as more time and resources are diverted to the business side of life and less to the personal side of life. I missed countless family gatherings, weekends together with loved ones, and countless evenings with friends playing cards and hanging out so that I could work, solidify my brand, and continue to grow my business. Some people call this “sacrifice” but I don’t think its a sacrifice. I think its a necessary commitment early on to help the business and practice take off.

Recently my family suffered a tremendous loss as my mother lost her battle with lung cancer. I found (and find) myself less motivated to grow the business and more interested in investing in those parts of my life that I have been putting by the wayside. Having lost someone I cared about I find myself wondering if it matters if I can increase the number of patients we help or how much money we can collect, or when I can finish paying off my student loan debt. I find myself wanting to spend more time with my girlfriend, my friends, and my family. I think its a natural mental frame shift that probably occurs with most people when they suffer a tremendous loss. It puts our mortality into perspective, as well it should.

To help honor my mother’s memory I put together a youcaring campaign.  The campaign details a little history of her life and it shines a light on her true passion – animal rescue. I made it a commitment to raise $5,000 in her memory to donate to the cause that brought her such joy and meaning in her life. Since her passing we have raised over $3,300 for the cause. We are about two-thirds of the way there!

Having said that, I would like to compel my blog reads to like, share, and if possible, donate to the cause. As my team and I have given to help you over the past four years, please help give back to communities outside of work and healthcare that mean a lot to me. And more importantly, I’d like those blog readers (especially other business owners, entrepreneurs, and Chiropractors) to take an evening off and spend some time with those who care about you the most. You don’t know when you won’t have that opportunity.

Lost In Translation – He Said, She Said, and the Truth

As a Baltimore Chiropractor that spends the majority of my time treating patients injured in Baltimore auto accidents, I have learned over the years that communication is paramount. Whether that be communication with a patient, an insurance company, or even while communicating my thoughts into a daily SOAP note. In my practice we work closely along side internists and specialists such as pain management physicians and orthopedic surgeons. A lot of the “co-management” of these patients requires continued back and forth communication on behalf of these patients with these other providers. My staff and I do our best to succinctly record our findings and our opinions regarding the patients that we are co-treating. I even have the personal cell phone numbers of most of the providers we work with so that I can call ahead and leave detailed messages regarding patient care.

An interesting phenomenon occurs when I refer a patient to another practice for an evaluation and future treatment recommendations. When they come back to discuss the encounter and the plan moving forward, most of the time the patient has no idea what was said, what was done, or what the plan is moving forward! It’s as if they were not present for their own appointment.

I can certainly fill them in and get them up to speed when I receive a copy of the medical records several days later, but it delays my understanding in how to best help them moving forward in light of the new medical evaluation.

I recently had an epiphany. I realized that if patients outside of my office have no idea what their conditions are or what the next step towards recovery is, then it stands to reason that even in my office there is probably a breach of communication. As the old saying goes “there’s his side, her side, and the truth.” That is to say in our world, there’s what I say to my patients, what they hear, and the truth. Most of the time losing some pieces of information has no clinical importance. However, sometimes missing small details can lead to grave issues.

I have a patient that I am treating for a Baltimore auto accident right now. In her crash she suffered lower back pain that has, for the most part, failed to respond well to conservative chiropractic therapy. We recently referred her for a lower back MRI to determine if she had disc inflammation. I reviewed the radiological report and it detailed some disc protrusions and a torn ligament her spine. It also found a kidney finding that was unusual, and it told her to follow up with her primary care physician for further diagnostic evaluation.

I got the MRI report prior to her next office visit. When she got in she said “Her Dr. G, did you get my results? Someone called my house and said I need to have my liver looked at. Any idea whats going on?” In a classic game of telephone the message was distorted and permuted before reaching its intended target. In this particular case I had to explain to the patient that the abnormal findings were of her kidney and not her liver. I made her a copy of her MRI report and I encouraged her to see her PCP and bring a copy of these results with her so that her PCP can order the next set of tests in order to help her determine if there is a problem with her kidney.

In light of these miscommunications it got me thinking about the best ways for patients to better communicate with their providers and how to get the most out of each clinical encounter. In no particular order these are as follows:

• Be prepared for your visit and write a list of questions you intend to ask.
• Bring a copy of any examinations (x-rays, MRIs) with you for the provider to review on the initial visit. This will help “speed up” the process of waiting two more weeks to return for imaging interpretation.
• Bring a “helper” who can go with you. 4 ears are better than 2.
• Write salient information down during the visit
• Ask for copy of any blood work or examination findings after the visit. This can help you keep track of what testing was already done so you don’t have to waste time or money repeating exams unnecessarily.
• Ask providers if you can record the encounter with your smart phone or other device (they may or may not say yes)
• Keep a notebook with you to record what pain you have and when you have it. It’s hard to remember when you had pain once you are feeling well.
• Keep a calendar of your appointments so that you can coordinate with all providers.

No one said recovering from a Baltimore auto accident injury would be easy. There is a lot of medical terminology and there are many doctors appointments. In order to recover as quickly as possible and in order to avoid any bad outcomes, it is extremely important that patients understand what their providers are saying and how it impacts them. Without a fluid understanding of their injury and the process to recover, patients will be left in the dark in terms of how to best improve their conditions. Most providers have no issue in slowing down, re-explaining exam findings, and coordinating care with other providers.

If you, or someone you know, has been injured in a Baltimore auto accident please contact Mid-Atlantic Spinal Rehab & Chiropractic at (443) 842-5500. We would be happy to help!

Dr. Gulitz

Will A Baltimore Chiropractor Accept My Insurance?

As a Baltimore chiropractor that spends the majority of my time treating injured patients that have been involved in Baltimore car accidents, I often get asked if my office will accept private health insurances. That is, prospective patients want to know if this office is in credentialed as an in-network provider for the major health insurance companies in order to provide chiropractic services. The answer is yes.

Currently the list of health insurance carriers that we are considered in network with include: Blue Cross and Blue Shield (CareFirst), Cigna, Johns Hopkins EHP, and United Healthcare. That list is not entirely inclusive. There are literally hunderds of other subplans that we may be able to accept as an in-network provider that fall under these umbrella companies. We will not be able to list all of those smaller companies on the website. If someone were interested in determining whether or not they had chiropractic coverage the best way to handle that would be to email or call the office, and let us know your name, date of birth, insurance company, plan number, and member ID. Armed with that information my staff is trained to “pre-certify” chiropractic care for Baltimore area residents. By the time you arrive for your first visit you will know if we accept your insurance, how much your copay is (money due at time of service), how much of your deductible you have met for this calendar year, and how many visits your insurance company may limit you to.

One thing that I want to express is that in this office we are just healthcare providers. We do not write the language of the health insurance contract. That means that I can not control how much your copay costs you, how many visits your insurance will pay for, or whether or not you have already met your deductible for a given calendar year. Sometimes patients get upset with us to learn that they have a $40 copay and that since they have not yet met their deductible they will owe us another $25 per visit for all of the services that we render. They feel somehow “ripped off” or “misguided” because they pay for insurance and our office accepts it, but the costs are more expensive than if they simply paid our cash fee schedule. This is why all new patients are informed of their financial obligations as of their first office visit. While I certainly understand wanting to use health insurance if you pay for it and we accept it, sometimes it is less expensive to pay our cash rate than it is to involve insurance companies. As a provider of healthcare all we can do is inform prospective patients of their options and they can make whatever financial decision they want to, whether that means that we process it through their insurance, or whether they pay cash and are allowed a small time-of-service discount.

At Mid-Atlantic Spinal Rehab & Chiropractic we are proud to be in network with leading providers in the Baltimore area and we gladly will accept assignment for insurance payments. We will also be happy to discuss with you what your financial obligations are up front so that there are no surprises. The only thing that we can not do is control how much of a copay, deductible, or out of pocket expenses you will incur for treating in this office. Just like with medical benefits when you travel to a primary care doctors office, urgent care, or hospital emergency department, all of those benefits are CONTRACTUALLY agreed upon prior to your arrival.

If you, or someone you know, has health insurance and is curious as to whether or not this office is in network, please contact Mid-Atlantic Spinal Rehab & Chiropractic at (443) 842-5500. We would be happy to verify your benefits and help you if we can.

Dr. Gulitz

“Pokemon Go” Causing Baltimore Auto Accidents

As a Baltimore Chiropractor that spends the majority of my time treating Baltimore Auto Accident injuries, I thought that by 8 years of clinical practice and nearly four thousand patients, I had seen it all. I can now say that I am seeing things I never would have imagined: video game induced auto accident injuries in Baltimore.

By now we all know what it is. Pokemon, the digital monsters from my childhood, are back with a vengeance taking over our mobile phones and tablets. Seemingly everyone with a mobile internet connection is staring down at their devices as they pursue a digital scavenger hunt in an effort to “collect them all.” Although it sounds cute and innocent, it has been leading to some unforeseeable problems. Most notably, injuries to players are starting to pile up at an alarming rate as participants are so immersed in the virtual game that they become unaware of their surroundings and then either injure themselves or others while playing.

The game uses “augmented reality” to transpose images of these cartoon monsters into every day life. In fact, where I live in Baltimore is right next to a PokeStop so I find myself filling up on pokeballs periodically to help me in my pursuit to “catch them all.” The game is meant to be fun and as a way for casual users to get together, walk, exercise, and explore their surroundings. However, the more aggressive players are pulling out all the stops in an effort to collect elusive pokemon.

In Massachusetts, a man caused a major pile up (multiple car accidents) while attempting to throw PokeBalls to catch a pokemon. Several people had injuries as a result of the crash. The story can be read here.

There are other accounts of players using skateboards to “walk” around their communities faster in order to capture more digital monsters. This has lead to skateboard injuries such as scraped knees, twisted ankles, and even small bone breaks in feet.

To their credit, the makers of the game do warn players to be aware of their surroundings all the time and not to forget that they are, in fact, walking through the real world when they play. But that does not seem to be stopping players from putting themselves and others in harms way in an effort to catch the most digital monsters.

By no means am I suggesting that the game should be removed from the apple store or from Google play. I just think we all need to be more aware of our surroundings. My suspicion is that this will lead to an epidemic of Baltimore car accidents as people attempt to use their cars to travel greater distances in an attempt to catch pokemon.

While I am not suggesting that it is a smart idea to “pokemon and drive”, I do think it is a wise idea to designate a driver if you must play pokemon in a car. Similar to designating a driver for an evening out with alcohol, and similar to how teenagers should be designating a “texter” to communicate on behalf of a driver, I think it is time we consider having a designated “pokemon player” so that any given driver can keep their attention to the road while another car occupant can focus on “catching them all.”

If you, or someone you know, has suffered a Baltimore auto accident injury as a result of Pokemon Go, please contact Mid-Atlantic Spinal Rehab & Chiropractic at (443) 842-5500. We would be happy to help!

Dr. Gulitz

Free Consultations vs. New Patient Examinations – What’s The Difference?

As a Baltimore Chiropractor that spends the majority of my time treating patients involved in Baltimore auto accidents, I often get asked by prospective patients what the difference is between a free consultation and a new patient examination. That is, a prospective patient will walk through the door and they may not know whether the treatment we provide is right for them and for the injuries. My office is happy to allow for a free 10 minute no-cost, no obligation consultation for patients. The thinking behind this is quite simple – Both parties, the patient, and the provider, want to make sure that there is a condition or series of conditions that we can help prior to beginning the arduous task of contacting insurance companies and filling out boatloads of paperwork. If your tooth hurt, chances are pretty good you already know that you need to see a dentist. But sometimes when people in Baltimore have headaches, neck pain or back pain, they are unsure whether they need to see a Baltimore chiropractor, Baltimore physical therapist, or Baltimore orthopedic surgeon. My staff and I welcome these opportunities to meet prospective patients, offer them our best guess as to what may be going on, and to let the prospective patients know that we either think we can help them or we think that we can’t. These free no-obligation consultations are not high-pressure sales tactics. If we think we can help you because you appear to be presenting with “bread and butter” chiropractic injuries, then we are happy to tell you so, have our front desk staff confirm your chiropractic benefits, and then schedule an appointment for your evaluation and treatment. If, on the other hand, you have conditions that do not fit into our “sweet spot” or your past medical history indicates that chiropractic care may be contraindicated for your condition (if could make you worse, for instance) then we will tell you that as well. Believe me when I tell you that even if our office is not a good fit for you, we are happy to give our two cents about how to go about feeling better and where to turn next.

During a free consultation one of the chiropractors on staff will listen to your complaints and we will give our best estimations as to whether or not chiropractic care is an appropriate treatment option for the condition. Here is where the tricky part comes in. We can’t always say for sure whether or not a patient will be a good fit for the practice, because technically, we are still having a conversation with a “stranger” at this point, and we have not yet entered into a “doctor patient relationship” with a client. That is, during the consultation, we are not examining the client, we are not physically evaluating the client, nor are we x-raying the prospective patient. We are just answering some questions about their condition and trying to determine if it is in the best interest of both parties to move forward with becoming a patient. In the free consultation our “duty” as providers is minimal. We may shake your hand to introduce ourselves and greet a prospective patient, but we are not “yet” your providers. We do not owe you any duties that we might otherwise owe you as a patient, since you are not yet technically a patient. Since that is the case, it is hard to answer “specifics” about an injury since we are not technically evaluating it.

If a patient decides after a consultation that they do want to become a patient, then they return to the waiting room to fill out new patient paperwork, as they would have had they been any type of new patient to the practice. If the office has time on its schedule to see the patient right then and there, then we will see the patient right away. If, on the other hand, the schedule is booked and we do not have time to see the patient that day, they will be offered the option of waiting to be seen as a walk in (with no guarantee that we can see them) or the option of rescheduling for a subsequent day. The choice is theirs and theirs alone.

If a patient or provider decides that a prospective patients is not a good fit for chiropractic care, then they can go on their way. They do not owe us any money and they are under no obligation to return. That is, they just had a discussion with a professional who did not undertake a doctor-patient relationship. The providers do not have to produce any medical record of the encounter and the person can leave, never having become a patient of the practice.

Although there is a fine line between prospective patient (during a consultation) and a new patient (during an evaluation) the line is very important from the provider side. In the first example of a consultation, we do not owe the prospective patient any duties typically owed during a doctor patient relationship. We can’t fail to diagnose an injury or “miss” a diagnosis since technically that “stranger” is not a patient that we owe that duty to. Whereas, once a stranger elects to become a patient, we now have an obligation to provide care for them without falling below the standard, thereby exposing ourselves to malpractice.

Several times in the first four years of my practice I have had patients ask me what constitutes a free-consultation vs. a new patient evaluation. Some have even gone as far as filling out paperwork and asking me to evaluate them and then have been shocked when they are told that they owe us money for services rendered. I hope that this information clears up the difference.

If you are not sure that you would benefit from Chiropractic care in Baltimore and would like to schedule a free no cost no obligation consultation, please contact Mid-Atlantic Spinal Rehab & Chiropractic at (443) 842-5500. We would be happy to help!

Dr. Gulitz