Putting The Stroke Issue to Bed

You got to make sure you've done your job clinically, as Ken talked about, and then you got to make sure you do your job, relate, and answer the question that's in front of you. If it's an analytical question, give an analytical answer. If it's an emotional question, respond with emotion, and then add whatever is necessary around it to support that and go from there. The doc has an important set of responsibilities in this that go way beyond anything to do with the adjustment or anything of the nature, and it's all in this world that's external to all of that, but imposes upon that moment and that circumstance. I hope that makes sense. Totally makes sense and appreciate it. Before I go back to Dr. Murkowski, I want to come back to John for a second because something that I indicated about the risk of aspirin compared to a cervical adjustment, but there's many other risk factors in the healthcare industry. Certainly, medicines specifically. When we look at that, I remember when we were originally talking about the informed consent and should you have stroke in there? If so, how should you have it in there? Because the incidence is so low that it doesn't even reach the statistical rate that you should even need to inform somebody. I remember you talking about buying a can of paint. It's one of the risk factors painting a ceiling. Someone can wind up with a dissection. You don't go and sign off on an informed consent for that, but can you talk about a little bit of the risk factors when it comes to chiropractic versus traditional risk factors that people think about when they're watching TV and seeing TV ads nonstop talking about this will create a vehicle for you to want to commit suicide or you'll just die from the medication, but that's just a side effect, let alone what happens in an operating room or in a physician's office? Can you touch on that a little bit for us? Certainly. These topics are intriguing because as we investigated the nature of informed consent, one thing came to the fore immediately, and that is the purpose of the document is to provide information that would help an individual assess risk. That is why typically information that's a part of an informed consent deals with risks that's quantifiable within percentages. When you undergo anesthesia, there may be a 1 in a 100 chance that you're going to have an adverse event. There may be a 10% chance of a adverse side effect from taking a drug, but what occurred to us as we further developed this concept was does it make any sense? Does it help a person make a decision if you say that there's a 1 in 5 million chance? Is that even information that should be reasonably a part of making the decision? If someone told you that going outside creates a 1 in 5 million chance of getting hit by lightning or there's a 1 in 5 million chance of you as you're walking through the park a tree's going to fall and kill you, is that information that helps a person in their daily lives make reasonable decisions? In other words, there are risks, which are so rare and so far out in the spectrum of percentages that that information really is not an aid to the individual trying to decide whether to move forward in a risk benefit analysis. Another way to explain it. If the risk is so remote, and there's real benefit, does that risk become or should it become a part of information you receive before you make the election. That's the direction from my third- party position outside the practice that came to me immediately and it's one that I developed with Dr. Cassidy when discussing his study with him and that he indeed embraced and that argument was a part of his presentation to the Connecticut board that

Dr. Hoffman:

John Salvucci:

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