Putting The Stroke Issue to Bed

ultimately concluded independently that chiropractors are not required to provide or give informed consent in regard to stroke in Connecticut. That idea, that concept, is shared by others and has indeed been adopted. What you ultimately intend to provide to individuals making a decision about whether to accept a therapy or treatment is information that helps them make a decision by providing to them risks that quantify to a point that require them to pause and consider. That's the conclusion we reached. Thanks, John. That's really helpful. I do want to go back to Dr. Murkowski though because, Ken, you talked a little earlier about the documentation from the doctor's perspective, and you mentioned a number of things that should be part of that in the initial examination consultation time. One of the things that you mentioned was the medications that the patients are on. That is one thing that we've highlighted quite a bit here because some of the medications are directly related to the health of the vessels. We've concluded you cannot cause a dissection in a patient that has a healthy vessel, but some of these risk factors are medications. How do you teach the doctors to address that in their paperwork, in their consultation, maybe even in follow-up’s because people are always updating medications that they're on? A couple of things. Number one, what I always say in all the seminars is when a patient comes in and they start saying that they're on medications, again, we want to show our concern, so what we do is say please bring all your medications with you the next time. The reason we do that is as you can tell, many patients carry their little medications in their pocket or purse wrapped up in a Kleenex or a tissue, but we want to see the exact medications in the containers they come because you can have one medication made by three different companies with three different reactions. We want to take down all the medications. We want to know what the adverse reactions are. We normally give the patient a printout of what the adverse reactions are. Again, show them that we're concerned. The other thing is so many doctors today are into wellness and nutritional situations. They have to understand that some of the nutritional products that they may recommend are contraindicated in some of the medications. Again, we have to, again, teach the doctors that they have to understand with knowledge what those particular things are. In other words, the nutritional aspects interacting with the medications. Again, it's based on documentation, but I think to dovetail on what Mr. Esteb said is, and I find that doing a simpler way, is to know your audience. In other words, if you're talking to doctors, obviously you want to give them statistics. If you're going to be talking to patients, you want to show them concern. If you're in a public setting and you get asked these questions and you have to make it and understand that they're asking because normally they've had a personal experience or somebody in their family, so you have to be cognizant of why they're asking the questions. There are so many different facets. I call it turning the magic prism, that again we want to address those, but in the office ... The other thing, too, you brought up a very interesting point, Stu. Patients change medications rapidly, so what we try to teach in the seminars, on every visit, on every visit, we want to ask every patient the same basic questions. Have you

Dr. Hoffman:

Dr. Murkowski:

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