That just comes with a good thorough history like a history form. Just a simple history form that goes through that check of systems, the review of past history, social history and all that I think can really help. Chiropractic, though, we have to make sure that we do a good job for ourselves and for our patients. I think if we just follow the simple things and I think part of it is, just coming to an understanding of what the heck does Medicare want. Medicare is probably the most philosophical payer we have. Medicare says, "Chiropractors, what do you believe in?" Of course, our belief is subluxations is the origin of disease. Medicare said, "Okay. Well, if that is the case, then subluxation is your primary diagnosis but you must have a secondary neuromusculoskeletal." Medicare gives us a list of what those codes are. I will tell doctors make sure to follow those lists. Don’t go outside of it. Come to the conclusion of how do you want to determine subluxation. If you want to determine it by x-ray, that's certainly acceptable, make sure you demonstrate in that way or by physical exam. Medicare has given us a 4-part system called P-A- R-T, for pain, assymetry, range of motion, and tissue tone that if you go with those. For instance, if just do something as simple as saying there's tenderness at T2 with hypomobility on flexion-extension, that would be sufficient for Medicare to demonstrate subluxation. Unfortunately, I think a lot of doctors really simply haven’t learned that. What we do with our seminars is to make sure doctors get that because at the end of the day, my focus will be or my statement will be Medicare in many ways should be our easiest payer because they're so formatted as to what they want. We just have to make sure we follow that format and I think we can end a lot of this speculation that chiropractors perform poorly. Once we can get the profession by doing services like we're doing right now to get them to understand this is what's necessary, I don’t think it's hard. Unfortunately, it's always been kind of the hidden issue that doctors will say, "Well, what the heck do they want?" That's where we want to start to give. Like Dr. Ken pointed out, we need a form or a format where the doctors go through, "Let's hit this contraindications. Let's go with Sam as talking about for subluxation, let's hit those areas." At the end of the day show that there is a functional improvement of your patient and when it reaches a point of maintenance, we indicate it as such. Sam, that's perfect. That's exactly what I’m looking for. I want to come back on that in a minute. I want to go back to Dr. Murkowski for a second. Ken, I just want to ask you more about the different exam protocols that would be necessary to document properly for Medicare. Can you elaborate on that a little bit for me because you started to touch on that a minute ago? I want to see if we can get a little bit deeper. Again, it's like Dr. Sam said, it's no different in the seminars that I teach. I try to tell the doctors in the seminars and the staff that you're going to treat a Medicare patient like basically any other patient and you have to do a good job. People always ask me, what the practice of the future of is. In my opinion it's Medicare because every day, thousands and thousands of people become of Medicare age. One of the things is, number 1, a proper patient-doctor interview. Obviously, there's a form for that, a good case history, especially if the patient
Dr. Hoffman:
Dr. Murkowski:
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