CFS Online Training Programs
Welcome to the Online Learning section of the CFS. Online learning is the way of the future and is rapidly becoming the educational delivery of choice. For this reason the CFS has chosen the University of Bridgeport (UBCC), Chiropractic Development International (CDI) and ChiroCredit to deliver the online learning components of the CFS training program.
Documentation – CME (non diplomate online programs)
Documentation 153 Documenting Bodily/Personal Injury Cases (4 hours)
The auto insurance industry has aggressively revolutionized its practices and procedures over the last two decades. This revolution has adopted the use of computer programs (Colossus, Decision Point, ICE, AIM, ADP, MBRS, Med¬Data and Mitchell Medical Expert), which allow the insurance industry to reduce the payout of claims. The insurance companies see these tools as a viable and reasonable avenue in their quest for cutting costs. Unfortunately, the Chiropractic profession has, to a great degree, assisted the insurance industry in its success. In the absence of accurate and proper documented patient daily progress notes, the chiropractic profession is finding itself receiving less than full reimbursement for their patient treatment. This program provides a solution, for the chiropractic provider, to address and realize full reimbursement of patient treatment utilizing proper, legible and evidenced-influenced daily progress notes. These progress notes should communicate and record parameters for value based (value drivers) computer programs for auto injury cases.
Documentation 154 Risk Management Considerations for Documentation (1 hour)
The adverse consequences when chiropractic providers fail to maintain patient care records as prescribed by law, practice standards, or custom are potentially severe. In particular, courts adjudicating healthcare malpractice cases in which records are unavailable for patients’ (and providers’) use may permit judges and/or juries to infer or even presume healthcare malpractice against chiropractic providers under the theory of spoliation of records. This program includes detailed discussion of 25 selected documentation problems, errors, and recommendations for improving patient care documentation. The goal that chiropractic providers must strive for is to document findings and observations of clinical relevance accurately; clearly, comprehensively, and in a timely manner. Documentation should be objective, specific, and non-defensive. The end result of a carefully designed documentation program is optimal quality patient care.
Forensics – CME (non diplomate online programs)
Forensics 101 Independent Medical Examinations and Chiropractic Issues (1 hour)
Independent medical evaluations (IMEs) providers must become more than casually acquainted with the specific provisions of the employment and workers’ compensation regulations and laws in the state(s) where they are performing IMEs. This presentation offers an introductory understanding of the conceptual framework within which these evaluations occur. This presentation is not intended to present the only, or necessarily best, methods or procedures for independent medical evaluations in the Workers Compensation arena, but rather is intended to represent an approach, view, statement, or opinion of the presenters, which may be helpful to others who face similar situations.
Forensics 102 Introduction to Forensic Science: Historical Perspectives (1 hour)
This course provides an overview of forensic science through a historical perspective, how it is incorporated into the chiropractic profession and identifies the rationale for obtaining the knowledge (education), training, skill sets and experience which must be acquired to meet current qualifications as a Forensic Examiner and litigative consultant.
Forensics 103 Introduction to the AMA Guides – Fifth Edition (1 hour)
This course provides an overview of the AMA Guides to the Evaluation of Permanent Impairment 5th edition. It provides a historical perspective of rating textbooks and how impairment evaluation for disability systems can be incorporated into the chiropractic practice. This overview identifies the rationale for obtaining the knowledge (education), training, skill sets and experience in the use of methods of evaluation necessary to determine the presence, nature and extent of functional impairment of pain, and musculoskeletal and neurological systems utilizing the Guides.
Forensics 104 Social Security Disability Assessment (1 hour)
This course has been designed to teach the chiropractic examiner to learn how to quickly and easily implement a social security evaluation after the initial rejection, based upon Social Security Administration (SSA) regulations and procedures. In addition, the course will provide some insight on how to develop skill sets and add to the knowledge base of the federal program.
Forensics 105 E-mail Issues and Your Chiropractic Practice, Keeping the Junk Chiropractic Out of Court – Parts I & II (1 hour)
More and more current and potential patients are using e-mail to ask questions about you and your education and practice, get advice on many health related topics, conditions, supplementation, confirm eligibility and whether you on in- or out-of-network, clarify billing problems, and even make or change appointments. Many chiropractic providers will provide posts excusing the patient from work because of the subjective complaints of pain (without outcome assessment tools or objective findings verification). Some would suggest that these practice tendencies are more for the convenience of or for economic gain on the part of the chiropractic provider, rather than for the benefit of the patient. Although the convenience and availability of e-mail makes it a popular means of communication, it presents a number of risk management issues that doctors of chiropractic must be aware of.
An underlying conflict is growing between chiropractic and the law. Trial lawyers, interested in possible multimillion dollar settlements, contribute to the conflict by retaining chiropractic experts to testify in court to what the lawyer needs them to say but which may not necessarily be based upon scientific truth.
Forensics 106 The Ethical Expert Witness (1 hour)
The forensic examiner serving as an expert witness in a court of law necessitates the consideration of a number of ethical obligations that are rarely delineated by those who seek or provide such testimony. Because expert witness testimony can directly affect the standard of care that will be applied to future chiropractic practice, providing such testimony can be considered to be within the realm of the practice of chiropractic. This course provides and identifies the rationale for obtaining the knowledge (education), training, skill sets and experience which must be acquired to become an ethical expert witness.
Forensics 107 The Opposing Attorney’s Intent (1 hour)
Many doctors of chiropractic are learning that medicolegal aspects of practice are becoming more important. The judicial system is in a state of revolution and chaos with respect to expert witnessing. The Daubert guidelines for expert scientific testimony promulgated by the U.S. Supreme Court in 1993 are a significant part of litigation in federal court and in most state courts. An expert has to anticipate that the opposing counsel will file a motion to exclude her opinions based on non-adherence to the guidelines and that some form of a hearing may be held (depending on the judge) to qualify or exclude the expert. The judge must decide whether the expert has the proper credentials and whether the opinions are relevant and reliable. -more information
Forensics 108 Surviving a Deposition (1 hour)
Many doctors of chiropractic are learning that medicolegal aspects of practice are becoming more important especially when they relate to scope of practice, patient care within the confines of managed care, in protecting themselves from allegations of negligence and how to defend themselves in court. The experience of participating in the deposition process can be very stressful. Learning the basics from an attorney’s perspective is offered.
Impairment Rating – CME (non diplomate online programs)
Impairment 101 Current Standards for Measuring Spinal Range of Motion for Impairment – Fifth Edition (1 hour)
This new edition incorporates updates in diagnostic criteria, key definition clarification, and more user friendly applications based on a blend of evidence-based principles and specialty society consensus recommendations. This enhances the readability, usability and consistency of this impairment rating system. Since the most current criteria, procedures and prevailing medical opinion are incorporated, it is strongly recommended that the fifth edition be utilized as directed by statute, regulation or by administrative/legal practice.
Decisions about work capacity and compensation based on physical measurements depend on ascertaining that the measurements are reliable, that is, that the measurements are consistent and have minimal error. There is a convincing necessity for simplification and standardization to facilitate communication among researchers, practitioners and triers of fact.
Impairment 102 Apportionment (1 hour)
Apportionment is a distribution or allocation of causation among multiple factors that caused or significantly contributed to the injury or disease and existing impairment. Most states have their customized methods for calculating apportionment.
Impairment 103 Writing Credible Impairment Ratings – Fifth Edition (1 hour)
The criteria and examples in this presentation are intended to serve as markers, for the impairment rater, which can assist in self-judging the quality of your own impairment rating report using the AMA Guides to the Evaluation of Permanent Impairment 5th edition.
Impairment 104 Writing Credible Impairment Ratings – Fourth Edition (1 hour)
The criteria and examples in this presentation are intended to serve as markers, for the impairment rater, which can assist in self-judging the quality of your own impairment rating report using the AMA Guides to the Evaluation of Permanent Impairment 4th edition.
Impairment 105 Rating Carpal Tunnel – Fifth Edition (1 hour)
Carpal tunnel syndrome is the most common peripheral nerve entrapment. Carpal tunnel syndrome (CTS; ICD-9-CM codes 354, 354.0) also known as median nerve compression neuropathy, is actually a condition (pathophysiology known) and not a syndrome. Considerable controversy continues to surround the cause (etiology), definition, and diagnosis with this disorder which in turns contributes to erroneous impairment ratings using the AMA Guides to the Evaluation of Permanent Impairment 5th edition.
Impairment 106 Introduction to Impairment Rating – Sixth Edition (2 hours)
The AMA Guides to the Evaluation of Permanent Impairment 6th edition defines an innovative new international standard for impairment assessment. The goal was to provide an impairment rating guide that is authoritative, fair, and equitable to all parties. A methodology was adopted and applied to each chapter to enhance the relevancy of impairment ratings, improve internal consistency, promote greater precision, and standardize the rating process. It is hoped that this new edition will prove to be a benefit to chiropractic providers/examiners by minimizing conflict and improve decision-making.
Independent Medical Examination (IME) – CME (non diplomate online programs)
Independent Medical Exam 101 Independent Medical Examination Proposed Standards (1 hour)
A committee of experienced IME physicians collaborated in proposing standards for IME reports. The committee consisted of Chet Nierenberg, MD (Chairman and Editor); Principal Contributors: Christopher Brigham, MD, Lorne K. Direnfeld, MD, Clarissa Burkert, MD; Contributors and reviewers: Mohammed Ranavaya, MD, William Shaw, MD, Henry Roth, MD, Allan Colledge, MD, Jack Richman, MD, Charles Brooks, MD, James Talmage, MD, Frank Jones, MD, J Mark Melhom, MD, and Steve Babitsky, JD. These committee members represented such entities as the AMA Guides Newsletter, ABIME, Disability Advisor, Utah Workers Compensation Commission, and SEAK, Inc. This committee published these proposed standards in The Guides Newsletter November/December 2005 issue. These standards reflect the consensus of this committee and are not standards defined by the American Medical Association. The College on Forensic Sciences (CFS) does not endorse this document in its entirety and disagrees strongly on several issues. The CFS feels that those that perform independent chiropractic examination should be aware of what is currently being proposed. These proposed standards will probably be adopted in some form since the committee make-up represents the primary entities involved with publishing, training and certifying for the medical profession relating to IMEs.
Orthopedic – CME (non diplomate online programs)
Ortho 115 Waddell Signs: Is It “Real” or Biopsychosocial? (1 hour)
Have you ever become frustrated while evaluating examinees who present with a confusing array of musculoskeletal complaints and other signs of illness? When evaluation does not suggest a diagnosis and you begin to suspect it’s “all in their head,” how do you identify the underlying cause? And what is the best tack to take when dealing with such examinees? Thanks to research by Waddell and colleagues, there is a way to distinguish between physical and biopsychosocial causes.
Physical Therapy – CME (non diplomate online programs)
Physical Therapy 103 Ultrasound: An Underused Modality (1 hour)
Therapeutic ultrasound has been used in the treatment of musculoskeletal injuries and conditions for years, primarily because it effectively promotes healing in the injured tissue and helps reduce pain. However, in spite of the beneficial healing effects, pain reduction, and the versatility of the process, ultrasound therapy continues to be underutilized or not utilized by many chiropractic providers. Ultrasound may not be the answer for every patient; however, it does offer unique benefits that should be taken into consideration.
Risk Management – CME (non diplomate online programs)
Risk 103 Establishing Internal Controls (1 hour)
Affirmative enforcement (prosecution and recovery of misspent funds) remains a central objective of the government’s fight against health care fraud and abuse. The Department of Health and Human Services (DHHS) Office of Inspector General published on October 05, 2000 final guidance to help physicians in individual and small group practices design voluntary compliance programs. The final guidance identifies four specific compliance risk areas for physicians: (1) proper coding and billing; (2) ensuring that services are reasonable and necessary; (3) proper documentation; and (4) avoiding improper inducements, kickbacks and self-referrals. These risk areas reflect areas in which the OIG has focused its investigations and audits related to chiropractic practices.
This presentation will highlight the most overlooked and short-changed portions of patient documentation. The purpose is to provide the tools to prepare complete and accurate progress notes.
Risk 106 Minimizing the Risk of Chiropractic Malpractice Claims (1 hour)
Chiropractors fear malpractice suits, and there is hardly a medical journal or periodical that does not describe some facet of malpractice. The patient may, out of fear, shame, guilt, or some other negative emotion, distort or even fail to provide information essential for an accurate understanding of the patient’s condition. Defensive medicine (chiropractic) is a consideration. We order more tests so that we can avoid primary responsibility if a malpractice action rears its ugly head. A malpractice action is a cause of fear – fear of the legal system.
Risk 107 Informed Consent (1 hour)
Failure to adequately inform a patient of the risks associated with a chiropractic procedure creates the basis for a negligence suit for damages caused by the undisclosed risks. Such suits can occur despite the procedures being performed properly and in a non-negligent manner. Standards of disclosure vary from state to state. In those states that follow the minority rule, the standard of disclosure is established by what information is relevant to the patient’s need-to-know in order to evaluate a risk, not by what other chiropractors would do under similar circumstances. By contrast, in those states that follow majority rule, the standard of disclosure for a chiropractic procedure’s inherent risks is determined by what another chiropractor practicing under similar circumstances would consider necessary to disclose to a patient. This course will highlight the importance of obtaining informed consent as it relates to chiropractic practice.
Risk 108 Manipulation and Neural Injury (1 hour)
The principle of every doctor of chiropractic is to provide good quality of care. Many doctors of chiropractic are learning not only new manipulative skills, but also how to protect themselves from allegations of negligence and how to defend themselves in court. From time to time mistakes will inevitably occur, but doctors of chiropractic hope that with goodwill and understanding on both sides – apologies and a genuine attempt to prevent recurrence – this will satisfy the injured party, and it will not result in litigation. Allegations are frequently about lack of informed consent, technical complications and equipment failure, poor manipulative performance, misdiagnosis and failure to identify and manage a complication.
Risk 109 Medicolegal Issue – Informed Consent (2 hours)
Many doctors of chiropractic are learning not only new manipulative skills, but also how to protect themselves from allegations of negligence and how to defend themselves in court. From time to time mistakes will inevitably occur, but doctors of chiropractic hope that with goodwill and understanding on both sides – apologies and a genuine attempt to prevent recurrence – this will satisfy the injured party, and it will not result in litigation.
Allegations are frequently about lack of informed consent, technical complications and equipment failure, poor manipulative performance, misdiagnosis and failure to identify and manage a complication.
Risk 110 How to Read a Legal Opinion (1 hour)
Many doctors of chiropractic are learning that medicolegal aspects of practice are becoming more important especially when they relate to scope of practice, patient care within the confines of managed care, in protecting themselves from allegations of negligence and how to defend themselves in court. Legal opinions (also known as judicial opinions, legal decisions, or cases) are written decisions authored by judges explaining how they resolved a particular legal dispute and explaining their reasoning. An opinion tells the story of the case: what the case is about, how the court is resolving the case, and why.
Georgia Examining Board Rules – CME (non diplomate online programs)
GA Chiropractic Board Rules 101a (1 hour)
This program is offered to Georgia chiropractors in order to meet the educational requirements for license renewal. This program is not a substitute for reading the entire Georgia chiropractic law.
The most important aspect of your chiropractic practice is your license. Without it your ability to practice and earn a living is lost. Defensive chiropractic is a consideration. It is essential to be fully aware of the Georgia chiropractic law. Most providers have no idea of their scope of practice or the “rules of the games” promulgated by the Georgia Board of Chiropractic Examiners. Scrupulous adherence to the statutory scope of practice is a well recognized, traditional, practice constraint.
GA Chiropractic Board Rules 101b (1 hour)
This program is offered to Georgia chiropractors in order to meet the educational requirements for license renewal. This program is not a substitute for reading the entire Georgia chiropractic examining board rules and policies.
The most important aspect of your chiropractic practice is your license. Without it your ability to practice and earn a living is lost. Defensive chiropractic is a consideration. It is essential to be fully aware of the Georgia chiropractic examining board rules and policies. Most providers have no idea of their scope of practice or the “rules of the games” promulgated by the Georgia Board of Chiropractic Examiners. Scrupulous adherence to the statutory scope of practice is a well recognized, traditional, practice constraint.