Daniel Paterson, DC APC

Documentation and coding of Evaluation and Management reports, psychological screening in patients with chronic pain, determining causality and problem-based training on the updated Medical Treatment Guidelines.

Trends in hospital and emergent care in the healthcare delivery system inclusive of policies, hospital staffing and current care paths for mechanical spine issues.

A review of public health concerns and injection safety protocol, developing competency and confidence in pain management injection techniques, providing algorithms for the clinical application of injection therapy, and the anatomy and injection treatments for the spine, shoulder, elbow, pelvic region, hip and knee.

Understanding and assessment of the latest research on Telomeres, Neuro-Degenerative Disorders, Metabolic Syndrome and its interwoven relationships to longevity, wellness, inflammation and cognitive decline; where the process originates and related risk factors. Inclusive of the epigenetic effects of toxins, nutrition, stress and lifestyle on genetic enzyme expression.

Triaging the injured and differentially diagnosing both the primary and secondary complaints. Connective tissue injuries and wound repair morphology focusing on the aberrant tissue replacement and permanency prognosis potential.

Spinal ligamentous anatomy and research focusing on wound repair, future negative sequelae of abnormal tissue replacement and the resultant aberrant kinematics and spinal biomechanics of the spine.

The application of spinal biomechanical engineering models in trauma and the negative sequelae it has on the central nervous system inclusive of the lateral horn, periaqueductal gray matter, thalamus and cortices involvement.

The biomechanics of traumatic disc bulges as sequelae from trauma and the co-morbidity of ligamentous pathology. Age-dating spinal disc pathology in accordance with Wolff’s Law.

The review of case histories of mechanical spine pathology and biomechanical failures inclusive of case histories, clinical findings and x-ray and advanced imaging studies. Assessing co-morbidities in the triage and prognosis of the injured.

The review of current literature standards in spinal trauma pathology and documentation review of biomechanical failure, ligamentous failure and age-dating disc pathology.

Conservative approaches to spinal and extremity joint pathologies utilizing Platelet Rich Plasma (PRP) and Bone Marrow Aspirate Concentrate (B-MAC) “stem cells”. Inter-professional management and rehabilitation of degenerative disc disease and degenerative joint disease post intra-articular and/or intra-discal procedures.

Effective assessment, rehabilitation and strategies for the management of musculoskeletal injuries and disorders. Implementation of a functional movement system, which reveals faulty movement patterns and protocols for correction. Science based clinical protocols for the management of symptoms and conditions including carpal tunnel, lumbar disc degeneration/sciatica, Tennis/Golfer’s elbow, plantar fasciitis, ankle sprain and peripheral nerve entrapments. An in depth study of neurodynamic testing. Reviewing the relationship between movement and pain and providing an understanding of the foundational approach that utilizes laser therapy to manage pain and inflammation.

MRI slices, views, T1, T2, STIR axial, stacking, FFE, FSE and sagittal images. Clinical indication for the utilization of MRI and pathologies of disc in both trauma and non-trauma sequelae, including bulge, herniation, protrusion, extrusion and sequestration.

An in-depth understanding of the protocols in triaging and reporting the clinical findings of the trauma patient. Maintaining ethical relationships with the medical-legal community.

An extensive understanding of the injured with clinically coordinating the history, physical findings and when to integrate neurodiagnostics. An understanding on how to utilize emergency room records in creating an accurate diagnosis and the significance of “risk factors” in spinal injury.

An extensive understanding of the physics involved in the transference of energy from the bullet car to the target car. This includes G’s of force, newtons, gravity, energy, skid marks, crumple zones, spring factors, event data recorder and the graphing of the movement of the vehicle before, during and after the crash. Determining the clinical correlation of forces and bodily injury.

MRI interpretation, physiology, history and clinical indications, bone scan interpretation, physiology and clinical indications, x-ray clinical indications for the trauma patient.

Electromyography (EMG), Nerve Conduction Velocity (NCV), Somato Sensory Evoked Potential (SSEP), Visual Evoked Potential (VEP), Brain Stem Auditory Evoked Potential (BAER) and Visual-Electronystagmosgraphy (V-ENG) interpretation, protocols and clinical indications for the trauma patient.

Understanding the necessity for accurate documentation and diagnosis utilizing the ICD-9 and the CPT to accurately describe the injury through diagnosis. Understanding and utilizing state regulations on reimbursement issues pertaining to healthcare.

Understanding the necessity for accurate documentation, diagnosis and clinical correlation to the injury when reporting injuries in the medical-legal community. Documenting the kinesiopathology, myopathology, neuropathology, and pathophysiology in both a functional and structural paradigm.

Magnetic fields, T1 and T2 relaxations, nuclear spins, phase encoding, spin echo, T1 and T2 contrast, magnetic properties of metals and the historical perspective of the creation of NMR and MRI.

Normal anatomy of axial and sagittal views utilizing T1, T2, 3D gradient and STIR sequences of imaging. Standardized and desired protocols in views and sequencing of MRI examination to create an accurate diagnosis in MRI.

MRI interpretation of bulged, herniated, protruded, extruded, sequestered and fragmented disc pathologies in etiology and neurological sequelae in relationship to the spinal cord and spinal nerve roots.

MRI interpretation of bone, intradural, extradural, cord and neural sleeve lesions. Tuberculosis, drop lesions, metastasis, ependymoma, schwanoma and numerous other spinal related tumors and lesions.

MRI interpretation sequencing of the cervical, thoracic and lumbar spine inclusive of T1, T2, STIR and 3D gradient studies to ensure the accurate diagnosis of the region visualized.

The clinical application of the results of space occupying lesions. Disc and tumor pathologies and the clinical indications of manual and adjustive therapies in the patient with spinal nerve root and spinal cord insult as sequelae.

The understanding and utilization of the protocols and parameters of the AMA Guide to the Evaluation of Permanent Impairment 6th Edition. Spine, neurological sequelae, migraine, sexual dysfunction, sleep and arousal disorders, station and gait disorders and consciousness are detailed for impairment rating. Herniated discs, radiculopathy, fracture, dislocations and functional loss are also detailed in relation to impairment ratings.

The forces in physics that prevail in accidents to cause bodily injury. Quantifying the force coefficients of vehicle mass and force vectors that can be translated to the occupant and subsequently cause serious injury.

Factors that cause negative acceleration to zero and the subsequent forces created for the vehicle that get translated to the occupant. Understanding critical documentation of hospitals, ambulance reports, doctors and the legal profession in reconstructing an accident.

The mathematical calculations necessary utilizing time, distance, speed, coefficients of friction and acceleration in reconstructing an accident. The application of the critical documentation acquired from an accident site.

Delta V issues correlated to injury and mortality, side impact crashes and severity of injuries, event data recorder reports correlated to injury, frontal impact kinematics, crash injury metrics with many variables and inquiries related to head restraints.

MRI slices, views, T1, T2, STIR axial, stacking, FFE, FSE and sagittal images in the interpretation of lumbar degeneration. With the co-morbidities and complications of stenosis, pseudo-protrusions, cantilevered vertebrate, Schmorl's nodes and herniations. Central canal and cauda equina compromise interpretation with management.

MRI slices, views, T1, T2, STIR axial, stacking, FFE, FSE and sagittal images in the interpretation of lumbar herniations. With the co-morbities and complications of stenosis, pseudo-protrusions, cantilevered vertebrate, Schmorl's nodes and herniations. Morphology of lumbar disc pathologies of central and lateral herniations, protrusions, extrusions, sequestration, focal and broad based herniations are defined and illustrated. Central canal and cauda equina compromise interpretation with management.

MRI slices, views, T1, T2, STIR axial, stacking, FFE, FSE and sagittal images in the interpretation of cervical degeneration. With the co-morbidities and complications of stenosis, pseudo-protrusions, cantilevered vertebrate, Schmorl's nodes and herniations. Spinal cord and canal compromise interpretation with management.

MRI slices, views, T1, T2, STIR Axial, FFE, FSE and sagittal images in the interpretation of lumbar herniations. With the co-morbidities and complications of stenosis, pseudo-protrusions, cantilevered vertebrate, Schmorl's nodes and herniations. Morphology of lumbar disc pathologies of central and lateral herniations, protrusions, extrusions, sequestration, focal and broad based herniations are defined and illustrated. Spinal cord and canal compromise interpretation with management.

MRI slices, views, T1, T2, STIR Axial, FFE, FSE and sagittal images in the interpretation of degenerative spondylolesthesis, spinal canal stenosis, Modic type 3 changes, central herniations, extrusions, compressions, nerve root compressions, advanced spurring and thecal sac involvement from an orthopedic, emergency room, chiropractic, neurological, neurosurgical, physical medicine perspective.

Brain and head physiology, brain mapping and pathology as a sequela to trauma. Traumatic brain injury, mild traumatic brain injury, axonal shearing, diffuse axonal injury and concussion are detailed in etiology and clinically. Clinical presentation, advanced diagnostic imaging and electrodiagnostics are detailed in analysis to create a differential diagnosis. Balance disorders that often occur as a result of trauma are also explored from clinical presentation to advanced imaging and differential diagnosis.

MRI slices, views, T1, T2, STIR axial, stacking, FFE, FSE and sagittal images. Clinical indication for the utilization of MRI and pathologies of disc in both trauma and non-trauma sequelae, including bulge, herniation, protrusion, extrusion and sequestration.

Correlating spinal biomechanics secondary to trauma and MRI findings inclusive of herniation, bulging, protruded and extruded discs. Correlating co-efficient of forces translated from the bullet vehicle to the target vehicle to the occupant in determining causality of bodily injury.

Chiropractic as Primary spine care based upon the literature conclusions and the documentation requirements to support those conclusions in an ethical collaborative environment inclusive of hospitals, emergency rooms, primary care medical doctors and medical specialists.

The latest scientific evidence of the effects of the chiropractic spinal adjustment on the central nervous system, both upper and lower motor neurons. A comparative analysis of chiropractic vs. other modalities and therapies.

The Cartesian Coordinate System from the history to the application in the human body. Explanation of the x, y and z axes in both translation and rotations (thetas) and how they are applicable to human biomechanics.

Spinal biomechanical engineering of the cervical and upper thoracic spine. This includes the normal and pathobiomechanical movement of both the anterior and posterior motor units and normal function and relationship of the intrinsic musculature to those motor units. Nomenclature in reporting normal and pathobiomechanical findings of the spine.

Spinal biomechanical engineering of the lumbar spine. This includes the normal and pathobiomechanical movement of both the anterior and posterior motor units and normal function and relationship of the intrinsic musculature to those motor units. Nomenclature in reporting normal and pathobiomechanical findings of the spine.

To utilize whiplash associated disorders in various vectors of impact and whiplash mechanisms in determining pathobiomechanics. To clinically correlate annular tears, disc herniations, fractures, ligament pathology and spinal segmental instability as sequellae to pathobiomechanics from trauma. The utilization of digital motion x-ray in diagnosing normal versus abnormal facet motion along with case studies to understand the clinical application.

Integrating spinal biomechanics and pathobiomechanics through digitized analysis.The comparison of organized versus disorganized compensation with regional and global compensation. Correlation of the vestibular, occular and proprioceptive neurological integration in the righting reflex as evidenced in imaging. Digital and numerical algorithm in analyzing a spine.

Digitizing and analyzing the cervical spine in neutral, flexion and extension views to diagnose pathobiomechanics. This includes alteration of motion segment integrity (AMOSI) in both angular and translational movement. Ligament instability/failure/pathology are identified all using numerical values and models. Review of case studies to analyze pathobiomechanics using a computerized/numerical algorithm.

Digitalizing and analyzing the lumbar spine images to diagnose pathobiomechanics. This includes anterior and posterior vertebral body elements in rotational analysis with neutral, left and right lateral bending in conjunction with gate analysis. Ligament instability/failure/pathology is identified all using numerical values and models. Review of case studies for analysis of pathobiomechanics using a computerized/numerical algorithm along with corrective guidelines.

Digitalizing and analyzing the full spine images to diagnose pathobiomechanics as sequelae to trauma in relation to ligamentous failure and disc and vertebral pathology as sequelae. This includes anterior and posterior vertebral body elements in rotational analysis with neutral, left and right lateral bending in conjunction with gate analysis. Ligament instability/failure/pathology is identified all using numerical values and models. Review of case studies for analysis of pathobiomechanics using a computerized/numerical algorithm along with corrective guidelines.

Advanced Surgical Techniques of the Spine and Stem Cell Therapies.

Understanding Injection Treatments and Techniques for Pain Management.

Program provides the practitioner with an understanding of the DOT examination process. Covering who must be examined, how often, examination format, systems review, pharmacology and the decision making process for disqualification and certification. This program meets all requirements of the National Registry of Certified Medical Examiners draft guidance and is an accredited program for those wishing to take the certification examination.

Treatment and management of acute and chronic pain patterns with injectable nutrients for Advanced Practice Certified Chiropractic Physicians.

Three module, intensive study of injectable therapies for the Advanced Practice Chiropractic Physician Program. Practical techniques, treatments, protocols, agents and review of current medical literature.

Three module, intensive study of pharmacology for Advanced Practice Certification. Providing the knowledge and understanding of the mechanisms of action, uses and toxicities related to the drugs in all categories of the Pharmacopoeia. Provides physician with a thorough understanding of the actions of drugs and the interactions both positive and negative which influence the outcome of treatment. Addresses the concepts of pharmacotherapeutics for each drug and group of drugs, including the mechanism of drug interaction, indications and contraindications, use and duration of treatment, dose and dosage forms, side effects and clinical problems, list of prototypical drugs, pharmacokinetics and pharmacodynamics. Provides a foundation for evidence-based pharmacological applications in clinical practice.

Radiological and pathological review of neoplastic disease of the skeletal system.

Utilization of contrast agents in Magnetic Resonance Imaging.

Regulations and proper procedures involved in the performance of IMEs. In-depth review of examination procedures and proper narrative report generation.

Review of normal radiographic anatomy and MRI evaluation of degenerative disease of the cervical spine.

Updates and current information on musculoskeletal applications of MRI.

Cause and reasoning behind delayed onset of pain, physical injury, post trauma degeneration and chronic pain.

Training seminar for providers. The IME process, regulations, report summary, suggested format for PIP examination narrative reports, suggested guidelines for PIP examination reports and handling letters of rejection.