AMERICAN
BOARD OF CHIROPRACTIC CONSULTANTS
PRACTICE ANALYSIS
AUGUST, 2000
A certified chiropractic consultant is a medical professional who by virtue of education, experience, specialized training, and knowledge is qualified to render expert opinions in response to questions regarding adherence to acceptable practice parameters, standards of chiropractic practice within a given jurisdiction, and legal and contractual rules and regulations.
DOMAIN I - CLINICAL CASE REVIEW
(Depending on the question(s) posed, clinical case review will include some combination of the tasks listed below.)
A. Review of the Documentary Record
T-1A.1 Determine if the documentary record provides sufficient information to make the judgment(s) necessary to respond to the question(s) posed
The effective performance of this task requires knowledge of:
K-1 Elements of a clinical record
K-2 Types and parameters of case reviews
K-3 Published guidelines pertaining to clinical reviews
K-4 Record keeping systems pertaining to clinical case records
T-1A.2 Identify and evaluate the extent of the history and complaint(s)/conditions documented
The effective performance of this task requires knowledge of:
K-5 Elements of a history
K-6 Parameters of complaints/conditions (OPQRST)
T-1A.3 Identify and evaluate the examination(s) performed
The effective performance of this task requires knowledge of:
K-7 Elements, procedures, and interpretation of physical, chiropractic, orthopedic, neurological, etc. examinations
K-8 Concepts of disability and impairment and the AMA Guidelines
T-1A.4 Identify and evaluate the diagnostic testing performed
The effective performance of this task requires knowledge of:
K-9 Protocols, indications, and interpretations of diagnostic testing
T-1A.5 Correlate diagnosis rendered with history, examination, and diagnostic testing
The effective performance of this task requires knowledge of:
K-1 Elements of a clinical record
K-4 Record keeping systems pertaining to clinical case records
K-5 Elements of a history
K-6 Parameters of complaints/conditions (OPQRST)
K-7 Elements, procedures, and interpretation of physical, chiropractic, orthopedic, neurological, etc. examinations
K-9 Protocols, indications, and interpretations of diagnostic testing
K-10 Elements and formulation of diagnosis
T-1A.6 Identify and evaluate treatment records
The effective performance of this task requires knowledge of:
K-1 Elements of a clinical record
K-4 Record keeping systems pertaining to clinical case records
K-11 Elements of a treatment plan
K-12 Patient management protocols
K-13 Protocols of treatment modalities and procedures (e.g., indications, contraindications, applications)
K-14 Natural history of conditions (tissue repair physiology)
T-1A.7 Identify and evaluate the circumstances expected to influence recovery
The effective performance of this task requires knowledge of:
K-8 Concepts of disability and impairment and the AMA Guidelines
K-14 Natural history of conditions (tissue repair physiology)
K-15 Bio/psycho/social elements (e.g., co-morbidity, risk factors, yellow flags, standardized tests/questionnaires)
B. Expert Judgments
(Depending on the question(s) posed, the chiropractic consultant performs one or more of the tasks listed below.)
T-1B.1 Formulate an opinion regarding causation
The effective performance of this task requires knowledge of:
K-1 Elements of a clinical record
K-2 Types and parameters of case reviews
K-3 Published guidelines pertaining to clinical reviews
K-4 Record keeping systems pertaining to clinical case records
K-5 Elements of a history
K-6 Parameters of complaints/conditions (OPQRST)
K-7 Elements, procedures, and interpretation of physical, chiropractic, orthopedic, neurological, etc. examinations
K-9 Protocols, indications, and interpretations of diagnostic testing
K-10 Elements and formulation of diagnosis
K-14 Natural history of conditions (tissue repair physiology)
K-15 Bio/psycho/social elements (e.g., co-morbidity, risk factors, yellow flags, standardized tests/questionnaires)
K-17 Literature search tools and techniques
K-18 Interpretations of the scientific literature
T-1B.2 Formulate an opinion regarding diagnosis
The effective performance of this task requires knowledge of:
K-1 Elements of a clinical record
K-4 Record keeping systems pertaining to clinical case records
K-5 Elements of a history
K-6 Parameters of complaints/conditions (OPQRST)
K-7 Elements, procedures, and interpretation of physical, chiropractic, orthopedic, neurological, etc. examinations
K-9 Protocols, indications, and interpretations of diagnostic testing
K-10 Elements and formulation of diagnosis
K-14 Natural history of conditions (tissue repair physiology)
K-15 Bio/psycho/social elements (e.g., co-morbidity, risk factors, yellow flag, standardized tests/questionnaires)
T-1B.3 Formulate an opinion regarding the appropriateness, medical necessity, and/or relatedness of services rendered (e.g., diagnostic testing, treatment)
The effective performance of this task requires knowledge of:
K-1 Elements of a clinical record
K-2 Types and parameters of case reviews
K-3 Published guidelines pertaining to clinical reviews
K-4 Record keeping systems pertaining to clinical case records
K-5 Elements of a history
K-6 Parameters of complaints/conditions (OPQRST)
K-7 Elements, procedures, and interpretation of physical, chiropractic, orthopedic, neurological, etc. examinations
K-8 Concepts of disability and impairment and the AMA Guidelines
K-9 Protocols, indications, and interpretations of diagnostic testing
K-10 Elements and formulation of diagnosis
K-11 Elements of a treatment plan
K-12 Patient management protocols
K-13 Protocols of treatment modalities and procedures
K-14 Natural history of conditions (tissue repair physiology)
K-15 Bio/psycho/social elements (e.g., co-morbidity, risk factors, yellow flags, standardized tests/questionnaires)
K-17 Literature search tools and techniques
K-18 Interpretations of the scientific literature
T1B.4 Formulate an opinion regarding treatment frequency and duration and Maximum Therapeutic Benefit (MTB)
The effective performance of this task requires knowledge of:
K-1 Elements of a clinical record
K-2 Types and parameters of case reviews
K-3 Published guidelines pertaining to clinical reviews
K-4 Record keeping systems pertaining to clinical case records
K-5 Elements of a history
K-6 Parameters of complaints/conditions (OPQRST)
K-7 Elements, procedures, and interpretation of physical, chiropractic, orthopedic, neurological, etc. examinations
K-8 Concepts of disability and impairment and the AMA Guidelines
K-9 Protocols, indications, and interpretations of diagnostic testing
K-10 Elements and formulation of diagnosis
K-11 Elements of a treatment plan
K-12 Patient management protocols
K-13 Protocols of treatment modalities and procedures
K-14 Natural history of conditions (tissue repair physiology)
K-15 Bio/psycho/social elements (e.g., co-morbidity, risk factors, yellow flags, standardized tests/questionnaires)
K-17 Literature search tools and techniques
K-18 Interpretations of the scientific literature
T1B.5 Formulate an opinion regarding the need for referral, consultation, and/or other evaluation
The effective performance of this task requires knowledge of:
K-1 Elements of a clinical record
K-2 Types and parameters of case reviews
K-3 Published guidelines pertaining to clinical reviews
K-4 Record keeping systems pertaining to clinical case records
K-5 Elements of a history
K-6 Parameters of complaints/conditions (OPQRST)
K-7 Elements, procedures, and interpretation of physical, chiropractic, orthopedic, neurological, etc. examinations
K-8 Concepts of disability and impairment and the AMA Guidelines
K-9 Protocols, indications, and interpretations of diagnostic testing
K-10 Elements and formulation of diagnosis
K-11 Elements of a treatment plan
K-12 Patient management protocols
K-13 Protocols of treatment modalities and procedures
K-14 Natural history of conditions (tissue repair physiology)
K-15 Bio/psycho/social elements (e.g., co-morbidity, risk factors, standardized tests/questionnaires)
K-16 Other healthcare entities and their domains
K-17 Literature search tools and techniques
K-18 Interpretations of the scientific literature
C. Report
T-1C.1 Report findings, opinions, and/or rationales
The effective performance of this task requires knowledge of:
K-8 Concepts of disability and impairment and the AMA Guidelines
K-19 Content and structure of medical/legal reports
K-20 Medical/legal implications and risk management of reporting and testimony
DOMAIN II - TESTIMONY
T-2.1 Provide expert testimony
The effective performance of this task requires knowledge of:
K-20 Medical/legal implications and risk management of reporting and testimony
K-21 Requirements for qualifying as an expert
K-22 The role of the expert witness
K-23 Legal venues
K-24 Medical/legal definitions (e.g., fraud, negligence, malpractice)
K-25 Concepts and applications of informed consent
T-2.2 Provide consultation in legal proceedings
The effective performance of this task requires knowledge of:
K-24 Medical/legal definitions (e.g., fraud, negligence, malpractice)
K-25 Concepts and applications of informed consent
K-26 The role of the expert as a consultant
DOMAIN III - ADMINISTRATIVE ROLES AND FUNCTIONS
T-3.1 Develop and manage quality assurance processes (e.g., utilization management (UM), quality management (QM), quality improvement (QI), credentialing, accreditation compliance)
The effective performance of this task requires knowledge of:
K-1 Elements of a clinical record
K-2 Types and parameters of case reviews
K-3 Published guidelines pertaining to clinical reviews
K-4 Record keeping systems pertaining to clinical case records
K-5 Elements of a history
K-6 Parameters of complaints/conditions (OPQRST)
K-7 Elements, procedures, and interpretation of physical, chiropractic, orthopedic, neurological, etc. examinations
K-9 Protocols, indications, and interpretations of diagnostic testing
K-10 Elements and formulation of diagnosis
K-11 Elements of a treatment plan
K-12 Patient management protocols
K-13 Protocols of treatment modalities and procedures
K-14 Natural history of conditions (tissue repair physiology)
K-15 Bio/psycho/social elements (e.g., co-morbidity, risk factors, standardized tests/questionnaires)
K-16 Other healthcare entities and their domains
K-17 Literature search tools and techniques
K-18 Interpretations of the scientific literature
K-27 Accreditation requirements (e.g., NCQA, URAC, HIPAA)
K-28 Patient/member rights and responsibilities
T-3.2 Interpret contracts
The effective performance of this task requires knowledge of:
K-24 Medical/legal definitions (e.g., fraud, negligence, malpractice)
K-28 Patient/member rights and responsibilities
T-3.3 Provide advice and counsel in the development of contracts
The effective performance of this task requires knowledge of:
K-1 Elements of a clinical record
K-2 Types and parameters of case reviews
K-3 Published guidelines pertaining to clinical reviews
K-4 Record keeping systems pertaining to clinical case records
K-5 Elements of a history
K-6 Parameters of complaints/conditions (OPQRST)
K-7 Elements, procedures, and interpretation of physical, chiropractic, orthopedic, neurological, etc. examinations
K-9 Protocols, indications, and interpretations of diagnostic testing
K-10 Elements and formulation of diagnosis
K-11 Elements of a treatment plan
K-12 Patient management protocols
K-13 Protocols of treatment modalities and procedures
K-14 Natural history of conditions (tissue repair physiology)
K-15 Bio/psycho/social elements (e.g., co-morbidity, risk factors, yellow flags, standardized tests/questionnaires)
K-16 Other healthcare entities and their domains
K-17 Literature search tools and techniques
K-18 Interpretations of the scientific literature
K-20 Medical/legal implications and risk management of reporting and testimony
DOMAIN IV - ETHICAL, PROFESSIONAL, AND LEGAL ISSUES
T-4.1 Apply ethical principles in the performance of chiropractic consulting tasks
The effective performance of this task requires knowledge of:
K-29 Published ethics codes (e.g., ACCC, ACA, ICA)
T-4.2 Formulate opinions based on scientific methodology
The effective performance of this task requires knowledge of:
K-17 Literature search tools and techniques
K-18 Interpretations of the scientific literature
K-30 Statistical analysis including definitions of validity, reliability, specificity, sensitivity, statistics, research design, etc.
T-4.3 Render services in a manner consistent with scope of practice, laws, rules, regulations, and contracts
The effective performance of this task requires knowledge of:
K-31 Laws, rules, regulations, and legal and contractual definitions of scope of practice
K-32 Legal and contractual terminology
Knowledge Statements
K-1 Elements of a clinical record
K-2 Types and parameters of case reviews
K-3 Published guidelines pertaining to clinical reviews
K-4 Record keeping systems pertaining to clinical case records
K-5 Elements of a history
K-6 Parameters of complaints/conditions (OPQRST)
K-7 Elements, procedures, and interpretation of physical, chiropractic, orthopedic, neurological, etc. examinations
K-8 Concepts of disability and impairment and the AMA Guidelines
K-9 Protocols, indications, and interpretations of diagnostic testing
K-10 Elements and formulation of diagnosis
K-11 Elements of a treatment plan
K-12 Patient management protocols
K-13 Protocols of treatment modalities and procedures
K-14 Natural history of conditions
K-15 Bio/psycho/social elements (e.g., co-morbidity, risk factors, yellow flags, standardized tests/questionnaires)
K-16 Other healthcare entities and their domains
K-17 Literature search tools and techniques
K-18 Interpretations of the scientific literature
K-19 Content and structure of medical/legal reports
K-20 Medical/legal implications and risk management of reporting and testimony
K-21 Requirements for qualifying as an expert
K-22 The role of the expert witness
K-23 Legal venues
K-24 Medical/legal definitions (e.g., fraud, negligence, malpractice)
K-25 Concepts and applications of informed consent
K-26 The role of the expert as a consultant
K-27 Accreditation requirements (e.g., NCQA, URAC, HIPPA)
K-28 Patient/member rights and responsibilities
K-29 Published ethics codes
K-30 Statistical analysis including definitions of validity, reliability, specificity, sensitivity, statistics, research design, etc.
K-31 Laws, rules, regulations, and legal and contractual definitions of scope of practice
K-32 Legal and contractual terminology