#130 - When your Clinical Documentation Ends up In Court: What Healthcare Providers Need to Know with Dr. Pankti Fadia, Part 3

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Let's dive in.

Welcome back to The Factor Podcast, where we bridge the gap between rehabilitation, performance, and real-world clinical practice. I'm your host, Jessica Riddle, and today we're closing out our 3-part conversation with Dr. Pengti Faddea on what healthcare providers need to understand when clinical care intersects with the legal system. In parts 1 and 2, we talked about personal injury documentation. We talked about topics such as causation, subpoenas, depositions, testimony, and how providers can better prepare when their records or clinical decisions are questioned. In this final part of the series, the conversation will move into some of the areas that are often a little bit more complicated and frankly more uncomfortable to discuss. Topics such as ethics, attorney-driven care, reimbursement challenges, board complaints, co-managing care with other providers, and how chiropractors can better advocate for the value of conservative care. Dr. Fadia also shares more about her own journey from chiropractor to law student. Why she believes the chiropractic profession needs stronger research and legal advocacy, and why providers should take pride in their role, their training, and the care they deliver. This episode is a strong reminder that credibility is not just about what's written in your notes. It's also about how you communicate, how you make clinical decisions, how you collaborate with other healthcare providers, and how confidently you stand behind the value of your work. Let's dive into part three of my conversation with Dr. Pengti Fadia.

In the next three minutes, let's talk about ethics. No kickback referral scheme, guys. It's illegal for attorneys to pay you for giving them cases or sending you cases. Same thing for you. You cannot be getting paid from. MD offices for sending them cases or MRI companies. We know that, you know, it's always good to be reminded of that again. Please don't do it. Please don't have— it's bad. You can lose your license and also get sued. So now you're going to incur attorney expenses to defend. It's not worth it. Please avoid attorney-driven medical care documentation. Please, please do not document that. I've seen so many chiropractic notes and it's just embarrassing. Like, why would you write that? But people do it, so don't do it. RICO is, is a new thing that chiropractors are facing. It's a— it's basically chiropractors are getting sued under the RICO Act. So make sure that you don't have any unethical conduct. If not, the defense side insurance companies can book you under RICO. And that's another 3-hour seminar for that, webinars for that. Okay. Board complaints. A lot of these patients are complaining to the board because what happens is you release the patient and you expect the lawyer to give you money once their case gets settled, even with the reductions. But either attorneys don't pay you or there's something else going on. So a lot of these chiropractors are going to the patients and asking, hey, you sought treatment, pay me for my bill. Is that wrong to do? Absolutely not. You are legally allowed to do it. Should you do it though? The answer is please don't do it because this patient of yours who were sent to your office by an attorney will not be very nice to you. And he will say, well, go talk to my attorney and have them pay you. I don't owe you anything. They don't understand how the system works. And if you go after them really strongly, then they'll file a board complaint and they'll make your life really, really difficult. So you as a provider business owner, it's your decision on how you want to approach these cases. I personally, I want peace of mind, so I don't go after my patients for non-payment issues. It's just my personal business step, but again, to each their own. And yeah, use models or visual aid. I don't know why it's in the ethics slide, but basically, like, giving depositions, I always use models like this and I explain them— disc herniation, normal disc, herniated disc, things like that. So it helps to illustrate, explain injuries, causation, things like that. That's it. Any questions? I have 3 minutes, Jessica.

Thank you so much. Yes, we do have a few questions we wanted to kind of dive into rather quickly. I appreciate again your time today and all of this great information. I know I certainly learned a lot and was taking some feverish notes over here. One of the questions I always like to start with, especially for instructors I have that are entering into a new career field such as yourself. Everyone has their chiropractic story, right? Like so many times we hear of doctors telling us why they decided to choose the profession they're in.

I'd love to learn a little bit more about what your attorney story is.

So what inspired you after already having your MBA, already having your doctorate in chiropractic, to go back to school to pursue your JD?

Yeah, so I was actually a patient first. I, I got into a wreck. I didn't know what chiropractic was. And back then I used to do radio for fun. And so one of my mentors who's a chiropractor attorney was the one that I used to interview and things like that. So I reached out to him many years ago after my accident and he inspired me to be a chiropractor first. And I had no intention of going to law school, but things happen and I got betrayed by— I don't want to get into details, but yeah, I was— it was a sad story, and somebody defrauded me. And I said, you know what, I'm gonna take things into my own hand, and I won't let this happen to me. So what can I do? And in that moment, I said, that's it, I'm going to be a lawyer, and I will never let this happen to me again. So I applied to law school without thinking too much, and I said, if I get in, maybe it's destiny. And then I got in, and now I'm doing exactly what my mentor always did. He was a chiropractor first, Then he became an attorney, and I'm kind of following that trajectory now myself.

Absolutely. Well, I would say that your immense education is going to serve you well in practice as an attorney, as well as educating other chiropractors as you are today. So another question that someone had reached out and written in about was, at what point did you realize that the healthcare system and the legal system were kind of speaking 2 different languages. Like, what has really kind of inspired you to go and do the research and publish the paper that you've published and to continue pursuing these education opportunities to really advocate for chiropractic as a partner for the legal system, specifically when it comes to PI?

I, I really want to say this, like, I feel Chiropractors were not given the respect that other communities were given, and that always bothered me even when I was in school. And oftentimes, like chiropractors in general, like we're not—we don't sound very confident, and we're not really advocating for ourselves. And so, when I started going to law school and started meeting a lot of attorneys, some of them didn't even know what chiropractic was, or they didn't. Quite understand how we're different than PTs. And so it was mostly like just me educating them. And I realized, how about I come up with a legal article, a law review article that I can explain them what chiropractic is, how we can help them, how they can use our evidence and getting those verdicts that you see on social media. So how can we be help to you? And so when I started doing that, I started writing a paper. Once you have something in written that can be used as evidence. So I'm trying to build evidence right now for future generations. So one day, when in, in some random county in Texas that there is a case out there and that attorney wants to say that this chiropractor is really good and this chiropractor helped my client and whatever he says is really good, how, how does he establish that? He'll pull up an article that I've written and other people have written and say, look, chiropractic credible for all the jury bias out there. So it starts at this level. We have to get the research out, not just what TCC is doing with science research, but we also have to get research in the legal side. We also have to get research where we're saying that when we're billing somebody, that it's not just— it's valuable.

Mm-hmm.

And our profession can, can break that jury bias because we help patients, they get better. and take us seriously. And so you have to come up with all that articles at the ground level. So a lot of the times people ask me, what guidelines do we use in practice? Somebody made those guidelines long time ago that we're still using, right? And insurance company were paying a lot of these doctors to say that chiropractic care was not necessary beyond a certain point. That's why we're being hammered by this defensive right now that they're saying, oh, if you've treated them more than 20 times or whatever, I'm just throwing numbers out there. That's excessive.

Mm-hmm.

Why? Because they'll pull out a guideline that's dated '90, back in 1990s, funded by the insurance company to say that what we do is useless. So I'm saying, no, let's come up with more research and more legal articles to say across the globe, not just in Texas, but in the United States, this is what we do. Our patients are getting better and therefore you should pay us.

Absolutely. And, you know, I want to touch on something you said there that was very interesting to me. As soon as it's in written form, It can be utilized as evidence.

Yes.

So essentially, the, the call to action for the healthcare community, but also it sounds like the legal community and those of your soon-to-be colleagues who do handle personal injury and workers' compensation where they would prefer to have conservative care as a means for their patients to, to get better faster, is really to, to do the work, to do the research, to document well, but then also to put forth case studies and continue progressing and, and try to get published so that it can carry forward, it sounds like, for future generations to be able to establish chiropractic as a, a go-to means for that.

Persuasive tool. A plaintiff attorney can bring my article in courtroom and say, look, Judge, if I'm bringing this chiropractor as expert, he's qualified. many cases before you in this jurisdiction have accepted chiropractors similar to this resume as an expert, and whatever they say is valuable. So this adds value from the legal side where when defense is trying to say, we're not accepting this person's testimony, they're not even qualified as expert. No, they have been doing it for past 20 years in this jurisdiction. This is the number of cases that we've utilized this, and juries have given large verdicts on these cases. Right. So that's where the legal documentation comes in for science. these papers. My goal in the science journal is, again, I'm not teaching doctors science. That's, that's you guys. You guys are doing the actual research. I am just teaching doctors whatever science we have got right now. How about we articulate that and now win cases for our side?

Yeah.

And it can be anything, not just personal injury, medical malpractice or scope. We're fighting for our scope all the time, right? You'll hear the Texas Chiropractic Association fighting all these cases. And so it's important So my, my job is to come here and like do my best to educate chiropractors and say, you have everything that you need. Let's just learn to communicate that to the other side, to legal professionals and medical doctors, and let's build credibility.

Absolutely. So I know you had mentioned that as a chiropractor, you have been the one that has been In that seat for depositions. You've testified before. What was that experience like for you the first time? And what are some just foundational pieces of advice that you would give, especially to students or those that are brand new in practice? What do you do when you get that call? And what are just some tips to, to help them have a great first experience?

So I was very scared the first time I heard about it. And it, because I was also in, like, I switched that clinic, so I didn't have access to patient records and I got subpoenaed, so I had to be there and nobody was helping me. And so, yeah, and there was no ChatGPT back then that you can kind of Google and they come up with like, oh, what, what to say on the fly. So that was just very, very like not knowing the information was just, I didn't even know what deposition was. And so. Then I asked around, like, other senior doctors who have done that. And so they explained to me, it's okay, they'll just ask you questions, basic stuff, just answer what you can, let them know that you don't have the record. So that I was like, I— people used to say, oh, it's HIPAA, we can't release the records. Well, no, it's not really true in PI cases. When you sue somebody, then your records are going to be part of the official on record. So you can get the records from either one of the lawyers and then prepare. So that was me navigating all of that. Now I exactly know what to do. So for younger chiros out there who are listening to me and have never been deposed before, first of all, understand it's such a normal bread and butter for attorneys to do it. So it's a regular day in their job, just like how you see a new patient. This is what they do for a living, right? So it's not a big deal. First of all, don't be anxious. Just get your documentation. If you did, if your employer can give it to you, great. If not, you can always get them from either one of the attorneys. Plaintiff attorney, their information is on the subpoena, or if they reach out to you by email, ask them, I don't have any records, can you please give it to me? Once you have your records, read it 3, 4, 5, 6 times. Read it word to word. Understand what you wrote. This may be 2, 3 years ago, right? So, because that's how long the litigation process is. So by now you don't have any memory of this patient. So remember that, read your notes, and then Go in and sound confident. You have to back up your own treatment. If you sound like, oh, I didn't think the MRI was necessary, then why did you order it, doctor? So even if at this point in retrospect you're looking at your records and like, what was I thinking? But don't do that in front of the— don't do that in deposition. Just act confident and say, yeah, I did that and I stand by my record. The other person who's asking the questions, they're not A professor of chiropractic school. They're not doctors even. They're lawyers. They don't know anything about chiropractic or law or medical. And even if they do, you saw the patient, you thought it was medically necessary, you documented that, you ordered it, you stand behind your notes. So that's my best advice to everybody who's taking a deposition or trial testimony. You have to be confident. You have to stand behind your, your treatment and your notes, even if you deep down you don't believe it. I'm sorry, you're that person. You should have believed it to begin with. But right now you're gonna be like, nope, I am— I think this is the best treatment ever and I'm the best doctor ever. And that's how you answer those questions.

No, 100%. Confidence is key, especially when you're defending your own treatment plan, your own documentation of what you did for that patient. What have you found in your experience and what have you seen that is one of the most common documentation mistakes? that chiropractors often make that may kill a case? It may really damage the case.

So red flags, first of all, documenting attorney-driven care. That's a problem. What happens in practice is that we generally seek, we call these case managers and say, do you approve this particular treatment? Right? Which is wrong thing to do. Attorneys cannot approve medical treatment. But it's common industry practice. Now, we're not saying do you approve a neck or back MRI. What we're saying is, is there enough money in this case for the patient to go seek all this treatment? And so we can't document either one of these things in our in our documentation charts. It's just something that when you do it, you are saying that the lawyers are making all the decision instead of you making the medical decision. And in reality, the lawyers are not. The lawyers are not asking you to order this particular MRI or do this kind of treatment. You are making that decision as a kind. Chiropractor, but in industry practice, oftentimes our staff will contact them and say this is what we're recommending, and the lawyers will either say yes or no depending on the finances of the case. And so my my best advice to everybody who's listening right now is don't document that. Have those conversations on the phone, but definitely nowhere on your record that it should reflect that attorney denied MRI or attorney approved MRI or attorney denied. Extension of treatment. No, you, you can never say that, and they should never be dictating you on how you should treat your patient.

And I think the through line of, of everything that you said today and everything that you taught in today's webinar is that do what's right for your patient, right? Just like the oath that you take when you become a chiropractor, when you walk across that stage, just like what you agree to in your jurisprudence exam when you're getting your license in your state. Your role as their healthcare provider is to put the patient's best interest first and to prioritize their health and what is needed. And from everything you've said, the main place where people really can mess up is if they forget that fact and they get more focused on the dollars and cents.

Yeah.

Or possibly even the, the legal process involved instead of Truly saying, okay, this is— this individual patient needs individual care. They're not going to need, as you mentioned earlier, they're not going to need cookie-cutter care. And every single patient that comes in that has a whiplash injury needs to get exactly the same thing because everyone's different. Everyone may respond differently. So I think that's really kind of an important thing to mention there. Another question that came in, someone was asking—

Just to ask the red flags. The other thing that I see a lot is it's not necessarily a red flag, but you're not really putting causation there. So causation is the element that you are going to get hammered a lot by the defense attorney. So always make sure that you're saying these injuries are because of the car accident. Like there's one line here somewhere connecting that all your orthopedic findings, all of that says more likely than not, this is from the car accident. So that you should definitely document. And please don't throw your client under the bus. This is what the plaintiff attorneys say. So I was just having a conversation with one of the attorney friends of mine, and he said a lot of the time these chiropractors are saying things like the patient is not exercising. They're documenting these things. Patient refused to exercise. Patient is not consistently coming in. We're doing this. I, I guess I don't know why a chiropractor would say that. Maybe they're trying to justify the gap.

Mm-hmm.

Or they're saying, hey, like CYA, like I'm telling you to do these things, but you're not doing it. These are the conversation best to have done on the phone or face-to-face with the client or with the patient. Please don't document that. Like you're making them look really bad on purpose. You want me to say patient's just not compliant. I think that's okay to say. Don't go into details as to what they're doing wrong. So documenting the negatives. I don't document it unless you absolutely have to. Try to be thoughtful about what you're writing because every single thing that you write is going to be used against you or for you in court by both sides.

Yeah, no, absolutely. And I think you're right. There is a, a very salient way to still document in a compliant manner to say the patient's being in compliant Without, as you mentioned, kind of airing all the dirty laundry and throwing them under the bus and saying, well, they did yard work this weekend when I told them not to, or they aren't doing their exercises on these specific days or whatnot. Someone else was asking a question here about the first thing that a defense attorney usually looks for when they get the notes, when they get the documentation from a chiropractor. Are they going through with a big yellow highlighter? And if they see these specific things, they're like, oh yeah, I I've got this, this doc.

So long before AI happened, I think insurance companies had softwares. So your notes are not being read by a human. It was going through a software even before the whole AI stuff. I'm sure even right now it goes through a software where it'll spit out a number, like how much is the case worth? And it goes through your diagnosis and some key language in there. And it's also designed to red flag some of the Inconsistencies. So you— your notes in reality are not being read by defense attorney. Defense attorneys don't even come into play in the beginning. It's only your lawyer— I mean, your patient's lawyer and an insurance adjuster on the other side. And the adjuster's job is they think that this money is their own money, and if they give you $1 of their own money, that they're going to die tomorrow. So they will not—

Yeah.

Yes. Their job. Minimal expenditure.

So, so they will, so they will find the same thing. They'll say treatment was not medically necessary. It's too excessive. You wouldn't have ordered an MRI if this was a health insurance case. So they'll say the same thing irrespective of whatever case is going on. But then defense attorneys will generally come into play if it's a commercial case. So it's a really big policy case. That's why insurance people will hire defense attorneys cuz it It makes— at this point, the stakes are so high that they're okay spending money on defense because defense attorneys, they, they don't get paid. Like, for plaintiff's side, you get paid if you win the case. If there's settlement, you get paid. For defense, the insurance company will pay them per hour.

Oh yeah.

They are very expensive for the insurance side, so they won't get a defense attorney. So your case is not being looked by a defense attorney. Now, when they do look at it, Their paralegal have gone through every single note, every single word, and they will look for inconsistency. So if the pains— if the pain level was really high one day and it's super down the next day and then again high. So if it's, if it's really the case, then you have to explain why. So like you mentioned the yard work, right?

Mm-hmm.

I would document that. Oh, patient did yard work and that flared up their symptoms. And it's a good thing because they were doing yard work before the car accident. They started it again and now they're not able to and it causes them a lot of pain and exacerbates their symptoms. And so those are the things. If there is inconsistency in your findings, explain it. If your treatment is going really good, most of the time it's like a lot of pain, a lot of pain getting better and, and it's better, better, better. And they're still treating them, the patient, another 10, 15 sessions. Why? If it was that good, why did you not release them? If it was that bad, why did you not send them out? Because clearly chiropractic care is not working. So it's this sweet spot in there somewhere where you have to explain why you are still treating them. Also, if they are in so much pain, are you sending them somewhere else because your treatment is reaching MME? And so these are the things that a good chiropractor will try to explain in charting as best as they can. And then, like I said, your job is not to Defend the patient. So you do your best to defend your notes. If you have bad facts, you have bad facts. That's up to the attorneys to then swing it and say, "Yes, I understand, doctor. You said that the patient had gaps in treatment, but when they came back, what did they do? Were they exercising? What happened?" So then the attorneys will use your testimony in whichever way they want to guide you there. But I wouldn't go out of my way as a provider to be an advocate for them personally. I'll try to stay as best as I can.

Absolutely. And I think one thing that you said was key there, it is so important to do an, a great exam history and kind of an initial assessment to get that starting point. You mentioned earlier, even Oswestry questionnaires or yellow flag questionnaires, like go ahead and get a baseline and do a really thorough job in the beginning. So that you know your starting point, and then continue to reassess along the way, which is something that I know we teach in our FACTOR courses. That's something that so many evidence-based systems advocate for, is you have to continue to assess along the way to see how they're progressing in their care, and then be prepared to pivot and make a change or refer out if necessary. Now, how How sticky of a situation does that become when the chiropractor does the initial assessment and intake, they treat a patient for a period of time, they're not getting the, the level of improvement that they expected, and then they have to refer out to another provider? Co-managing care for patients inside of a case like this, does that become very cumbersome on the— on behalf of the chiropractor? Does that become a headache for the attorney when you have multiple healthcare providers that you're trying to make sure all can still get reimbursed for the care that they do provide for this patient?

So very good question. When you are working the personal injury world, it's not me versus the other provider. We're all on one side and we're towards the patient side. Mm-hmm. So reimbursement, I'll talk about it later, but first, when it comes to co-management, Every single PI case will be co-managed because if it's a car accident case, a lot of the times they've gone to ER, they've already seen a medical doctor, or they may have gone to an urgent care, or the lawyers may send them to these places for them to get their initial medicine. Once you get the MRIs done, if they need it, if the MRI is medically necessary, a lot of the times these patients come back with herniated discs, some kind of traumatic Injuries that require at least a second opinion, in my personal opinion, for you to have them sent to a medical doctor. Because at the end of the day, these are— I think a car accident disc herniation is permanent damage. A disc never goes back to zero. A herniated disc will maybe go down a little bit, but it'll never be what it used to be before the car accident. So it's always important for them to have the best possible treatment. We as chiropractors, we do rehab, physical therapy modalities. We help them with the structural aspect, but then there's also a need for them to see other providers, especially MD, so that they have their options. What if they want to do other interventions? What if they want a discectomy? Or what if they want initial pain medicine, things like that? It's, it's, you should give them all the options. And so it's not me versus MD and who's going to see the patient more. It's always me, MD, PT. Orthopedic doctor, neurologist, we're all one team. We're all going to do what we can do for these patients. So I focus on what I can do within my scope. Neurologist will evaluate them. If the patient doesn't need surgery, no other intervention, they'll release them, say, yeah, you're doing good, chiropractor, keep doing this. So that's how it works in our line of, in the PI work. You're always going to work with other, other doctors. Now let's talk about reimbursement. Now that's where it gets murky because the more providers this particular patient is going to see, everybody's going to have their own bill. And when the insurance is handing out money, somebody is going to get really bad reduction. And it's most of the time it's us. And it's really sad. As chiropractors, we see them For so many more visits than what an MD would. MD will see them maybe twice. We'll see them n number of visits. And then towards the end, an MD will probably get paid more than what I will. And it's sad, but again, that's the nature of the industry. But a lot of the times chiropractors will then say, well, in that case, how about I not send these patients to other providers and I keep the whole check to myself? Really, really bad business decision. Also really bad for your patient. Also bad from a defense perspective. Why? Because you will get that question. It's counterintuitive, right? We are always expecting that question. Oh, doctor, did you send out for this MRI? Yes, I did. Was it medically necessary? You will also get the question, well, why did you not send out for MRI if your patient was hurting for 4 weeks? Why did you not? If the MRI came back positive for disc herniation, Why did you not send them to a medical doctor? And if you say, well, I don't think that was necessary, you Hong Kong believe they're going to have a whole list of other chiropractors' testimony from God knows everywhere and say, if you have a herniated disc, the standard practice, a standard of care is for them to see an MD. You failed to do that. You are falling below the standard. So it's like a double-edged sword. Like if I do it, I still get in. Questioning from the defense side. If I don't do it, the defense will attack that. So you don't think too much. See your patients, do your best. And when it comes to compensation, have a spine. Just know that you are going to get compensated. And if the attorneys are not paying you, don't work with them. But don't go after your patients for the rest of the bill because they'll bite you. Like they'll file board complaints and do everything in their power to make you look bad. It's bad PR, more stress. So write it off and maybe sign up for Factor and you can start having a different stream of revenue coming in from cash patients and health insurance patients, right?

Yeah, absolutely. And that's a, that's a good point too. As a patient, you've already been through a traumatic accident of some sort. You've already encountered pain and to have to also navigate The legal process and all of the different providers. The last thing that you want after everything finally gets settled is to get a phone call with someone saying, hey, I really need you to pay this bill because even though you thought it was going to be covered, it wasn't. So I think that's, that's an important takeaway for sure. I have one last question that I wanted to kind of ask and leave us with today for today's discussion. Again, I appreciate you so much coming on and teaching about this because It's so important. And I think there is a great deal of opportunity for doctors out there that are looking to work with attorneys in this manner and to help patients that are dealing with these type of injuries or situations. What is the one question that no one ever really asks you, but you are secretly hoping that someone would in regards to all of this? I know that oftentimes you may get questions about specific cases or things that you can't necessarily speak to, but is there something that's kind of a burning topic or just a statement that you wanted to leave either existing healthcare providers with, or even the next generation of either providers or attorneys coming up that you'd wanna leave our audience with today just to kind of ponder and think on?

Oh, this is a tough question. I mean, they generally ask me like from everything from technical to what law is and where I stand. I just want to tell my fellow chiropractors who are listening right now, I love being a chiropractor. I'm so passionate about this profession. Even if I'm going to be an attorney, I'll always be a chiropractor first. I think that's my identity now, and I take pride in what I do. And that means I will also charge for my time. I feel like chiropractors, when they are giving testimony or depositions, or even on the other side, sometimes defense will hire chiropractors to give expert testimony. We're not charging them enough. We feel like we are undervalued and that shows. So please be proud of your profession. Just know that you're an incredible doctor. Why? Because you're healing these people. Without giving them opioids, your patients will love you. Whatever treatment that you're doing, you're not—you're not doing anything wrong. Even if they say you're doing excessive treatment, that's insurance company trying to play with your head. Don't believe them. You're not injecting them with medicine. You're not doing any surgeries on them. You are training them how to take care of their bodies. You're teaching them posture exercises, any kind of rehab. Even after they're done with you. Whatever you taught them, that will stay with them. So, so take pride in your profession. And when the legal community approaches you and they ask for your help, don't do it for free. It's okay to, to ask for money. And if they don't pay you for your cases, there are things that you can do, which I'm not gonna go into details for, but like, don't— your patient is not your problem. Don't, don't go after the patient. You can still go after the attorneys, but there's a right way and wrong way to do it. So just, just, just love what you do and, and have faith in yourself and in your profession and, and be aggressive out there. Like, don't, don't come off as, oh, I'm just a, I'm just a chiropractor. No, no, no. I'm, I'm a doctor of chiropractic. I have all these credentials and I'm doing good work every day, and therefore I earned my place in this industry.

Oh, I love it. That's a great message. Definitely a, a great one to wrap up today. Well, congratulations on your journey through this new facet of your education, and congratulations on your upcoming graduation next month. We look forward to hearing much more from you in the future and some additional courses and trainings to help educate your fellow healthcare providers. And we thank you again for today. We really appreciate you coming on.

Thank you, Jessica, and shout out to Dr. Riddle. I still use every single rehab exercise he taught me. And so both of you are amazing people and you're doing a lot for our chiropractic community. So I really, really appreciate that, and thank you for this platform.

That wraps up our three-part conversation with Dr. Pengti Fadiah. Throughout the series, Dr. Fadiah helped us. better understand the intersection of chiropractic care, personal injury documentation, legal proceedings, testimony, ethics, and professional credibility. And in this final episode, she left us with an important reminder: chiropractors and other healthcare providers should not minimize the value they provide. When you're helping patients recover, teaching them how to move better, documenting their progress, Referring when appropriate, and staying focused on ethical, patient-centered care, the work that you do matters. And when that care becomes part of legal process, providers need to be prepared to communicate clearly, stay within their scope, and stand confidently behind clinical decisions. One of the biggest themes from this series is that good documentation starts long before anyone requests your records. It starts with a thorough history, a strong exam, clear clinical reasoning, appropriate reassessment, and thoughtful communication across the continuum of care. A huge thank you to Dr. Pankti Faddea for sharing such a unique and valuable perspective as both a practicing chiropractor and soon-to-be attorney. Her work is helping to bridge an important gap between healthcare and law, and I know this conversation will be valuable for providers navigating personal injury care, documentation, depositions, and everything that goes along with the medico-legal questions in practice. As always, thanks for listening to the Factor Podcast. If this series was helpful, be sure to share it with a colleague, subscribe to the show, and sign up to attend one of our hands-on course dates. You can visit the link in our show notes. That'll take you directly to factoreducation.com. That's F-A-K-T-R education.com, where you can learn more about All of the different offerings that we have from hands-on trainings to online courses and certifications, as well as a number of different free resources as well. If there are other topics, trainings, or even guests that you'd like us to have on the show, please be sure to head to our website. It's also linked in the show notes at factorpodcast.com. That's F-A-K-T-R podcast.com. And we'd love to hear from you. We're always interested in learning more about different instructors that could bring value to our audience and are not shy about tackling any new topics that you might want to have us cover or feature so that we can continue to add value to those of you that are listening from around the globe. Our next episode drops in 2 weeks, so be sure to tune in there. We'll be talking about the mental aspects of performance. And some of the important things that healthcare providers should consider when working with athletes or even just high performers in general, people that are CEOs, extremely driven, people who are trying to improve their life in some way, and different ways that you can spot some of the mental health aspects, some of the emotional or the psychological aspects that might be contributing to how that patient is or is not progressing according to your care plan. Be sure to tune in every 2 weeks on Friday where we drop new episodes, and we'll see you next time. Hey guys, if you like what you heard today, I encourage you to visit our website at factor-store.com. That's spelled F-A-K-T-R-store.com to find out more information about all that we have to offer.

We have a variety of online offerings as well as our hands-on Factor Rehab System course scheduled in cities around the globe.

Be sure to also check out our event calendar and bookmark any of these upcoming live webinar dates coming up in the near future so you can join us live.

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