Orlan Fikes, D.C.

• Certified Impairment Rating Attending Physician
• Certified in Injury Model Examination Protocol
• Certified In Electronic Medical Injury Record System
• Certified by Ligament Injury Institute

OCCUPATIONAL HISTORY

• Clinic Director, Spinal Trauma & Rehabilitation Center, 5309 Wurzbach, Suite 114, San Antonio, Texas: 2017-Present
• Clinic Director, Fikes Chiropractic Center, 5309 Wurzbach Road, Suite 114, San Antonio, Texas: 1989-Present
• Clinic Director, Great Northwest Chiropractic Center, 5581 Grissom Road, San Antonio, Texas: 1982-1989

EDUCATION AND LICENSURE

• Bachelor of Science in Biology, East Texas State University, Commerce, Texas, 1977
• Doctorate of Chiropractic, Texas Chiropractic Center College, Pasadena, Texas, 1981
• Internship, Texas Chiropractic College Outpatient Clinic, Pasadena, Texas, 1980-1981
• National Board of Chiropractic Examiners, Part I, 1981
• National Board of Chiropractic Examiners, Part II, 1981
• Doctor of Chiropractic, Licensed in the State of Texas, License # 2784, 1981-Present

SELECTED POST GRADUATE EDUCATION

• Documenting Trauma and Non- Trauma Cases & Triaging Disc Pathology, Triage care and collaboration for herniated, bulged, protruded, extruded and fragmented spinal disc. Compliant documentation of evaluation and management of new and established patients inclusive of chief complaint, history of present illness, review of systems, past-family-social histories with case management protocols and the required elements. Clinically coordinating treatment with subjective complaints, clinical findings and diagnosis for each encounter. Cleveland University- Kansas City Chiropractic and Health Sciences, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2018
• Evidence Based Care in a Collaborative Setting. Primary Spine Care 5, a literature based model for collaborating with hospitals, medical primary care providers and specialists. Reviewing the documentation requirements to communicate the diagnosis, prognosis and treatment plans with medical entities and having the evidence as a basis for those recommendation. Academy of Chiropractic Post-Doctoral Division. PACE Approved for the Federation of Chiropractic Licensing Boards, Cleveland University-Kansas City and College of Chiropractic, Long Island, NY, 2018
• Current Literature Standards pf MRI Spine Interpretation, Primary Spine Care 5. MRI Spine Interpretation of the spine. How to triage a trauma and non-trauma patient and advanced imaging and document the necessity. Covered the basis of MRI Spine Interpretation inclusive of all types of herniation and bulges. Academy of Chiropractic Post-Doctoral Division, PACE Approved for the Federation of Chiropractic Licensing Boards, Cleveland University-Kansas City of College of Chiropractic, Long Island, NY, 2018
• Spine Brain Connection in Path Pathways, Primary Spine Care 5, MRI Spine, the spine-brain connection in managing chronic pain patients. Understanding how chronic pain negatively effects brain morphology and potential pathology as sequela. The role of chiropractic in preventing the loss of gray matter and the most recent evidence as outlined in indexed peer reviewed literature over the last 10 years verifying chiropractic’s role. Academy of Chiropractic Post-Doctoral Division, PACE Approved for the Federation of Chiropractic Licensing Boards, Cleveland University – Kansas City, College of Chiropractic, Long Island, NY, 2018
• Bio-Neuro-Mechanical Mechanism of the Chiropractic Spinal Adjustment, Primary Spine Care 5,
• the biological neurological and mechanical mechanisms and pathways from the thrust to the lateral horn and brain connection and how the brain processes the chiropractic spinal adjustment based upon the literature. Care paths of chiropractic and physical therapy from an outcome basis. Academy of Chiropractic Post-Doctoral Division, PACE Approved for the Federation of Chiropractic Licensing Boards, Cleveland University Kansas City, Chiropractic, Long Island, NY 2018
• Science of the Chiropractic Spinal Adjustment and Vertebral Subluxation. The literature-based definitions of both the mechanisms of the chiropractic adjustment and how it affects the central nervous system in pain pathways and systemic issues that the arbiter for normal vs abnormal function. The physiological mechanisms of how the chiropractic spinal adjustment affects the peripheral and central nervous systems. Subluxation degeneration/Wolff’s Law was detailed from a literature perspective combined with the mechanisms of subluxation (bio-neuro- mechanical lesion). A literature perspective why long-term chiropractic care is clinically indicated that is usual and customary to effectuate demonstrable biomechanical changes in the spine. In evidence-based perspective of why physical therapy is a poor choice for spine as a 1st referral option for any provider inclusive of the literature. Cleveland University Kansas City, Chiropractic, Long Island, NY 2018
• Spinal Biomechanical Engineering Digitizing, Integrating automated mensuration into creating treatment plans determining maximum medical improvement. A literature-based study of normal vs abnormal motor unit function. Determining ligamentous laxity, alteration of motion segment integrity and pathological stress units and whole person impairments based upon the literature and academic standards. Cleveland University Kansas City, Chiropractic and Health Services, Academy of Post-Doctoral Division, Long Island, NY 2018
• Connective Tissue Pathology, Spinal Biomechanics as Sequella to Trauma, MRI Spine Interpretation, Ordering Protocols & Triaging the Injured, The latest research on the 6 ways to age-date disc herniations and bulges from trauma inclusive of disc pathology nomenclature. MRI ordering protocols, inclusive of Dixon format and fat suppressed images. The neurology and pathology of connective tissue and the sequella of trauma at the biomechanical level leading to bio-neuro-mechanical failure Contemporary evidenced-based building blocks for triaging in a collaborative environment. Cleveland University Kansas City, Chiropractic and Health Services, Academy of Post-Doctoral Division, Long Island, NY 2018
• Primary Spine Care Qualified. This qualification includes graduate chiropractic education in healthy and traumatically altered spinal morphology inclusive of osseous, connective tissue and neurological structure, function, and pathology. This certifies you are qualified in accessing the predictive models in spinal biomechanics and devising engineering paradigms for treatment plans to maximize spinal homeostasis in an evidence-based conclusion. Also, this qualification acknowledges your expertise in triaging the in the injured and coordinating collaborative care from the trauma through the conclusion of re-habilitation, Academy of Chiropractic Post- Doctoral Division, Cleveland University-Kansas City , College of Chiropractic , Long Island NY, 2017.
• Spinal Bio-Engineering Seminar, A course describing the structural and functional organization of the spinal-pelvic system. Fundamental and advanced concepts on spinal biomechanics are introduced by presenting a coherent spinal model describing normal segmental coupling reginal adaptation and global compensation. The clinical model is a structural and mechanical engineering approach based on x-ray physics, mathematics and statistical analysis. The normal movements of gait are integrated in this total biomechanical approach to explain spine distortion, predictable functional scoliosis and lumbar failure. Case studies are demonstrated to radiographic analyses and physical findings to determine clinical solutions and soft tissue rehabilitation. PACE Recognized by The Federation of Chiropractic Licensing Boards, Weldon Spring, MO 2018; 12 hours
• Contemporary Literature in Spinal Biomechanics, Normal vs. pathological biomechanical spinal motion both in a single motor unit and coupling actions. Interdisciplinary approach to mechanical spine issues and evidenced based care paths, PACE Approved for the Federation of Chiropractic Licensing Board, Academy of Chiropractic, Melville NY, 2017
• Documentation of Spinal Trauma, Interdisciplinary approaches in documentation of spinal related injuries inclusive of connective tissue disorders and biomechanical failure. Clinically correlating history, imaging, advanced imaging and clinical findings to conclude an accurate diagnosis, prognosis and treatment plan, Texas Chiropractic College, PACE approved for the Federation of Chiropractic Licensing Board, Academy of Chiropractic, Melville NY, 2017
• Excellence in Trauma Spine Care 2017, Academy of Chiropractic, Post-Doctoral Division, Melville NY 2017
• Spinal Biomechanical Engineering Analysis, Normal vs. abnormal coupling motions in a mechanical model utilizing engineering principles in a predictive model. Applying the Cartesian nomenclature to normal and pathological sequella of human spine, PACE approved for the Federation of Chiropractic Licensure Boards, Melville NY 2017
• Spinal Biomechanical Engineering Clinical Application, Creating treatment plans based upon predictive models in determining what is corrective vs. management of pathological spinal biomechanical behavior, PACE approved for the Federation of Chiropractic Licensing Boards, Melville VY, 2017
• Stroke Anatomy and Physiology: Brain Vascular Anatomy, The anatomy and physiology of the brain and how blood perfusion effects brain function. A detailed analysis of the blood supply to the brain and the physiology of ischemia. [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards], ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2017
• Stroke Anatomy and Physiology: Stroke Types and Blood Flow, Various type of stroke identifying ischemia, hypo-perfusion, infarct and penumbra zones and emboli. Cardiac etiologies and clinical features as precursor to stoke with associated paradoxical emboli and thrombotic etiologies. Historical and co-morbidities that have etiology instroke inclusive of diabetes, coagulopathy, acquired and hereditary deficiencies. [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards], ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2017
• Stroke Principles of Treatment an Overview for the Primary Care Provider, Stroke type and treatments performed by vascular specialist. The goals of treatment with the physiology of the infarct and penumbra zones and the role of immediate triage in the primary care setting. Detailing the complications of stroke and future care in the chiropractic, primary care or manual medicine clinical setting. [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards], ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2017
• Clinical Evaluation and Protocols for Identifying Stroke Risk, The neurological history and examination for identifying stoke risks with a focus on supra and infratentorial regions, upper and lower motor lesions, cranial nerve signs, spinal cord pathology, motor and sensory pathology and gait abnormalities. Examining genetic and family histories along with dissection risk factors. Stroke orthopedic testing and clinical guidelines pertaining to triage for the primary care provider. [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards], ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2017
• Triaging the Trauma and Non-Trauma Patients, Correlating clinical findings and the patient history in determining the correct course of care in triaging the patient utilizing orthopedic and neurological evaluations in the clinical setting. Understanding the parameters for immediate referrals vs. following the continuum of care to determine the necessity for referrals. Texas Chiropractic College, Academy of Chiropractic Post-Doctoral Division, Long Island, NY 2017
• Primary Spine Care – Credentials and Knowledge Base, The credentials and knowledge based from an academia perspective when cooperatively treating in a collaborative environment inclusive of understanding pathology and mechanical spine issues. Texas Chiropractic College Graduate Doctoral Program, PACE approved for the Federation of Chiropractic Licensing Boards, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2017
• Primary Spine Care – Spinal Biomechanical Engineering and MRI Spine Interpretation,
• Integrating Spinal Biomechanical Engineering and MRI Spine Interpretation into a primary spine care model, inclusive of necessity and acquisition protocols. A comprehensive review the latest evidence in documenting mechanical issues. Texas Chiropractic College Graduate Doctoral Program, PACE approved for the Federation of Chiropractic Licensing Boards, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2017
• Primary Spine Care – Hospital Administration, Triage, Clinical Requirements and Collaborative Relationships with Medical Specialists, Understanding hospital and medical specialist’s care paths for mechanical spine pathology and integrating the doctor of chiropractic in the hospital and allopathic treatment protocols. Texas Chiropractic College Graduate Doctoral Program, PACE approved for the Federation of Chiropractic Licensing Boards, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2017
• Primary Spine Care – Contemporary Spine Research and Documentation, Central nervous system connection and the thalamus, hypothalamus connection in both ascending and descending central pathways with neuro-endocrine implications that have the mechanisms to be a component of Schizophrenia, Dementia and Alzheimer’s with a linear relationship to the chiropractic spinal adjustment and chronic pain. Texas Chiropractic College Graduate Doctoral Program, PACE approved for the Federation of Chiropractic Licensing Boards, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2017
• Orthopedic Testing: Principles, Clinical Application and Triage, Integration of orthopedic testing in the clinical setting to develop a differential diagnosis. Utilizing radiographic and advanced imaging inclusive of MRI and CAT scan findings to verify tissue pathology suspected by orthopedic testing conclusions and developing a treatment plan as sequelae. Texas
• Chiropractic College, ACCME Joint Providership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2017
• Orthopedic Testing: Cervical Spine, Integration of cervical orthopedic testing in the clinical setting to develop a differential diagnosis. Utilizing radiographic and advanced imaging inclusive of MRI and CAT scan findings to verify tissue pathology suspected y orthopedic testing conclusions and developing a treatment plan as sequelae. Texas Chiropractic College, ACCME Joint Providership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2017
• Orthopedic Testing: Lumbar Spine, Integration of lumbar orthopedic testing in the clinical setting to develop a differential diagnosis. Utilizing radiographic and advanced imaging inclusive of MRI and CAT scan findings to verify tissue pathology suspected by orthopedic testing conclusions and developing a treatment pan as sequelae. Texas Chiropractic College, ACCME Joint Providership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2017
• Orthopedic Testing: Clinical Grand Rounds, How to integrate orthopedic testing in the clinical setting utilizing both simple and complex patient scenarios. It includes potential stroke, vertebrobasilar insufficient patients and understanding the nuances in a clinical evaluation with orthopedic testing as a critical part of the evaluation and screening process. How to integrate orthopedic testing in the clinical setting utilizing both simple and complex patient scenarios. It includes potential stroke, or vetebrobasilar insufficient patients and understanding the nuances in a clinical evaluation with orthopedic testing as a critical part of the evaluation and screening process. Texas Chiropractic College, ACCME Joint Providership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2017
• Spinal Trauma Pathology, Triage and Connective Tissue Injuries and Wound Repair, 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. ACCME joint partnership with the State University of New York, Buffalo, New York, 2017
• Spinal Trauma Pathology: Ligament, Anatomy and Injury Research Kinematics, 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. ACCME joint partnership with the State University of New York, Buffalo, New York, 2017
• Spinal Trauma Pathology: Spinal Biomechanics, Central Nervous System and Spinal Disc Nomenclature, The application of spinal biomechanical engineering models in trauma and the negative sequella it has on the central nervous system inclusive of the lateral horn, periaqueductal gray matter, thalamus and cortices involvement. ACCME joint partnership with the State University of New York, Buffalo, New York, 2017
• Spinal Trauma Pathology: Biomechanics of traumatic Disc Bulge and Age Dating Herniated Disc Pathology, The Biomechanics of traumatic disc bulges as sequella from trauma and the comorbidity of ligamentous pathology. Age dating spinal disc pathology in accordance with Wolf’s Law. ACCME joint partnership with the State University of New York, Buffalo, New York, 2017
• Spinal Trauma Pathology: Clinical grand Rounds, The review of case histories of mechanical spine pathology and biomechanical failures inclusive case histories, clinical findings and x-ray and advanced imaging studies. Assessing comorbidities in the triage and prognosis of the injured. ACCME joint partnership with the State University of New York, Buffalo, New York, 2017
• Spinal Trauma Pathology: Research Perspectives, The review of current literature standards in spinal trauma pathology and documentation review of biomechanical failure, ligamentous failure and age-dating disc pathology. ACCME joint partnership with the State University of New York, Buffalo, New York, 2017
• Primary Spine Care Symposium – Interprofessional Spine Care, Clinical analysis of anatomic versus biomechanical spine pain and clinical triage protocols. Relating current research trends in the Whole Spine Model of patient including normal versus abnormal sagittal curvature in the adolescent and adult spine, pelvic incidence as a parameter for sagittal balance in the human spine and current methods of assessment. Patient centered approach to Evidenced Based Spine care with a focus on diagnosis, prognosis and triage of the spine pain patient, Texas Chiropractic College Post-Doctoral Division, Academy of Chiropractic Post- Doctoral Division, Melville NY 2017
• Primary Spine Care Symposium – Epidemiology of Spine Pain, Review of the current Centers for Disease Control [CDC] data on the frequency of musculoskeletal pain in the United States population with emphasis on pain if spinal origin. CDC guidelines on opioid medication were discussed and correlated to persistent pain syndromes. Research was reviewed showing the importance of managing the spine pain patient properly from the entry point of care with a concentration on maintenance of spinal biomechanics, Texas Chiropractic College Post- Doctoral Division, Academy of Chiropractic Post-Doctoral Division, Melville NY 2017
• Primary Spine Care Symposium – Connective Tissue and Spinal Disc Pathology, The morphology and pathology of connective tissue, inclusive of spinal disc disorders and prognosticating wound repair with permanency implications. Disc bulge, herniation, protrusion and extrusion classifications based upon contemporary literature and how to age- date disc pathology, Texas Chiropractic College Post-Doctoral Division, Academy of Chiropractic Post- Doctoral Division, Melville NY 2017
• Primary Spine Care Symposium – Physiology and Anatomy of Spinal Manual Adjusting, Understanding the role of mechanoreceptors, proprioceptors and nociceptors with facets, ligaments, tendons and muscles in aberrant spinal biomechanics. MRI and imaging studies of decompressing via a chiropractic spinal adjustment of the bio-neuro-mechanical lesion and its effects on the central nervous system both reflexively and supratentorally, Texas Chiropractic
• College Post-Doctoral Division, Academy of Chiropractic Post-Doctoral Division, Melville NY 2017
• Primary Spine Care Symposium – Medical-legal Documentation, The contemporary documentation required in a medical-legal environment that is evidenced based and meets the standards of the courts and academia. Utilizing the scientific data to support a diagnosis, prognosis and treatment plan while meeting the admissibility standards based upon a professional’s credentials. Texas Chiropractic College Post-Doctoral Division, Academy of Chiropractic Post-Doctoral Division, Melville NY 2017
• Spinal Biomechanical Engineering: Cartesian System, 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. Texas Chiropractic College, ACCME Joint Providership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo NY 2017
• Spinal Biomechanical Engineering: Cervical Pathobiomechanics, 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. Texas Chiropractic College, ACCME Joint Providership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo NY 2017
• Spinal Biomechanical Engineering: Lumbar Pathobiomechanics, 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. Texas Chiropractic College, ACCME Joint Providership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo NY 2017
• Spinal Biomechanics in Trauma, Toutilize 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 sequella 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. Texas Chiropractic College ACCME Joint Providership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo NY 2017
• Primary Spine Care – Central Nervous System Processing of Pain and Physiology, Central neural pathways of pain and higher cortical responses to pain and the effect of high amplitude-low velocity forces on mechanoreceptors and proprioceptors. The effects of neuropeptides on the hypothalamus, pituitary and adrenal axis when treating patients. Texas Chiropractic College, Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, Melville NY 2017
• Primary Spine Care – MRI, Bone Edema and Degeneration, The effects of trauma on spinal vertebral segments and the short and long term sequella to morphology. Identify and diagnosing bone edema, spurring, types of degeneration in assessing biomechanical stability in conjunction with Modic and Pfeiffer changes. Texas Chiropractic College, Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, Melville NY 2017
• Primary Spine Care – Hospital and Emergency Room Care, Identifying spinal lesions inclusive of cord and root lesion through examination and advanced imaging in creating an accurate diagnosis, prognosis and treatment plan to effectively triage in collaboration and coordination with medical specialists and emergency department physicians. Differentially diagnosing and triaging disc degenerative bulges, traumatic disc bulges, protrusion herniations, extrusion herniations and fragmented herniations along with managing traumatically induced pain as sequella to degenerative disc trauma, Chiropractic College, Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, Melville NY 2017
• Spinal Biomechanical Engineering & Organizational Analysis, Integrating spinal biomechanics and Pathobiomechanics through digitized analysis. The comparison of organized versus disorganized compensation with regional and global compensation. Correlation of the vestibular, ocular and proprioceptive neurological integration in the righting reflex as evidence in imaging. Digital and numerical algorithm in analyzing a spine. Texas Chiropractic College. ACCME Joint Providership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2017
• Spinal Biomechanical Engineering: Cervical Digital Analysis, 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. Texas Chiropractic College, ACCME Joint Providership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo NY 2017
• Spinal Biomechanical Engineering: Lumbar Digital Analysis, 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. Texas Chiropractic College, ACCME Joint Providership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo NY 2017
• Spinal Biomechanical Engineering: Full Spine Digital Analysis, Digitalizing and analyzing the full spine images to diagnose Pathobiomechanics as sequella to trauma in relation to ligamentous failure and disc and vertebral pathology as sequella. 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. Texas Chiropractic College, ACCME Joint Providership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo NY 2017
• Clinical Excellence in Chiropractic and Primary Spine Care, Academy of Chiropractic, 2017
• New Blood Biomarkers Useful for Concussion Diagnosis, The utilization of GFAP and UCH-I-1 in determining, traumatic brain injury, mild traumatic brain injury and mild-moderate traumatic brain injury as a triage tool to manage head trauma patients, Accreditation Council on Continuing Medical Education in cooperation with Medscape, 2016
• Primary Spine Care – Central Nervous System Processing of Pain and Physiology, Central neural pathways of pain and higher cortical responses to pain and the effect of high amplitude-low velocity forces on mechanoreceptors and proprioceptors. The effects of neuropeptides on the hypothalamus, pituitary and adrenal axis when treating patients. Texas Chiropractic College, Academy of Chiropractic, Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, Melville NY, 2016
• Primary Spine Care – MRI, Bone Edema and Degeneration, The effects of trauma on spinal vertebral segments and the short and long term sequella to morphology. Identifying and diagnosing bone edema, spurring, types of degeneration in assessing biomechanical stability in conjunction with Modic and Pfeiffer changes, Texas Chiropractic College, Academy of Chiropractic, PACE Recognized by the Federation of Chiropractic Licensing boards, Melville NY, 2016
• Primary Spine Care – Hospital and Emergency Room Care, Identifying spinal lesions inclusive of cord and root lesion through examination and advanced imaging in creating an accurate diagnosis, prognosis and treatment plan to effectively triage in collaboration and coordination with medical specialists and emergency department physicians. Differentially diagnosing and triaging disc degenerative bulges, traumatic disc bulges, protrusion herniations, extrusion herniations and fragmented herniations along with managing traumatically induced pain as sequella to degenerative disc trauma, Texas Chiropractic College, Academy of chiropractic, Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, Melville NY 2016
• Clinical Excellence in Chiropractic and Primary Spine Care, Academy of Chiropractic, 2016
• Accident Reconstruction: Terms, Concepts and Definitions, 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. Academy of Chiropractic Post-Doctoral Division, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, Long Island, New York, 2014
• Accident Reconstruction: Causality, Bodily Injury, Negative Acceleration Forces, Crumple Zones and Critical Documentation, 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. Academy of Chiropractic Post-Doctoral Division, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, Long Island, New York, 2014
• Accident Reconstruction: Skid Marks, Time, Distance, Velocity, Speed Formulas and Road Surfaces, 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. Academy of Chiropractic Post-Doctoral Division, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, Long Island, New York, 2014
• Accident Reconstruction: Research, Causality and Bodily Injury, 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, Academy of Chiropractic Post-Doctoral Division, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, Long Island, New York, 2014
• MRI Protocols Clinical Necessity, 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 sequella, including bulge, herniation, protrusion, extrusion and sequestration. ACCME Joint Sponsorship with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic s Division, Buffalo, New York, 2014
• MRI Interpretation of Lumbar Degeneration/Bulges, 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. ACCME Joint Sponsorship with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, New York, 2014
• Lumbar Interpretation of Lumbar Herniations, MRI slices, views, T1, T2, STIR axial, stacking, 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. Central canal and cauda equina compromise interpretation with management. ACCME Joint Sponsorship with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, New York, 2014
• MRI Interpretation of Cervical Degeneration/Bulges, 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. ACCME Joint Sponsorship with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, New York, 2014
• MRI Interpretation of Cervical Herniations, MRI slices, views, T1, T2, STIR axial, FFE, FSE and sagittal images in the interpretation of cervical herniations. With the co-morbidities and complications of stenosis, pseudo-protrusions, cantilevered vertebrate, Schmorl’s nodes and herniations. Morphology of cervical 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. ACCME Joint Sponsorship with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, New York, 2014
• MRI Interpretation of Degenerative Spine and Disc Disease with Overlapping Traumatic Insult to Both Spine and Disc, MRI slices, views, T1, T2, STIR axial, FFE, FSE and sagittal images in the interpretation of degenerative spondylolisthesis, 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. ACCME Joint Sponsorship with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, New York, 2014
• Neurodiagnostics, Imaging Protocols and Pathology of the Trauma Patient, 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. Academy of Chiropractic Post-Doctoral Division, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, Long Island, New York, 2014
• Diagnosis, Risk Factors, Clinical Presentation and Triaging the Trauma Patient, 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. Academy of Chiropractic Post-Doctoral Division, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, Long Island, New York, 2014
• Crash Dynamics and its Relationship to Causality, 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, Newton’s, 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. Academy of Chiropractic Post- Doctoral Division, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, Long Island, New York, 2014
• MRI, Bone Scan and X-Ray Protocols, Physiology and Indications for the Trauma Patient, MRI interpretation, physiology, history and clinical indications, bone scan interpretation, physiology and clinical indications, x-ray clinical indications for the trauma patient. Academy of Chiropractic Post-Doctoral Division, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, Long Island, New York, 2014
• Neurodiagnostic Testing Protocols, Physiology and 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 Electronystagmography (V-ENG) interpretation, protocols and clinical indications for the trauma patient. Academy of Chiropractic Post-Doctoral Division, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, Long Island, New York, 2014
• Documentation and Reporting for the Trauma Victim, Understanding the necessity for accurate documentation and diagnosis using the ICD-9 and the CPT to accurately describe the injury through diagnosis. Understanding and utilizing state regulations on reimbursement issues pertaining to healthcare. Academy of Chiropractic Post-Doctoral Division, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, Long Island, New York, 2014
• Documenting Clinically Correlated Bodily Injury to Causality, 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. Academy of Chiropractic Post-Doctoral Division, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, Long Island, New York, 2014
• MRI History and Physics, 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. ACCME Joint Sponsorship with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences and Academy of Chiropractic Post-Doctoral Division, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, Buffalo, New York, 2014
• MRI Spinal Anatomy and Protocols, 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. ACCME Joint Sponsorship with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences and Academy of Chiropractic Post-Doctoral Division, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, Buffalo, New York, 2014
• MRI Disc Pathology and Spinal Stenosis, 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. ACCME Joint Sponsorship with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences and Academy of Chiropractic Post-Doctoral Division, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, Buffalo, New York, 2014
• MRI Spinal Pathology, 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. ACCME Joint Sponsorship with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences and Academy of Chiropractic Post-Doctoral Division, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards , Buffalo, New York, 2014
• MRI Methodology of Analysis, 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. ACCME Joint Sponsorship with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences and Academy of Chiropractic Post- Doctoral Division, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, Buffalo, New York, 2014
• MRI Clinical Application, 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. ACCME Joint Sponsorship with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences and Academy of Chiropractic Post-Doctoral Division, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, Buffalo, New York, 2014
• Spinal Biomechanical Engineering Principles and Application, Integrating spinal biomechanics and pathobiomechanics through digitized analysis. The comparison of organized versus disorganized compensation with regional and global compensation. Advanced analysis and integration of pathobiomechanics as sequella to trauma in clinical practice and documentation, PACE Recognized by the Federation Chiropractic Licensure Boards, Las Vegas NV 2013
• Evidenced Based Practice, Integrating indexed peer reviewed research as evidence into clinical practice related to trauma and the creation of a diagnosis, prognosis and treatment plan, PACE Recognized by the Federation of Chiropractic Licensure Boards, Las Vegas NV 2013
• Auto Injuries Differential Assessment, The differential assessment of the injuries sustained due to an automobile accident. Triage for different types of injury from slight to serve injury including concussion, brain injury, post-concussion symptoms, whiplash, closed head trauma and the examination issues of the injured patient with reporting and imaging studies that are available. Texas Chiropractic College Division of Postgraduate Studies, San Antonio, Texas, 2012
• Permanent Soft Tissue Injuries and Records Documentation, Examination, X-ray and MRI findings associated with permanent soft tissue injuries and the documentation and reports needed to meet the standard of care requirements. Texas Chiropractic College Division of Postgraduate Studies, San Antonio, Texas, 2011
• Coding Compliance and Documenting Medical Necessity in the Chiropractic Practice, The proper use of the coding of examinations, office visits, therapy, rehabilitation and therapeutic exercises with the documentation needed to support the level of each service for accurate billing. Texas Chiropractic College Division of Postgraduate Studies, San Antonio, Texas, 2011
• Chiropractic Research Year in Review, Review of medical publications and research concerning spinal manipulation and extra spinal manipulation with effectiveness of treatment and patient satisfaction outcomes. Wyoming Chiropractic Council, San Antonio, Texas, 2000
• Texas Workers’ Compensation Commission, Designated Doctor Program, Implementation and proper utilization of the AMA Guide of Impairment 4th Ed. in determining whole person impairment of an injured worker. Texas Chiropractic Association and Texas Council of Chiropractic Orthopedists, Austin, Texas, 1997
• Issues Associated with Imaging, Issues with ordering the correct scan, use of IV contrast, imaging of spine and soft tissue, imaging of suspected fracture and imaging of pathological conditions. Texas Chiropractic Association-National, Chiropractic Mutual Insurance Company, Dallas, Texas, 1997
• Risk Management Associated with the Cervical & Lumbar Spine, The risk factors including instability, stenosis, fracture, congenital factors and pathology of the spine when using chiropractic manipulative therapy. Texas Chiropractic Association-National, Chiropractic Mutual Insurance Company, Dallas, Texas, 1997
• X-ray & MRI Advanced Imaging Techniques, Current Research & Literature on soft tissue injuries, Neurological patterns, response and risk management. Current insight on X-ray and MRI scans and techniques for optimal films. There was detailed discussion of current research and literature on soft tissue injuries including literature and research from international sources. There was discussion on the neurological patterns and response to injury, treatment and rehabilitation. There was discussion on risk management and minimizing risk through clinical excellence and documentation. Texas Chiropractic Division of Postgraduate Studies, Houston, Texas, 1996
• Utilizing Plain Film X-ray in Diagnosis of Arthritis, Infection and Pathological Conditions, Proper use of x-ray to diagnose arthritis, infection and pathological conditions of the spine and extremities. Sunport Radiology, San Antonio, Texas, 1995
• Introduction to Diagnostic Ultrasound-Spinal Musculoskeletal Applications, Clinical application and equipping the doctor to cover all aspects of musculoskeletal ultrasound used on a day to day basis with proper reporting of the findings. Research and current literature on the clinical applications. Anatomy and physiology of the body in response to utilizing diagnostic ultrasound. Protocols and usage in a clinical setting. Fukuda Denshi of America, Los Angeles, California, 1995
• Diagnostic Ultrasound-Spinal Musculoskeletal Applications, The use of diagnostic ultrasound for musculoskeletal conditions. Current literature and research and clinical applications and extremity applications for shoulder, elbow, wrist, knee and ankle conditions. Demonstration for the use of the equipment and hard copy documentation of the results. Fukuda Denshi of America, San Antonio, Texas, 1995
• Documentation, The documentation necessary to provide the standard of care for the patient. History, initial examination, re-evaluation, supplemental reports, and specialty reports including final reports and work status reports. Texas Chiropractic Association, San Antonio, Texas, 1995
• Radiographic Imaging & Diagnosis, Proper diagnosis with radiographic imaging. Technique and positioning of patients for ideal imaging. Normal imaging joint degeneration, compression fractures, joint hypermobility, joint pathology and lesions. Texas Chiropractic Association, San Antonio, Texas, 1995
• Stabilization/Rehabilitation-Acute Low Back, The stabilization and rehabilitation of the acute low back pain patient. Examination and radiographic findings. The lumbar spine and pelvis with stabilization and rehabilitation of the acute low back patient. Texas Chiropractic Association, Grapevine, Texas, 1995
• Whiplash, An overview of the whiplash injury and the current literature and research articles related to whiplash. Mechanism of injury, types of injury, complaints of patients, examination findings, orthopedic and neurological findings, radiographic and MRI findings associated with the whiplash injured patient. Texas Chiropractic Association, San Antonio, Texas, 1994
• Lumbar Degenerative Joint Disease, The process of joint degeneration and the lumbar spine. Mechanism of injury verses aging and current research and literature findings on degeneration and its effect on the patient. X-ray and MRI findings for the normal verses the injured patient. Texas Chiropractic Association, San Antonio, Texas, 1994
• Spinal Surgery and Microsurgery of the Brain and Spine, Types of spinal surgery and microsurgery options currently available for the brain and spine. Protocols for referral for surgical opinions and examination, radiological, MRI, CT scan, and Myelogram findings for the surgical patient. Texas Chiropractic Association, San Antonio, Texas, 1994
• Biomechanics of the Spine and Lower Extremities, The normal and the injured patient findings on evaluation, exam findings, orthopedic and neurological exam, range of motion testing, sensory and motor nerve examination and radiology evaluation for the spine and the lower extremities. Texas Chiropractic Association, San Antonio, Texas, 1994
• What MRI Can Do for Chiropractors and Their Patients, The use of advanced medical imaging utilizing MRI for the spine. Normal findings verses pathological findings including disc pathology and metastatic lesions with case studies. Texas Chiropractic Association, San Antonio, Texas, 1994
• Acute Spinal Cord Traumas-Current Prospective, Acute spinal cord trauma and protocols for evaluation of a patient with a spinal cord injury. Crash site and field evaluation and protocols. Triage and medications along with surgical protocols. Alamo Bone and Joint, San Antonio, Texas, 1993
• Documentation and Hard Copy Evidence of Trauma, How to document and report the evidence of trauma, including mechanism of injury, case history, examination, orthopedic and neurological testing and radiographs. External medical photography was discussed as a part of the examination findings. Report writing including narratives, supplemental reports and final reports with future medical cost estimates were discussed for documentation protocols. Quality Care Seminars, Dallas, Texas, 1993
• Dermatomal Somato-Sensory Evoked Potential, The Map to the Future, Neuro-diagnostics to aid in the treatment and referral protocol of an injured patient. The clinical findings and the protocol of when and how to properly order neurological testing and clinical significance of the testing. Sunrise Imaging, San Antonio, Texas, 1993
• MRI Protocols and Usage, This presentation was on protocols for using MRI studies in a clinical setting. There was discussion and rationale for using MRI to make an accurate diagnosis and to rule out disc pathology that would warrant a surgical opinion. Sunrise Imaging, San Antonio, Texas, 1993
• Med-Legal, Disposition, Arbitrations and Appearances. This module was on the Medical-Legal arena and how to handle dispositions, arbitrations and courtroom appearances. There was at length discussion of the proper way to address these issues and preparation of the Doctor for the different issues. Spinal Research institute of San Diego, Houston, Texas, 1992
• Narrative Report Writing, note taking and supplement reporting, purpose and format, general guidelines, and dictation. The reports how to make them quickly, efficiently and special problems. This class was specific for narrative report writing, supplemental reports, note taking and dictation of reports. There was discussion on the purpose, format and general guidelines of the reports with recommendations on how to handle special problems in the reports. Spinal Research institute of San Diego, Houston, Texas, 1992
• Whiplash Case Management and Introduction to TMJ, Treatment for the acute injury, sub-acute injury and chronic injury, rehab- when and how. Maximum Medical Improvement, Outside consults, when and why, Disorders of the TMJ. This course was for case management of Whiplash with treatment protocols for the acute injury, sub-acute injury and chronic injury patient. There was rehab protocols for the different stages of injury with recommendations for duration and frequency of treatment. There was a module on TMJ disorders and proper diagnosis and treatment protocols. There was a discussion of when and how to determine a patient is at maximum medical improvement. There was an in depth discussion and flowchart for the use of outside consultants. Spinal Research Institute of San Diego, Houston, Texas, 1992
• Diagnostics Special exam procedures II (contract CT and MRI, bone scan, video-fluoroscopy and electro-diagnostics), neurology of soft tissue injuries (including the latest on fibromyalgia syndrome and referred pain syndromes), head injuries and the post-concussion syndrome, and diagnosis making. This course was on diagnostics and advanced imaging techniques and electro- diagnosis pertaining to head injuries and post-concussion syndrome. There was special emphasis on diagnosis and determining the proper diagnosis with imaging. The neurology of soft tissue injury was reviewed and discussed in relation to fibromyalgia and referred pain syndromes. Spinal Research Institute of San Diego, Houston, Texas, 1992
• Whiplash an Overview-Basic and advanced concepts of biomechanics, soft tissue injuries, history and physical examination procedures, Whiplash injury and proper case history and physical examination of the injured patient. The anatomy and physiology of soft tissue injury. How different stages of soft tissue injury heal. The basic and the advanced concepts of spinal biomechanics and how injured tissue is evaluated with x-rays and advanced imaging technique like MRI and CT scan. Spinal Research Institute of San Diego, Houston, Texas, 1992
• Unit Brain Electrical Activity Mapping Protocols and Usage, Introduction to brain electrical mapping. Testing procedures available for diagnosing and documentation of the patient with brain injury. Sunrise Imaging, San Antonio, Texas, 1992
• Documentation of Soft Tissue Injury and the Components of the Vertebral Subluxation Complex, Proper documentation of soft tissue injury including the mechanism of injury, case history, physical, orthopedic, and neurological examination findings, x-ray studies and reports needed to properly document the evaluation. The five components of the vertebral Subluxation were discussed in detail as they pertain to injury. Parker Chiropractic Research Foundation, Dallas, Texas, 1992
• Digitizing Radiographic Analysis of the Spine, The analysis and documentation to quantify and clarify joint injury to aid the doctor in a good clinical decision making for treatment and spinal rehabilitation of the injured patient. Impairment ratings utilizing the AMA Guide to Permanent Impairment 4th Ed. to determine the Impairment ratings utilizing digitizing radiographic analysis. Spinal Analysis Systems, Acton, Massachusetts, 1990
• Practical Preparation for the Expert Witness, Documentation requirements of the courts in a medical-legal case including causality, bodily injury, and persistent functional losses as they pertain to the integrity of the joints, activities of daily living and implications of chronicity with reporting of normal and abnormal findings, maximum medical improvement and release of the patient in the medical-legal arena. Select Success Seminars, Dallas, Texas, 1990
• Trauma, Neurology and Chiropractic Physician, Trauma patients and the neurological workup and evaluation involved in the triage of the injured patient by the chiropractor. Discussion of the neuro-anatomy of the brain and the spinal cord, the central nervous system and the peripheral nervous system. Texas Chiropractic Association, Dallas, Texas, 1990
• Principles of Soft Tissue Injury and Repair, How soft tissue injury heals and the repair process that is involved with healing including the three stages of repair, the time involved for each stage and the healing degree expected in percentages. Selected Success Seminars, Austin, Texas, 1990
• Whiplash and Spinal Trauma, Current research and literature review of recent articles and treatment protocols for treating whiplash injury and the healing stages of injury for ligamentous and soft tissue injury repair. Mechanism of injury, forces involved in collision time, vehicle mass, velocity of striking vehicle, inertia, magnitudes and factors influencing the extent of injury. Radiological studies with findings for evidence of ligamentous injury or fracture. Technology that is available to use to get an accurate diagnosis for brain injury patients. Selected Success Seminars, Austin, Texas, 1989
• Chiropractic Care of Soft Tissue Injury, Current research and hard copy documentation of spinal and soft tissue injury. The current research related to soft tissue injuries and documentation protocol for spinal and soft tissue injury including examination procedures range of motion, functional testing and documentation of findings. Parker Chiropractic Research Foundation, Dallas, Texas, 1989
• The Amazing Cervical Spine, Anatomy of the cervical spine. Physiology, spinal anatomy and x- ray findings associated with spinal injury and trauma. The physical examination, orthopedic and neurological testing, treatment and protocols of the patient. Quality Care Seminars, Dallas, Texas, 1989
• Examination Procedures, Report of Findings, Second Opinion Examinations, When to refer and Protocols, Examination and evaluation protocol and procedures, report of findings with the patient, when to refer for the second opinions for the primary care physician, orthopedic/neurosurgical opinion, neurological testing and protocols for timing of the second opinions. Parker Chiropractic Research Foundation, Dallas, Texas, 1987
• Care and Treatment of Geriatric Patients, X-ray analysis and review, proper insurance coding reports, and follow-up narratives. The treatment and proper care of the geriatric patients including x-rays protocol, x-ray analysis and review, insurance coding protocol and follow-up narrative reporting. Parker Chiropractic Research Foundation, Dallas, Texas, 1986
• Office Management, Case History, Reports and Treatment Schedules, Proper office management procedure and utilizing case history in determining the reports and treatment needed. Parker Chiropractic Research Foundation, Dallas, Texas 1985
• Current Research and Literature on the Vertebral Subluxation Complex, Current literature and research pertaining to the Vertebral Subluxation Complex its five components. Renaissance International, San Antonio, Texas, 1984
• Diagnosis, Care Protocols in Treatment of Low Back Disc Injuries, Managing and Treatment of Low Back Disc, Proper diagnoses for low back pain patients, allowing proper care, management and treatment for patients with low back disc injuries. Texas Chiropractic Association, Dallas, Texas, 1983
• Philosophy, X-ray, Record Keeping, Case Management, and Treatment Protocols, Chiropractic philosophy and the basic principles of patient record keeping on the new and existing patients. X-ray protocols and requirements, case management with scenarios for re-evaluation and referral protocols. Treatment protocols including low and high risk patients, non-responding patients and referrals for second opinions. Texas Chiropractic College Division of Postgraduate Studies, Houston, Texas, 1982
• Clinical Nutrition, How to utilize nutrition in your office for specific patient conditions. Protocols, implementation, research and treatment. Texas Chiropractic Association, Houston, Texas, 1981

SELECTED MEMBERSHIPS

• Texas Chiropractic Association, Member, year-year
• American Academy of Medical Legal Practitioners, Member, year-year Academy of Chiropractic 2012-Present
• Academy of Chiropractic – Active Trauma Team Member, 2017-present

SELECTED COMMUNITY SERVICE

• Village Parkway Baptist Church – Deacon
• Village Parkway Baptist Church – Family Ministry 1989 to present Boy Scouts of America – Adult Volunteer 1990-91
• Bexar County 4H – Adult Volunteer 1992-2006
• Marshall High School – Mentor 2014-15

SELECTED HONORS

• Texas Chiropractors Association, District 10 – 2018 Doctor of the Year